“I was shocked when I read in the news that the financial situation of the hospital is going into a serious crisis due to the lack of donations; I thought it would be very sad for the hospital to start declining requests for help due to the lack of resources,” she said.

Sandra considers herself “a first-hand witness to the quality of medical care that this hospital provides” as she saw the son of her best friend having been treated and cured in the hospital. “When I thought of what could happen to other families whose children could be saved from cancer at this hospital, I felt that something has to be done,” she said.

Luckily, she added, her appeal on WhatsApp “eventually got some positive reactions.”

“In the beginning some people were hesitant due to an older defamation campaign [against the hospital], but when I shared the experience I saw for myself their reactions somehow changed,” she said.

Sandra added that the donations made to "Save 57357" from the Ministry of Social Solidarity and later from Banque Misr encouraged more people to donate.

“Of course, the donations were not very big, because clearly most people now are trying to manage their budgets under the stress of inflation, but in the end something is better than nothing,” Sandra said.

“I think had it not been for the aggressive campaign that was launched against this very good hospital a few years back things could have been different. The only way to break this negative image is for more public figures and bodies to donate to 57357,” she added.

Over the past two weeks, the Ministry of Social Solidarity and Banque Misr donated EGP 75 million and EGP 30 million, respectively, to the children’s cancer hospital. The subsequent donations came after the administration of the hospital went public with the financial crisis it has been facing since the media attack that was launched against the hospital’s financial management in 2018.

At that time late prominent journalist and script writer Wahid Hamed wrote a series of articles about the hospital. Hamed’s articles questioned the standards of the hospital’s financial governance and indicated that there is a pattern of bad spending, especially in relation to the intensive commercial campaigns that the hospital has been long associated with.

The administration of the hospital tried to deny all the allegations. However, it took a while before the competent auditing bodies sent the administration the necessary documentation to prove that all donations were spent properly.

According to a source at the hospital, “unfortunately, the official documents that cleared the administration of wrongdoing did not get as much attention as those that aimed to undermine the credibility of the hospital in what was essentially a war over commercials between companies.”

Heba Wahba, marketing director at 57357, said the campaign that questioned the spending of the hospital’s donations “caused a drop of around 80 per cent of the donations in about seven months.”

Apart from the huge financial decline in resources, Wahba said, the team that launched the idea of the hospital in the late 1990s was demoralised. “It was a very tough time, the toughest since the launch,” she said.

According to Wahba, the hospital cannot simply do without commercials “in view of the very simple fact that this is a hospital that depends on donations; we have to reach out to people to get them to help the patients that get full free medical service; we need big donations because treating cancer at this scale and at this level is simply costly.”

To make things worse for 57357, the severe drop in donations came after a considerable devaluation of the Egyptian pound in the autumn of 2016. The depreciation of the pound had already caused a significant drop in the actual value of donations given the fact that a good part of the budget of the hospital is dedicated to medicine, equipment, and medical training all of which require foreign currency.

To overcome the sequel of drops in resources and their value, Wahba explained, the administration asked the banks to release saving bonds prior to their maturity date. So, instead of counting on the interest rate, the administration had to go straight to saving bonds and investment certificates.

The hope for recovery from the financial hiccup was dashed by the pandemic in early 2020 and then two successive devaluations of the pound that came at a moment when the country’s economic situation was significantly compromised by the Russian war on Ukraine.

“It has been a tough time. During the pandemic we made every effort to keep on providing our service and care for the patients that we treat who got infected with COVID-19, but we were hoping that things would pick up,” she said.

Sources at the hospital agree that the damage done by the 2018 campaign was never fully undone, especially that it had included allegations of nepotism. They agree that there are some relatives who work at the hospital, including the spouse of its current president Sherif Abul-Naga. However, they insist that all staff, medical and administration, are qualified and trained. They also insist that there is nothing that is done in the hospital, either in terms of finance, recruitment, or medical service, that is exempted from the supervision of all competent bodies.

They also shrug complaints that the administration is "selective" when it comes to accepting patients. The first criterion, they say, is who has a better chance to win the battle against cancer, and the second who has not started a treatment path already.

“We sincerely wish we could accept every single child that comes to us, but the fact of the matter is that we don’t have these resources, so if we get a child whose symptoms have been long neglected to the point that his chances to survive cancer are dismal and another child who has a good chance to win the battle, I would be simply doing injustice to the one who has a chance if I don’t give him or her priority.

"It is harsh, and it is certainly painful for the families, but this is how it works at times,” said a member of the medical team who asked for his name to be withheld.

“It is not about us wanting to have high recovery rates, but it is about us wanting to make our help best invested,” he argued.

He added that it is equally purposeful to accept children who had already been put on a treatment protocol, because with cancer what makes a difference often, in addition to early detection, is the application of the most adequate protocol right from the onset. “At the end, we try to provide our service to as many children as possible and we hope we could do more,” he added.

According to Moataz El-Zanaty, deputy president for medical affairs, in terms of capacity, the 57357 hospital has 300 beds for its inpatient department. The number of patients annually exceeds 19,000, between newly diagnosed cases (2,000-3,000 patients), patients on treatment protocols (6,000 patients), and follow-up cases (more than 11,000 patients).

All the patients, El-Zanaty said, including those who can afford to pay, are offered fully free service in all of the 23 departments of the hospital that cover everything and not just oncology.

“Families who wish to donate can do so, but the hospital offers all equal service and we are constantly working to improve this service through continued training, upgrading our protocols, and having the most advanced technology,” he said.

According to Wahba, the result of this commitment to “value over volume” is that the recovery rate at 57357 is around 72 per cent which is not much less than the international 80 per cent rate.

“We hope we can do better, but ultimately it is a matter of means,” she said. “We were hoping to expand our service and we had already started a secondary operation in Tanta to allow for children of the Delta to come to Cairo for diagnosis and protocol and to stay in the Delta for treatment and follow up. However, due to the lack of resources we had to suspend this operation and transfer patients to Cairo. We hope we can resume the Tanta operation.”

According to Sherif Aly Abdel-Aal, a board member of the children’s cancer hospital, to deal with the tight financial situation, the hospital is embarking on a number of initiatives to improve efficiency without compromising the quality of patient care. These include a more mindful approach with entertainment programmes offered to children, a more constrained post-recovery medical service, and more constraints on using all resources, including water and electricity.

However, he added that in view of the ongoing exponential increase in costs and expenses the hospital needs more donations. “Every time a patient is admitted for treatment, the hospital has to make sure that the total cost of his full treatment is allocated under his or her name. With children’s cancer we are not talking about anything less than a year of treatment if we are lucky, but in most cases, we are talking about three years on average,” Abdel-Aal said.

Abdel-Aal said he is hopeful that the scare over the future of 57357 would encourage more people to come forward even with very small donations. Actually, he added, a large segment of the donations that had kept the hospital working since its start back in 2007 comes from the small and medium donations of people who just give a few pounds.

“Of course, this is not an easy time for many people, but we really hope that we will not downsize our service,” he said. He added that the solidarity that the public has been showing and the support of some prominent art and sports figures give hope that the hospital may have a new lease on life.