Essayed Lotfy, a frail-looking 46-year-old baker from Cairo, faces difficult choices if he’s to continue making a living in his city which has been besieged by the new coronavirus for the past few weeks. “I’m worried if I stay home, we’ll run out of money and food. But when I go out, I’m always terrified I’ll pass [the virus] on to my eight-year old who has type 1 diabetes,” he says as he sorts his fresh bread at his stall in a mostly-deserted street.
As of 13 April, Egypt had 2,065 confirmed cases of Covid-19, the respiratory illness caused by the new coronavirus. The death toll had reached 159—one of the highest among African countries. The illness is likely to push Egypt’s healthcare and economy to breaking point. One-third of the country’s 100 million inhabitants live on less than US$1.30 a day, and the country’s healthcare system does not serve them well.
But in the wake of the virus another epidemic looms: Egyptians like Lofty are coming under unprecedented mental strain, with little to no support to alleviate their anxiety.
It’s this secondary epidemic that Egyptian entrepreneur and environmentalist Shady Khalil wants to address with Khadraa, a non-profit initiative aimed at taking some of the strain off Egypt’s health system. Khadraa is a Facebook-based platform where ordinary Egyptians can access medical professionals from all disciplines that can advise them on how to protect themselves and their families, and what to do if they feel unwell. That way, people who don’t need to go to overcrowded hospitals won’t have to, says Khalil. “Khadraa is trying to stop what’s happening in Italy, Spain and the United Kingdom from happening here,” he says.
The initiative is a joint effort between Egyptian medical professionals and environmental experts like Khalil. “Before Covid-19 we saw a connection between public health and the environment,” he says. “We instantly thought of setting up an online portal enabling individuals with health concerns to reach out to us.” He says doctors will be able to advise on whether or not somebody is likely to be ill with Covid-19, and whether to stay at home in isolation or seek immediate medical attention if there are underlying health conditions.
Khalil says there are already 150 doctors on board, and that the portal is currently filtering through 1,500 more applications from healthcare professionals who want to join. These range from emergency room doctors to epidemiologists and paediatricians. As a result, the team behind Khadraa will also be able to advise individuals on health conditions other than Covid-19, which can help limit movement and therefore the spread of the virus.
Civil society initiatives like Khadraa are needed more now than ever before to cushion the impact of Covid-19 on the fragile health system, says Mohamed Eltantawy, a frontline emergency doctor and assistant lecturer of neurology at Egypt’s Delta University for Science and Technology. He says the country’s health ministry has begun evacuating hospital wards in preparation for a flood of Covid-19 patients. “Some hospitals like Mansoura University Hospital are allocating an entire building for quarantine and gathering donations for additional intensive care beds,” he says.
Khadraa will work as a symptom tracker identifying suspected hotspots in the country. It will help hospitals plan how to distribute their resources based on the need arising from their communities, says Mohamed Shalaby, another co-founder of Khadraa and executive director of the Magrabi Foundation, a non-profit organisation that provides eyecare in the Arab world. “We’re currently working on a disaster planning and crisis management scheme to help hospitals, according to their situation on the ground, to maximize [their] efficiency,” he says.
Shalaby says the platform will also provide psychiatric and psychological help for those who need it—with a focus on individuals who get paid daily and who, if they don’t work, don’t eat. Khadraa will draw on existing mental health services such as Shezlong, an Egyptian online therapy clinic and the first of its kind in the Middle East, which is now offering a number of sessions free to people in need.