Exodus of talent: Is violence driving ME doctors to emigrate?

By Tarak Guizani

WASHINGTON: In central Egypt last summer, a man attacked a doctor and hospital workers with a knife. In a hospital near the Suez canal, the husband of a pregnant woman tried to beat her gynaecologist because the couple disagreed with the potential date of birth.

In southern Tunisia, patients threw a chair at a young emergency ward doctor and forced her to lock herself into her office until the police came. She had only told the patient to report to the outpatient’s department rather than emergency.

In Iraq, it is traditional for families and supporters to accompany a patient into hospital. Doctors regularly report threats and violence from these groups if the patient doesn’t improve.

A 2021 survey of doctors at Baghdad hospitals found that 87% of them had experienced verbal or physical violence at work during the past six months. Almost all of it — 94% — was by patients or their families.

These are just a few of the worrying stories about violence told by health care providers in the region.

Surveys of health care workers in countries across the Middle East found that anywhere between 67% and 80% of doctors and nurses reported experiencing physical or verbal violence while at work.

Surveys also confirm that younger doctors, usually those under 40 years of age, bear the brunt of this kind of workplace harassment.

Over the past three years, the coronavirus pandemic has worsened this .

According to a 2022 survey published by the International Council of Nurses, there was “a higher frequency of [violent] incidents after the coronavirus pandemic started.”

In the Middle East and surrounding nations, medical authorities say the pandemic has been a tipping point, one that is leading to increased emigration of doctors.

For example, the Egyptian Medical Syndicate, or EMS, which represents thousands of doctors, recently concluded that the number of physicians resigning from the country’s public sector in 2022 was the highest in seven years.

Last year, 4,261 doctors left their posts and applied for certificates that would allow them to work outside of the country.

The Turkish Medical Association, or TMA, reported that in 2021, 1,405 local doctors asked for certificates that would allow them to apply for jobs abroad.

“Are you aware of the fact that we are losing our physicians who have to live with violence every day and cannot find rewards for their labor?” the president of the TMA, Sebnem Korur Fincanci, wrote on social media.

He predicted those numbers would continue to rise. In Tunisia, labor unions reported that around 2,700 doctors had left the country in 2022, up from 800 in 2018.

Surveys of young Tunisian doctors have found that almost 40% were considering leaving.

In 2021, the World Health Organization estimated that nearly 40% of Lebanon’s doctors had emigrated, and this year Lebanese medical associations reported that almost one-third of the remaining doctors plan to leave.

Similar reports regularly come out of Iraq, Morocco, Jordan, Iran and Kuwait. However, it is not just the violence or threat of violence that’s causing this exodus.

Though the definition of violence and aggression in the workplace differs for each study, scientific surveys from around the world suggest that attacks on doctors and nurses are common everywhere.

Many young doctors from the Middle East want to work in Europe or in wealthier Gulf countries. But there’s violence there too.

The more doctors emigrate, the worse conditions become in public hospitals, Yahya Diwer, an Egyptian doctor and spokesperson for the EMS based in Cairo, told DW.

That means more potential for violence, but also for misinformation and damage to the reputation of local doctors, which in turn leads to more violence.