Introduction

Amgad is creating and growing a nation-wide citizen based movement that is able to systematically combine a nation-wide fight against blood diseases with the mobilization of blood donors across Egypt.

 

Amgad is using technology and cross sector alliances to mobilize citizens at large scale to address treatable blood diseases while increasing the national blood supply. He mobilizes tens of thousands of people including students, scouts, NGOs and whole companies to lead nation-wide blood donation and awareness campaigns. These campaigns are special in the way that they integrate the three most important pillars of solving the problem of blood diseases and the lack of blood quantities in Egypt: raising supply, building awareness about the ramifications of those diseases, and fighting those diseases. Amgad practically links the donation of blood throughout his campaigns to a holistic scanning, identification and treatment process. To Amgad, a blood donor is not only a donor but also a potential patient who needs to be empowered to deal with his or her blood disease (such as: Hepatitis C and Mediterranean Anemia). He directs infected citizens to effective means of receiving medication and dealing with the stigma associated with those diseases.

Amgad empowers people to become change agents in their communities not only by donating blood but also by raising awareness about deadly blood diseases, helping in scanning  to identify blood patients and eventually become engaged themselves in growing the movement. A vital pillar of his campaigns is that he raises awareness about the risks of infection, the ways of prevention and treatment, and the importance as well as the advantages of blood donation. These awareness workshops are not led by Amgad but by volunteers whom he capacitates to do so. Amgad empowers citizens, companies and institutions to become leaders in the combat of blood diseases and ignorance towards blood donation by providing trainings, a network of cross sector alliances linking government as treatment provider to infected citizens who are directed to governments by the initiatives that grew out of Amgad’s venture, a comprehensive strategy and tools. Citizens can either become active incubators of change through engaging in the organization and implementation of the nation-wide blood donation campaigns, or become part of the network as a long-term active blood donor, making use of the mobile application “Hope”, which empowers donors to secure the lives of fellow citizens, who need blood in a location close to them. Through his unique strategy, Amgad manages to mobilize massive number of people that no one has ever managed to mobilize before. Through its huge geographical scope, the movement succeeds in reaching people who need it most, unprivileged people in rural areas who are usually difficult to reach.

Through establishing a powerful network that combines citizen-based and institutional efforts (including government funds, companies, NGOs and national blood banks), Amgad manages to shift the mind sets of many and reach wide influence. The recruited volunteers and trained NGOs carry on change independently. Amgad mobilizes NGOs and companies to engage not only in sponsoring campaigns but also in financing treatment of citizens who could otherwise not afford it; through this countering the problem of lacking financial means through Egyptian health system. In addition, he lobbies the government to enhance the provision of medication for people with blood diseases. Moreover, Amgad leverages his work in Egypt to educate himself about potential geographies where his systemic solutions can empower African citizens who suffer from similar blood diseases with a similar broken public health system to save their lives and grow a network of fellow citizens who can replicate his model.

Egyptians who are infected with blood diseases do not only threaten their own well-being but the one of Egypt’s whole population and its economy. Egypt’s problem is twofold: on the one hand, a substantial share of its population is infected with high-risk blood diseases, on the other hand, the demand of healthy blood rises, while its supply falls; all of which is at the cost of individual life quality and Egypt’s economy. Blood diseases and viruses are one of the ten most frequent causes of death in Egypt. In 2012 only, 12.400 Egyptians died from blood diseases and the trend is increasing. Two of the blood diseases that are exceptionally widely-spread across the Egyptian population are the Hepatitis C Virus and Anaemia. Remarkably, Egypt has the highest prevalence of the Hepatitis C Virus worldwide with 22% (WHO). Hepatitis C virus can lead to kidney diseases, circulatory diseases, renal failure, and cancers of the oesophagus, prostate and thyroid, all of which cause mortality. Anaemia is particularly dangerous during pregnancy as it causes an increased risk of maternal and perinatal mortality and abnormalities of the newly born babies. In 2011, the Nutrition Impact Model Study Group found that almost one in three pregnant Egyptians had Anaemia. Besides the high risk Anaemia poses to pregnant women, adversely affect cognitive and motor development and cause fatigue and low productivity. In addition to threatening the health of individuals, represent a great burden to Egyptian economy. On one hand, high number of infected citizens means a loss of valuable productivity and a substantial loss of labor force for Egypt’s economy. On the other hand, the many infected people cause high financial costs for Egypt. According to Pharmerit International, 80 million dollars, which constitute 20% of Egypt’s annual health budget, are spent on Hepatitis C care and treatment only. That costs Egypt, according to the National American Library of Medicine, $1.4B a year for the treatment of the virus.

Despite the wide spread of blood diseases among Egyptians, their awareness of the illness is very low. In the case of Hepatitis C, a substantial 78.7% of Egypt’s population has never been tested for the infection and approximately 18% of Egyptians have never heard about it (as blood tests are not part of regular health care in Egypt). The high danger of the unawareness is twofold: On the one hand, the further development of blood diseases can cause a high threat to individual health and even death. On the other hand, a high number of citizens infected with commutable diseases, exposes the whole population to the risk of infection through transmission. The lack of education on and of awareness of blood diseases among Egypt’s population prevents people from taking preventative measures, taking the step to actually scan their blood and even from treating their detected disease adequately. This comes with an associated stigma of that disease as people are afraid to get fired by their employers or losing their social capital as their neighbours believes that this disease has no cure. Egypt’s poor population in particular, is very often unaware of their illness or neglect their infection due to high stigmas and the risk of losing their jobs. Moreover, the lack of awareness of the importance of blood donations, as well as problems with adequate quality controls, makes hard to find people who want to donate their blood. The National Blood Bank adopts a policy that in order to receive blood a citizen either has to pay for it or get 4 blood donors. Even if this policy works for some, it is unsustainable and does not respond to the lack of trust because of the belief that the equipment that is used at the bank is contaminated. The unavailability of blood can require family members or obliged donors to fill the gap quickly leading to inadequately controlled, low quality blood transfusions with a high risk of transmission. The National Blood Transfusion Services make an effort to collect sufficient blood donations, however, they do not even collect one third of the blood supply Egyptian’s need. In Egypt, around 150,000 hepatitis C patients need regular blood transfusions. These patients need both a sufficient supply and an assured quality of blood, of which both are problematic in Egypt. In Egypt, an alarming 22% of blood donors themselves are infected with Hepatitis C, still excluding other blood diseases. In terms of quantity, in recent years, the number of blood donors has fallen sharply according to health experts, threatening the lives of hundreds of thousands of patients, where is no systematized blood supply in Egypt.

In modern health care, blood transfusions are an ever more integrated practice that has the potential to save millions of lives. WHO argues that 1% of the population regularly donates blood globally and in order to have a proper blood supply, the percentage should be increased to 4-5%. The unavailability of healthy blood, as well as transfusions with defected blood risks the lives of hundreds of thousand patients in Egypt. At the same time, the number of people who are infected with blood diseases is increasing. The national cost for curing blood diseases exceeds the Egyptian spending on health. The growing number of infected citizens decreases Egypt’s productivity and burdens its economy. Long Live Egypt Fund (Tahia Masr) has launched a campaign working for a Virus C free Egypt in 2020, yet the patients did not go and receive the medication as they lack the awareness that the disease is curable, afraid of the associated stigma, or sell the disease in the black market to finance their dependents. Egypt is not the only country in the region, with an exceptionally wide spread of blood diseases. In fact, North Africa is one of the regions with the highest number of infected people and the lowest quality controls. As history has shown, blood diseases that are not contaminated adequately are able to turn into epidemics, threatening citizens over many countries.

Amgad is adopting an actor based approach (connecting NGOs with companies and the government) where he creates a system for blood donation that is accessible by every citizen. He is leveraging blood donations to do wide scale testing for blood disease. He then enables treatment through connecting with the government to offer citizens subsidized medication.

Amgad builds a network of NGOs that establish trust with the infected citizens, overcoming the associated stigma with blood diseases and creating focal points for health education in communities. He capacitates NGOs through his training of trainers program with tools such as his mobile application, strategies and content to develop successful blood donation campaigns, contact with hospitals to recruit medical doctors to participate in the campaign, and recruit volunteers. Hope, Amgad’s mobile application connects patients in need of blood to suitable donors. This, in case of emergency in particular, saves crucial time by efficiently locating the nearest available matching donor through GPS and by connecting him or her with the patient in need. To date, Amgad’s mobile application (Hope) is used in 35 countries and available in 8 different languages. At the same time, Amgad takes advantage of his already established networks of scouts and students to recruit thousands of volunteers for the campaigns. The volunteers are empowered not only to lead awareness workshops on blood diseases and donations, but also to help conducting the scanning. He as well builds an incentive system to grow and sustain the number of participating NGOs like breaking Guinness World Record for example. Amgad organizes nation wide blood donations campaigns four times a year, where he, through a partnership, directs the blood to the national blood transfusion center. Through door knocking campaigns, citizens’ blood is tested, reports are then generated by state owned companies (such as Vaxera), public schools of medicine, and the different branches of blood transfusion centers according to the geographical spread of the campaigns. Out of the 40,000 blood bags Amgad’s movement managed to collect during the last blood donation campaign, a considerable number of 2.000 were actually infected. Subsequently, an adequate follow up treatment is discussed with the infected people. Results are afterwards delivered to citizens homes through NGOs. NGOs deliver Smart Identification Hand Watch which contains all the medical data of each citizen who donated his blood during Amgad’s campaigns. The infected are then notified and NGOs link them to the government to receive their subsidized medication. The watch is used as a tracker to track the quantities of medication that the citizen received. The watch as well contains points that citizens who donate their blood receive, where they can trade these points with blood bags from the nearest blood transfusion center when needed. In order to reach out to more citizens, Amgad informs and encourage citizens to participate in his blood donation campaigns through sending them SMS (in partnership with Ministry of Information and Communication Technology) and building kiosks in hospitals to find blood whenever its needed.

Through his unique networking, mobilizing and systemic thinking, Amgad influences individuals and whole institutions like nobody has ever done before. Amgad has successfully built a movement of 70k citizens, 40k blood donors and enabled the creation of 22 NGOs to replicate his model. The outstanding impact of his initiative was underlined by his last campaign breaking the Guinness World Records, as he managed to actively engage 3500 citizen in his campaigns across 22 of 27 governorates in only 8 hours. This huge success is possible through Amgad’s very strategic approach in which he plans the spread of his campaigns in a systematic way, in which he reaches people in a step-by-step manner. His approach is not to simply reach out to the people who are willing to donate and participate and to neglect anyone else; he concentrates on reaching the people who would usually not donate blood and let themselves be checked. Since its implementation in early 2015, his initiative has reached the population of 132 villages across whole Egypt, which made it possible for Amgad to engage with the least educated and aware parts of Egypt’s population. Moreover, to widen the impact of his initiative and to reach poorer segments of the society on a large-scale, Amgad has started implementing the “virus free company” certificate in companies with a considerable number of low-paid workers. Through companies requesting this certificate, Amgad gains the permission to scan every employee of a company, reaching out to a substantial number of people. Currently, Amgad collaborates with two organizations, the Egyptian Ministry of Telecommunications and General Motors to implement a “virus free company” campaign in these organizations. He brings the initiative to an institutional level by using the data he collects to lobby the government to better direct and supervise the administration and distribution of medication.

Amgad has already achieved exceptional success and impact through his initiative and he is not even close to having reached the scale and impact he aims at reaching. He is currently partnering with Tahia Masr Fund (a national fund that is dedicated to promote Egypt’s economic growth and solve stagnant social issues) on producing Smart Identification Card, which will enable patients to carry the card with them displaying their blood and health data and facilitating safe blood transfusions and adequate, risk-free medication. To enhance the supply of blood, he is also working on connecting his mobile application with an SMS service to reach out to donors in a more efficient way. Moreover, Amgad endeavours to bring his initiative to an institutional level as he plans to deploy tablets in hospitals and blood banks which are equipped with the Hope application and will enhance the search for healthy blood donors. By the end of 2017, he wants to have deployed this tab in 30 hospitals. Furthermore, Amgad aspires to grow his movement to include 400k+ citizens and 100k+ blood donors and enable 110 NGOs replicate his model in 22 Egyptian governorates by the end of 2017. In the meantime, he is working towards receiving an accreditation from WHO in order to license his model to the government impacting the public health system on a much bigger scale by the end of 2020. Through that, Amgad is aspiring to champion virus free communities and companies.

Amgad was born in 1973, in Lybia and returned to Egypt when he was 3 years old. His childhood was predominated by sports, music, drawing, writing, and reading. The creative environment where he grew up triggered creativity in his early childhood onwards. He was called “addicted to innovation” and thus decided to study Software Engineering in 1997 when this field was still completely new to the Egyptian society.

Two years after he got his first job in the field of medical informatics, Amgad’s father fell into a diabetic coma and was transferred to a hospital where doctors spent almost 20 minutes trying to find out what was wrong with him. Only when his father woke up from his coma and told the doctors that he was diabetic, they provided adequate medication. That situation triggered Amgad to start developing his first Patient Smart Identification Handheld System, which provides inclusive information about the patient’s medical situation.  Amgad’s mother has another story. She is infected with Hepatitis C. That introduced Amgad to the situation and the different stakeholders that are engaged in the public health sector, focusing on blood diseases. Starting from identification to treatment and follow up, Amgad became well-acquainted with the different causes and the experiences that Egyptian citizens go through, aspiring to bring that disease to an end.

In 2011, he founded NetCare, his first company specialised in Medical Informatics Systems. Later, one of Amgad’s friends called him to come and donate blood to his friend’s mother in law. Her case was very critical and there was a huge delay in getting her blood. When Amgad arrived, he discovered afterwards that he has a different blood type. That incident reminded him of his mother’s fight with the disease.  He then knew that even dedicating his time to provide hospitals and blood banks with better information systems to increase efficiency will not end the suffrage of so many patients with deadly blood diseases and who are in need for blood. Amgad started devoting his time to NGOs working on blood donation campaigns (such as Misr el-Kheir) and he got acquainted with the fact that there is a huge numbers of volunteers who can be mobilized to respond to the situation of blood diseases (especially Hepatitis C) and who can be systemically organized to increasing the blood supply. Those learned lessons gave birth to Nabd El Haya, Amgad’s systemic social venture, where he utilizes the power of citizens to bring an end to blood diseases in Egypt.