The MENA region countries, notably the republics amongst them, have undergone upheaval of vital importance lately. The latest but not least would be the military dominating civilian life and society in Egypt. This country being at the forefront of all the republics in all domain of governance could be an indicator of the trend for the other governments. Algeria and Sudan come literally on the brink of following, such as their own military dominating the country’s civilian and societal life.
Amgad Hamdiin his 20 May 2019 article elaborates thus on the Egyptian Institute for Studies.
It is no longer a secret that the military dominates civilian life and society as a whole in Egypt. The present cabinet with all its civil ministries is no longer the only civilian front for the military rule. In fact, the military has tightened its grip on all aspects of civil life through employing military officers, both retired or in office.
On 22 December 2018, Hala Zayed, the current Minister of Health, announced that directors of 48 model hospitals (29 of which belong to the Ministry of Health and 19 to the Ministry of Higher Education) will be chosen from among the military. This decision violates all legal and constitutional values of ensuring that all citizens have equal opportunities when applying for a job based on objective evaluation criteria, not due to belonging to any State body or party, whether civilian or military. This move comes after founding the Faculty of Military Medicine, a critical development in the course of military dominance over the civilian sphere, and within the framework of seeking to tighten control over service sectors that are directly related to citizens, such as the health sector.
Militarization of leading positions in the Ministry of Health
As the Egyptian government that came after the military coup sought to exclude all components of the civil society, the phenomenon of controlling the vital sectors in the Ministry of Health, including the security, finance and administrative sectors, in addition to dozens of jobs in the middle administration at the level of director-general, which is difficult to monitor because of lack of transparency in the announcement of mechanisms of military personnel appointment in those positions.
The prevalence of the presence of the military in various sectors of the Ministry of Health contributed to increasing anger among employees, in light of the huge salaries that those military commanders receive added to the huge salaries they receive from the army starting from 15 thousand pounds to officers with the rank of Colonel and up to 25 thousand pounds for officers with the rank of Maj. General, which increases the psychological burden on civil servants in those sectors, whose salary may not exceed 1500 pounds per month.
A- The military in the Ministry of Health
Among the most important military figures that were appointed in leading positions at the Ministry of Health after the July 2013 coup:
1- Major General Mohamed Fathallah, an anesthesiologist in the Armed Forces, was appointed to the position of spokesman for the Ministry of Health, from 29 July 2013 to 25 November 2013, and was then promoted to the Head of the Health Minister’s Office.
Fathallah only made one statement on the number of deaths during the dispersal of the Rabaa and Nahda sit-ins as well as subsequent events all over the country, during his tenure as an official spokesman of the Ministry of Health. On 15 August 2013, one day after the massacre, the Egyptian Ministry of Health officially announced that the incidents left 578 dead and 4201 injured all over the country, including 288 deaths in Rabaa only.
Meanwhile, the Anti-Coup Alliance, known as the National Alliance Supporting Legitimacy, announced that the number of victims after the dispersal of anti-coup sit-ins reached 2,600 in Rabaa Adawiya alone; and some Brotherhood leaders, such as Mohamed El-Beltagy and Essam El-Erian, said 3000 protesters were killed by the army and security forces on 14 August, while the number jumped to 4000 or 5000, including those viewed as “coup victims” in general. However, the Human Rights Watch said the death toll reached one thousand.
Commenting on this:
– The Ministry of Health was supposed to issue several consecutive statements on the situation following the initial statement. However, only three statements were issued between 14 and 17 August.
– The total number of victims announced by Major General Mohammad Fathallah, the official spokesman of the Ministry of Health, (578 people), after only one day of the Rabaa sit-in dispersal cannot be accurate due to the state of liquidity and severe disintegration of the State institutions at the time.
– No subsequent data were issued to indicate the status of the injured and the hospitals to which they were transferred, and whether there were subsequent deaths among the injured.
– The Ministry of Health did not play its role in preserving the rights of the dead and injured through issuance of official death certificates showing the real causes of death or injury, which could support the legal position of the families of those affected in the course of criminal prosecution of army and police forces involved in killing demonstrators.
– So far, the Ministry of Health has not released any new data or statistics regarding the massacre of dispersal of Rabaa and Nahda sit-ins, especially causes of death.
– The Ministry of Health did not respond to the complaints raised by the Egyptian or international press about discrepancies in statements about the numbers of victims and remained silent.
The appointment of a military doctor in this position as spokesman of the Ministry of Health, at this specific stage, begs a question about the accuracy and transparency of information regarding the incident, where the victims were civilians and the convicts were army and police forces, amid silence of the official spokesman of the ministry.
2- The position of assistant to the Minister of Health for Financial and Administrative Affairs was mostly occupied by the military except for the period from January to October 2015, where the current Minister of Finance, Mohamed Maeit, held the post: Major General Ahmed Farag took over from 2006 until the January Revolution (2011), then Major General Ashraf Khairi, and after that Dr. Maeit as we mentioned earlier, and finally Major General Sayed Al Shahid, who has been in this position until today.
3- The Central Department of Administrative Affairs: Dr. Ahmed Emad Eddin, former Minister of Health in March 2017 appointed Major General Ahmed Baligh Al Hadidi as Head of the Health Ministry’s Central Department of Administrative Affairs. The Administrative Affairs Sector is responsible for all types of maintenance within the ministry office including plumbing, carpentry, electricity, as well as sending and receiving the office correspondence.
4- General Security Department: Dr. Ahmed Emad Eddin, the former Minister of Health, appointed Major General Ahmed Zaghloul as Assistant to the Minister of Health for Political Communication and Security Affairs, replacing Major General Ahmad Said, former Director of the Ministry of Health’s Security Department. Also, the former minister of health appointed Major General Hisham Abdel Raouf as assistant to the minister for basic care.
As we have seen, the military control all sectors of the Ministry of Health as well as the overall policy-making within the Ministry and the Ministry’s resources, logistics, personnel files, communication systems, facilities and services, in addition to the operating system and internal regulations.
B- Management of model hospitals
The decision of Hala Zayed, the current Minister of Health, to appoint the directors of the model hospitals (48) from among those who have a military background is the most dangerous decision in the context of development of the course of military dominance on the health sector in Egypt, for the following reasons:
– The decision is the first of its kind that restricts applying for a civil position to the military.
– The decision allows the military to systematically invade the Ministry of Health’s middle administration, as directors of hospitals, which enables them to control the joints of the health sector as a whole, not only the top administration and policy-making, but also extends to the executive.
– The decision represents a qualitative leap in the path of imposing military hegemony on society, through the appointment of soldiers in service or retired in civil service sites where there is direct interaction with citizens on a daily basis.
– The appointment of the military as directors of government-owned hospitals, this time not as military doctors, but as professional soldiers assigned to work in administrative not technical positions. Therefore, the decision represents a quantitative and qualitative transformation in this regard.
– The decision will increase the drop-out and emigration of doctors due to deprivation of the possibility of promotion and holding administrative positions in the ministry.
– This military move is an encroachment on the civil rights and social structure of the Egyptian working environment. It is also a negative indicator of the tendency towards a full militarization of society.
– The aim of such decision is to appease the military, who were fired from their positions in the armed forces, especially after the coup of 2013.
The World Happiness Report 2018 is the annual report published by the U.N. Sustainable Development Solutions Network and as a relatively new survey of the state of happiness in the world of 2018, gives an idea of the state of the world’s countries per the resulting ranking of 156 countries by their happiness levels, and 117 countries by the happiness of their immigrants. This ranking graph would perhaps be the most sought-after outcome of such an endeavour.
Where is Happiness in 2018 ?
In few words, this year’s report zeroed in, in addition to its usual “ranking of the levels and changes in happiness around the world, on migration within and between countries”.
The MENA region amongst other regions of the world was assessed in its own right and the resulting ranking is below :
·United Arab Emirates 20th
·Saudi Arabia 33rd
·Palestinian territories 104
Apart from some countries that unexpected ranked high such as Algeria and way down such as Lebanon, Egypt and Tunisia, most ranking in our view tend to reflect quite diligently wat is going on the respective countries ground. The reasons obvious for some countries are not exactly as clear as one would think as off one’s deep knowledge of the region. It remains in any way that generally the proposed ranking would be in correlation with the movement of populations or migration as labelled in the report as literally the resulting effect of all those socio-political and economical mutations that each country is going through in its own specific way.
The report dwelling on migration found that people’s tolerance as a predominant character trait towards newcomers could be that whilst the least accepting countries were amongst those of Europe, four were from the MENA region and are Israel, Egypt, Iraq and Jordan. Those most accepting are of course those of the GCC, whose settled populations are overwhelmingly foreign born.
The report goes on to wonder “What determines the happiness of immigrants living in different countries and coming from different, other countries?
Three striking facts emerge.
In the typical country, immigrants are about as happy as people born locally.
The happiness of each migrant depends not only on the happiness of locals but also on the level of happiness in the migrant’s country of origin.
The happiness of immigrants also depends importantly on how accepting the locals are towards immigrants.
In conclusion, there are large gaps in happiness between countries, and these will continue to create major pressures to migrate. Some of those who migrate between countries will benefit and others will lose. In general, those who move to happier countries than their own will gain in happiness, while those who move to unhappier countries will tend to lose. Those left behind will not on average lose, although once again there will be gainers and losers. Immigration will continue to pose both opportunities and costs for those who move, for those who remain behind, and for natives of the immigrant- receiving countries.
Where immigrants are welcome and where they integrate well, immigration works best. A more tolerant attitude in the host country will prove best for migrants and for the original residents. But there are clearly limits to the annual flows which can be accommodated without damage to the social fabric that provides the very basis of the country’s attraction to immigrants. One obvious solution, which has no upper limit, is to raise the happiness of people in the sending countries – perhaps by the traditional means of foreign aid and better access to rich-country markets, but more importantly by helping them to grow their own levels of trust, and institutions of the sort that make possible better lives in the happier countries.
Preventing risk behaviours among young people is key to curbing the Non Communicable Disease epidemic in the MENA, according to a new set of Population Reference Bureau(PRB) publications. NCDs are the leading cause of death globally, and they account for 74 percent of all deaths in MENA. These deaths occur at the peak of individuals’ economic productivity, imposing a significant burden on families and health systems, as well as challenging economic growth and sustainable development.
Per Wikipedia, the Population Reference Bureau is a private, non-profit organization that was founded in 1929. The organization specializes in collecting and supplying statistics necessary for research and/or academic purposes. It informs people around the world about population, health, and the environment, and empowers them to use that information to advance the well-being of current and future generations.
This article by Toshiko Kaneda, senior research associate in International Programs at PRB and Sameh El-Saharty, program leader for human development in the Department of the Gulf Cooperation Council Countries at the World Bank is about the MENA would not be clearer than it portends. The often-desperate situation of most parts of the region tend to make us overlook the real facts that there are such things as these noncommunicable disease epidemic like elsewhere in the developing world.
(December 2017) Preventing risk behaviours among young people is key to curbing the noncommunicable disease (NCD) epidemic in the Middle East and North Africa (MENA), according to a new set of PRB publications.
NCDs are the leading cause of death globally, and they account for 74 percent of all deaths in MENA. The likelihood of dying prematurely from four main NCDs in MENA is 19 percent, compared to 12 percent in higher-income countries globally. These deaths occur at the peak of individuals’ economic productivity, imposing a significant burden on families and health systems, as well as challenging economic growth and sustainable development.
The four principal NCDs threatening MENA are cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases. They share four behavioural risk factors:
• Tobacco use.
• Physical inactivity.
• Poor diet.
• Harmful use of alcohol.
These modifiable risk behaviours often begin in adolescence and young adulthood. Since young people ages 10 to 24 account for an average of one in four people in MENA, it is crucial to address the risk behaviours of this young cohort to change the trajectory of NCDs in the region.
This package of publications, supported by the AstraZeneca Young Health Programme (YHP), includes a policy report and data sheet that highlight the importance of taking action now to address NCD risk factors among young people in MENA. The report describes the scale and scope of NCDs and their risk factors in MENA; provides examples of promising policy and programmatic interventions for young people; and highlights the need for data collection and rigorous monitoring and evaluation of policies and programs to identify the most effective and sustainable interventions for MENA countries. The data sheet includes the latest available data on the four risk factors among young people for 19 countries and territories across the MENA region.
• Policy Report.
• Data Sheet.
Capitalising on its technological expertise in the field of E-health and Diabetes, Africa Diabetes retailing Medtronic insulin pump in Morocco started a well publicised marketing operation; it is about an insulin pump and a wide range of innovative accompanying solutions for all health professionals in Morocco.
Innovation: Africa Diabetes, a company specializing in innovative supply to diabetes, starts marketing off the catalogue of the American leader Medtronic insulin pump.
Goal: To allow Insulin-dependent diabetics to monitor 24/7 their blood sugar and be able to protect themselves from the hypos.
In practice, two ranges of pumps are available in Morocco. It’s the last pump generation “MiniMed 640 G” and the pump “MiniMed Paradigm Veo”. The offer covers, in addition to the supply of these two insulin pumps, an accompaniment of potential pump holders in consumables to monitor on the day to day their blood sugar (catheters, quick-set infusion set, silhouette infusion set, safe-T infusion set, tanks of insulin and Enlite Sensor).
The deployment of this innovative technology by Africa Diabetes, which requires a closer follow-up of a patient by a health care professional, including endocrinologists, relies on the expertise of two strategic partners, in this case, Eramedic and teams of Medtronic in the Middle East and North Africa region.
At the same time, Africa Diabetes makes available to the type 1 diabetics, children and adults, sensitive to pain of injections of insulin or who suffer from anxiety related to injections, the I-port Advance technology. It is a solution to use with a syringe or an insulin Pen for several injections a day without repeated bites, for a maximum of three days (72 hours).
In another line, Africa Diabetes makes accessible, the “IPro2” solution from Medtronic for the measurement of glucose for professional use by ecosystem health (endocrinologists, diabetologists, clinical, and University Hospitals).
In addition to the advanced offer on the insulin pump supply, Africa Diabetes has, through its platform e-Commerce www.africa-diabetes.com of a catalogue of 100 products that cover the daily needs of type 1 and 2 diabetes such as test strips to measure blood sugar and urinary, needles, injection, insulated kits pens, books, diabetic foot, nutrition… Patients can order and pay online through the interbank electronic payment Center (IJC) platform.
In terms of logistics, Africa Diabetes delivers its products through Morocco using Aramex services that allow users to track their orders online.
Danielle Roberts, a friend recommended to link her website work on how Technology Is Improving Your Health to this MENA-Forum site. We decided after review of the positive healthwellness to publish some excerpts of an article with compliments to its authors. It is all about how technology is affecting healthcare generally and wellness in particular. State of the Art technology is no doubt changing our life for the better in the developed countries but appears however to encounter some difficulty in penetrating and committing to the good welfare of the MENA countries peoples. The reasons would be multiple and varied from one corner to the other of the region.
We propose these excerpts of this article below in the hope to spread its words further out in the MENA region and beyond.
We hear all the time about how technology is bad for us. Since the introduction of computers, we spend more time sitting at a desk than moving around at work. We have created this sedentary lifestyle that is causing havoc in our overall life.
What if I were to tell you that technology has produced benefits? Would you believe me if I said that technology is good for your health?
Most of you wouldn’t look at first. Well, you may be able to think of a couple of ways that the computer has helped, but you are still stuck on all the negatives that ‘experts’ have shared in the past. The problem with the ‘experts’ is that they are only focused on the negatives. They haven’t looked at so many of the benefits.
So, that’s what we’ll do today. We’ll consider all the ways that technology improves our health. We’ll discuss just how it has boosted results in certain areas of healthcare and what it does for us daily.
Technology Is Everywhere in Medicine
Before we do move onto all the benefits, it’s worth discussing just how technology is used. It is found everywhere in medicine. Think about the x-ray machines, MRI scanners, and even the research equipment used daily. [ . . . ]
It Pushes Us to Do More Activity
Sure, technology has led to us sitting more. And sitting is the new smoking when it comes to health problems. However, technology has also helped to push us to do more activity.
We just must take the examples of the Fitbit, pedometers, and apps that track our steps. They all encourage us to meet our daily targets—setting personal targets to get us to walk more and meet the goals that we know are realistic to us. While there is the goal to walk at least 10,000 steps a day, that just doesn’t seem realistic for many. The pedometers and smartphone apps give us more control. [ . . . ]
Better Ability for Communication Between Doctors and Patients
With technology being widely available, there are chances that everyone has some sort of access to doctor and health websites. These sites can create chat boxes and instant messengers, where real doctors and nurses can monitor communications. When a patient comes on with a question, the doctors and nurses can provide factual answers and share their thoughts and advice. [ . . . ]
More Ability to Do Research into Problems
Medical students and professor using laptop at the university
The internet has certainly opened the ability to research. We all tend to turn to Google, calling it Dr. Google at times. The search engine allows you to input your symptoms or ask questions about a certain symptom to find out all the ailments that involve them/it. People can look through a list of other symptoms to determine the chances of suffering from certain ailments. [ . . . ]
There Are Devices That Keep the Body Working as It Should
Man after heart surgery in a hospital ward
Some devices are created purposely to help promote a healthy body. They are placed inside or outside to help keep the body working as it should. There are also other types of treatments that cause reactions in the body to support organs and the overall health.
The pacemaker is just one that will come to mind for everyone. This is a device created for those who have heart problems. The pacemaker helps to send electrical currents into the heart to prevent it from suffering from spasms. This little device is a lifesaver for so many people. It keeps the heart pumping as it should, which will support the rest of the body. [ . . . ]
Better Treatment Options for Various Ailments and Diseases
equipment and medical devices in modern operating room
It’s no secret that treatments have advanced in recent years to the point where some ailments are virtually unheard of. Vaccinations and various medical advances have completely eradicated the likes of smallpox and led to the point where polio is now less common and far more treatable.
Some of the advances have only come in the last few years, and are all due to technology. We’re able to do more research and test without the use of animals and humans. There are ways to create vaccinations and treatments without putting people at risk, increasing the chance of a better quality of life. Just look at how HIV treatments have changed since the disease was noted in the early 1980s. It is now at a point where the virus doesn’t have the chance to develop into AIDS. [ . . . ]
Improved Prediction of Diagnosis and Life Expectancy
Ever wondered if you could get a disease later in life? Maybe you wonder if a current symptom is a sign that you could develop a condition. You could even wonder just how long you have left to live when you are diagnosed with a condition.
Technology has helped to improve the prediction process of a diagnosis. Doctors will have information all in one place and can see all the symptoms at the same time. They have formulas to work out averages of when a condition occurs.
You get this type of risk assessment, and doctors will be able to predict if you are more likely to suffer from a certaintype of disease or ailment. [ . . . ]
Faster and More Accurate Diagnosis of Conditions
While the prediction side of diagnosis is improved, technology also improves the accuracy of a diagnosis. Like before, doctors gather all the information in one place and will be able to keep an eye on results more closely. They can also put together symptoms and signs sooner than before, meaning an earlier diagnosis for many people. [ . . . ]
Technology Improves Recording of Information in Real Time
Many of the benefits mentioned above rely on an accurate and timely recording of information. There is no denying that recording of symptoms between doctors has led to issues of conditions not being diagnosed and the right treatment not being administered.
Before computers, doctors would write all the information on charts. They would document it through paperwork, and that paperwork would need to be sent to various doctors. If you changed family doctor, there was a chance of the information going missing. If you went to see a different doctor in between visits, such as at the hospital or a locum, you ran the risk of the information not being sent to your regular doctor. [ . . . ]
There Are Two Sides to Technology
Technology has helped to improve the health. It will continue to do this as there are more advancements made.
There is no denying that technology can be bad. We are at a point where we sit more because we don’t have the need to go outside anymore. Socializing is possible online, and recreation is often spent watching TV shows and movies. ‘Experts’ tend to focus on all these negatives of technology, without really focusing on the ways that technology is helping us. [ . . . ]
For all the lovely things in Britain, for me and most others the best thing about Britain is our National Health Service. You don’t pay to see a doctor or use a hospital for things you need. It has often been called the Envy of the World and rightly so. It might be one of the greatest advances in social justice ever seen and has remained unmatched since its inception in 1948.
The health of the general population has been crucial to those in power at many key points in British history. No-one, of course, escaped the effects of the Black Death which killed up to a third of our population. Many whole communities were destroyed. But the whole ancient feudal system entered a terminal decline that allowed people to become untethered to their overlords, free to sell their labour to the highest bidder.
For most of our history, treatment, such as it was, was administered (freely) by religious communities and these provide the roots of many of our oldest established hospitals. Most people, in history, however, were cared for at home using traditional medicines. And therein lies some of the reason for the late growth of comprehensive free healthcare, and that is, until recently, most illnesses were pretty much untreatable and accepted as part of life. However, things changed rapidly from the eighteenth century onwards. When Edward Jenner created a vaccine to cure Smallpox, it was freely promoted in order to stop the spread of this deadly disease. Vaccines for Smallpox have been so effective that the disease itself was declared eradicated in 1979.
Crossness Pumping Station of London’s Sewer System
Through the Victorian era there were various Public Health Acts, including the 1848 establishment of (still working) sewers that stemmed the spread typhus and cholera. The government also came to glance into the most personal aspects of citizen’s lives. In the 1800 it was estimated that as many military personnel were lost to venereal disease as in battle and in the Victorian era there was a real fear, for the same reason, that there were not enough healthy sailors to man the fleet if it needed to sail into battle. In 1864, the Contagious Diseases Act allowed women to be snatched off the street, examined and hospitalized if they were suspected of carrying VD.
The general health of the population continued to be worry to governments during the First World War. Many potential recruits had be turned away because of ill-health often stemming from the effects of poverty and neglect. During this time, the cogs slowly rolled towards the establishment of our National Health Service. A National Insurance Scheme was established in 1911 and access to medical help improved. In 1943, at the height of the Second World War, the Beveridge report proposed the `Cradle to Grave’ welfare system that has improved the life of every person in the country, directly or indirectly.
Great Ormond Str Hospital Junior Doctors demonstration