Battling to improve Egypt’s health care
 
 
Courtesy: Amr al-Shora
 

Amr al-Shora is doing battle again, this time in the Doctors Syndicate elections.

Shora is running as part of the Independent List of syndicate board candidates seeking to oust the overwhelmingly Muslim Brotherhood board, 20 out of whose 24 members are affiliated with the organization. The elections are scheduled to take place in October, and are the latest installment in Shora’s ongoing battle with the syndicate, other doctors and the whole crumbling system for better healthcare in Egypt.

As the eldest son of a doctor and nurse from a rural town in Giza, medicine was to some extent thrust on Shora, who jokes that in the Shora household “democracy was a formality” and that his lack of interest in becoming a doctor had little bearing on his father, who cheerfully filled out the application form for Cairo University’s school of medicine.

Shora was born in 1983 and the years before university were spent in Wardan, a one-street town surrounded by lush green Nile-fed countryside. During holidays Shora was dragged to Cairo, whose noise and chaos he hated.

Shora says his political allegiances were — and still are — based on familial ties rather than any political leanings.

The Brotherhood played along with the then-ruling National Democratic Party (NDP) and fielded candidates in elections whose success they knew depended on fraud rather than popularity. Shora witnessed this himself in the 1995 People’s Assembly elections when Hazem Salah Abu Ismail (now in prison, but who in 2012 had his presidential ambitions scuppered by the revelation that his deceased mother was a US citizen) stood for election on a Brotherhood ticket in Shora’s constituency.

A 12-year-old Shora watched two busloads of men — “they were dressed in plainclothes but we knew they were policemen” — enter a polling station where they filled out votes for the now disbanded NDP. Angry residents destroyed the ballot boxes. Ultimately, Abu Ismail, who was from the area and extremely popular, lost in the second round of these elections.

There were other tensions in Wardan, too. Shora recounts that it was a “source of pride” at his school that at one point there were no Christian pupils. On the last day of term it was a tradition among the schoolchildren that they fight pupils from neighboring schools.

One year, the pupils in Shora’s school decided they wanted to hit the Christians from the other school and approached Shora, a star pupil and also a rebel, to arrange this. (Worth noting here that Shora says his first demonstration took place when a teacher failed to show up for a class and the pupils were ordered to sit at their desks in silence — 10-year-old Shora began chanting “we want to leave”.) They ended up trying to force three Christian schoolboys to say the shahada (the Islamic confession of faith) under the threat of violence.

“We got a Bible and told him that it was all made up. A Muslim man with a knife arrived and shooed us away,” Shora recalls.

This casual sectarianism, endemic in Egypt, turned particularly ugly in the 1990s, when Christian residents of Wardan attempted to build a church but were opposed by some of their Muslim neighbors. Shora remembers that a teacher took classes out of the school to join in the attack on the church. A Christian girl was killed during the violence.

Shora left behind such attitudes when he was exposed to Cairo University and its relative cosmopolitanism. But Wardan was never far away. During the first term a fifth-year medical student – also from Wardan – introduced himself to Shora.

“He showed me the ropes, told me what to study, what lectures to go to. Gradually he started talking about protests. I went to the 2000 intifada protest and afterwards had problems with university security. They started searching me when I was entering the university and sometimes refused to let me in,” Shora says.

Shora says he had been noticed because he had stood at the front of the demonstrations: “I didn’t have a clue about anything.”

On one occasion, Shora discovered that a student informer had written a report about him for security bodies. “I bought a necklace and fashionable t-shirt. At the university gates they took me to the head security officer. He couldn’t understand which group I belonged to. After that they stopped bothering me,” Shora says.

The student who had been so keen on helping him with his studies also lost interest. He was in charge of recruiting student members to the Muslim Brotherhood, and realized Shora was a lost cause when he ignored his repeated advice to stop socializing with female students.

This early introduction to the Brotherhood’s insistence on conformity to a moral code left Shora disillusioned with the group — but they were the only entity organizing politically in Cairo University’s Faculty of Medicine at the time. The political turbulence of 2004 made an impression on the young student — “we always used to say these things among ourselves. They were saying it out loud” — but, he says, he didn’t have the courage to approach organized political groups until 2006.

Meanwhile, Shora was discovering that in the real world his studies “were absolutely useless” and that everything about the way medical students are taught “is wrong.”

“I had to learn everything all over again,” he says.

For the final years of his qualification he was sent to a Ministry of Health hospital where he experienced firsthand the consequences of the chronic underfunding that has plagued Egypt’s health sector for decades.

While asleep in a colleague’s room during a break from a shift he was bitten by a rat, and hospital orderlies presented him with a cat as a means of addressing the problem. On another occasion a colleague slipped while inserting a drain and Shora’s finger was cut. Some of the patient’s blood entered his, and she had Hepatitis C. Shora was left to pay for immediate treatment and subsequent blood tests to establish whether he had contracted the disease (he hadn’t).

In 2007, Shora joined Doctors Without Rights (DWR), a group of Ministry of Health doctors fighting for better pay and conditions for Egypt’s doctors and an improved health system overall. Much of their energy was spent confronting the board of the Doctors Syndicate, sometimes literally, with repeated protests and sit-ins on the steps of its Cairo headquarters.

DWR spent much of its time attempting to get its voice heard during syndicate general assemblies, and its 2008 sit-in was prompted by the syndicate failing to uphold an assembly decision to go on strike for better wages. The board was dominated by members of the Brotherhood and the NDP, and the Brotherhood was careful not to compromise the reach the syndicate offered it by challenging the regime.

“The Brotherhood used the syndicates as a political platform that led to a battle between them and the regime that paralyzed syndicate activity for 20 years. They still see syndicates as a political tool and a means of imposing their agenda,” Shora says.

Shora also discovered that the work of DWR and other lobby groups is itself compromised by internal squabbles and power struggles, leaving him disillusioned about their failure to work together.

In standing for election to the syndicate board, Shora aims to be a “radical voice” on it. He is seeking to “keep doctors connected to the syndicate and encourage them to take part in decision making.” Long term, he wants to increase government health spending and change the law to prevent government interference in syndicate work.

Only 12 seats are up for grabs in the October elections and Shora is aware that in order for non-Brotherhood members to form a majority on the board they must win 10 seats. This, he says, is impossible after July 3, when former President Mohamed Morsi was deposed by the army following mass protests against the Brotherhood.

“Before June 30, doctors were frustrated with the Brotherhood and would go to vote against them. Now, after Morsi’s ousting, doctors feel satisfied and won’t vote. Egyptians don’t yet know the importance of small fights and syndicates. They are out of breath because they exercised for two years after 60 years of no practice.”

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