Editor’s Note: his story is part of a special reporting project, “What Lies Beyond.” It is featuring students across six universities, reporting in-depth features and investigations on many of Egypt’s current events and issues.
By Nourhan Badawy
For hundreds of thousands of Egyptians with cancer, the National Cancer Institute (NCI) is the only option to receive treatment. However, stepping into the institute, one could easily mistake the reception for that of a low-budget hotel. Women are seen dressed in black, covering themselves with heavy blankets to sleep.
These women have travelled for miles, from rural villages to Qasr Al-Eini Street in Cairo seeking treatment, but cannot afford to spend the night in hotels, or even at the hospital.
“I am staying here with my stepmother for a week for my chemotherapy sessions that I have every day,” said Sanaa Awad, a 42-year-old cancer patient. “We sleep by the stairs and most of the time we cannot eat, as the food served here doesn’t taste good,” Awad continued.
Awad further pointed to the unavailability of a dedicated spacenear the NCI that can host patients coming from rural areas who cannot afford to stay in the hospital rooms.
The NCI always appears to be crowded, with people’s luggage littered across its halls, and people eating and sleeping on the stairs being a common sight. Every year, approximately 244,000 patients go to the NCI for treatment, according to the institute’s website.
Founded in 1969, the NCI was established with the highly ambitious aim of discovering a cure for cancer, according to the website.
The number of people diagnosed with cancer in Egypt reached 108,600 in 2012, when Egypt’s population was 83.9 million, and 72,300 of those faced the risk of dying of cancer, according to the International Agency for Research on Cancer (IARC).
“Lack of professionalism”
Several hygiene issues are prevalent inside the institute. A resident physician at the institute, who requested to remain anonymous, told Daily News Egypt that that in 2009, a major hygiene scandal occurred when the NCI’s crematorium, which burns amputated body parts of the cancer patients, was out of order.
The physician said the NCI had no choice but to transfer the body parts to be burned at the nearest possible hospital, which was the Qasr Al-Eini School of Medicine Hospital. “The NCI’s dustman took these [body] parts in a bag and went to Qasr Al- Eini hospital to burn them in their crematorium, although the parts were supposed to be transferred in a safer and more organised manner,” he said.
“The Qasr Al-Eini hospital refused to take in these parts as they already had an excess, and there was no more space for the NCI parts,” the doctor said, adding that the NCI nonetheless refused to take the body parts back.
“The dustman ended up having to fulfil the task of burying the parts himself anywhere far from the hospital,” the doctor said. The dustman was fired a few months later, with no justifiable cause, according to the doctor.
Due to the lack of budget, the doctor said the NCI has yet to come up with an alternative solution other than burning body parts in other hospitals. He added that the incident reocurred in 2012.
Moreover, inside the institute, there are no rubbish bins in the waiting areas, and if people want to throw anything away, they have to go inside the patients’ rooms.
In one highlight of the visit, a painter was found painting the doors of the children’s rooms; however, he appeared to be smoking heavily near the patients. There were no “No smoking” signs to be seen anywhere.
The patients’ meals were strewn across the floor, while others were being consumed by the patients, also on the floor.
Another resident doctor, who also wished to remain anonymous, recalled an incident when three nurses stole drugs from the institute’s pharmacy to sell them, with a 50% commission on their total cost.
“It began when one nurse discovered that a lot of drugs disappear when those three nurses were on shift, and he immediately reported them,” the doctor said, adding that the case was investigated and it was discovered that a lot of drugs were missing from the inventory.
The accused nurses told the police they sold the drugs to a pharmacy, but the investigation later revealed that they sold them to a teacher who needed them. However, the nurses were not dismissed from their positions; they were simply banned from working in the drugs section.
Patients speak up about their experiences
“Everything is negative over here, I thought I would find people who would try to raise our spirits,” said Hanaa Rady, a 33-year-old cancer patient.
“One time, I was receiving an injection from a nurse and I started bleeding profusely, so I told her to stop but she refused and told me I do not know her job better than her. I ended up losing about a litre of blood,” Rady said, adding that the staff is “really unprofessional”.
Rady said the doctors are “better than the nurses” in terms of professionalism, “but they are not always there as they have their private clinics or hospitals,” Rady continued. She continued that patients wait for the doctors for hours, especially those who come from villages, as they do not have another option.
Further, Heba Abdel Rahman described her mother’s experience at the institute. Abdel Rahman said last year, while her mother was undergoing a chemotherapy session, she felt very dizzy and nauseous. Her blood pressure was low, so she was administered a saline solution.
“The stand that holds up the solution was not there, so I tried to find one, but I could not. I had to hold it up for her for about an hour with my hands,” she said.
“The surprise was that one of the nurses told me that this is normal here and the relatives of patients do this often.”
Another instance indicating a lack of professionalism was retold by nine-year-old Ahmed Hany. “The workers here smoke sometimes, and I don’t like the smell of cigarettes,” said Hany, who has a brain tumour.
Smoking inside hospitals is known to be completely forbidden in Egypt for anyone on hospital premises.
A number of stories of negligence inside the NCI went viral on social media platforms, and one of the most widespread stories was that of Youssef Galal, who spent three years receiving treatment in the institute. Galal was diagnosed with lymphoma when he was 17 years old, and he shared his experience of ill treatment in the NCI, especially from the workers there.
Galal claimed he was once physically assaulted by a worker in the NCI when Galal argued with him after they lost the results of a bone marrow test, and Galal had to repeat the test, despite it being painful.
The officer allegedly hit Galal; and told him: “You are already dead, don’t make me push you there faster.”
Moreover, the institute is often accused of intransigence in handling patients’ files; patients cannot take their test results out of the hospital, whether to show them to a doctor, or to keep a copy themselves.
Galal is now a cancer survivor who aims to counter the psychological difficulties that cancer patients are subject to in hospitals, with their families and friends.
“Nothing is more painful than seeing your beloved ones suffering, not only from the disease but also from negligence and ill treatment,” said Mohamed Refaat, 24, whose father was a cancer patient.
“Patients here have to buy the drugs on their own budget, and purchase blood bags from other hospitals,” he explained.
“My father died in June 2014. I know that it was his time to go, but all I wished for was that he passes away with dignity and good treatment. But all he saw was illness, pain and negligence,” Refaat said, noting that they could not afford to treat him in an international hospital.
Campaigns for better conditions in cancer hospitals
Hend Ashraf, a member of an initiative for cancer awareness, called for more respect from hospitals for patients. “If the government paid attention to those who are in pain, I think our people would be stronger, healthier and more loyal to this country,” she said.
The conditions in hospitals were called into question with the launch of a campaign following former prime minister Ibrahim Mehleb’s unannounced inspection visit to the National Cardiac Centre early June, where he said he was “surprised” by the conditions in the hospitals. In response, a group of doctors formed a Facebook campaign page named “So that he isn’t surprised if he comes”, and began sharing images of the substandard conditions in hospitals.
The campaign prompted people to call for better conditions, while another campaign emerged to collect donations to improve the performance of public hospitals.
Further, “Cansurvive”, an Egyptian association providing support to cancer patients, is aiming to include patients in the decision-making process regarding the improvement of healthcare in Egypt. Cansurvive is holding the first patients-oriented medical conference in April.
Other campaigns have been announced on television calling on people to donate to cancer patients in order to be able to seek better treatment in other hospitals. However, some of the patients have complained that these campaigns “make patients feel ashamed”, according to one cancer patient.
“All the ads portray people with no hair who look tired, so they make us feel weak,” she said.