23 -29 May 2002
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The doctor is in
Unstoppable, unflappable, he seems always one step ahead
Profile by Fatemah Farag
His name is a household word when it comes to assisted fertility in Egypt though it takes quite a bit of finding among the dusty plaques that adorn the front of one of those otherwise anonymous Bab Al-Louq buildings. Indeed, we were spotted by the bawwab long before identifying the nameplate, much to Sherif's, Al-Ahram Weekly's photographer's, discomfort. Just one knowing glance and "He's on the first floor."
"We should go back and tell him we're journalists," insisted Sherif. "And why did you make an appointment at his downtown office in any case?"
But where could I have made an appointment that would have been less incriminating? At Abul-Ghar's four-storey Egyptian Invitro Fertilisation Clinic in Maadi?
Not that Mohamed Abul-Ghar's name is restricted to his various medical practices. It appears on almost every Palestine-solidarity campaign e-mail flashing up on your computer screen, is attached to one of the most scathing critiques on university education yet written. From current news to photography and poetry, he has opinions on them all. A striking figure, tall, thin, with a strong grip and a way of leaning in towards you when he shakes your hand, he exudes charm as well as the unmistakable body language of a man who is driven.
Of course there are his two clinics, the slick one in Mohandiseen and the more popular one in Bab Al-Louq, both overflowing with patients. There are appointments at the Mohandiseen hospital, there is the Egyptian IVF clinic, the country's first specialised unit for assisted fertility and, arguably, its most successful. He teaches at Cairo University, globe trots from convention to conference, and still finds the time to publish his research findings.
"If you divide your time efficiently then everything can be done," he says, a little nonchalantly, perhaps, but then given all the evidence he has every right to that.
And yet he is a contemplative man. Looking back on his life it is the details that are foregrounded. His first school -- "housed in a beautiful palace that used to be the premises of the High School for Commerce in the 19th century": his high school -- "a private school for the sons of pashas that was terrible, many of the children were spoiled and wrote essays denouncing Land Reform laws while coming to school in chauffeur-driven Cadillacs."
The beginnings were simple enough: Abul-Ghar was born on 2 July, 1940 in the village of Shibeen Al-Kom in the governorate of Menoufia. At the time his father was head of the Agricultural Bank in Minya.
"The place of birth was an accident," he says. "My mother had originally planned to be in Cairo but at the time the Germans and the Italians seemed to be closing in on Egypt and many people who had relatives in the countryside left the cities.
"For the first five years of my life I lived in Minya. And then we moved to Cairo, to a huge flat in Bab Al-Louq -- the building has since been pulled down. Seven rooms, all five by six metres with high ceilings. My father paid LE100 as insurance and LE5 per month. The building, though, was not well- maintained, so in 1957 we moved to Dokki."
It was from the balcony of the Bab Al- Louq apartment, though, that the young Mohamed watched the Cairo fires of 1952; it was in that flat that he would ask his mother for the piastre needed to buy Al-Balagh.
"I don't know how much I understood from the paper at the time," he confesses. But a great deal of effort would subsequently be spent in coming to an understanding of those times, to the extent that he can now speak fluently about the society and economic conditions of the Minya he left at the age of five, and has read copiously about the events that baffled him as a child.
"In the summer of 1952 my family was going to Alexandria for the summer vacation and I picked up a book at the station by Ahmed Bahaeddin on the monarchy. He had written the book in just two weeks and I still have the copy. There was only one other published edition, which appeared years later... "
Bahaeddin's book was an early acquisition; his library now contains some 3,000 titles. And one of his fondest memories as a young man is taking the tram to Dar Al- Kutub and sitting for hours "in the magnificent reading rooms with their large hardwood tables." They were days in which he wrote "lousy" poetry and began work on a novel, only to discover that what he was actually doing was rewriting a novel by Tawfiq Al-Hakim that he had recently finished.
At the age of 16 Abul-Ghar entered university, joining the faculty of medicine. "I had the grades and it would have been a shame to waste them."
After seven years it was time to choose a specialisation. "I thought I would enter dermatology. I wanted to read and write and had many projects in mind and in dermatology doctors have regular hours and no emergency operations. But I had top grades and so could specialise in gynaecology. How could I waste the opportunity?"
Such life decisions based on grades -- it suggests more than a hint of the competitive. Yet in spite of the driving need to excel in all things professional Abul-Ghar never lost sight of his other interests.
"I supported the Nasserite regime wholeheartedly," he says. "In 1956 I had just entered university and immediately volunteered for army training, as did all my colleagues. Then came the arrests of the Communists, and news of torture began to leak out and I was very disappointed. I read a lot and became convinced of the importance of democracy. At the same time I remain convinced that there could be no solution to the problems of a country such as ours except through socialism."
But for all his enthusiasm, support and criticism, Abul-Ghar somehow steered clear of both the establishment and the opposition.
"I always wondered why the [ruling] Arab Socialist Union (ASU) never approached me. I remember in 1966 the ASU held a [cadre education] camp in Helwan and while many clearly right-wing colleagues of mine were invited I was not. Neither was I invited in 1967 or 1969. Perhaps they had heard about my criticisms?"
Not that Abul-Ghar has ever coveted political posts, and it is a matter of some pride that he has never held one. But if not the establishment, then why not the leftist opposition?
"They should have recruited me, but I was missed by a year. When I joined the university in 1956 I was only 16 and by the time I was ready, in 1958, the left was being arrested and nationalism had swept over everything. And when the left was released by Abdel-Nasser they were for the most part co- opted by the regime and I was never a regime-type person. By the time a new generation had emerged, in 1972, I was already teaching, and although I was supportive of the movement I guess, yet again, I just belonged to the wrong generation. And that was the end of that."
If there is one lesson Abul-Ghar has learned well it is that there is a fine line to be drawn between standing up for your beliefs and compromising with the system to make things work. The year 1964 provided a salutary experience: as one of the highest scoring graduates Abul-Ghar was technically exempt from compulsory duty in the rural clinics, but by virtue of some bureaucratic twist he was given a four-month term of duty. He chose the small village of Al-Rimalie, four kilometres off of the Cairo/Alexandria road.
"I could have chosen any village and chose this one because of its easy access. At the time the plan was to build 5,000 such clinics nation-wide. In fact the regime succeeded in building more than 2,000 -- a valuable medical infrastructure. The clinics were very well built, clean, with a room for the doctor which, although it had no electricity, had a gas refrigerator and was well kept. There was a club and a government radio. I felt it was a nice opportunity to try and provide medical service to the farmers."
Whatever his political inclinations, though, Abul-Ghar had no illusions about working for long among the rural poor.
"It is a deadlock for any doctor career-wise. You can never be a good doctor if you are isolated from new research and other doctors. It might work if a system was in place that could keep you in touch and networked, but that is not the case."
His most poignant memory of the village concerned that most basic of all commodities, flour. "In 1964 the Americans decided to send flour to Egypt and it came in sacks with American flags and friendship logos on them. And for some reason the regime decided to send the flour to the clinics and have doctors distribute it as they saw fit. When I received our shipment I had the flour locked up in the clinic and went about trying to draw up a list of people. At first I asked the ASU people to help but when we compiled a list I was told by one of the employees at the clinic that it was made up exclusively of members of the ASU and so we compiled an alternative list. Then the day came to distribute the flour and hundreds of people stood outside the gates waiting. When the ASU people found we were using another list all hell broke loose. In the end I had to lock up the clinic and return to Cairo. They came after me and a deal was reached and I returned and distributed as I saw fit. Of course we also distributed to the ASU people. You have to compromise but within limits."
In 1967 he was appointed an instructor at Cairo University's Medical School, and not long after he obtained his PhD, eventually leaving Egypt for postdoctoral studies. "Never for long though," he explains. "I would no sooner have left than I would start longing for home, for all those things I criticised, the newspapers, all the details of everyday life." (There is a telling statistic: of the 220 doctors who graduated with Abul-Ghar only 80 practise in Egypt today.)
"At first I just wanted to be a very good doctor. But then I realised that was not enough, that there were many others who could also be very good doctors. I realised that I would have to pioneer a new branch of medicine in Egypt which I did in 1984 when I introduced assisted fertility, and that it was important to excel in research on an international level. And so I organised a group of doctors whose work has received international acclaim."
The rewards have been immense. "I make a lot of money but I can never think of myself as a businessman. I add my earnings, not multiply," he says. But what of those long held beliefs, the necessity for socialism "in a country like ours"?
"One person cannot change the system. This requires political parties and interest groups which do not exist. One does what one can but that is not for discussion."
It would be easy to shrug off Abul-Ghar's attitude as cynical. But that would be short- sighted. For all the money that he makes he does not take for granted the conditions of the poor. "I have a patient who works at the Ministry of Agriculture. I was talking to her about her work and she was complaining that she and her colleagues are not paid regularly. She has been working for 10 years and you know how much she makes? LE140. I still believe that in a country which has that kind of poverty socialism, some sort of social justice, is necessary."
In the meantime, though, he is out fighting his own battles, against poverty, corruption, ignorance and a lack of scientific integrity. He shows me a letter he is sending to an official regarding a recent lecture given by the latter. It points out the errors made by this official in his presentation, and argues that precision in such matters is of the utmost importance.
"I write letters all the time. To officials. To the press. Not that much of it gets published." And not that he is daunted by that.
He is also working on his autobiography, and on a book on contemporary Egyptian art "from an amateur's perspective. It is one of my great passions. I have a very good collection at home."
But what of the hundreds of women who are waiting for their turn to see the doctor -- women I now feel guilty towards for having taken so much of their doctor's time. How does he fit them in to his schedule. "You can sit with a patient and talk to her for half and hour and she will be happy, but if she is not followed up properly it is useless. If I sit with her for five to ten minutes, and then the follow-up is handled more efficiently it is better."
But surely women need time to talk of such intimate details of their lives and hopes, and they flock to his office in search of that time.
"They flock," he tells me, "because I am a doctor who has cured many, many patients. And when a patient wants to spend a lot of time talking I ask her bluntly, 'Do you want to have a conversation or have a baby?' Again it is about compromise. You cannot get everything. What if we give every patient all the time she wants but when a new patient tries to get an appointment I can only give it to her after a year? Would that make her happy?"
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