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Geriatric medicine in Egypt as a speciality was introduced in 1982, and in 1984 a Geriatrics and Gerontology unit in Ain Shams University Faculty of Medicine was established ^[1].

Many Ancient Arabic Physicians were interested in the field of geriatrics and some of them wrote separate books on this subject and shared in the development of the field of geriatrics. Abu Ali Ibn-Sina Avicenna's The Canon of MedicineAl-Canon scanned photos (1025) was the first book to offer instruction for the care of the aged, foreshadowing modern gerontology and geriatrics. In a chapter entitled "Regimen of Old Age", Avicenna was concerned with how "old folk need plenty of sleep", how their bodies should be anointed with oil, and recommended exercises such as walking or horse-riding. Thesis III of the Canon discussed the diet suitable for old people, and dedicated several sections to elderly patients who become constipated.^[2][3][4] Also the famous Physician Ibn Al-Jazzar (Algizar) Al-Qayrawani (circa 898-980) wrote a special book on the medicine and health of elderly (Kitab Tibb Al Machayikh)^[5] or (Teb Al-Mashaikh wa hefz sehatahom)^[6]. Also a book on sleep disorders and another one on forgetfulness and how to strengthen memory (Kitab Al Nissian wa Toroq Taqwiati Adhakira)^[7][8] and a Treatise on causes of mortality (Rissala Fi Asbab Al Wafah)^[5]. Another Arabic physician in the 9th century by Ishaq ibn Hunayn (died in 910) wrote a Treatise on Drugs for Forgetfulness (Risalah al-Shafiyah fi adwiyat al-nisyan)^[9]

Contents 1 Current situation 2 Geriatrics governmental services 3 Geriatric education 4 Geriatrics societies 5 Conferences and workshops 6 Private based geriatrics services 7 Psychogeriatrics 8 Books on geriatric medicine 9 See also 10 References 11 External links

[edit] Current situation

Covering the cost of healthcare is another major challenge for seniors. Currently, 62 percent of elderly men have health insurance compared to 35 percent of elderly women. However, medical care for the elderly, in the absence of a comprehensive health insurance plan, is extremely expensive. Few hospitals have wings just for the elderly, two percent of whom have a permanent disability (that’s 81,000 people). There are only 52 physical therapy centers in Egypt serving 1,258 of those over 60.^[10]

Geriatric teaching programs were available in Egypt ^[11]

[edit] Geriatrics governmental services

• The Ain Shams University Geriatric medicine department started as an outpatient clinic in 1984 then a clinical Unit in 1990^[12] then (Coordinates: 30°4'26"N 31°16'33"E) became an academic department in 1996^[13][14][15] having its own inpatient department(23 beds), outpatient clinic, follow-up clinic and residents and issuing academic degrees (M.Sc., M.D)in geriatric medicine. In 2002 the department established a 12 beds Geriatric Intensive care unit (GICU). The department has partnership with United nation's International institute of aging INIA in Malta ^[16] to carry-out short-term training programmes in Cairo specifically designed for personnel from the Arab World working in the field of Ageing. The two organisations have also agreed to collaborate in identifying, setting up and implementing projects in the field of Ageing both in the Mediterranean region and in the Arab World^[16].

The clinical unit has around 20-25 acute assessment bed which accept patients form the out-patient departments. Patient usually admitted for comprehensive geriatric assessment CGA. Followed by discharge plan should be implemented in the community. The unit has interdisciplinary team which work in the assessment stage as well as in the implementing the care plan. The unit has the availability of free medications as well as free medical investigation. This clinical unit could be considered as a very good unit for CGA and management of acute illness for older people. The unit is only one of 2 clinical unit in the whole country in which the clinical service is run by qualified geriatricians. In 2002 the Geriatrics Intensive care unit or high dependency unit was opened in the clinical unit. This unit has 8 beds and is offering a clinical service for the seriously ill elderly patients. This unit offers subsidized service as regard medications and investigation. However, poor patient could get a free service through the ministry of health paying a contribution for treatment. This service is run by qualified geriatricians. Also the department the osteoporosis unit This unit offers a diagnostic and a therapeutic service for older patient with generalized bone ache or a suspected diagnosis of the condition.^[17]

• The International Medical center at Cairo-Ismaïlia road has a 12 bed geriatric medicine department (Inpatient admission and Day-care service), Geriatrics outpatient clinic in collaboration with Physical Medicine department since October 2008.
• Ministry of Health and Population: In 2002, The number of hospital beds in Egypt was around 141,000, of which about 93,000 beds (66%) were affiliated to the Ministry of Health and Population. The total number of beds for elder people was 3856. The health services were distributed all over the country. In each governorate (province), there are the three levels of health care, primary, secondary and tertiary; but the geriatric specialty is presented mostly in Cairo, and a few big cities. The ministry of health and population started from 2001 to develop health programs targeting older people within its structure.^[18]

In 2002, The number of specialized physicians was about 38,000 including just only 70 specialists in geriatric medicine. The number of consultants in geriatric medicine was around 12 and are mainly based in the capital of Egypt. As regarding health insurance there are 352 units which are mainly clinics (202), beneficiaries are 7.5 millions in which pensioners and widows 1.8 millions. Despite such high percentage of older people there is no geriatric specialist or consultant with the health insurance agency.^[19]

• Alexandria University Faculty of medicine contain a geriatrics department and started a biweekly geriatrics outpatient clinic beside the elder health section of the family health department of the high institute of public health of the university ^[20].^[21]

• Mansoura University is establishing its own department and has started a weekly geriatrics outpatient clinic^[22].^[23]

• Helwan University has also established a center for elderly care in 1996^[24] The center of elderly care has been established in 1996. This center is a self-financed unit under the umbrella of the center for community development in Helwan University. The main objective of the center is to provide both the clinical service for older Egyptians as well as trying to develop a geriatric care model which could be transferred to other institutions and organizations involved in older people care in Egypt.^[25]

• Cairo University has the geriatrics inside the public health department, but geriatrics is not a separate entity. It is included in the family medicine curriculum & Family medicine M.Sc.

• Al-Matariyyah teaching hospital ^[26] and Elsahel teaching hospital^[27] are establishing its departments.

• Boulaq Al-Dakror Hospital ^[28] opened a new department in 2007.

• Elderly rehabilitation & treatment center in Helwan (26 beds) ^[29] one of the single speciality centers of ministry of health and population.

• The national institute of neuromotor disabilities also contain a geriatrics outpatient clinic ^[30].

• In 2008 the ministry of health & population announced its plan to establish the geriatric medicine speciality by recruiting 89 doctors to work as geriatricians in the various elderly health care units (Cairo, Alexandria, Port Said, Isailyia, Suez, Sharqyia, Dakahlyia and Assuit).

• Egyptian fellowship of family medicine ^[31]& Egyptian fellowship of Internal medicine^[32] curricula includes a training module on Geriatric medicine as a part of the Egyptian fellowship programs provided by the Ministry of health and Population.

• Official Medical Insurance healthcare: Covering the cost of healthcare is another major challenge for seniors. Currently, 62 percent of elderly men have health insurance compared to 35 percent of elderly women. However, medical care for the elderly, in the absence of a comprehensive health insurance plan, is extremely expensive. Few hospitals have wings just for the elderly, two percent of whom have a permanent disability (that’s 81,000 people). There are only 52 physical therapy centers in Egypt serving 1,258 of those over 60.^[33]

[edit] Geriatric education

• Geriatric Medicine: Till 1988 there was no specialized study in Geriatric medicine. It started in Ain Shams University Faculty of Medicine at the post graduate level as Master degree in Geriatric Medicine which is a taught course in geriatric medicine and a research topic. It is obtained through a written examination, a clinical examination in geriatric medicine. Also there is a doctorate degree in geriatric medicine, in which it has clinical and written examinations and the student also has to choose a research topic as a partial fulfillment to obtain the degree.^[34]
• Geriatric Physical therapy education: Physical therapy education is available in three universities, The study of geriatrics is introduced at the third year undergraduate for two terms. Higher degree studies are available to attain higher diploma, Masters and Ph.D. degrees in geriatric Internal medicine and geriatrics.^[35]
• Geriatric Nursing education: At the colleges of nursing in many universities there is a module in geriatrics nursing both at the undergraduate level as well as postgraduate level at the diploma level, M.Sc. In geriatric nursing and Ph.D. in geriatric nursing. most of these degrees are obtained by studying specialized courses and attending seminars, choose the research topic and do the written examination and an oral examination.^[36]
• The Higher Institute For Public Health Alexandria university: This is a postgraduate institute for public health. This institute there are 9 academic departments from which one is especially for family health. One of these departments is the department of Health at old age. This department offers postgraduate training in geriatric health at the diploma level, Master degree level and Ph.D. degree level in public health.^[37]

[edit] Geriatrics societies

• The Egyptian society of Geriatric medicine ^[38] was established in the 1982, but is frozen now.
• The Egypt Al-Zehiemer association is active in the field of Dementia and also in geriatric care, it was established in 1998 by Professor Abdel Moneim Ashour. It a member of the Alzheimer's Disease International Associations.

[edit] Conferences and workshops

Many conferences about geriatric medicine were held in Egypt.

• 1st conference Ain Shams Faculty of medicine conference of Geriatrics & Gerontology in 1988
• Ain Shams University During the 1990s
• Helwan University during 1990s & 2005
• Al-Azhar University Faculty of medicine conference 2006
• Alexandria university Faculty of medicine conference 2006
• Cairo University aging conference 2009
• Tanta University Geriatrics health & Prevention conference 2009
• Ain Shams University conference and condensed geriatrics and gerontology course 2009

[edit] Private based geriatrics services

• Ain Shams University specialised hospital has a Geriatrics outpatient clinic.
• Palastine hospital (a private owned hospital) established a long term care unit in 1994 ^[39]
• Also many private centers are present as Center for Geriatric Services^[40]

• Wadi El-Nile hospital has a geriatrics outpatient clinic.

• Abdel Kader Fahmy hospital has a geriatrics clinic.

[edit] Psychogeriatrics

Many psychogeriatrics governmental (Most of Psychaitry departments in Egyptian Universities have or are establishing its psychogeriatrics section) and also other non-governmental private services exist.

• Psychiatric unit at Ain Shams University has a geriatric psychiatry unit with a dementia and memory clinic.^[41]
• Several private Psychogeriatrics Units are available in Egypt^[42]

[edit] Books on geriatric medicine

• Geriatrics at your fingertips.

[edit] See also

• see list of hospitals in Egypt
• see Geriatrics

[edit] References

[edit] External links

• The Age of Reason By: Gihan Shanine Al-Ahram Weekly, July 15-21, 1999
• Aging in Egypt