Babies' deaths cast shadow on Egypt's health care

CAIRO (Reuters) - The video shows a poorly lit hospitalnursery filled with premature babies in incubators. Doctors arefrantically trying to resuscitate some babies while others wailin the background after a night-time power cut.

"God help us! Five are suffering from (cardiac) arrests?" avoice in the background says angrily. "We can handle one or twoat most, but five?"

"This is natural, doctor. It's been an hour and a half,"says another male voice, apparently referring to the length ofthe power cut.

A mobile phone camera caught this scene at Cairo'sstate-run Al-Matariya Educational Hospital in late May on anight when the electricity was cut for nearly three hours aftermidnight and back-up generators failed to work.

Doctors at the hospital said the outage led to the deathsof four infants. The health ministry, which has referred thematter to the public prosecutor for investigation, says twobabies died but that was before, rather than during, the powercut.

The video, which surfaced on YouTube and several Egyptianblogs in June, has sparked a national uproar over a health-caresystem suffering from a lack of funds, a long legacy ofmismanagement and allegations of corruption.

For decades, the government has provided poor Egyptianswith subsidized food and fuel, free education and health care.

But public spending on health care has fallen behind overthe last six years, accounting for 1.3 percent of grossdomestic product in 2006, compared with 2.4 percent in 2001,data from the United Nations report on human development inEgypt showed.

Robust economic growth of around 7 percent over the lasttwo years has swollen the ranks of Egypt's wealthy, but leftmillions of unskilled, poorly educated people struggling tocope with inflation running at a 19-year high.

This widening gulf between the rich and poor in the Arabworld's most populous country is also visible in thehealth-care system.

Private hospitals offer superior care for those who canafford it -- not much consolation to most in a country whereone-fifth of 76 million people live on less than $1 (50 pence)a day.

A 2004 study by Christian Gericke of the Berlin Universityof Technology said poor Egyptians "pay relatively more (bothout-of-pocket and through the tax system) and receiverelatively less in benefits than the better-off social strata."

"There is a huge disparity in financial access to care,"the study said.

NOT ENOUGH BAGS

Doctors at Al-Matariya hospital posted the video of thepower cut on a blog (https://www.akroot4ever.blogspot.com),along with details of what they described as "tragedies" at thehospital.

"Two babies died during the power cut. I saw them with myown eyes," a doctor, who said he was in the nursery during thepower outage, told Reuters in a telephone interview.

"A third died after electricity was restored and a fourththe following day," he added. The last two deaths, he said,were a direct result of the power outage.

The doctors said the back-up generators did not workbecause of poor maintenance.

The video shows doctors trying to help the babies with Ambubags, hand-held devices used to provide ventilation to patientswho have trouble breathing.

"We had five cases that needed this. We only had two Ambubags," the doctor interviewed by Reuters said. He said a thirdbag later came in from another department at the hospital.

Another doctor, who also runs the blog, said: "How come ahospital with six intensive care units relies on one source ofelectricity?" Both doctors spoke on condition of anonymity,fearing management retribution.

But Mortagi Negm, secretary-general of educationalhospitals and institutions, a government department, said thepower outage had no effect on the health of any baby at thenursery.

"Two babies died before the electricity went off," he toldReuters. "The law states that they must remain on the machinefor two hours after death."

Reda Salama, the mother of 20-day-old Ali Gamal who diedthat night, does not believe this. She says gross negligence bythe hospital led to the death of her son.

"I want those who caused the murder of my son dead. Even ifI strangle them myself, it won't satisfy me," she said, sittingin a small room in her dilapidated home in Bahteam, a poordistrict in Cairo. She was wearing a black dress and a blackheadscarf as a sign of mourning.

"GREAT SYSTEM ON PAPER"

Salama, who sells fruit and vegetables on the street whileher husband works at a textile factory, said she was notseeking financial compensation.

"This is negligence," she said in a loud, angry voice asshe sat surrounded by relatives. "If I give up the rights of myson and others do the same, what will become of us?"

The deaths at the hospital received front-page treatment inindependent and opposition newspapers. Dozens of people phonedtelevision talk shows and sent messages to online forumsattacking the government's health policies, which they blamefor the run-down system.

The Ministry of Health will spend some 12 billion Egyptianpounds (1.12 billion pounds) on health care this year. Incomparison, the government spends nearly 80 billion on food andfuel subsidies, and spending on defence and security will beabout 22 billion pounds next year.

Health Minister Hatem el-Gabali has vowed to "chop off theheads of those responsible" if investigations prove the poweroutage caused the death of any infants. He acknowledged thatpublic hospitals in Egypt were battling many problems.

"Funding is scarce," he told state-run Egyptian televisionin an interview. "On paper, we have a great system. On paper,the powers, obligations and rights are great."

Gabali said state-run hospitals were in reality negligentand that connections and favouritism played a role in theappointment of employees. "And who pays the price? You and thecitizen," he said.

Al-Heseniya Fever Hospital east of Cairo showcases theproblems Gabali mentioned.

Patients sleep on worn-out cots in dirty rooms, where wallsare daubed with graffiti.

Director Moustafa Abdel-Aal said he cannot hire permanentworkers like cleaners because of budget restraints. He said thehospital, with a capacity of 70 beds, has only five doctors.

"We should at least have 10 or 12 doctors," he said.

Several doctors interviewed by Reuters said governmentwages were too low at state-run hospitals.

"The salary of a young doctor is 250 pounds a month," saidAmr Abu El-Ela, a doctor at Al-Sahil hospital in Cairo.

"I have a doctorate and my salary is 415 pounds ... Youcannot ask a human being to work hard (with these wages)." hesaid. "This is the crux of the issue."

(Writing by Alaa Shahine, Editing by Clar Ni Chonghaile)