That was how the blur started. A few days before the Egyptian Doctors’ Syndicate held its first internal elections in 19 years, the leaders of the Muslim Brotherhood electoral list, Doctors for Egypt, organised a press conference which seemed more like an early victory celebration than a leg in an electoral campaign.
Feeling confident that the Brotherhood, which has dominated the union for 30 years, would sweep the elections and retain its tight hold over the Syndicate, Doctors for Egypt merrily titled their press conference “Looking ahead towards a new future for our syndicate.”
Falling in line with the group’s cocky posture towards the outcome of the historic vote, all major media outlets and newspapers, including this website’s parent newspaper, predicted that the Brotherhood, favourites to win a sizeable chunk of the seats in next month’s parliamentary elections, would finish off their closest competitors, the Independence List, with a knockout punch.
Shortly after 5pm on Friday 14 October, many hours before monitoring judges opened all the ballot boxes, and even before the phosphoric voting ink on the thumbs of some of the doctors who voted had dried, media outlets rushed to declare that Doctors for Egypt had won by a landslide.
Reliable preliminary results added to this sense by showing that the independent candidate endorsed by the Brotherhood for the position of the Syndiacte's national president, Dr Khairy Abdel Dayem, had secured a landslide victory against 22 other competitors, including his closest challanger Dr Tarek El-Gazaly Harb, who was portrayed by the media as a "secular" alternative to the Brotherhood's candidate.
Abdel Dayem’s victory seemed to confirm all earlier predictions that the Brotherhood could be on its way to securing massive majorities in provincial battles across all 27 governorates.
However, after the last ballot was tallied, the country discovered that the Brotherhood not only failed to win by a landslide, but had actually suffered huge losses across the board.
The Independence List stunned all observers by winning solid majorities of seats in syndicate boards in 14 out of 27 governorates, and trounced the Brotherhood in a number of places they never dreamed of losing.
In the national syndicate board elections, the Independence List won six out of 24 seats, and broke the Brotherhood’s monopoly over power there.
The Indepenence List also won total, or near total, control of provincial syndicate boards in Ismailiya, Suez and Aswan – governorates where the Brotherhood could claim widespread support for its brand of politics.
In Alexandria, the country’s second largest city and one of the most important strongholds of the Brotherhood, and Islamists in general, Independence candidates won 14 out of 16 seats. The Brotherhood were left with two seats, and plenty to think about.
Back in Cairo, home to the country’s largest concentration of physicians, the Indpendence List garnered almost 70 per cent of the vote.
When the dust had settled, and it became strikingly clear to everyone that the Independence List and its allies had made a huge breakthrough, the Brotherhood attempted to put a positive spin on the defeats it accrued by arguing that the real winner in the elections was the doctors who made the union’s first democratic elections in decades a success.
Doctors for Egypt leaders hastily congratulated Independence winners and welcomed what they called “new blood” into the Syndicate’s leadership. They also urged everyone to put the elections behind them and announced that they were ready to cooperate with newcomers for the country’s good.
However, few of the Syndicate’s Brotherhood leaders were willing to publicly admit that their losses in the election might have been the result of anger against them brewing among a large number of physicians over time.
Indeed, many independent and partisan observers believe that the Brotherhood’s conservative record in office over the last three decades and its inability to fight against the Mubarak regime to improve doctors’ conditions set the stage for last weekend’s defeats.
El-Sayed Refaat, a physician and long-time Brotherhood activist in Suez, told Ahram Online that in his opinion the Brotherhood suffered heavy losses in the elections because it became too comfortable in its union offices, and was not able to adjust its policies and rhetoric to accommodate a new generation of radical doctors, especially since the revolution.
Ahmed Nour, a 27 year-old physician and a campaigner for the Independence List in Port Said, believes that the Brotherhood’s current woes date back to how they ran the Syndicate when assuming full control back in the 1980s, and has worsened in recent years.
Nour believes that the Brotherhood failed to mobilise doctors to take a stand against conditions that steadily infuriated more and more doctors.
“They did very little to fight deteriorating salaries or working conditions for doctors. They did not fight to improve infra-structure in public hospitals where 100,000 government doctors who are union members serve millions of poor people,” Nour said.
Some critics also charge that the Brotherhood leadership tried to impose an "Islamic" colouring on medical convoys that the Syndicate periodically sent to service poor Egyptians in the countryside, and even medical caravans to support Palestinians besieged by Israel in Gaza, in order gain a political advantage for the group.
Brotherhood leaders, for example, often made sure that Syndicate banners at the front of those medical convoys carried the group’s two-crossed swords logo, critics recall.
“The Syndicate under their control alienated many doctors because Brotherhood leaders were preoccupied with religious preaching and supporting Islamist-run healthcare charities and clinics, and they ignored mobilising doctors around basic bread and butter issues,” Nour added.
Moreover, the Brotherhood’s strategy of putting Islamic faith issues and slogans front and centre in Syndicate activities alienated Christian doctors who make up between 20 and 25 per cent of its membership, and further weakened the union.
As a result, a younger generation of doctors came into the medical profession in the latter years of the Mubarak regime only to find that all their Syndicate leaders were for the most part bearded men in their 60s who have held office without elections since Mubarak passed laws in 1993 to make it near impossible for professional syndicates to hold polls or elect accountable leaders.
Furthermore, a new generation of physicians entered professional life and joined the Syndicate only to find that the preacher-doctors who controlled it methodically violated their self-professed puritanical values in practice as they systematically doled out administrative positions to friends, political supporters and co-religionists.
"Because there were no elections in the Syndicate for many long years, the Brotherhood leadership simply replaced administrators who passed away with political supporters of the Brotherhood," Nour told Ahram Online.
Ultimately, according to Nour, the Brotherhood’s national syndicate board members, after thirty years on the top, grew comfortable in their positions of power, and even maintained a semi-cordial relationship with Hamdy El-Sayed – Mubarak’s National Democratic Party’s president of the Syndicate since 1978.
"The Brotherhood leaders failed both to mount a strong fight around doctors' demands for better wages and launch effective campaigns to force the regime to allow democratic elections in the organisation," says Nour.
Indeed, in the last years of Mubarak, a younger generation of doctors started to organise in rank and file militant groups such as Doctors Without Rights (DWR) outside of the Syndicate’s internal body, against both Mubarak’s regime and the Brotherhood’s conservative union policies.
In the aftermath of the January 25 revolution, these radical doctors, many of whom actually took part in the uprising against the dictator and were emboldened by their success in ousting him, embarked on organising their co-workers for campaigns to take workplace actions and strikes to improve their conditions.
Still, the Syndicate’s Brotherhood leadership persisted in its no-strikes, non-confrontational strategies and proved either unable or unwilling to adjust their actions or rhetoric to the new reality.
This contrast between the new attitude of emboldened members and a static leadership was illustrated during the unprecedented national doctors’ strike last May. When doctors in public hospitals took industrial action against the government to demand minimum salaries and increased spending on healthcare from 4 per cent to 15 per cent of the budget, both the president of the Syndicate, Hamdy El-Sayed, and the Brotherhood-controlled national syndicate board denounced the strikers.
Dr Mona Mina, a member of DWR who won a seat on the new national syndicate board in last Friday’s election and was one of the organisers of that historic strike, told Ahram Online that doctors found it hard to win that battle because of the Syndicate’s hostile position.
Indeed, the national leadership of the Brotherhood dispatched physicians who support it around the country to talk strikers into returning to work, arguing that negotiations with the government were the only reasonable course of action. Brotherhood anti-strike doctors enthusiastically worked in across the country, especially in areas such as Ismailiya where the strike enjoyed overwhelming support, to convince others to return to work.
On a national level, the Brotherhood took an anti-strike position, aligning itself with the government and military council against revolutionaries and workers.
Dr Essam El-Erian, a senior Brotherhood figure and a one-time young radical member of the Doctors’ Syndicate himself, spoke out against the decision to press for their demands in the media by striking.
“We were not just fighting against government intransigence and anti-doctor propaganda in the mainstream media. Our own syndicate was against us. They campaigned against us in the media. They let doctors in managerial positions in hospitals and clinics take punitive measures against strikers to break the action,” Dr Mina revealed.
Indeed, the Syndicate’s role in undermining the strikers’ efforts last May confirmed to many doctors that the success of their battle against the government is partly predicated on changing the old, conservative leaders within their ranks.
“The strike debacle confirmed to us that we needed to elect a new leadership for our Syndicate, a leadership that could back doctors’ demands, and unite all doctors in order to fight for a better future for the profession,” Dr Mina told Ahram Online.
Despite growing criticism among the rank and file of the Syndicate’s leaders, the Brotherhood insisted on maintaining its policy of avoiding confrontation with the state, and averted taking up issues that could antagonise the government – the ruling military council at this point.
For example, Doctors for Egypt campaign material failed to endorse a number of key demands that doctors have been fighting for in recent months such as a minimum monthly salary of 1200 pounds for doctors, a 700-750 pounds monthly stipend for first year residents and all expenses incurred by mandatory post-graduate academic training met by the government.
Oblivious to the financial crunch those young medics who earn an impoverishing 250-300 pounds per month suffer, Doctors for Egypt merely suggested that Syndicate leaders could help doctors finish post-graduate work by securing low-interest loans for them.
Staying true to Brotherhood non-confrontational strategies, Doctors for Egypt insisted in its campaign rhetoric and material that patient negotiations, and not strikes, were the only ways to put forward demands.
Moreover, Doctors for Egypt, continuing a Brotherhood tradition from thirty years atop the Syndicate, employed verses from the Quran in campaign material to rally the faithful among its supporters.
In this way the group’s candidates continued to alienate Coptic Christian voters, as well as Muslims who wanted religion out of union politics.
At the end, the Brotherhood candidates failed, by and large, to connect with a new generation of doctors who have become more open to ideas of struggle along the lines of industrial action.
In contrast, the Independence candidates, fresh from leading strikes and other rank-and-file campaigns, put great emphasis in their electoral campaigns on higher wages, a 12-hour cap on shifts and increased government spending on healthcare, and in this way managed to connect with doctors’ anger and desire for change.
Indeed, Independence won landslide victories in the places where the May strike was particularly solid, such as Ismailiya, the birthplace of the Muslim Brotherhood.
Moreover, the Independence laid out a strategy that was based on empowering Syndicate members, and championed the establishment, for the first time, of Syndicate chapters in all hospitals to represent doctors on a day to day basis.
On healthcare in general, the Independence candidates insisted on one of the key demands that doctors struck over last spring: increased government spending on healthcare to 15 per cent of the budget.
In tandem with the Independence efforts, Tahrir Doctors, another rank and file group of radical doctors who played a big role in treating those injured during the 18-day uprising against Mubarak, also ran candidates on a radical program.
Both groups coordinated their activities in a number of places such as Cairo and Alexandria to defeat Brotherhood incumbents.
Although the Brotherhood backed Abdel Dayem for the position of Syndicate president, the Islamist group will not be able to count on him as an erstwhile ally.
In fact, a large number of those who supported Independence and Tahrir candidates also voted for Khairy Abdel Dayem to head the Syndicate.
Indeed, Dr Mona Mina herself supported Abdel Dayem for syndicate president.
A closer look at Abdel Dayem’s campaign literature and interviews to media actually showed that he pushed economic demands and healthcare reform proposals almost identical to those raised by the Independence and Tahrir lists.
This suggests that Abdel Dayem’s radical positions might have been a key factor behind his success, not the Brotherhood’s endorsement.
Dr Nour, the 27-year-old doctor who campaigned for radicals, told Ahram Online that he and friends among Independence and Tahrir candidates had acquired organisational experience and gained the trust of many young doctors through their participation in strikes and in the uprising. They were able to utilise this to their advantage at the ballot boxes.
Dr Mona Mina, now one of six Independence members of the national syndicate board, insisted that the Independence List does not have an anti-Brotherhood agenda.
“On the contrary, we want to unify all doctors regardless of political background in order to build a strong organisation which is capable of fighting for doctors’ interests and better healthcare in Egypt,” Dr Mina said.
“We want this to be a strong professional union and we will work with anyone who wants the same thing,” she added.
Meanwhile, Dr Refaat told Ahram Online that he is happy that Dr Mona Mina was elected to the national board.
“I always speak my mind even if my own group disagrees with me. Our leadership woke up after the revolution to find that 40 per cent of doctors were young people in their early thirties, and they wanted to fight,” said Dr Refaat.
“I can say in all honesty that our people in the Brotherhood took doctors for granted. Many doctors felt that it might be time for change,” he lamented.