Aleppo – Muhammad al-Ali

The suffering of Syrians with an illness or health problem extends beyond the physical pain, as it is exacerbated by the pain of examination fees in doctors’ clinics, which have become too heavy for patients to bear.

Last June, the fees for doctors in their private clinics soared to unprecedented levels, forcing the Ministry of Health to ultimately concede and raise all examination fees for various specialties by 600%.

The ministry set the examination fee at 25,000 Syrian pounds for a general practitioner, 40,000 for a specialist doctor, and 50,000 for a consultant doctor with more than ten years of practice.

The cost of a medical consultation, which includes examining the patient, studying their file, and writing a report on their condition, was raised to 150,000 Syrian pounds, while the decision allowed patients to consult the doctor for free within the first week following the examination, but only once.

Despite the significant increase of 600%, which exceeds the ability of most people, it is not applied in many private clinics and hospitals in Aleppo, and the examination fees vary from one doctor to another.

Exceeding the set prices

Rabi, 39, suffered from a problem with the nerves in his hands and feet but delayed his visit to a doctor due to his financial situation. He works in a clothing store and earns a monthly salary of 1,200,000 Syrian pounds, which does not cover his expenses for rent, bills, and food for himself, his wife, and their only daughter.

His health condition worsened over the days, and the noticeable tremors in his hands attracted attention even at work, forcing him to visit a neurologist in his private clinic in the al-Jamiliyah neighborhood, only to be surprised when the nurse demanded 125,000 Syrian pounds for the examination, which would allow him one subsequent free visit.

Rabi said that the examination did not last more than five minutes, during which the doctor asked him some routine questions and then wrote him a prescription consisting of two types of medication. When he went to the adjacent pharmacy, he discovered that one of the medications was foreign-made and priced at 90,000 Syrian pounds, with a box containing ten tablets, while he needed at least two boxes over 20 days to test his body’s response to the treatment as prescribed by the doctor.

He pointed out that he began inquiring about the examination fees for other neurologists in hopes of finding a cheaper option, but found no lower fee; rather, the charges from other doctors could reach 200,000 Syrian pounds for an examination.

A brief visit

Marwan, 67, suffers from chronic heart and respiratory problems due to decades of smoking, and his condition worsened with age, culminating in respiratory crises that led him to a private hospital in Aleppo.

The price for one night in the intensive care unit reached 1,000,000 Syrian pounds, while he spent his second night in a regular room outside of intensive care at 600,000 Syrian pounds. The Ministry of Health states that pricing is based on the classification of rooms in hospitals, calculated at half the price set by the Ministry of Tourism for hotel rooms, including accommodation and meals in all categories and classifications in hospitals.

However, Marwan’s experience was different, as the private hospital did not provide him with any meals on the first day and offered only breakfast and lunch on the second day. Additionally, the refrigerator in the room for food storage was not working, and the room did not have any features that would qualify it as top-class or even first-class.

Marwan chose the hospital located in the al-Seryan neighborhood based on his doctor’s recommendation, who works there and refuses to follow up with cases at other hospitals. He discovered that the cardiologist visited him twice daily to monitor his health, with each visit costing him 300,000 Syrian pounds, and each visit lasted only a few minutes.

A bill in US dollars

Ghalia, a dentist who works in her private clinic in the Seif al-Dawla neighborhood, said that dentists typically do not charge patients for examination fees, while other specialties rely on consultations and writing prescriptions, apart from surgical operations.

She added that the fees vary significantly among doctors, as while she charges 250,000 Syrian pounds for a tooth treatment (drilling, nerve extraction, and filling), other doctors charge up to 1.5 million Syrian pounds (about 100 USD) for the same treatment, often determining their fees in Syrian pounds but based on the exchange rate against the US dollar.

Dr. Ghalia charges 75,000 Syrian pounds for extracting a tooth, while the price can exceed 300,000 at other clinics, which is related to the clinic’s location, the socioeconomic status of the neighborhood, and the decor of the clinic intended to attract attention and create opportunities for boasting and show-off, according to the doctor.

No commitment to pricing

The Ministry of Health considers the new prices to be reasonable for doctors and expects them to adhere to them, calling on the medical association to monitor doctors’ compliance with these prices, while continuously urging citizens to file complaints against any doctor who charges higher fees.

A source from the Aleppo branch of the medical association (who preferred not to be named) mentioned that the association is in a difficult position when it comes to penalizing doctors, as its members understand that the ministry’s pricing is unrealistic for doctors, even though it is burdensome for the citizens’ pockets at the same time.

The source explained that the variation in doctors’ fees according to the location of their clinics results from the costs that doctors incur to open their clinics, whether in terms of rent, purchasing property, or equipping it with various means of electricity, such as ampere subscriptions and solar energy, in addition to the different taxes and fees that doctors pay for their clinics and even for their signage on the street. The association tacitly acknowledges this and overlooks doctors’ fees.

65% of Syrians need healthcare

In March, the World Health Organization (WHO) announced that 15 million people, representing 65% of the population of Syria, require healthcare, while at the same time, 90% of the population suffers from poverty.

Government hospitals and healthcare centers are lacking many services and equipment, suffering from poor service delivery and overwhelming overcrowding of their patients, forcing most patients to resort to private clinics and hospitals despite their exorbitant costs.