In October, paediatric cardiologist Dr. Wael Lotfy published his first book, Regaining Identity: A New Model, which looks at ways of improving Egypt’s healthcare system.
Lotfy, a professor of paediatric cardiology at Cairo University, has worked in public hospitals since 1992, and has completed his share of social work. The book, which is more of a study, is based on his personal experience.
The book examines the deteriorating healthcare system in Egypt from a larger perspective: that of civilisation. Leaning towards the theories of historian Arnold Toynbee put forth in his A Study of History, Lotfy argues that the key problem of cultural and civil deterioration is the deterioration of the creative minority of each society, and the transformation of these minorities into dominant and manipulative bodies that allow no subordinates.
This usually happens due to excessive self-idealisation and being proud of previous victories while failing to address current challenges. Sound familiar?
Lotfy's book contrasts Islamic and Western civilisations, claiming that the first is based on sovereignty of power while the latter insists on the sovereignty of welfare, highlighting the irony of the current status quo of both. The civilisation that is asked to be compassionate and to seek knowledge (the first verse of Quran is “read!”) is at present suffering from under-development in science as well as other problems.
Lotfy elaborates on the current state of healthcare in Egypt, where innocent lives are lost every day due to malpractice, negligence, or mere unawareness.
“The healthcare problem in Egypt starts with the fact that the number of beds in each hospital hardly matches the number of patients in need: 22 beds per 1,000 people. In addition to the bad service in a lot of places, there has been a decrease in salaries in the public healthcare sector, and lots of tax evasion from private health entities. Finally there is the fact that 60-70 percent of medical expenses are spent in pharmacies, clinics, and private hospitals,” he writes.
Lotfy believes that the key challenges lay between ineffective and uncooperative health authorities, and cultural resistance from doctors, nurses, and others.
“We need to communicate a vision to everybody, then work on the details,” he argues.
To address the multilayered chronic problems of Egypt's poor healthcare system, Lotfy suggests a multidisciplinary approach, from paving the road to science and opening up the doors to research and questioning instead of blind approval, as well as increased social responsibility.
Education is another foundation that needs to be renewed and amplified, he argues, suggesting that quality control departments are needed in each medical school. Since the major challenge in Egypt is maintaining the quality of medical service in the public and private sectors, such units would help educate and train people on the basics of quality medical service, something that is alarmingly absent in Egypt.
Lotfy suggests that the government allow the private healthcare sector to be accessible to the public, because healthcare is a basic human right. He proposes a system wherein a patient would be given an ID card by that has a certain value attached to it, to be exchanged for medical services of their choice. The private services would then be able to claim taxes back on those services, and so it would be a win-win situation.
He also proposes numerous ways to upgrade the quality of medical services and ensure the sustainability of such changes.
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