Medicare

Lack of Medical Workers Plagues Developing World

Africa, with a quarter of the world's disease burden but only three per cent of its healthcare workers, is the worst affected region

“Health systems (in developing countries) are on the brink of collapse due to the lack of skilled personnel," according to Ezekiel Nukuro, an official with the World Health Organisation. The health crisis in developing countries is, some experts say, being exacerbated by the West as countries relax stringent immigration regulations to attract doctors and nurses from less developed countries to boost their own flagging health systems while saving money on expensive training. The consequences of this 'brain drain' are grave as it leaves gaping holes in the healthcare systems of developing countries where diseases such as AIDS, tuberculosis and malaria run rampant and children die daily from diarrhea. Aid agencies have warned that a European Union 'blue card' scheme to attract highly skilled migrants like hospital workers, which was given initial backing by ministers this month, will worsen the already debilitating brain drain. Africa, with a quarter of the world's disease burden but only three per cent of its healthcare workers, is the worst affected region. International disease experts called earlier this year for the poaching of African health workers to be viewed as an international crime. In India, a country with the world's third highest HIV caseload, patients may spend days queuing up for tests and drugs at New Delhi hospitals as there simply are not enough doctors and nurses to attend to them all. "Many end up sleeping outside the clinics and we are now looking at building shelters so people can come and stay," said AIDS activist Loon Gangte, adding that some patients abandon treatment because the waiting is too grueling. In Afghanistan, some of the best public hospitals can't afford disinfectant or rubber gloves and doctors and nurses don't earn enough to feed their families. "I am an associate professor and I earn US$100 a month. That's not enough to buy wheat for my family," said a doctor at a public hospital in Kabul on condition of anonymity. Doctors and nurses in India are being poached either by private medical centers that cater to India's expanding middle class or by hospitals abroad. Some leave medicine and opt for jobs in the burgeoning and relatively high paying IT sector. India suffers an acute shortage of medical care workers, including 600,000 doctors, 200,000 dental surgeons, 1 million nurses as well as X-ray technicians, dental hygienists, physiotherapists and lab technicians. There is one nurse to 1,000 patients in India, compared to about 11 nurses to 1,000 patients in Europe. This in a country that boasts of a flourishing 'medical tourism' industry as low cost plastic surgery and other procedures attract patients from around the world. Yet India's own poor and sick often get no medical assistance at all.

Experts admit there is no easy solution as the problems of developing countries, including war, disease and malnutrition, often prompt those who are able, to leave. However, they do suggest retention strategies to reduce the problem. Some practical steps being taken in India include reducing the burden on health professionals by training housewives to give medical advice for conditions such as diarrhea, and to dispense fever medicine, oral rehydration tablets and rapid diagnostic kits for malaria and pregnancy. Such community-based training projects are also underway in African countries, especially in remote rural areas. "This is a small intervention but it will have a big impact on reducing maternal mortality rates and infant mortality rates," said Naresh Dayal, India's Federal Health Secretary.

Reuters