Rural health workers in developing countries need support to stay
Nov 16th, 2008 by admin
By Peter Moszynski, London
This article appears in the 15 November 2008 Edition of BMJ. (BMJ 2008; 337:a2464)
Frédéric Courbet/Merlin/Panos Pictures
An international campaign to support rural health workers in the developing world has been launched “to give people caught up in conflict, disaster, and health system collapse the chance to lead healthy lives.”
The Hands Up for Health Workers campaign (www.handsupforhealthworkers.org), run by the UK medical charity Merlin, aims to ensure that all health workers in the developing world receive a regular wage and that workers in remote and isolated areas receive incentives to stay.
The charity also wants to secure funding to train the additional health workers who are needed to deliver essential health care, and to refresh the skills of existing ones. All health workers should also be able to practise in a safe and secure working environment, it says.
“No community, let alone country, can hope to achieve social and economic development without enough skilled and motivated health workers,” says the charity.
“Three of the eight millennium development goals cannot be reached without health workers. Billions of dollars in aid are spent on malaria, HIV/AIDS, and tuberculosis, yet such funding rarely covers the cost of skilled health workers—the very people who are central to tackling these diseases effectively.”
Merlin points out that a woman dies in childbirth every minute but that research shows that maternal mortality can be cut by nearly three quarters when women have access to reproductive health services, particularly trained midwives.
“The World Health Organization estimates that the continent [Africa] needs at least one million more health workers—from community midwives and nurses to doctors and pharmacists—to deliver quality essential health care.
Globally, four million more health workers are needed. Nowhere is this shortage more acute than in remote rural areas and countries caught up in conflict,” it says.
The campaign is being launched on 20 November with an exhibition at the Barbican, London, by renowned photographer Frédéric Courbet, who has documented the conditions of health workers in the Central African Republic.
One worker, called Arsène, is the only qualified health worker among the 10 staff at Ndomete health centre, in the Nana Gribizi district of the north central part of the country. His salary, less than £30 (€40; $50) a month, hasn’t been paid for more than six months. He said, “We used to treat an average of 20 patients a month. Now Merlin’s helped to rebuild the clinic and stock the pharmacy we see as many as 100 patients a day. I alone can’t provide all the care. I need support.”
Some people are shocked by the conditions. Olga Yetikoua, one of Merlin’s nurse supervisors, said, “CAR [the Central African Republic] has gone backwards. We don’t even have the minimum level of health care any more.
I’ve spent most of my professional life in Bangui, CAR’s capital, cushioned against reality. Coming here, I realised just how neglected our health services and health workers are. I literally had to start from zero.”
Merlin says, “To stem the needless loss of millions of lives, international donors and national governments must act now. Investment in health workers in countries caught up in conflict, disaster, and health system collapse must be made an absolute priority.”
