Agence France-Presse Examines Doctor Shortage in MalawiAgence France-Presse on Wednesday examined the "uphill battle" Malawi faces in training and retaining doctors, who are "badly needed" to provide basic care and fight HIV/AIDS. Malawi has a population-to-doctor ratio of 64,000-to-1, half of the country's 28 district hospitals have no physicians, and a recent survey from the country's Ministry of Health and Population said the country has only 139 doctors in the public health sector and needs at least 433. The government had hoped doctors trained at a $25 million college in Blantyre, Malawi, which opened in 1991, would stay in the country to practice, but "poor pay and a difficult working environment have conspired to spur on the flight of doctors," Agence France-Presse reports. Last year, a $236 million initiative to increase physician pay -- funded by the United Kingdom and other donors -- seemed to have "little impact," as a junior doctor still receives about $450 monthly, according to Agence France-Presse. Although some health workers are staying "amid the exodus" to make "a difference" in Malawi, Health Minister Hetherwick Ntaba said the country's economy is not creating enough money for the government to fund the health system adequately, according to Agence France-Presse (Agence France-Presse, 12/14).
U.S. Should Decrease Dependence on Foreign Doctors, Opinion Piece Says
"The United States and other Western countries have not only ignored the appalling lack of qualified doctors in undeveloped countries, but because of self-interest have perpetuated this problem," Norman Wall, a retired doctor and medical educator and author of "Living Longer, Living Stronger," writes in a New York Times opinion piece. Demand for physicians in the U.S. has "grown significantly" in recent years, but medical school enrollment has remained stagnant, in part because "there remains a strong bias in favor of training an elite few for research instead of rank-and-file general practitioners," according to Wall. The U.S. should increase medical school enrollment by lowering standards and opening new schools "geared toward training general practitioners," which would "increase the supply of American-trained doctors at a relatively low cost," Wall writes. In addition, the U.S. should invest in training physicians and building hospitals abroad, especially in Asia and Africa, and support the World Health Organization in "augment[ing] the meager pay doctors and health care workers receive" in developing countries, Wall says. "By luring and keeping large numbers of immigrant doctors, the American medical establishment is reducing medical care where it is needed most -- and, perversely, hastening the eventual arrival of health problems in our own communities," Wall writes, adding, "We should resolve our shortage by ourselves" (Wall, New York Times, 12/14).