For this weekend reading I bring a chronicle of an eye-surgeon working in West Africa. It reviews some of the main challenges physicians face when working in developing countries but also on the moral contradictions that pose the way developed countries are helping. As in the paragraphs I’m citing here under, training doctors take a long time (much more than desired); the alternative is to train non-doctors to perform basic surgeries and general medicine. But what are the consequences of this?
Much debate is taking place with the Ebola epidemics, but the truth is that things don’t (and won’t) change. Public health is widely mis interpreted as the majority of drug production is in hands of highly profitable corporations. What can be “Public” in such a market? In this Chronicle, Aron Dana Rose depicts how medicine and idiosyncrasy are in Liberia and The Gambia. Even if hesitating regarding the outcome, there is still hope.
Who can serve those in need? There is a chronic shortage of medical practitioners throughout the developing world. Funds are lacking, and the process of training physicians is lengthy and expensive. Educational facilities are meager, expertise rare. Young doctors from the developing world lucky enough to train abroad rarely return home to work, and those who do almost never serve in the rural, impoverished regions where they are needed most. Patients are sicker, the work is harder, resources are slimmer, remuneration is lower, and burnout is endemic.
To help fill the desperate shortage of doctors throughout the developing world, trainees such as Robert have begun to receive enough rudimentary medical training to practice general medicine, general surgery, obstetrics, orthopedics, and anesthesia. This is a subject rarely discussed outside of public health circles, for it hides an uncomfortable truth: Complication rates deemed unacceptable in the industrialized world are tolerated when there are no other solutions at hand. Most physicians who are sophisticated about global medicine have come to condone the practice, although the vast majority of Western doctors still find the idea anathema.
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