A venerable institution brought back to life
Beneath the skin
photo: Randa Shaath
Dr Abdel-Rehim greeted us at the door of his villa in Muqattam with two grandchildren clinging to his legs. The walls of the living room where we hold our interview are covered with paintings by contemporary Egyptian artists, the coffee tables littered with exotic knick-knacks collected from various travels abroad. He is more than happy to detail the circumstances surrounding his acquisition of the artworks displayed as well as his friendships with the artists that produced them.
Abdallah was born in Shebin Al- Kom. His father, a doctor in charge of the health department of Menoufiya province, would regularly take Abdel- Rehim with him on inspection tours of the provincial towns and villages that fell under his jurisdiction. These visits awakened in the young boy a sense of curiosity towards the habits of the people, an interest that has remained with him to this day though it is now most often exercised during trips abroad.
Following his father's retirement the family moved to Cairo, a city that both intimidated him and afforded new pleasures. His school work suffered following the move and for much of his thanawiya 'ama year he was confined to bed by sporadic relapses of typhoid fever. Though his grades were poor he managed to enroll in the Faculty of Medicine largely because he was the son of a doctor. Once enrolled he worked hard to catch up with his fellow students, his efforts reinforced by his anxiety to be accepted as a colleague.
"The climax of my happiness," he says, "was when I joined the faculty Scouts and began to enjoy the camaraderie of my colleagues, enjoy my first glass of beer and first puff of a cigarette."
In the summer of 1963 he met Zeinab during a university outing. The attraction was immediate, and mutual. They decided that they should get married in 1966, by which time Abdel-Rehim would have qualified.
"By 1966 though," he smiles, "we were not only married but had two children."
To meet the additional expenses involved in supporting a family Abdel- Rehim worked in various dispensaries, a strategy that meant that when he finally established his private clinic he was already a well-known figure.
Not content with a teaching job at the university and his private practice, Abdel-Rehim determined to pursue his studies and research abroad. He obtained a scholarship to Germany that specifically stated that the applicant undertake research. This suited him fine.
"I had three papers on tinea pedis ready for publication," he recounts. "My research showed results that contradicted the accepted views, the views we had been taught. I was keen to show the discrepancy. The difficulty was that at the time printed matter from the West was assumed to be gospel. What appeared in text books from the West was accepted without question though my repeated tests had shown that the text books had got it wrong."
Zeinab and the children followed Abdel-Rehim to Germany as soon as he had settled in. Keen that his family be exposed to a different, a new culture, he was happy that they should do so.
His stay in Germany was to prove immensely productive. During a relatively short time he published 11 papers, supervised two PhD theses and regularly assisted Egyptian doctors based in the Gulf with their papers.
"They would send me samples to cultivate and then I would report the results back."
He became a regular at conferences, meeting large numbers of people from different nationalities and backgrounds, meetings which, he believes, "greatly benefited me scientifically and socially".
"They gave me a clear insight into the state of affairs of Egypt vis-a-vis the West and at the same time opened my eyes to new directions in my professional career."
He was offered a lucrative job in Germany with the promise of an early professorship. Yet though he found his work there very rewarding, enjoying the ambiance generated by the scientific community and profiting from access to a large scientific library, invitations to conferences and the absence of masses of red tape involved in acquiring so much as a pipette, he remained hesitant about accepting. He consulted Professor Hamdy El-Sayed who, without a moment's hesitation, asked whether the promise of success abroad justified staying away from your homeland. "Remember, we have studied at the expence of the working people and we have a duty to repay them that debt," he told Abdel-Rehim.
"They were beautiful words," he recalls, "though psychologically and financially it remained a hard decision. Yet I have never regretted returning to Egypt."
Those who had returned home before him loaded with qualifications earned abroad had faced a hard time. Circumstances were against them. The economy was failing, educational standards were in decline, professional ethics were slipping, and fissures were appearing across the social fabric. Yet they were persistent in their efforts to raise professional standards.
A great many achieved eminence in their specialisations. But Abdel-Rehim believes they "felt frustrated with their inability to radically change what is obviously and blatantly in need of improvement".
"I firmly believe that these people are the ones deserving our respect, not the ones who fled abroad and succeeded because of the supportive systems within which they worked. When these people returned, they did so, essentially, as foreign experts. Had our scientists been working in similar situations, under similar conditions, I can guarantee that Egypt would have produced a great many more Nobel prize nominees. Such is the price they paid for their love of Egypt."
Upon his return from Germany Abdel- Rehim embarked on a new project to raise standards within the department of dermatology at Ain Shams University. Improving the system of examinations would, he believed, be the key to effecting the necessary improvements and so he approached his superiors with his suggestions and samples of the new examinations which had already been run past WHO experts and an eminent specialist from Glasgow University. They accepted -- testimony, one can assume, to Abdel-Rehim's tact -- and the result was a marked rise in the standard of the dermatology department.
In 1986 Abdel-Rehim travelled to Khartoum for a month on a WHO mission to assist in the curriculum development of Khartoum university. He is also a facilitator in the Medical Education Programme, travelling all over the country presenting cases for study. He has also participated with the National Aids Programme, delivering numerous lectures.
"I was often asked whether kissing transmits the disease," he remembers. And so he stressed the need to use condoms as a precaution against HIV, urging the young to keep a condom in their wallets at all times, advice that led to accusations from some groups that he was advocating adultery.
At the age of 60 and no longer head of the department but professor emeritus, Abdel-Rehim began to devote most of his teaching time to Hod Al-Marsood Hospital (HMM). The history of the district within which the hospital is situated, and from which it takes its name, dates back to the 13th century. The hod, a sarcophagus of black granite, was used as a trough for horses and was popularly believed to conceal a treasure protected by an afreet, genie. The tub was plundered by the French and, on its way to Paris, was seized by the British. It is now housed in a museum in London, though the area has retained its name.
HMM was originally a garrison, later turned into an arsenal, then a depot, then officially a hospital for women which in reality treated professional prostitutes. As most venereal diseases have skin manifestations, by the early 1900s the hospital had specialised in dermatological treatments. It now sees some 1,500 patients daily, with the number increasing to approximately 2,000 in the hot summer season. Among such large numbers of patients rare diseases are sometimes diagnosed.
"We once," he tells me, "presented a case at an international conference that was only the eighth ever recorded."
At the hospital Abdel-Rehim works closely with a team of 40 young doctors, all of whom share his enthusiasm and dedication to an institution determined to reassert its former pre-eminence. Before his arrival the standard of work at the once venerable institution had been in steady decline despite the potential of an eager young staff. Abdel-Rehim encouraged them to use computers as an integral part of the diagnostic process and taught them how to proceed with their investigations until they reached the correct diagnosis.
"It is not a shame to show that one does not know something and ask for a biopsy," he stresses. "That is far, far better than to give a wrong diagnosis."
He reinstated clinical meetings, allowing junior as well as senior staff to present their cases, alongside regular monthly conferences, measures that resulted in a marked improvement in the institution's overall performance. The young staff have now secured a reputation throughout the region and have been invited to participate in conferences in Dubai and Bahrain.
"The presentation of these doctors and the information contained therein was, I was told, outstanding," Abel-Rehim recalls.
Attending conferences and delivering papers has taken him around the globe. His first taste of international recognition came when he was invited to head a session at the Global Conference for Dermatology. That was followed by conferences in European capitals, China, Pakistan, Arab countries and Australia. In Sydney he delivered a paper at the International Conference of Dermatology on skin diseases in the Arab world, arguing against the use of expensive, patented medicines and their replacement by equally effective and much cheaper generic substitutes.
He has written three books on dermatology, two for medical students, one of which is an illustrated atlas, and a third for the layman. in which he explains in simple terms the causes and cures of skin diseases. The impulse behind the latter was, he admits, partly an attempt to refute erroneous claims made by cosmetic companies. He also contributed to the chapter "Foreign Body Reactions" contained in the latest, and most comprehensive reference book on skin diseases published in the US.
He has been awarded many prizes, including a German citation singling out his combining of laboratory with clinical mycology. "Which reminds me," he says, as we run through the list of honours. "I was chosen as a member of the Music, Ballet and Opera Committee at the Supreme Council of Culture because of my appreciation of Arabic and western classical music as well as folklore".
Abdel-Rehim's hobbies, outside of work, include gardening -- apart from cultivating his own garden with fruit trees he has planted a small copse in front of his home -- and cooking, especially on Fridays and holidays when his children and grandchildren come to visit.