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Alexandria Univ. interns go on strike over Swine flu (Egypt)
http://bikyamasr.com/?p=4816
14 October 2009

ALEXANDRIA: More swine flu panic is in store for Alexandria, as talk about a swine flu death in a school in Assafra spreads like wildfire. No trip on public transportation is free from a conversation about swine flu. Minibus drivers and passengers exchange opinions and rumors about the disease.

Comments like “hospitals are filled with cases” are repeated on trams and buses. Parents are worried about their children, with many sending them to school in masks. Some are hoping to make a quick pound or two and have jumped on the swine flu bandwagon.

For the first time in history, some newspaper stands are now selling masks. During the holy month of Ramadan, street vendors waited outside Kaid Ibrahim mosque after prayers, carrying boxes filled with masks to sell for one Egyptian pound each. In general, an atmosphere of panic is gripping many of the city’s citizens.

Alexandria University decided to offer its idea of a solution to combat the spread, where the fresh graduates of the Faculty of Medicine, currently training as interns in university hospitals, would be transferred to schools all over the governorate of Alexandria to spot warning signs of swine flu among pupils. Alexandria University president, Dr. Hend Hanafi, offered to “donate” the interns to fight the disease. The decision will see the 1000-plus interns relieved of their training at the university hospitals and distributed among schools of varying distance, according to their grades at graduation.

The top 180 graduates will be assigned in rotations of 40 to the Alexandria University dorms, leaving the other 140 to tend to their duties at the hospitals. The remainder will be assigned to other schools, in places as far away as Khorshed or the industrial city of Amreya.

This idea has its detractors. It does not in any way contribute to the fight against swine flu, some argue. The interns undergoing training at the university’s hospitals do not yet have a license to practice medicine and cannot practice anywhere outside these hospitals, a number of medical professionals have stated.

Furthermore, they have not received adequate training to deal with swine flu. Even if they encounter a student with lab tests proving infection with swine flu, all they can do is refer him or her to the Fever Hospital because that’s the only place where the anti-viral drug Tamiflu is (officially) available.

In response to the decision, several interns expressed their frustration online. One intern tried to explain the situation on the al-Youm al-Saba’a.

“I am an intern and I swear to God I don’t know anything about swine flu cases or how to deal with them. The only information we have is a 20-minute seminar we attended and did not understand. We are still under training and not licensed to make any decisions without consulting a resident doctor, so how are we supposed to go to schools in remote areas with no facilities to make medical decisions when there is no supervising doctor within kilometers?”

In addition to providing schools with ill-equipped trainees, the decision is harmful to both interns and hospitals. The Faculty of Medicine senior professors who head the various departments are not supervising night shifts at the hospital, and their duties are limited to teaching the students and supervising the younger staff. The interns are left to do what is affectionately called by doctors the “dirty work,” work that no one wants to do. This includes giving injections, measuring blood pressure and temperatures, setting up patients for ECGs and accompanying them to the radiology department to have the necessary investigations done for them. These duties can be performed by any nurse, but interns who want to learn the necessary basic skills needed by any doctor must endure this “dirty work,” for the sake of the patient and the betterment of his own abilities. With all the interns sitting at schools from 8 AM to 2 PM, university hospitals will be understaffed.

Nada, an intern and in the top 180 of her class, confirms this. “I went once to the university dorms and was just like a government employee. I signed in in the morning and sat down and did nothing until two o’ clock, and decided not to go again. I didn’t learn anything in my six years of college, and this is my only chance to learn and practice and make mistakes, so it’s totally unfair to throw us to far flung places for no reason,” she argued.

“Diagnosis of swine flu is based on lab tests, so what we’re asked to do is measure the temperature of students who appear to be sick, then refer them to labs for the necessary tests. That makes us totally useless, and any nurse’s assistant can measure temperature,” the intern added.

In protest, about 500 interns staged a sit in at the university in an attempt to draw attention to what they see as an unjust decision harming their future. They are on strike until Thursday, in the hope the decision will be reversed.

Not all are sympathetic to the doctors’ plight. An Emergency Room junior resident who asked not to be named said “they are just spoiled. It’s not about learning. No one learns anything in their internship anyway. They’re just objecting because they don’t want to go to schools in far away places. As for the dirty work, the junior residents can do it.”

Apart from reports in local independent press, most media coverage has not been in the doctors’ favor. On Egyptian TV, the doctors are being accused of forfeiting their duty to Egypt, after Egypt provided them with a “free education for six years so they could become doctors.”

Doctors have lashed back, saying this is a blatant distortion of the truth.

“After acquiring the necessary skills in their internship; these doctors will be distributed all over Egypt in ill-equipped health units in the most remote areas where they will be the only medical expert for miles around,” one doctor stated bluntly.

“Not to mention the salaries they get. A doctor working for the government owned Gamal Abdel Nasser hospital, after over 20 years of experience, receives an official salary that is less than 400 pounds.”