A prime ministerial decree banning government employed doctors from taking unpaid leave has provoked anger.

Immediately after the decision was announced by Prime Minister Mustafa Madbouli – he argued Egypt suffers from a shortage of doctors and the decision will help cover the shortfall – doctors working for the Health Ministry threatened to resign their posts.

Ahmed Harhash, a pediatrician working in Saudi Arabia after taking unpaid leave, said he would leave his government job permanently if the decree is implemented.

 “All my Egyptian colleagues have either resigned or will resign. We are working abroad for the sake of a better life for our families,” he said.

Ali Mahrous, Head of the Central Administration for Free Treatment at the Ministry of Health, says that since the decree was announced more than 2,000 doctors have resigned.

Mahrous pointed out that though there are no accurate statistics for the number of doctors affiliated to the Health Ministry they are estimated at around 170,000, of whom more than half are currently working abroad.

“There are 69,000 Egyptian doctors in Gulf countries while between 15,000 and 20,000 have permanently left for the US, Canada and Australia,” said Mahrous.

Egyptian doctors working abroad, says Mahrous, earn far more than they make working for the Ministry of Health.

“Why would they sacrifice these salaries to return to Egypt,” he asks, where working conditions leave a lot to be desired. Their salaries are low, and often hospitals lack essential equipment and supplies.

The doctors who have resigned, says Mahrous, “are paid multiple times more than they receive in Egypt”.

“They do not want to risk their positions abroad or lose their salaries.”

Ihab Taher, a member of the board of the Doctors’ Syndicate, believes the decree may well be illegal since it undermines the constitutionally guaranteed right of Egyptian workers to seek employment abroad.

“More than half of doctors currently working abroad have already threatened to resign should the decision not be annulled,” he warned.

But some medical professionals argue doctors working abroad should return for the sake of Egypt, which needs their services.

Rashwan Shaaban, assistant secretary general of the Doctors’ Syndicate, says the country has just one doctor per 800 patients, far short of the doctor per 300 patients recommended internationally.

“This ratio negatively affects the services provided to patients. Egyptian doctors should return as a national duty,” says Taher.

While Taher notes that the basic salary of government employed doctors does not exceed $80 per month – they can earn as much an hour in some countries – additional incentives are in place.

“Doctors who work in remote areas are paid four times more than those in cities, and there are incentives in place for those working in dangerous fields or dealing with highly contagious diseases.”

Doctors, adds Taher, have to make sacrifices for the sake of Egypt which suffers from a serious shortage of Intensive Care Unit (ICU) specialists, anesthetists and orthopedic, neurology and cardiac disease specialists.

Ahmed Harhash argues the prime ministerial decree will have the opposite effect to the one intended, encouraging many doctors to leave for good.

Ihab Ramsis, an ophthalmologist who moved to the US five years ago, says the decision is unrealistic and will soon be withdrawn. “We have seen similar decrees before,” he says.

“One was issued in 2015, and before that in 2013. They were annulled when the government realised the consequences of the decision.”

“Government officials need to be more realistic. They should improve doctors’ working conditions before asking them to leave better paying jobs.”

*A version of this article appears in print in the 15 November, 2018 edition of Al-Ahram Weekly under the headline: Forced return