Nurses Lampooned In Egypt, Hospitals Face Shortages

Students at Gouna Technical Nursing Institute
Students at Gouna Technical Nursing Institute
David Wood

CAIRO â€" Mechell Vencing Gimarangan, a Filipina nurse, strides into an upmarket restaurant in Sheikh Zayed City, part of the greater Cairo region. She speaks to the waiter in Egyptian Arabic and then transitions immediately to impeccable English. She appears totally at ease in her foreign surroundings.

Gimarangan has travelled a great distance to work as a nurse on the outskirts of the Egyptian capital. About 9,000 kilometers lie between her native Philippines and Dar al-Fouad Hospital, her employer in Egypt.

At present, Egyptian private hospitals employ a significant number of foreign nurses, from countries as far flung as India, Bulgaria and Algeria. A third of nurses from Gimarangan’s unit are from the Philippines.

Egypt faces a chronic nursing shortage. A 2015 World Health Organization report found there are 14.8 nurses and midwives for every 10,000 Egyptians. This ratio amounts to almost half the global benchmark figure of 28.6 nurses. By comparison, Egypt does not suffer from a human resources shortfall as severe as this with doctors, pharmacists or dentists. In this climate, Egypt’s private medical sector has turned its gaze overseas to fill nursing job vacancies even though these foreign nationals usually command much higher salaries than their Egyptian counterparts.

At first glance, this trend of hiring non-Egyptian nurses appears puzzling. Egypt’s overall unemployment is currently about 13 percent, with more than 30% unemployment among youth. Educational institutions throughout the country offer nursing training courses. Labor laws protect Egyptian citizens against competition for jobs from foreign nationals and, in theory, companies may only employ non-Egyptians if no qualified citizen has applied for the same position. For these reasons, Egyptian nurses should have little difficulty obtaining employment after graduation.

Given high unemployment rates and job availability in the field, why do Egyptians shy away from careers in nursing? Ayman Sabae, a trained doctor and a health researcher for the Egyptian Initiative for Personal Rights, traces this widespread aversion to social stigma.

The work of nurses is undervalued. "They are often seen as second-class citizens, who provide services similar to a maid or cleaner," he says.

Sabae sees this social bias portrayed in popular culture. Nurses are shown as lazy, crass and "completely incompetent" characters in films and television. The Nurses Syndicate railed against this hurtful media image in 2010, unsuccessfully lobbying the Ministry of Culture to cancel a Ramadan soap opera that featured a corrupt and unethical nurse.

Salaries in this profession are also low. Egyptian nurses typically earn between $135 to $280 per month in public hospitals. This lowly remuneration provides little incentive for Egyptians to enter this profession. The government has not yet met its constitutional obligation to commit at least 3% of its GDP to healthcare.

Sabae says that this combination of social and economic concerns tends to drive young Egyptians with ambition away from a career in nursing.

Hassanat Naguib, dean of privately funded nursing college Gouna Technical Nursing Institute, concurs that adverse perceptions of the nursing sector stem from "ignorance regarding the nurse’s role." She adds that a lack of proper nursing training has compounded this trend. Most Egyptians receive healthcare in public hospitals. This often brings patients into contact with inexperienced nurses, many of whom have completed only basic training. Naguib argues that until the quality of training improves, public confidence in nurses is unlikely to increase.

Social perceptions of nursing in the Philippines are markedly different from those prevalent in Egypt. Gimarangan describes the deep respect commanded by nurses in her home country. Her mother dreamed that her daughter would enter the profession, financially supporting Gimarangan on a long path to becoming a registered nurse. Filipino students must study four years at nursing school before completing â€" and paying for â€" various medical licensing courses. The student finally becomes a registered nurse upon passing a standardized bar exam.

Gimarangan has a straightforward answer as to why Filipinos go to such lengths to become nurses. "When you are wearing the white uniform, you are respected" in Philippines, she says.

Unlike Egypt, the Philippines has too many qualified nursing practitioners. Due to extreme competition for jobs, Filipinos typically begin their careers by paying a local hospital for the privilege of working as a volunteer nurse. Gimaragan worked under these conditions in her home country for 10 months. This unpaid work experience enabled her to obtain her current role at Dar al-Fouad Hospital. She views her job in Egypt as a "stepping stone" to other nursing opportunities, which she hopes will take her to countries such as the United States and Australia.

Naguib, the dean, encourages her graduates to pursue careers in the private healthcare sector, where hospitals tend to provide the latest training to nursing staff.

Mohamed Fakih, chief nursing officer at Cairo’s Al-Salam International Hospital, says that public and university hospitals must progress away from practicing an "old school" type of nursing. Nurses in these institutions usually do not learn with up-to-date medical equipment, Fakih says, limiting the quality of care that publicly trained nurses can provide to patients.

Despite their misgivings, both Naguib and Fakih praise the ongoing efforts of the Egyptian Nursing Syndicate to promote better training practices. Over the past decade, the British University in Egypt has also developed a state of the art nursing faculty and Dar al-Fouad Hospital has its own plans to open a nursing academy in the future.

Sabae applauds the efforts of non-governmental organizations such as Misr al-Kheir Foundation, which aims to provide educational support to nurses working in university and government hospitals.

In a country rife with unemployment, nursing stands out as a field that can potentially provide jobs. But without significant funding and investment, a dearth of nursing staff will likely persist.

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Running of the Bulls in Tafalla, northern Spain

Anne-Sophie Goninet, Jane Herbelin and Bertrand Hauger

👋 Здравейте!*

Welcome to Monday, where an apparent coup is underway in Sudan, Colombia's most-wanted drug lord gets caught, and Michael Jordan's rookie sneakers score an auction record. We also focus on a report that the Thai government is abusing the country's centuries-old law to protect the monarchy from criticism (lèse-majesté) to target pro-democracy activists and protesters.

[*Zdraveite - Bulgarian]


• Developing: Sudan leaders arrested amid military coup reports: Soldiers have arrested several members of Sudan's transitional government as well as civilian leaders, and Prime Minister Abdallah Hamdok has reportedly been put under house arrest, in what the information ministry called a military coup. Pro-democracy protesters have taken to the streets of the capital city Khartoum where there are reports of gunfire and clashes.

• Colombia's most wanted drug lord to be sent to U.S.: Colombia's most dangerous drug trafficker, known as Otoniel, was caught after a joint army, air force and police operation and faces extradition to the U.S. He led the country's largest criminal gang, and was on the U.S. most wanted list for years.

• Xi speech marks China's UN anniversary: China's President Xi Jinping marked the 50th anniversary of Beijing's entry into the United Nations with a speech calling for greater global cooperation, adding that issues like climate change, terrorism and cyber security needed multilateral solutions. Taiwan was not mentioned.

• German ISIS bride jailed for crimes against humanity: A German court has sentenced a German woman and former member of the Islamic State to 10 years in prison for letting a 5-year-old Yazidi enslaved girl die of thirst in Iraq. The case is one of the world's first trials to prosecute a war crime against the Yazidis.

• COVID update: The Beijing marathon scheduled next weekend has been postponed until further notice as China seeks to stamp out Delta variant outbreak and return to zero cases ahead of the Winter Olympics next February. Meanwhile, coronavirus cases in Eastern Europe have surpassed the 20 million mark as the region fights against its worst outbreak since the pandemic started and vaccination efforts lag.

Goodbye, Gunther: U.S. actor James Michael Tyler, best known for his role as the barista Gunther on the TV show Friends, has died at 59 of prostate cancer.

• Sneakers record: A pair of Michael Jordan's white-and-red Nike shoes, which he wore during his rookie season with the Chicago Bulls in 1984, sold for $1.47 million — a new record price for sneakers at auction.


"The end of a boss," titles Colombian daily El Espectador, reporting on the arrest of drug lord Dairo Antonio Usuga, known as Otoniel, who had led Colombia's largest criminal gang and had been on the U.S. Drug Enforcement Agency's most wanted list for years. He was captured in a raid and will be extradited to the U.S.



A Georgia man is being prosecuted for wire fraud after spending most of his business's COVID relief loan to buy one Pokémon trading card for $57,789.


How Thailand's "Lèse-Majesté" law is used to stifle all protest

Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.

👑 Thailand's Criminal Code "Lèse-Majesté" Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family. But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.

🚨 The recent report "Second Wave: The Return of Lèse-Majesté in Thailand," documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations." The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.

💻 The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Thai student activist Juthatip Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them. Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind.

➡️


"Children are going to die. People are going to starve."

— The United Nations warns that Afghanistan verges on a "total breakdown" as millions of Afghans, including children, could die of starvation unless urgent action is taken by the international community. The agency calls for the release of frozen assets to avoid economic and social collapse, despite concerns over the Taliban government. A recent report said that about 97% of Afghanistan's population may sink below the poverty line, and World Food Programme (WFP) Executive Director David Beasley warned that more than half of Afghanistan's population of 39 million were facing acute food insecurity and "marching to starvation" in comparison to 14 million two months ago.


Dutch cities have been secretly probing mosques since 2013

At least ten Dutch towns and cities have secretly used a private agency to probe mosques and other local religious organizations, Amsterdam-based daily het NRC reports in an exclusive investigation.

The clandestine operation — funded by NCTV, the National Security Services, the Netherlands' leading counter-terrorism agency — was prompted by the social unrest and uncertainty following multiple terror attacks in 2013, and a rise in Islamic radicalization.

The NCTV, which advises and financially supports municipalities in countering radicalization, put the municipalities in touch with Nuance by Training and Advice (Nuance door Trainingen en Advies, NTA), a private research agency based in Deventer, Netherlands. Among the institutions targeted by the investigations, which came at a cost of circa 500,000 euros, were the Al Mouahidin mosque in the central Dutch town of Ede, and the Nasser mosque east of the city of Utrecht, according to NRC.

Unlike public officials, the private agency can enter the mosques to clandestinely research the situation. In this case, the agents observed activity, talked to visitors, administrators, and religious leaders, and investigated what they do and say on social media.

All findings then wound up in a secret report which includes personal details about what the administrators and teachers studied, who their relatives are, with whom they argued, and how often they had contact with authorities in foreign countries, like Morocco.

It is unclear whether the practice is legal, which is why several members of the Dutch Parliament are now demanding clarification from the outgoing Minister of Justice and Security, Ferd Grapperhaus, who is said to be involved.

"The ease with which the government violates (fundamental) rights when it comes to Islam or Muslims is shocking," Stephan van Baarle, member of the leftist party DENK, told De Volkskrant, another Dutch newspaper.

Leaders of the Muslim organizations that were secretly probed say they feel betrayed. Hassan Saidi, director of one of the mosques investigated, said that the relationship with the local municipality had been good. "This puts a huge dent in the trust I'd had in the municipality," he told the Dutch public broadcaster NOS.

✍️ Newsletter by Anne-Sophie Goninet, Jane Herbelin and Bertrand Hauger

Are you more Chicago Bulls or running of the bulls? Let us know what the news looks like from your corner of the world!!

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