On a chilly morning in March, patients began gathering within the thick stone walls of the old Franciscan dispensary in Cairo’s Klot Beik neighborhood, a bustling commercial district on the outskirts of the Egyptian capital.

The dispensary is situated within an Italianate complex of buildings, constructed in 1859 to house the convent and various apostolates of the Franciscan Missionary Sisters of the Immaculate Heart of Mary, the first order of Catholic women religious in the city. Today the sisters run 15 schools and five dispensaries throughout Egypt. 

The dispensary in Klot Beik sees about 150-200 patients daily and has been serving the area’s most vulnerable residents since its founding. It offers several specialties, including dentistry, gastroenterology, otolaryngology, ophthalmology and dermatology. However, it is best known for its otolaryngology clinic. 

Sister Suhair Mamdouh, the dispensary manager, is trained to conduct a few minor procedures, such as ear irrigations. Procedures carried out by the sisters are usually offered without charge. Fees are applied for a visit with a doctor, but even these fees are waived if a patient does not have the means to pay.

Sister Suhair conducts an initial exam of Hassan Suleiman’s ear. The 70-year-old, who is dependent on the government pensions distributed to Egypt’s poor, has come to have his ear irrigated. 

“They are good people,” he says of the dispensary staff. “When my four children and I need treatment, we come here. They help us a lot.”

Sister Suhair underlines how the dispensary continues to live up to the spirit of the congregation’s Italian founder, Blessed Maria Caterina Troiani, in its care for all people, regardless of race, class or religion. 

“We accept the patient on the grounds that this person has value and is beloved and appreciated by God,” she says.

Starting in the 19th century, several Catholic orders of religious men and women came to Egypt and built schools, dispensaries and orphanages to serve the poor. Health care has been an integral part of their mission. 

The Klot Beik Dispensary — known locally as the Saba Banat (Seven Daughters) Dispensary, referring to the seven sisters who established the service in Egypt — is one of about 30 dispensaries operated by Catholic religious congregations and providing low-cost or free health care to Egypt’s poorest residents.

With the current economic crisis in Egypt, these services have become even more important for vulnerable populations. The rising cost of living has put medical care out of reach for millions of Egyptians struggling to make ends meet.

Sanaa Hosni, 52, traveled to the dispensary from Al Hassanin, a village in Giza, south of Cairo, with her 12-year-old son to have an abscess in his ear removed. Her local outpatient clinic would have cost her many times more, she says.

“There are other places that ask the same price I pay here, but there is no attention, cleanliness or order,” she adds, “and the doctor there conducts the checkup quickly and does not answer my questions.”

Mrs. Hosni says she struggles to make a living selling detergent to provide for her two children. Still, her family is faring better than others.

“Some families have five or seven children,” she says. “These families are suffering greatly. They can’t afford meat. I know many people who go to the butcher to buy only a bone to make soup.”

In 2022, since the start of the war on Ukraine, the Egyptian government devalued the Egyptian pound three times, stripping the currency of more than half of its value, while commodity prices doubled. A fourth devaluation was anticipated in spring 2023, but the government was reluctant to take that step, as inflation had reached the limit of what most Egyptians could afford: In February, Egypt’s annual core inflation rate reached 40.26 percent, the highest level in the country’s history.

The government blames the economic crisis on the coronavirus pandemic and the war in Ukraine. However, after granting Egypt a $3-billion bailout last December, the International Monetary Fund stated in its January report that those world events accelerated but did not cause the crisis in the country.

Egypt has spent heavily on non-revenue-generating luxury mega-projects, such as expressways, monorails and new city infrastructure, since the current government took office in 2014. The most prominent project is a new administrative capital in the desert east of Cairo, costing $58 billion. Egypt is currently struggling to repay the loans that funded most of these projects.

In the backdrop, 29.7 percent of the Egyptian population is living in poverty, according to 2019-2020 statistics. This segment of the population is expected to rise significantly, as millions of people, currently considered lower-middle class, continue to lose their financial footing under the economic strain.

Father Kirollos Nazim heads the development office of the Coptic Catholic Patriarchate of Alexandria. He says the number of people seeking medical assistance from church-run clinics has swelled in recent months and increasingly for stress-related conditions, such as diabetes, high blood pressure and heart disease.

“As basic needs become more expensive, people are no longer able to cover the cost of treatment,” says Father Nazim, adding that Egypt’s poor population keeps growing, despite efforts on the part of the state to help.

“We find more and more people asking for our help, and this makes us feel responsible to continue and improve the quality of our service.”

Sister Mariam Faragalla, superior of the Franciscan Missionary Sisters of the Immaculate Heart of Mary, says the dispensary has not raised its fees despite inflation.

“That would increase the burden for poor families, and we cannot put more pressure on them,” she says.

A medical checkup at the Klot Beik Dispensary costs 50 Egyptian pounds ($1.62). The Egyptian government had been providing similarly low-cost or free health care services for the poor, but these services have deteriorated over recent decades. Care is possible in a private clinic or hospital, but the cost is more than four or five times the dispensary fee.

Over the past three decades, Egypt’s population has almost doubled to 105 million people — becoming the most populous country in the Arab world — and with it the proportion of the country’s poor. This growth has outpaced the government’s ability to invest in health care, education and infrastructure, making these state services insufficient, crowded and obsolete, and resulting in a decline in the country’s human development indicators.

Samira Muhammad waits outside the dispensary to have a tooth extracted. The 68-year-old widowed homemaker lives in Al Haram, west of Cairo, with her eldest son, a house painter, who struggles to support his wife and three children due to irregular work and rising costs. 

Without a pension or a regular income, Mrs. Muhammad says she cannot afford to pay for her health care needs. 

“Who can afford 300 or 400 pounds for a doctor at a private clinic? I needed an X-ray, which cost me 500 pounds, and God sent people to help me,” she says referring to a providential experience in her life.

“How much does a chicken cost? How much does a kilo of rice cost?” she continues. “The need increases every day, and we don’t know how to catch up.”

Sister Clara Caramagno, provincial of the Franciscan Missionary Sisters of the Immaculate Heart of Mary, describes the dispensary as “a shelter for the poor.”

“When we closed during COVID-19, people would knock on the door asking where they could go,” she adds.

The sisters are currently having a new dispensary built on the second floor of their convent in El Berba, a poor village in Abu Qirqas, Minya, about 180 miles south of Cairo. Sister Clara says El Berba lacks health care services and a new dispensary would be a great help for the people. While the congregation covered the finishing costs, the price of medical equipment has exceeded their budget. Sister Clara is praying for a solution.

“I am sure that when I work for the poor, God himself comes and intervenes,” she says. “I have great faith in God; I have seen miracles in the past in this house.

“I think of the poor; God thinks of the sisters. There is a contract between us,” she adds smiling.

The Franciscan Minim Sisters of the Sacred Heart, founded in Italy by Blessed Maria Margherita Caiani in 1902, operate a dispensary in Kafr el Dawar, an industrial city almost 20 miles southeast of Alexandria, as well as an orphanage for girls. Four sisters run the dispensary, which serves about 150 patients. Most patients come from the countryside nearby, where the poverty rate is higher and health services are poorer.

The dispensary was founded in 1972 in response to the increasing number of people who would come to the convent to see Sister Efisia Motci, who had developed an effective ointment to treat burns. 

“Because of the efficacy of the ointment, the place was reputed to have a holy lady,” says Sister Afaf Nassih, superior of the community. “She was not just a nurse to them; she was a saint who performed miracles.”

The dispensary today addresses several health needs. On this day, an elderly woman in typical rural attire sits in front of Dr. Ismail Arafa, the otolaryngologist at the dispensary, who raises his voice to address her. “You need a hearing aid,” he says several times until she hears him. 

She responds, her hands raised: “I don’t have money to buy it.”

Dr. Arafa tells his assistant not to take the examination fee from her, but neither he nor the sisters can offer more care because the cost of such devices exceeds the dispensary’s budget. Dr. Arafa advises the woman to go to the government hospital and apply for a state-funded hearing aid, which may take months to process.

Issam Abu al Yazid, 52, suffers from a subconjunctival hemorrhage, or eye bleeding. Despite working as a health insurance employee at the state-run El Miri Hospital, where he is entitled to free treatment, he chooses to come to the dispensary.

“In other dispensaries, doctors don’t talk to patients. Instead, they are told, ‘You need to come to my private clinic,’ which costs four or five times what they pay here,” explains Mr. Al Yazid. “Here, it is like an examination in a private clinic, but at a lower price.”

The depreciation of the Egyptian pound and inflation have increased the cost and scarcity of medicine, surgery and treatment for chronic diseases, despite the government’s attempts to provide hard currency to import these goods.

“The cost for medical services has become astronomical for most Egyptians,” says Dr. Reneh William Naoom, a dermatologist at the dispensary. “As soon as I grab the pen to write a prescription, it is common to hear the patient say: ‘Be careful, doctor, don’t write anything expensive.’ Here, they only pay 50 pounds, while they would pay at least about 300 pounds for the same service in outpatient clinics.”

Dr. Ashraf Boulos, an orthopedist, has been working at the clinic since 1990. He is usually very busy, as he is well known in town.

“The compensation I get at other clinics for the same time is three or four times as much,” he says. “But I feel the time I spend here is a blessing for me.”

The church’s mission to establish new health care services in Egypt collides with a lack of vocations to religious life, says Father Nazim. To overcome this problem, an increasing number of lay people are being trained in the mission, he says.

Dr. Nader Michel, S.J., a cardiologist and a Jesuit priest, works at another church-run clinic in Cairo. To promote ongoing excellent care in church-run clinics, he has been organizing regular professional training and development seminars since 1993. About 45 nurses — 15 lay people and 30 women religious from several congregations in Cairo and Alexandria — participate in these sessions.

He says church-run health care facilities treat many patients because they “have a history” of having qualified nurses and doctors who provide good care with “respect and appreciation for the human being.”

“The poor know that they will not be exploited or disregarded here,” he says.

Read this article in our digital print format here.

Based in Cairo, Magdy Samaan is the Egypt correspondent for The Times of London. His work also has been published by CNN, the Daily Telegraph and Foreign Policy.