Dr. Madiha Khattab doesn't believe in mincing words when it comes to the state of the country's public healthcare system.
"People are unhappy," says the Dean of Cairo University's Faculty of Medicine. "They're complaining they're not receiving satisfactory healthcare services, and I don't blame them."
For nearly three decades, Khattab has been a part of that system. Sadly, she has seen little improvement since her medical school days in the 1960s. Public hospitals remain under-funded and understaffed, pharmacies continue to be run more as grocery stores by uneducated attendants, and accountability for malpractice of any sort is nowhere to be found.
Today, Khattab also finds herself on the political scene as the head of the health committee at the governing National Democratic Party's powerful Higher Council for Policies. In addition to helping fix the system so many had given up on, she has recently begun working with Council President Gamal Mubarak and Minister of Finance and Insurance Yousef Boutros-Ghali on implementing President Hosni Mubarak's campaign promise to provide better healthcare coverage to all Egyptians.
"I think the press has played a big role in exposing our shortcomings as a sector," says Khattab. "If you look back on what has been written and what has been on television, it has all been negative. But I don't think there is anything wrong with that. Sure, I would have liked to have more coverage of the progress we have made, but when your weaknesses are magnified, you are forced to pursue improvement with more urgency.
"That's where we are at right now. We are at a turning point. We're trying to implement national healthcare coverage and what people are saying is, 'Be careful, we don't have a good healthcare system. We don't have a good education system. We don't have a good nursing system. So you better take care of these basics before you give us health insurance.'"
Khattab, who was put in charge of the country's largest medical faculty and one of its largest hospitals, Kasr El-Aini, almost simultaneously in 2002, says she is unsatisfied with her sector's progress in the past two years. The policies of the Nazif government, which have done wonders in accelerating liberalization of the economy and drawing foreign investment, have yet to impact health care. But with health care making up a significant block of the president's campaign platform, the Ministry of Health and Population is now under more pressure than ever to implement sweeping changes.
This time, though, there's reason to be optimistic about the approach taken by the institution's new head, Minister Hatem El-Gabali, she says.
"The new minister has a scientific approach to the problems that have plagued the system for decades," she says. "The new government is basing its policies on facts and numbers, not emotions. And that's why I'm optimistic. It's not easy; it's very difficult. And it needs the understanding and support of the public."
One of the major changes now being implemented is the systematic accounting of all services and drugs provided on a per-patient basis in all public hospitals, says Khattab. In the past, government hospitals used to receive fixed annual budgets based on the Health Ministry's own budget, not the hospitals' individual needs. As a result, most hospitals did not receive adequate funding, she adds.
It was not unusual, for example, for doctors to require their patients to buy their own syringes, gauze and other standard medical supplies in order to cover hospital shortages. While the new accounting system might not solve all funding problems, it should give the ministry a better idea of how much each hospital needs to run efficiently, Khattab says.
In addition, on the consumer level, Khattab says a change of culture is needed. "If you want to have a real, satisfactory medical experience for the patient, you have to provide him with proven treatments," she says.
"And if you want to provide a health service that conforms to high standards of quality, then yes, it will be expensive."
Egyptians currently pay about 60% of healthcare costs out-of-pocket, up from 50% in the early 1990s, says Khattab. The main task now, she says, is getting them their money's worth.
"My main indicator for success is the increased satisfaction of patients," says Khattab. "Right now, patients go to the clinic, and they don't find the doctor. When they find the doctor, he doesn't speak to them. And when he speaks to them, he gives them medication that they don't understand how to use or he doesn't inform them of the effects it will have on them. All of this needs to change, and we realize the need for change is more urgent than ever."
Madiha M. Khattab (59)
Dean, Faculty of Medicine, Cairo University President of Kasr El-Aini Hospital (3,000 beds) President of the new Kasr El-Aini Teaching Hospital (1,200 beds) Chair of the Health Committee, NDP Higher Council for Policies
Mentor: Minister of Legal and Parliamentary Affairs Mufid Shehab, who was president of Cairo University and Minister of Higher Education, for teaching me exceptional leadership skills.
Best advice: Keep up the good work.
Brand Egypt: "Reform." Everything that is going on in this country, from the top down, says "Reform."
Growing up I wanted to be: A scientist.
By Ahmed Namatalla
Business Today Egypt 2006
