Egypt’s Ministry of Health announced last month that there had been a firm decline in the number of registered cases of Covid-19 in the country and in the registered cases of Covid-19 associated with morbidity.

The announcement came against the background of the spread in coronavirus vaccination and plans to keep up the momentum to provide booster shots for all vulnerable cases, especially with the beginning of the new academic year.

This was particularly good news for Heba Rashed, founder and manager of Mersal (Messenger), a charity designed to reach out to people in need of assistance with medical treatment. The two years of the pandemic confronted this small and low-profile charity with a major challenge, but it also offered it an enormous opportunity to grow.

It was in March 2015 that Rashed received a permit from the Ministry of Social Solidarity to launch her NGO. The permit allowed her to make a leap in her pursuit of a vocation, rather than a job, with a sense of purpose that led her to shift career from wanting to be a professor of Arabic linguistics to the founder and manager of one of the country’s most esteemed charities.

The path that Rashed took when she was still a student in the late 1990s was simple: helping to collect money for individual cases who needed financial help. However, with the passing of time it became clear that providing assistance for individuals who cannot afford to pay their medical bills was a top priority for society.

From collecting money to help families with no financial savings provide for their life-or-death medical treatment to helping out with injuries sustained during and after the 25 January Revolution, Rashed built a network both of potential donors and volunteer medical doctors.

Despite a possible academic career and an alternative career in development management, she chose to launch a small charity that would focus on reaching out to those who have “no other way to access healthcare, in the sense that they are not covered by any form of health insurance or are illegible to access government-covered treatment.”

“These are also not just a few people,” she said.

During her charity work, Rashed knew that some patients in the late stages of cancer, still very treatable, are not always covered by health insurance and often cannot apply for government-covered treatment either because of the high prices of relevant medications or because of the complications involved in getting approval.

The same thing, she said, applies to immune-system diseases that are becoming a lot more common for one reason or another. Then, there is always a long queue of people who desperately need what could well be life-saving surgery or simply life-changing medical interventions like hearing aids for children, for example.

In its work to provide help for such people, Mersal at first focused on two paths: the first to provide the necessary money to help patients to either partially or fully cover their pharmacy bills and the second to get volunteer doctors to agree to provide medical interventions, either for free or for partial fees.

It was this network of volunteers and donors that helped Mersal to play a key role in reaching out during the pandemic years, especially in the first wave when things were rough. “When the government announced the first cases of Covid-19 in Egypt, it was towards the end of winter 2020. At the time, nobody knew how things were going to turn out. However, only a couple of months later we realised that things were bound to be tough, even if they were not going to be as devastating as they were for some other countries,” she recalled.

 

CHALLENGES: At the beginning, Rashed said, Mersal had no idea what kind of challenges the pandemic was going to offer to the healthcare system in Egypt.

However, in a few weeks it became clear that the challenge was huge. “We used to go to buy masks and gloves to give them to doctors and medical workers at the public hospitals as the pressure on supplies was huge,” she said. She added that Mersal started contributing to public awareness about the coronavirus and how to avoid infection and what to do in case of suspected infection.

That was the easy part, she said. The tough part came later, with social media being turned into an SOS space for people desperately trying to find ambulances to take suspected Covid-19 cases to designated hospitals. There were also endless appeals for help to find ways for the hospitalisation of Covid-19 patients, to get them a bed in an intensive-care unit, or even to get an oxygen pump to help patients with declining oxygen levels due to the infection.

According to Rashed, that was a turn-around moment. “First, I spoke with the team on whether or not we should do outreach work for Covid-19 cases, and most members were worried that we were a small NGO with very limited resources. However, I was convinced that if it was the sense of purpose that we were pursuing, then we could not be turning our back on people at the time of the pandemic.”

In a few weeks, Mersal had managed to carry out an ambitious and successful fund-raising campaign that helped this small organisation to become the go-to destination for people who did not know what to do when Covid-19 hit.

Mersal was also there for refugees with no access to healthcare. “Our purpose is strictly humanitarian; we reach out to those who need help, irrespective of their faith or nationality. We are here to help everyone who is here in this country and who needs help,” Rashed stressed.

Mersal bought two ambulances, they operated a small intensive-care unit mostly with volunteer doctors, they provided a hotline for medical consultations, and they created an efficient delivery system to help provide oxygen pumps to patients at home.

“It was a very challenging moment, but it was also a moment of revelation because we all realised that it was then and there that we had to reach out. Despite the fact that we did not do everything we wanted to do during the pandemic, we still did a lot,” she said. “We really got a very strong push.”

However, while Mersal was receiving applause for the remarkable low-profile work it did during the first and second wave of the pandemic, the team was heartbroken over and over again at having to decline requests and desperate appeals for help for non-coronavirus cases.

“We are talking about severe cases that were unable to find medical help as the whole medical system was consumed with the pandemic,” she said. When the pandemic started to recede, some patients had already lost their battle with cancer or other illnesses. “This is part of the price or impact of the pandemic that we need to take into account when we talk about what coronavirus meant to us,” Rashed said.

Another part of the price, Rashed said, was purely socio-economic, with families who had lost their breadwinners to the coronavirus or whose breadwinners had lost their jobs as a result of the economic impact of the pandemic. This, she added, has expanded the outreach services of Mersal to cover basics for these families pending their access to some sort of stable income.

 

UKRAINE WAR: According to Rashed, the compound impact of the pandemic, the later world economic crisis, and the Russian war in Ukraine has made things worse for many people and increased the number of those seeking financial support for medical treatment.

“It is very hard for us to see that some of our previous donors are now coming to us seeking help. It is really daunting,” she said.

However, Rashed is convinced that “like during the pandemic, with the new challenges there will come the ability to do more.” She takes pride in the fact that this charity that makes a policy of not having advertisement campaigns has jumped from a base fund of LE20,000 in 2013, when registration started, to over LE250 million.

This, she said, has helped to expand the scope of its work to establish facilities for in-patient healthcare services for children with critical cases, a residence for patients who need to travel to Cairo from faraway cities for medical treatment, and a new hostel for older patients with terminal illnesses.

“We are committed to doing more, more in terms of the numbers of cases we take, and more in terms of the scope of coverage we provide, because we want to make the medical assistance that Mersal provides more comprehensive,” she said.

For example, Mersal has already been working on providing psychotherapy for suffering individuals. “With so many pressures, more and more people have been needing therapy. We try to provide it fully or partially,” she said. She added that with the devastating impact of the pandemic on people who have lost their loved ones or lost their jobs and the current economic crisis, the need for psychological help is getting bigger.

“This is not a luxury because psychological illness can be as life-threatening as some physical illnesses,” she said.

“There is a lot of work to be done, especially with managing the fall-out of cases whose treatment was compromised by the coronavirus, but also with the growing number of patients that will need to seek help with their medical bills,” she said.

She added that to help expand its resources, Mersal is considering starting some paid service facilities to generate funds that can cover those who need free treatment. “We are very lucky with the donations we are getting, but what we want to do, and what needs to be done, still goes beyond the generous donations we are getting,” Rashed concluded.

*A version of this article appears in print in the 17 November, 2022 edition of Al-Ahram Weekly.