Wednesday 25 July 2012

Why the Health Care System in Cairo is Doomed.

Well it's not exactly one reason. There are a number of reasons the public health sector in Egypt is entirely flawed and not up to par with any golden set of standards imposed on it by even the saddest of developing countries.

Lack of finance, lack of resources, lack of decentralization. These are all very valid points.

But let's focus on one that can be changed but won't ever change due to how the health care system works.
I'll call it the Circle of Residency.

Now bear with me because I'm about to compress a lifetime of a medical student in a few measly sentences.

First off, let's consider the student that just got accepted into medical school. Let's even assume he actually wanted to go to med school and wasn't forced to fulfill his parents' failed dreams of success. He's ecstatic, he's hopeful but most importantly he knows he wants to be a doctor to benefit society. He makes an oath to himself, swearing to study hard and become a success despite the poor teaching conditions in most of the public universities here.

He finally finishes those 6 years, still wide eyed and full of hope. He guarantees a good enough grade to work in the hospital with a guaranteed teaching position.

Then he starts his internship, and that's when things start to turn sour. He witnesses the corruption, the poor ethical standards, the abysmal working conditions of the resident. He starts to realize that maybe, just maybe, life isn't going to be that easy. He's still set on making a change though. He brushes off all the horrible attitudes the residents take and tells himself he will not be THAT resident. He finds a field he's comfortable with and decides to spend all his free time there, soaking up and absorbing all sorts of information to prepare him for when he becomes a resident.

The year ends and he finds out he was 2 marks away from getting that field he wanted.
So he settles.
For a field that that he wasn't so in love with in the first place.

No matter though, his heart will not be broken, his spirits uncrushed, he moves on! He goes into the field wholeheartedly, anticipating all the excitement. After all, he's a resident now. Now is when actual professors will give him advice on management and treatment and he'll finally notice how much of a difference he makes.

Until the professors never really show up. And he's forced to make decisions based on his minimal experience and then he unintentionally harms a patient because he was forced to make a gut decision due to the fact that there was no one there to guide him.

His mind begins to jade.

And when the professors actually show up, they don't offer guidance or help. They ostracize and demean the poor resident. They put him in harsher conditions not offering him even the tiniest bit of solace or gratitude.

He soldiers on.
He tells himself, "It's alright. I'm going to be an Assistant Lecturer in 4 years. Then I won't be the one getting shit from the professors. Not only that, but I'll show them. I'll show them how it's supposed to be done. I'll teach the new residents. I'll be there all the time and guide them and make my hospital a better place."

The man falls in love with a girl. They get engaged and soon to be married. Just as soon as he finishes his residency.

He succeeds and gets his Master degree thus ensuring his position as assistant lecturer.
It can only go uphill from now, he thinks to himself.
He gets married, his wife gets pregnant and he's there teaching the new residents and enjoying his life.
Then he realizes the money isn't enough. That he needs to work in the private sector.

"It's only a few days a week. I can manage. I can do both."
But then those days become weeks.
The new residents call him on the phone, asking for the guidance but he's too busy. A month passes and he finally shows up and sees the department in a mess.
He shouts at the residents for their poor management skills. He tells them how he barely made these mistakes when he was a resident.

He forgets how hard it was.


Eventually as time goes by, he becomes exactly what he hated, and the cycle repeats itself.
Believe me when I say, that I haven't even begun to shed light on what happens to residents in public hospitals. Believe me when I say, I totally understand why we become jaded, cynical and just not the greatest of human beings.

It still doesn't make it right though. 

1 comment:

  1. This is an informative post regarding health care system which exists in various countries specially in Europe.This can be helpful for those who are taking this as profession or study purpose.
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