A report issued by the Egyptian Medical Syndicate has revealed that 11,586 Egyptian doctors resigned from their positions in government hospitals during the past three years in what it described as an “unprecedented brain drain.”
The London-based Al-Sharq Al-Awsat newspaper also reported recently a comment by Egyptian MP Hazem El-Gendy which revealed that half of Egypt’s doctors – 110,000 out of more than 212,000 — had fled the country during the same period.
“During the recent period, especially the last three years, Egypt has witnessed an unprecedented migration wave of medical personnel, which has triggered successive warnings, fears of the effects of this migration on the Egyptian health system and the level of services provided to patients,” he explained.
These are alarming statistics in a country where there are just 8.6 doctors for every 10,000 Egyptians. The global average is 23 doctors for every 10,000 people.
Credible recent studies, including one issued in 2019 by the World Bank in cooperation with LinkedIn, found that Egyptian professionals in fields such as scientific research, programming, artificial intelligence and information technology have been leaving the country.
According to El-Gendy, “The reasons for the emigration of the doctors are low wages, the search for better opportunities for scientific research and the current lack of legal protection and work safety.”
These are not the only reasons, though. To know what they are, and to get an idea when this crisis might end, we have to go back a decade to see what happened in Egypt.
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Following the 25 January Revolution in 2011, the people of Egypt were on the brink of a new political, social and economic reality that might have seen their country ranked alongside the most powerful states. The revolution ousted the late President Hosni Mubarak, whose lengthy dictatorship was an extension of previous autocratic regimes that had ruled Egypt since the 1952 revolution. This replaced the royal family which had reigned for more than a century, including the period of British occupation.
Prior to 2011, the socialist or secular dictators ruled the Muslim-majority country with the Social Contract: a promise to satisfy citizens’ basic needs in exchange for their obedience. However, none of the regimes fulfilled their side of the bargain and Egypt remained among the worst countries according to global economic, social, health, governance, corruption and freedom indices.
With Mubarak gone, the people of Egypt expected to see a new era of political diversity that would lead them to real freedom from external domination over the state’s politics, resources and foreign policy. They elected their president and parliament in free elections, but President Mohamed Morsi was overthrown in a 2013 coup led by the then Defence Minister, and now President, Abdel Fattah Al-Sisi.
Al-Sisi cracked down violently on the opposition, mainly Morsi’s Muslim Brotherhood, killing thousands and sending tens of thousands to prison. “After the 2013 coup, the [Brotherhood] was dissolved, and all parties that had been critical of the new regime were gradually silenced or brought under the regime’s control,” said BTI Transformation Index in its Egypt Country Report 2022. “In consequence, the 2020 elections were contested almost solely by pro-regime parties.”
The return to a de facto one-party state and the fierce crackdown on the Islamist movement and its Freedom and Justice Party — which, according to BTI Transformation Index, was “the most professional and socially rooted party” — saw mismanagement, nepotism and corruption spread across the country. Egypt’s talented professionals and graduates started to know that they did not have a place at home, and so started to look for opportunities abroad.
In 2019, Egypt was ranked 116th out of 189 countries in the Human Development Index (HDI). The World Bank classifies Egypt as a lower-middle income country. In 2017, the bank indicated that 28.7 per cent of the population was living on less than $3.20 per day; by 2020, that figure had risen to 29.7 per cent of the population living below the poverty line.
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The current Egyptian regime “has made insufficient use of human, financial and organisational resources,” explained BTI Transformation Index. “[It is] favouring loyalty over competences.” The regime is also using “public sector employment to counter unemployment and buy loyalty.” This is leading to dramatic inflation in the state apparatus, which consists of some seven million employees, or 25 per cent of Egypt’s total work force. “This results in redundancies and underemployment, and ultimately in low efficiency both in providing public services and completing regulatory procedures.” As such, the regime has been facing low productivity that leads to a higher budget deficit, low income and poverty.
Sisi’s government has found no way to avoid the austerity measures introduced under the framework of the 2016 International Monetary Fund loan that put additional pressure on low-income population segments in particular, and pushed the regime to reduce spending on education, health and other sectors.
“In addition to these reasons, the lack of justice and feeling of safety in the country are among the main reasons for the brain drain,” said former Egyptian MP Ahmed Tantawi last week. “If there has been a dispute between a professional and someone from the ruling regime, will he have a just resolution for this dispute? If my son expressed his opinion freely on social media, is there a guarantee that he will remain safe?”
In Egypt, the regime is only working to secure its own survival. Hence, it is concentrating on reinforcing its power and empowering its supporters at the expense of basic freedoms, creativity, innovation, quality of education and work opportunities. The Sisi regime is the enemy of science, technology and knowledge. As long as this is the situation in the country, the brain drain will continue. Real change from the top down is required before it will end.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.