Babies' deaths cast shadow on Egypt's health care

The video shows a poorly lit hospital nursery filled with premature babies in incubators. Doctors are frantically trying to resuscitate some babies while others wail in the background after a night-time power cut.

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

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

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

Doctors at the hospital said the outage led to the deaths of four infants. The health ministry, which has referred the matter to the public prosecutor for investigation, says two babies died but that was before, rather than during, the power cut.

The video, which surfaced on YouTube and several Egyptian blogs in June, has sparked a national uproar over a health-care system suffering from a lack of funds, a long legacy of mismanagement and allegations of corruption.

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

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

Robust economic growth of around 7 percent over the last two years has swollen the ranks of Egypt's wealthy, but left millions of unskilled, poorly educated people struggling to cope with inflation running at a 19-year high.

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

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

A 2004 study by Christian Gericke of the Berlin University of Technology said poor Egyptians "pay relatively more (both out-of-pocket and through the tax system) and receive relatively 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 the power cut on a blog (https://www.akroot4ever.blogspot.com), along with details of what they described as "tragedies" at the hospital.

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

"A third died after electricity was restored and a fourth the 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 work because of poor maintenance.

The video shows doctors trying to help the babies with Ambu bags, hand-held devices used to provide ventilation to patients who have trouble breathing.

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

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

But Mortagi Negm, secretary-general of educational hospitals and institutions, a government department, said the power outage had no effect on the health of any baby at the nursery.

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

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

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

"GREAT SYSTEM ON PAPER"

Salama, who sells fruit and vegetables on the street while her husband works at a textile factory, said she was not seeking financial compensation.

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

The deaths at the hospital received front-page treatment in independent and opposition newspapers. Dozens of people phoned television talk shows and sent messages to online forums attacking the government's health policies, which they blame for the run-down system.

The Ministry of Health will spend some 12 billion Egyptian pounds (1.12 billion pounds) on health care this year. In comparison, the government spends nearly 80 billion on food and fuel subsidies, and spending on defence and security will be about 22 billion pounds next year.

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

"Funding is scarce," he told state-run Egyptian television in 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 negligent and that connections and favouritism played a role in the appointment of employees. "And who pays the price? You and the citizen," he said.

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

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

Director Moustafa Abdel-Aal said he cannot hire permanent workers like cleaners because of budget restraints. He said the hospital, 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 government wages were too low at state-run hospitals.

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

"I have a doctorate and my salary is 415 pounds . You cannot ask a human being to work hard (with these wages)." he said. "This is the crux of the issue."


=============================2=========================


Nicaragua Ortega says won't let enemies depose him
Sun Jul 6, 2008 5:59am BST

MANAGUA (Reuters) - Nicaraguan President Daniel Ortega warned his political adversaries on Saturday that he would not allow them to depose him as opposition groups planned street protests against his government.

"We love peace, but we are also ready to use the steel of war if they try to bring down this" government, Ortega said in a speech.

Ortega, a leftist who fought U.S.-backed Contra rebels during his first stint as head of state in the 1980s, returned to power last year after beating conservative rivals in an election.

Thousands of people took to the streets on June 27 to protest Ortega's handling of the economy and the exclusion of two small parties from municipal elections last year, though the country's largest opposition party did not participate actively in the march.

Protesters that day chanted slogans that called Ortega a dictator. Nicaragua is one of Latin America's poorest countries.

Opposition leaders are planning another protest on Friday.

Ortega, an ally of leftist Venezuelan President Hugo Chavez, repeated accusations on Saturday that the U.S. government is funding the opposition groups.

"Those that are conspiring, who are openly financed by the Yankees, better respect the institutional norms in this country. They better not provoke the people," he said.