Where Are the Doctors?

Nicholas Kristof's, two traveling companions in Africa, are producing some excellent entries in their blog, including this one, which hits upon the lack of medical infrastructure and the associated brain drain of physicians in Africa. When I was in Nigeria year before last, one of the medical chiefs at the ECWA hospital in Jos estimated that at least 1/3 of his graduating class had emigrated (mostly to Europe). This excellent post articulates the many reasons for the brain drain.In ophhlmology, there is about 1 eyeMD/million population vs 1/10,000 in the U.S...

“Can you take me back to the U.S. with you?”

Dr. Rudasingwa loves his country. He also cares about his own future. He wants to pursue specialty training in neurosurgery, which is not available in Rwanda. Everyday, he sees patients who need brain surgery, heart surgery, chemotherapy, or other specialized treatments to survive. There is no doctor who can provide these treatments. The best he can do is to watch the patients die. The only person he was able to “save” recently was a high-level official who was airlifted to South Africa after a head injury.

The problems with health care access in Africa are often attributed to lack of resources, but a more insidious and perhaps more difficult problem is the dearth of doctors.

Africa is facing a severe crisis of doctor shortage, on a scale almost imaginable in the U.S. and Western Europe. Rwanda, a country with 10 million people, has about 500 doctors — a ratio of one doctor per 20,000 people. This is less than 10 percent of the World Health Organization recommendation. The vast majority of the country will not see a physician in their lifetimes. The Congo and Burundi have similarly poor ratios. Suburban U.S. hospitals could have more than 200 doctors on staff, while in Burundi, 165 doctors serve 8 million people.