He said that most of the medicine in Egypt is provided in private clinics that operate in the late afternoons and evenings. However, because of curfews, most of the private clinics were closed. "I get all the time calls from the patients [asking] 'when are you going to your clinic? When can we see you?'" Shaalan said. "I say 'don't come to the clinic, I'll meet you at the hospital to change dressings.' Women I operated upon last week need someone to pull out the drains. They need to see somebody."
The risk of encountering street violence was enough for Shaalan's mother-in-law, a kidney failure patient, to travel to a seaside resort for every-other-day dialysis, he said. "She goes for renal dialysis 100 meters away from the Tahrir Square in the Cairo Kidney Center. She went to another city on the Red Sea 500 kilometers away to have dialysis to not have to go through these crowds."
Shaalan also sent his wife and young sons, ages 6 and 8, to the Red Sea on Tuesday. "The kids were scared in seeing … hearing all these shots. They watch on TV what's happening. The criminals were out of the prison. It wasn't even safe in one's own house," he said. "They feel better now."
All nuclear medicine scans were cancelled because the necessary radioactive isotopes were stuck at the airport, said Allam. The isotopes normally are transported, with an accompanying police car, to Egypt's atomic agency, "where they look at them, clear them and take them to the hospital. This process cannot be done because there are no police."
However, there hasn't yet been any indication that heart attack patients are staying away from hospitals, he said. Five Cairo hospitals and a sixth in Alexandria that are collaborating on a cardiac study were reporting no decline in heart attacks being treated this week.
But he said, given medical findings that "during times of mental stress, the number of myocardial infarctions do increase," the cardiologists will have to wait for updated reports to see if there was any difference between heart attack incidence "at the time of this big crisis" and calmer times. Allam said it was possible that the curfew might be making it difficult for patients in distress to come to the hospital, because most Egyptian cardiac patients arrive by car, with only 5 percent transported through the emergency system.
As traditional ways of delivering and getting access to care became more problematic, creative doctors found new ways to serve patients in need.
"Most of my patients call me for medical advice because with the curfew it is not possible to see them in person and they feel more comfortable (the parents) to do this in the mornings so that if they need any medications they can find it easily," said Dr. Yasmin Galal, a pediatrician who practices in several different Cairo areas. With the resumption of Internet service two days ago, Galal and friends in several medical specialties created a Facebook page with their specialties and phone numbers "so that if anyone during curfew is in need they can call us."