Egypt Unrest Casualties Mount; No Official Death Toll Yet

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As emergency and critical care services were continuing apace, patients in many cities were facing significant obstacles to surgery, scheduled appointments, diagnostic tests and services such as kidney dialysis. Although major public hospitals were faring well, curfews impeded many health professionals' ability to get to other hospitals, clinics and medical offices, and their patients' abilities to see them. Public transportation was shut down and many gas stations were out of gas, further thwarting the mobility of patients and doctors. Several doctors conveyed their own and their patients' increasing wariness about encountering armed thugs in the sometimes lawless streets.

Medical Care Disrupted

"Medical care has been disrupted to a big extent," said Dr. Adel Allam, an internationally renowned cardiologist whose private practice is closed, but who continued seeing patients at Al Azhar University in Cairo. "Because of the curfew and the situation, the private places, like private radiology centers, they are not getting the usual flow of patients, and most of them are closed."

With Egypt's banks closed, many patients couldn't come up with the out-of-pocket cash payments typically made for medical appointments. Egyptians can get only emergency services when they cannot pay.

To accommodate the influx of newly injured and wounded patients, Cairo University Hospitals reorganized the delivery of medical services, which included closing an outpatient service and converting it to an emergency service, Fattah said.

"We evacuated most of the stable patients from the main hospital when we started to receive many wounded patients after Jan. 25th," Fattah said. Doctors doubled emergency room capacity by preparing 200 beds, and doubled the number of senior staff on call to make sure they had experienced doctors available 24 hours a day. "You can see a lot of professors in surgery," Fattah said.

Emergency and critical care services fared better than other types of medical services in the capital city. For example, operating rooms at the National Cancer Institute hospital closed for a week, partly because nurses, doctors and technicians had difficulty commuting through the chaos. Curfews made it even harder to get to and from work, said Dr. Mohamed Shaalan, a professor of surgical oncology at the National Cancer Institute at Cairo University Hospital.

"Today was the first day I operated on a cancer patient after a week of not being able to operate," he said in a telephone interview Thursday. However, in a sign of how flexible some health professionals have been in recent days, Shaalan said that as a favor to friends, he went to a small private hospital to surgically remove a bullet from the scalp of their 23-year-old son, a young demonstrator who had been struck in the head while fleeing security forces in Cairo.

Shaalan, a breast cancer specialist, said he had to close the offices of the Breast Cancer Foundation, which he chairs, because of proximity to Tahrir Square. As a result, many women couldn't get the mammograms or breast prostheses the foundation provides free. Most diagnostic centers and pathology labs were closed, forcing his cancer patients to wait for important imaging tests. A patient with cancer of the head and neck was supposed to have a PET scan earlier this week, but the test was postponed until Sunday because the facility didn't have required materials.

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