Public health is a central topic of development work in the Middle East with great local and regional significance. As state resources for health protection and care are limited the state often relies on international support to realise public health aims. In addition, prevention, health education and promotion often touch fundamental ethical ideas, especially justice and autonomy, and also lead to debates in religious contexts. Against this background, KAAD supports students from medical and health science disciplines such as International Health and Public Health. Numerous KAAD alumnae and alumni conduct research in the medical and bioethical field or work in it, for example in the management of health and nutrition programmes. In Cairo, they work in health facilities or are active in poor neighbourhoods for people who have little access to health services. “The input that KAAD alumni provide to society as change agents is overwhelming,” says Bishop Losinger.
This year’s International Academy, which we organised together with the German Academic Exchange Service (DAAD) in Cairo and in which 29 participants from six countries (Egypt, Jordan, Lebanon, the Palestinian Territories, Yemen and Germany) took part, dealt with questions of public health and its ethical foundations from an interreligious perspective.
At the opening of the International Academy, Lorena Mohr, Head of the Science and Protocol Department of the German Embassy in Cairo, emphasised the special value of the work of scholarship institutions such as the KAAD or the DAAD and highlighted the particular importance of transnational cooperation in scientific exchange in general and in the field of public health in particular. Personal encounters and cooperation are particularly important in these times. KAAD Secretary General Dr Nora Kalbarczyk also emphasised this aspect in her welcoming address – after all, the exchange leads to a better understanding of the respective host country as well as to cross-border friendships and networks.
In his opening address, KAAD President Fr Dr Hans Langendörfer SJ underlined the need for “fundamental reflection on what people need in the various phases of life and what our religions have to say about the basic questions of life, the beginning of life, the end of life and illness and health in general,” because “in many cases they strongly influence what we believe in and what we stand for, which is why ethical considerations are important.”
In his lecture “Ethical approaches in the public health from a German and European perspective", Prof Dr Walter Bruchhausen (Institute for Hygiene and Public Health at Bonn University Hospital and member of KAAD’s Academic Board) gave an overview of the German health insurance system and presented ethical problems such as the overuse or underuse of private or national health insurance, the increasing number of uninsured people and considerations about the inclusion of patients’ unhealthy lifestyles in the health insurance system.
Dr Fekri Dureab (WHO Regional Office for the Eastern Mediterranean, Department of Noncommunicable Diseases and Mental Health, Cairo) addressed the perspective of Egypt and the Middle East. In his presentation, he showed that challenges such as political instability, conflicts and excessive population growth in the region lead to chronic and mental illnesses. He illustrated the differences between rich and poor countries in the region and the resulting consequences using examples from the field of healthcare in Saudi Arabia, the United Arab Emirates and Qatar, where the local population has free access to healthcare services and where enormous medical progress has been made in recent years, for example in the field of cancer research. As a counterexample, he cited Yemen, where the healthcare system functions inadequately or not at all due to armed conflicts and necessary medical equipment is missing or cannot be used because, for example, spare parts are missing. The consequences are outbreaks of disease such as cholera, malnutrition or a lack of obstetric care and paediatric treatment options. Fekri Dureab also addressed the differences in care for locals, migrants and refugees in Saudi Arabia, the imbalance in care for rural and urban populations in Iran and the two-tiered healthcare system in Jordan.
Bishop Dr Dr Anton Losinger (Augsburg), Episcopal Representative for KAAD, spoke about Christian commitment in the public healthcare system. He emphasised that the Church “has always stood up for justice and equality in practice and in ethical discourse” and that “the Church’s great commitment to healthcare” is demonstrated by the fact that “its institutions are open to all people and treat all people equally.” He addressed the comprehensive protection of human life, which is central to the Church and also relates to embryo research and abortions. For the Church, and therefore also for Christians, the protection of life means that those in need, the weak and the sick are helped unconditionally. Bishop Losinger also referred to dying as an “inevitable part of human existence,” the rejection of euthanasia and the critical debate on organ donation and emphasised that Christian representatives in the healthcare sector are represented with their expertise and ethical convictions in many institutions throughout society, for example in ethics councils, hospital ethics committees, state and local commissions.
Dr Yasmin Shafei (Center for Economic, Legal and Social Studies and Documentation, Cairo) focused her presentation on Muslim perspectives on public health in Egypt. She began by looking at the history of nursing and healthcare in Egypt and described the change from holistic care in the Middle Ages to the modern era (mid-19th century), in which no distinction was made between the poor and the rich in treatment in the traditional hospital (‘bimaristan’). Help for the destitute sick went so far as to provide them with money when they were discharged from hospital and unable to work, in order to give them rest and time for a good convalescence. The hospitals were located in the centre of the city, making them easily accessible and a lively part of the city. During the period of renewal, the royal government introduced European-style healthcare. One consequence, for example, was that hospitals were built on the outskirts of the city. With colonialism and the English protectorate, the concept of European hospitals was continued: An example of the removal of hospitals and the sick from urban life is the treatment of the mentally ill, who were locked away and incarcerated in appropriate institutions.
The participants then discussed the content of the presentations with the speakers in four workshops and enriched the final discussion with personal views on the topic of public health.
Zum Programm der Auslandsakademie
