Egyptian Doctors’ Strike and the Quest for Bread, Freedom, and Social Justice

A small yet significant meeting takes place directly across the street from the Cairo central union office for healthcare professionals. It is a meeting of the strikers’ central committee for the Doctors Syndicate, in which the General Secretary Amr Bakr personally describes the divisions within the syndicate as an “extreme clash,”[1] between the Muslim Brotherhood-led leadership currently against the strike and a non-Brotherhood faction that is organizing the strike.

Unlike other syndicates, every physician votes to elect their syndicate leaders directly. In 2011, running against Muslim Brotherhood supported candidates, Amr Bakr and his colleagues gained about fifty percent of the syndicate seats nationwide, with thirty percent in Cairo alone. More than ten governorates across Egypt are run by this parallel non-Brotherhood syndicate.[2] This is no meager feat considering the history of syndicate elections in Egypt. Professional syndicates across Egypt have traditionally been dominated by the Muslim Brotherhood. During the early years of his reign, former President Hosni Mubarak allowed some degree of freedom in the syndicate elections and the Muslim Brotherhood took full advantage of this space in the 1980s, especially since regime-imposed restrictions were more prevalent in the political arena.

When the Mubarak regime finally caught on to the threat this trend posed to its survival, it began an era of restricted syndicate freedoms and greater political marginalization. By 1993, Law 100 allowed the regime to effectively end balanced elections by imposing a quorum system whereby a thirty percent participatory threshold was a required necessity for the syndicate leadership. The problem with reaching a mandatory thirty percent lies in syndicate voter apathy. Turnout for syndicate elections are low due to a sense of electoral stagnation based on voter’s perception of what was seen as choice between either a Brotherhood dominated syndicate or a state run union that nothing more than political window-dressing. If less than thirty percent of eligible voters turned out, control of the syndicate would pass to a panel of judges. In effect, this government tactic wrestled syndicate control away from the Muslim Brotherhood because syndicate voter turnout had been consistently low throughout the previous decades, thereby using the Law 100 to constrain the opposition from further syndicate gains.[3]

Now twenty years on, with Mubarak out of the picture, the professional syndicates elections are opening up to greater transparency, leading to the emergence of contesting voices and conflicting opinions. The doctors’ strike has risen to become one of the most bitter confrontations between public sector workers and the Muslim Brotherhood-affiliated president, Mohamed Morsi. Strikes have sky rocketed under Morsi’s presidency. Doctors, teachers, bus drivers and university professors have taken to the streets to voice their frustration with low wages and intolerable working conditions. Consequently, Egyptians have witnessed continuing street protests and widespread disruption to public services over the past few months.

The wave of strikes is indicative of an impatient society with high expectations for a swift transformation in the collective bargaining process following the revolution in January 2011. Better salaries and improved working conditions top the list of demands of most of the protests across the public sector. Doctors in particular have been vitriolic in voicing their demands. Other strikes have faltered, such as those of the public transportation drivers and school teachers, which have temporarily ceased after negotiations with government ministers. At the same time, the doctors’ dispute has continued to escalate. The length of this strike comes second only to the famous fifty day doctors’ strike in the aftermath of the 1952 Free Officers-led coup. Now in its sixth week, the strike shows no sign of abating and has been receiving increasing levels of public support where improved healthcare ensures emotive responses from most Egyptians. Additionally, the decision by the striking doctors to provide free check ups in the early days of the strike, along with a concerted approach to ring-fence emergency services so as not to endanger serious incidents in accident and emergency departments, has given the doctors the advantage in public opinion.[4]

Nearly half of the Doctors Syndicate’s chapters in twenty-seven governorates across Egypt are under the control of a leadership not affiliated with the Muslim Brotherhood. This leadership has been “accused” by Brotherhood members of being affiliated with some of the most prominent leftist groups in Egypt, such as the Revolutionary Socialists and the Socialist Alliance. Indeed, in an interview with Abdallah Khattab, a chief economic advisor for the Freedom and Justice Party, elaborated that the doctors were politicalized by socialists and others who are using the syndicates against Morsi in a planned campaign to force his resignation.[5]

What began as a strike for demands to increase the health budget from 4.5 percent to fifteen percent of the total state budget has become a hostile breeding ground for anti-Muslim Brotherhood dissent from a cross section of Egyptian society. The strike’s general committee indicated that Brotherhood representatives inside the syndicate do not support the strike because the doctors are demanding a total overhaul of the health system, including the introduction a general practitioner referral system, better training for paramedics and an independent labor court to administer industrial disputes. These are noteworthy issues because they extend beyond mere doctors’ grievances to deeper demands for nationwide labor rights, budget transparency and public service improvements.

Amr al-Shoura, a member of the strike’s general committee and of Doctors Without Rights movement pointed out that a signed document showing the support for the strike extended to parties from the left, center, right and Islamist sphere; including the Mohamed ElBaradei-backed Al-Dostour, the Salafist Al- Nour, and Abdel Moneim Aboul Feottouh’s Strong Egypt Party. What makes this significant is that in an atmosphere of severe partisan political maneuvering in the post-Mubarak period, Egyptians are once again uniting on issues revolving around social and economic rights. Except this time, their opposition is directed against a Brotherhood-controlled government instead of Mubarak’s now-defunct National Democratic Party. This trend perhaps underscores the emergence of a new line of discourse in Egyptian politics—one that is not shaped by Islamist-secularist spats; but rather instead focuses on the question of the most suitable economic model for a post-revolutionary Egypt that is struggling to cope with a socio-economic crisis.

The doctors’ strike may only represent one sectional interest in the public sector, but its importance lies in its exposure of ongoing conflicts over Egypt’s economic orientation. It is a microcosm of the broader economic grievances that resonate across Egyptian society. It highlights the continuing divisions that are entrenched between those who persist in perpetuating the status quo through the maintenance of the Egyptian neoliberal order that the regime of Hosni Mubarak promoted and those that stood against it during and before the eighteen-day uprising.

It is no coincidence that the turning point during the eighteen-day uprising took place not among the diverse coalition of demonstrators in Cairo, but rather in the peripheral areas where large groups of workers emboldened by the uprising began to revolt. Only days before Hosni Mubarak stepped down, the revolution appeared to be on the precipice of failure as fierce battles broke out between the police and protestors in Tahrir on 28 January 2011, commonly known as “Friday of Rage.” Following what was possibly the bloodiest day during the revolution, workers across Egypt began to express their support for the demands of the revolutionaries; with special emphasis on the demands for better wages and job security. Starting with six thousand Suez Canal workers going on strike on 8 February, they were later joined by textile and steel workers. Petroleum workers held protests the following day. The mood for a national strike soon began to spread, drawing in the big cities, smaller towns and workers from the transport sector, health industry and the civil service. This was the tipping point for the demise of Mubarak, who finally stepped down on 11 February 2011.

Since the creation of the Egyptian Trade Union Federation (ETUF) by Gamal Abdel Nasser in 1957, the Egyptian labor force has been prevented from attempts to organize collective action by developing independent workers’ organizations. With the entrenchment of the International Monetary Fund (IMF) package in the 1990s, the labor force began to coordinate a number of strikes in resistance to the hardships they faced as a result of the state-sponsored economic liberalization policies. The largest of these strikes took place in the northern town of al-Mahalla al-Kobra, which is home to the largest public sector textile company in Egypt. In early 2006, Mahalla workers went on strike following Prime Minister Ahmad Nazif’s decision to nullify the promised increase in annual bonuses, which was a supplement for the low wages of the workers.

Between 2006 and 2008, al-Mahalla workers staged mass strikes with over fifteen thousand workers protesting low wages and rising food prices. What had started as a workers’ strike soon spread beyond Mahalla. In 2008, a group of young Egyptian activists, called the April 6th Movement launched a Facebook page in support of the al-Mahalla strike. It was the beginning of a new wave of protest movements in Egypt, namely one that fused together the call for social justice and political change. It was the fusing of these two demands that set the stage for the 2011 eighteen-day uprising.

The doctors’ strike is significant in that it continues to fuse these two demands. It signals, moreover, that influential political players such as the liberal Al-Dostour Party and Islamist-leaning parties such Al-Wasat and Strong Egypt can in fact transcend identity politics and unite on socio-economic issues. Since the 2011 eighteen-day uprising, the transition away from Mubarak’s authoritarian rule has been stalled by political gridlock. The legislature remains inactive after it was dissolved last June, and disagreements between Islamist and secular political forces over the new constitution are deepening; all while the economy has yet to improve. However, for the doctors sitting in the hospital gardens in Sayyeda Zeinab the fight for greater equality and social justice continues. Their hopes and aspirations resonate with an Egyptian populace still struggling to improve their daily lives. As Amr al Shoura reflects on the situation: “They [the Muslim Brotherhood] think we are the opposition. Our main principle is to improve conditions for doctors and patients. We are a movement from across the political spectrum. It is a strong movement. There is solidarity from across Egyptian society, social movements, NGOs, political parties, new unions. They all support us.” It seems the Egyptian revolution’s quest for social justice continues.

[1] All quotes are taken from a series of recorded interviews with the Committee for the Doctor’s General Strike, which took place on 24 October 2012. All interviewees have signed consent forms to agree to the use of the interviews.

[2] All statistical sources on the syndicate elections were provided by the Chairman of the Cairo Doctors Syndicate, Amr Bakr. Sources from the Brotherhood led syndicate were unavailable, nor does the Government data website CAPMAS provide sources on syndicate elections.

[3] Bruce K. Rutherford , Egypt after Mubarak: Liberalism, Islam, and Democracy in the Arab World (2008: Princeton University Press), p. 93

[4] This information was provided by a recorded interview with Dr. Mona Mina, leader of the doctors’ strike committee, which took place on 24 October 2012. All interviewees have signed consent forms to agree to the use of the interviews.

[5] All quotes are taken from a recorded interview with Freedom and Justice Party Chief Economic advisor, Abdallah Khattab, which took place on 11 October 2012. All interviewees have signed consent forms to agree to the use of the interviews.

Article originally published on Jadaliyya.