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Lack of medical workers plague developing world

When her baby turned blue, Nivetha Biju rushed the child to the emergency room of an Indian hospital and watched helplessly as the baby lost consciousness because the nurses on duty had no idea what to do.

Eventually a doctor saved the baby's life, but many patients are not so lucky in India and in other developing countries where a scarcity of doctors and trained nurses means there is often no helping hand in times of need.

"Health systems (in developing countries) are on the brink of collapse due to the lack of skilled personnel," said Ezekiel Nukuro, an official with the World Health Organisation.

"In some countries, deaths from preventable diseases are rising and life expectancy is dropping," he said.

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 diarrhoea.

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 3 percent of its health care 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.

Across the continent, AIDS patients are often left unattended for days in rudimentary clinics staffed by a single overworked nurse and a few untrained orderlies. Doctors often only visit once every few weeks.

"There is a clinic run by a nurse who is over 70 years old, and she can hardly remember what she did with a patient yesterday ... and yet she still runs the clinic because there is no one willing to work there," said Dr Pheello Lethola, an HIV and TB specialist in the southern African country of Lesotho, where almost one-quarter of the population is infected with the HIV virus.

The lack of medical workers in Africa is most pronounced in regions where AIDS is rampant as the disease has whittled away the ranks of health workers.

"A nurse taking care of 400 patients is paid $3 a day in Malawi, not enough even for a bag of maize. So healthcare workers move overseas or to private companies here," said Moses Massaquoi, a doctor with Medecins Sans Frontieres in Malawi.

WHO experts said in a report in July that international aid to Africa should be used to boost doctors' salaries and bolster recruitment and training.

The report also said efforts to connect African hospitals with laboratories and experts abroad through the Internet and phone, known as "telemedicine", might ease cost pressures in countries that lack skilled personnel. 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 gruelling.



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