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Angels on the Corona frontline: Challenges facing nurses in Egypt

Ahram Online discusses the situation of Egypt’s nurses with head of the Egyptian Nursing Syndicate Dr Kawthar Mahmoud

Ingy Deif, Wednesday 13 May 2020
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Syndicator D Kawthar Mahmoud talking with young nurses
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Three days prior to 12 May, when the world marks International Nurse Day, Egypt bade farewell — in grief, fear and uncertainty — to yet to another member of the nursing community.

Nurse Atiat Arboud, from the rural governorate of Damanhur, died after contracting Covid-19 in a country still in lockdown amid the unpredictable coronavirus outbreak.

Ahram Online talked with head of the Egyptian Nursing Syndicate, Dr Kawthar Mahmoud, about the profession of nursing in Egypt in such dire times, and the challenges that loom.

On the frontline

“We are extremely proud of our nurses, who are at the forefront of efforts to combat the virus and who reach out with help and compassion to those struggling against their infection,” were her first words.

Official numbers of the Ministry of Health indicate that 50 nurses have contracted the virus, with six fatalities among their number since the virus first appeared in Egypt in February.

“We look highly upon the role played by nurses. Our nurses are the closest to patients at times when their families and friends are out of reach, amid isolation. The WHO has indicated that 59 percent of all medical service provision worldwide is given by the nursing sector,” Dr Kawthar says.

Ahram Online spoke by phone to Nanees El-Samman, an engineer currently being treated for Covid-19 in the isolation quarters of Kasr Al-Aini Hospital in Cairo.

“Words cannot express the role played by nurses here. Nurses are extremely committed; they are our connection to any help that reaches us during their shift, that lasts 14 days before another group of nurses replaces them. They are trained and professional — the true backbone of healthcare here,” she said.

Dissecting numbers

Dr Kawthar stresses that numbers speak volumes in such dire times.

“We have 300,000 registered nurses in the syndicate, 220,000 of whom work in the public sector, the other 80,000 are either pensioners, working abroad or workers in the private sector."

“The number of nurses now might suffice, but we have to look ahead and be prepared with backup plans in case of further spread of the disease by recruiting members of the syndicate who are registered but do not practice, providing training and allowing the way for them to join forces with their colleagues,” she added.

Challenges ahead

The syndicate inaugurated a crisis management delegation to look into the challenges that loom ahead.

“We do our best to mentor all workers in the profession about proper means of protection against the virus. We are in constant contact with all members of local syndicates in all governorates to help in regards to any complaint they have amid this crisis, and we act as a medium between nurses and the hospitals they work in to provide solutions in such dire times,” Dr Kawthar said.

At the onset of the pandemic, President Abdel-Fattah El-Sisi directed the government to increase the allowance for the medical professions, by 75 percent to a total cost of EGP 2.25 billion.

The syndicate says that more is required, especially concerning nurses.

“Still, we are looking forward to further enhancements. The compensation given due to incidents of infection is still around EGP 20, and many nurses work nightshifts in exchange for very low earnings,” Dr Kawthar said.

“The annual subscription required by the syndicate of nurses, up until 2016 was EGP 15 — a number that hasn’t budged since 1976. In 2016, we raised this sum to reach EGP 60 annually, and the nurse receives in exchange EGP 150 as a pension monthly after retirement. But we know that these numbers have to change."

“Nurses coming from far governorates to work must be provided with convenient accommodation for living as well as nurseries for their children."

“Egyptian nurses are generally well educated and trained. We had to provide a minimal course for them at the onset of the pandemic, and they proved that they already had a solid basis of training and education that proved effective on the ground,” she added.

Supporting role

The Nursing Syndicate is one of most important syndicates in Egypt. It was founded by Law 155/1976, published in the Official Gazette on 9 November 1976. It is the entity that represents Egyptian male and female nurses, with its headquarters in Cairo and branches across the governorates.

“The syndicate aims to advance the scientific and professional standards of its members through training and conferences to keep them up to date with the latest developments in the profession. It aims also to maintain the dignity and traditions of the profession, and provide medical, social, economic and cultural care for syndicate members and their families,” Dr Kawthar said.

“At a time when nurses are on the forefront of the battle against coronavirus, the syndicate plays a pivotal role of support. We have been in continuous contact with hospitals that deal with corona cases, to connect with members of the profession in regards to their fears and sources of anxiety. We make sure that they are provided with the necessary protection equipment and gear, and convey all their requests and inquiries," Dr Kawthar added.

“We give also monetary compensation to those suffering from diseases, including coronavirus. As a syndicate we make the best of the means we have, giving EGP 20,000 to the families of those deceased, and EGP 2,000 to those inflicted by the virus,” she said.

Stigmatisation

Stigma and misconceptions around nurses has long been a problem to the nursing community.

“For long we suffered from dramas and movies that offend nurses by presenting an erroneous image of them. This had never been acceptable. We asked that any drama depicting nurses should be approved by the syndicate, to avoid stigmatisation against our nurses, who should actually be treated with utmost respect. In a country like the Philippines nurses are considered national assets, with more than 10,000 of them working all over the world each year, being ambassadors for their country and contributing to its national income with foreign currency,” Dr Kawthar said.

Education first

Dr Kawthar explained the strength of the education system in the field of nursing.

“Huge progress was achieved in raising the benchmark when it comes to the nursing profession. In Egypt, we have 20 public nursing faculties and five private ones. We have 12 health institutes for nursing affiliated with the Ministry of Health, 17 institutes affiliated with university hospitals, in addition to 300 advanced nursing schools."

“Years ago we terminated diplomas whose duration was three years and whose efficiency was compromised. We also have the nursing institute that was inaugurated by the armed forces. It has been doing a great job, and its graduates work primarily in the hospitals affiliated with the armed forces."

“We have a solid and robust education system that certifies its graduates to be licensed by the syndicate, and we have prepared a draft law to be approved by the Egyptian parliament that requires those practicing nursing to be re-evaluated by the syndicate after five years of practice, to make sure that those who renew their licenses are up to date with new methods and practices in the field,” Dr Kawthar said.

Gender role

There are five requirements for being a member of the Nursing Syndicate and thus having a license to practice: to be of Egyptian nationality; to be of good reputation and commendable conduct; to have never been sentenced for a felony or misdemeanour (i.e., no criminal record); to have attained an academic degree certified by the Egyptian education system in the field of nursing; and to be licensed by the Ministry of Health to practice in the profession.

Dr Kawthar said that although until a few years ago only females ventured into the field, males are becoming motivated to join the profession, comprising 10 percent of the nursing workforce since they were allowed to apply to the profession in Egypt in 2003.

“We look forward to increasing this percentage in the future,” Dr Kawthar said. “There is huge demand for nursing education as it is a portal to a much needed profession. We look forward to changing the mindset of people so that this demand springs more from respect and passion for this profession, which is really the backbone of the health system,” she concluded.

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