Medicines are essential products to many, but like some other imported commodities they became much more expensive after the 2016 floatation of the Egyptian pound. The prices of some medicines have doubled if not tripled over recent years, making them either unavailable or available only to those with the means to pay. Over the past four years some patients, especially those with chronic conditions, have resorted to panic buying, and this has resulted in the lack of some types of medicines in the market.
Karim Abdel-Latif, a pharmacy owner in Cairo, gave practical examples of the average cost per month for medicine for patients with many types of chronic conditions. “The least cost of a packet of insulin, a medicine for a diabetes patient that could last a month, is LE110. Each pack contains two ampoules that cost LE55 each. If a patient takes tablets to treat his diabetes, it could cost him from LE100 to LE120 per month.
“A person with hypertension could pay the same sum for his medication. Heart disease patients could pay LE300 for their medication every month. A patient who has had a kidney transplant could pay LE3,000 per month for his medication. If a kidney patient is having dialysis, he could pay LE1,000 apart from the cost of a dialysis session for which he also pays an average of LE200 for the medicine he uses,” he said.
In a bid to make essential medicines more available, Medicine for All, an NGO, is collecting medicine that is no longer needed by some and offering it to those who cannot afford it.
Walid Shawki, a pharmacist and pharmacy owner who started the organisation, said it was established in 2013 based on an idea from 2006. “When I was working in my pharmacy one day, a patient gave me some medicine he wanted to donate to those in need. When I asked my colleagues where to send it, they told me to send it to a church or a mosque and they would give it to a person in need.
“Another patient then came into my pharmacy and asked me to calculate the cost of the medicine prescribed for him. When I had calculated the prescription, he said ‘thank you, but I cannot afford to buy it.’ This started me thinking as I was able to give him some of the medicine he needed from the earlier donation. The patient ended up paying less money, and that was the beginning of the idea of Medicine for All,” he said.
“Many people have excess medicine at home they do not know what to do with. On the other hand, there are about 40 per cent of patients who do not have medical insurance, so they cannot afford many types of medicines. We wanted to bridge the gap between the surplus medicine in households and the people who lack medical insurance,” Shawki added, hoping that this would be a way of making medicine more affordable for all.
The organisation consists of 15 employees working in various departments like the patient-support centre, the medicine department, and the social-media department or on marketing campaigns. People donating medicine give it using two different methods. “They either call us to give us the medicine directly or they put the medicine in our collecting boxes in churches, mosques, pharmacies, and clubs in different places,” Shawki said, adding that there are about 40 different collecting points.
The volunteers or staff members are of three types, those who collect the medicine, the doctors who check the patients, and the pharmacists who give them the medicines. The first go through the boxes and take the medicines or go to homes to collect it from donors. The medicine is then checked to ensure it is safe to be used.
“First of all, we check whether the medicine is valid or not. For example, we get some medicine that has been opened, like eye or ear drops. This cannot be used. Other types of medication have to be stored in special conditions like low temperatures, so it must be refrigerated to remain useable. This type will be discarded if it comes improperly stored, for example,” Shawki said.
“Then we check for the expiry date, and then we look the medicine up on a computer database to check it is standard. The medicine is then stored so that it is easier to find when needed after registering in the organisation’s software.
“Working on a parallel basis is a committee of doctors and pharmacists in the patient-support centre who check patients from government or charity hospitals all over Egypt,” Shawki said, adding that these are given medical prescriptions and reports after seeing their IDs and welfare documents. Medical files are prepared for them, and relatives of each patient contacted to verify information before accepting a patient and giving him or her medication on a monthly basis.
“We do not have branches in other governorates, but our medicine centre and patient-support centre are located in Nasr City in Cairo. A patient comes only once to meet the committee on Mondays or Wednesdays and is then asked to call us every month on Mondays and Thursdays to make sure that his medicine is available,” Shawki said.
Magdi Awad is a pharmacist who volunteers in the organisation’s medicine centre and described the way he works to Al-Ahram Weekly.
“The organisation works in many phases. First, there is a medical committee that meets patients twice a week. There are two doctors and two pharmacists in each committee, and we review cases and decide which medicine is suitable for each.” In some case, they also refer a patient to another doctor if he needs surgery.
“The first phase is collecting medicine that either comes from the general public directly or from collecting boxes. Then it comes to the storerooms where it is sorted to see if it useable,” Awad said. “The medicine is then registered on the organisation’s software system and stored on the shelves of the charity pharmacy. Each patient is given a date to get his medicine from the pharmacy written on each prescription. We prepare the medicine and send it to the patient-support centre for patients to collect.”
“Some cases that come to the organisation are of children suffering from cerebral damage or adults with kidney failure, heart disease, and diabetes,” Awad noted, adding that the medicine that is least available includes pills or injections for kidney patients, medicine for strokes, for high blood-cholesterol, and insulin for diabetes patients.
Salma Ramadan is a student at the Faculty of Arts Psychology Department in Cairo, and she explained how she came to work for the organisation. “It was a coincidence. I met someone working here, and I then trained for about two months and started working. The thing I like best is that my work is for charity,” she said.
“We receive medicine from the stores or medicine centre after we send the prescriptions of patients checked by doctors. I give the patients their medicine and write down their contact details. I also check the medicine with the patients to make sure it is the right type and amount they need,” she added, saying that she had been working with the organisation for around five months.
Awad has some reservations about how things work. “Medicines like insulin, hormones, and for strokes should be refrigerated and sent to the centre in special cooling bags. We prefer donors to give us money to buy this kind of medicine since we get discounts and the donor doesn’t have to buy it for a higher price.
“The main problems we face at the moment are the lack of some types of medicines and the lack of marketing and advertising for our organisation,” Awad said. Not many people are familiar with Medicine for All, and “we try as much as we can to buy medicine that is not available with the money we get,” he added.
They also hear many touching stories of patients who have benefited from the initiative and have now recovered. “There was one female patient who used to take medicine on a regular basis and had a severe heart problem. We referred her to a cardiologist for a second opinion. He gave her another type of medicine, and she is now in a better condition. She came to the headquarters of the organisation to thank us,” Awad said.
The organisation is ready to collect medicine from donors wherever they are and can make exceptions for some patients. “In the case of a patient who is unable to walk, we have a representative who goes to their house and checks that he is a patient who really needs the medicine and cannot afford it,” Shawki commented.
He also gave statistics indicating what the organisation has achieved thus far. “We have more than 1,000 patients who are receiving medicine on a monthly basis. Some 250 of them are dialysis patients, 250 are brain atrophy or disability patients, especially children, and 500 suffer from diseases like hypertension or diabetes,” he said.
The medicine collected is also doubling every year. “In 2013, we collected medicine worth LE300,000. In 2014, the number became LE600,000. In 2015, it became LE1.6 million, and in 2016 it became LE3.2 million. In 2017, it was LE4 million, in 2018 LE7 million, and in 2019 LE9 million,” Shawki said.
Such numbers would not have been possible without co-operation with other entities. “Every year we work with other NGOs and have 200 convoys that go to rural areas for those who cannot afford medicine,” he said, with each convoy helping more than 5,000 patients.
Shawki and his colleagues are seeking more methods to introduce the organisation’s work to the public. “We occasionally organise events in clubs to promote the work of the organisation, as well as in schools to raise the awareness of children and their parents about the problem of the misuse of medicines,” he said, adding that they planned to hold more events in the near future. One instance has been a fun day in a nearby school at which they asked parents for extra medicine they could donate.
The organisation also partly depends on “crowd-funding”, as Shawki puts it, or funding directly made available by members of the public. “There are some pharmacies that donate medicine as well as small but regular monthly donations of LE100,” he said. The organisation tried to approach the Ministry of Health but was not successful. However, it is supported by the Ministry of Social Solidarity and many patients come from departments there.
The organisation is open to volunteers who want to join it as well. “If anyone wants to volunteer with us, they have to know how they can help us because there are rarely permanent volunteers in Egypt. We have an application form for those who want to volunteer that is available online. Any would-be volunteers should fill out the application and send it to us,” he explained.
Today, the organisation would like to expand but faces various problems. “We have financial problems in terms of fundraising. We don’t have a budget for fundraising, so we cannot always organise promotional campaigns on TV. As a result, we are just doing social-media campaigns,” Shawki said. “We try our best to be known through social-media campaigns and reach influencers or actors to start campaigns for us and now we have a YouTube channel as well.”
“We need support from the government, banks, and companies. We want to have more branches all over Egypt. We have also been collecting some medicine from the Gulf states and getting donations from them.
“We need more medicine because sometimes we have a lack of some types. We want more people to get to know the organisation and to donate more,” Ramadan said. “It is the role of the media to let people know about the organisation so that they can also donate. People could even come to see for themselves the role of the organisation if they want to be convinced,” Awad added.
*A version of this article appears in print in the 13 February, 2020 edition of Al-Ahram Weekly under the title: Cure for the needy