Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.

Training Egyptian Surgeons for Service in Rural Settings

Jayson Casper


By Jayson Casper

April 4, 2014 

A version of this article was first published by and is used with kind permission. 

A new collaboration – in an old mission hospital – will train Egyptian surgeons to serve in rural settings. Sixty percent of Egyptian doctors work abroad, but this unique collaboration aims to fight this trend.

Incredibly perhaps, Egyptian Christian Dr. Hanna Sherif is relocating from an élite life in Toronto, Canada to the small village of Menouf in the Nile Delta for the next five years, in defiance of a US State Department warning of “risks of travel.” An acclaimed liver surgeon and academic, Sherif is returning to his country of birth after a forty-three year absence to run a new in-country surgical training program that could help make rural provision the envy of North Africa.

The Harpur Memorial Hospital began life as a floating clinic on the Nile in the early 1900s, founded by Irishman Dr. Frank Harpur. Offered land by a local sheikh, Harpur set up a tent hospital in Menouf, seventy-five miles northwest of Cairo. Now owned by the Anglican Diocese of Egypt, it is one of a handful of mission hospitals still functioning along the Nile.

The hospital has won high praise from Egyptian Muslim leaders, including the former Grand Mufti, Ali Gomaa, who said after an eye campaign:  “I was touched by the joy of the patients.”

His endorsement, together with that of the Archbishop of Canterbury Justin Welby, graces the hospital brochure. 

Now Harpur is set to offer Egypt surgeons a state-of-the-art, on-the-spot surgical training program so sister hospitals can provide similar services in other less populated regions. “There is no shortage of surgeons in Egypt,” said Hanna's colleague Dr. David Thompson. “There is a shortage of fully trained surgeons willing to work outside of the biggest cities.”

That’s because the best opportunities are available in urban settings with large university hospitals. Smaller hospitals, some say, cannot offer a comparable scope of training. Dr. Safwat Salem, vice-president of the Egyptian Society of Surgeons and a professor of surgery at Cairo University is skeptical, maintaining that “Medicine needs institutional training and cumulative experience to provide a decent level of training.” He fears that at a smaller hospital like Harpur, the surgeons’ case load would not be enough to offer training in all surgical procedures.

“Students would be better served if brought to established hospitals in the West, and then obliged to return,” he added. 

But they don’t return, according to pioneer surgeon Dr. David Thompson who founded the Pan-African Academy of Christian Surgeons (PAACS) in 1996 to tackle the problem.

Based on almost three decades of African experience, Thompson, the man behind the Harpur development, says that non-returnees are - incredibly - more than ninety percent of those who go abroad.

There are now PAACS surgical training centers in twelve hospitals from Ethiopia to Gabon which have graduated thirty-six surgeons through an accreditation partnership with Loma Linda University in the United States. Six surgeons will eventually join the program at Harpur. PAACS hopes the five-year training program Thompson and Hanna administer will be fully Egyptian within ten years, offering training to the highest international standards.

Last year, throughout the political unrest, and despite having just seventy-five inpatient beds, the hospital treated 120,000 outpatients, ninety-nine percent of whom were Muslim. Its staff, a mix of Muslims and Christians, have doubled its services since 2009.

Thompson acknowledges Salem’s critique but standard PAACS procedure offers extensive collaboration with other affiliated hospitals and Western specialists. Harpur’s resident trainees will benefit from ten to fifteen visiting surgeons each year, and will spend six months of their program in large hospitals in Kenya, Cameroon, and South Africa. In exchange, the residents will work at least one year in the handful of PAACS-accredited Christian hospitals in Egypt for every year they are financially supported.

Rural hospitals, including old mission hospitals, are often not well equipped and generally pay low salaries and as such, they fail to attract well-trained surgeons. In addition, according to Dr Amr al-Shoury, a leading figure in the ongoing partial doctors’ strike in Egypt, the government system pays abysmally poor wages to medical professionals, driving sixty percent of doctors abroad.

Local leaders give Harpur Memorial Hospital the thumbs up. A brochure produced by the Anglican Diocese contains a special endorsement by an imam of a Menouf mosque, Sheikh Raafat Mohammed. Mohammed says: “The first time I came to Harpur Memorial Hospital, I was admitted as an emergency patient. I was amazed by the treatment I received at this Christian hospital.”

Thompson believes that maintaining the standards of care for the poor under these circumstances in the least attractive districts requires a special commitment. “Christian hospitals will go out of business if they cannot hire well-trained specialists that are committed to their values,” said Thompson. “Ours is to honor and glorify Christ in his command to care for the sick.”

-  Jayson Casper is a freelance journalist based in Cairo. He writes extensively on political, social, and religious life in Egypt for a number of publications. Follow his blog at 

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Capital Commentary is a weekly current-affairs publication of the Center for Public Justice. Published since 1996, it is written to encourage the pursuit of justice. Commentaries do not necessarily represent an official position of the Center for Public Justice but are intended to help advance discussion. Articles, with attribution, may be republished according to our publishing guidelines.”