Emma Tocci/Collegian
Alfred Bediako, an obstetrician at Hillsdale Community Center, left his practice in Ghana to come to the U.S.
“How many children do you have?”
Quiet glances go around the circle. In Kenya this is not a question parents can answer with a number. In a country where 12 percent of children die before their fifth birthday, the only answer to such a question is, “I have many.”
With exponentially high rates of child mortality and life expectancies decades less than those of more developed countries, Africa's medical situation is dire. But with thousands of doctors, nurses and other medical professionals emigrating to other places every year, the situation is not improving quickly.
Burdened by overwhelming numbers of patients, staff shortages, insufficient pay, antiquated equipment and ineffective governmental control of national medical care, doctors say that moving overseas is a choice they are forced to make.
“It's not that we want to leave, but for different reasons we cannot stay,” said Alfred Bediako, an obstetrician at Hillsdale Community Health Center.
Bediako left Ghana 21 years ago to learn and to work in the United States. He said the education he received in Ghana was excellent, but there was little room for specializing, and mobility was limited and slow.
The state of affairs varies from country to country, but Bediako's circumstance is not unusual. After years of rigorous government-funded schooling, many doctors will work in near isolation, treating patients without the help they need.
“When a patient comes in, you are all in all for that person,” Bediako said.
The trouble is not providing comprehensive care for patients, however—the trouble is the number of patients. As AIDS and other infectious diseases overwhelm citizens, politics and economies, they exhaust any available assistance and leave Africa ever more strained.
At the Salawa Health Center in Baringo, Kenya, the sole health worker, Phyllis Tovoitich, watches children die from parasites, diarrhea and common colds. She asks their mothers to buy medicine, knowing that many will not because they cannot.
“What can be done?” Tovoitch asks. “You can tell her to go and buy, but if she has no money she will let nature take its own course.”
Gesturing to the white shelves that stand empty in the clinic, Tovoitch said although she makes very little, she gives what she can.
“I reach into my own pocket,” she said. “At times you give your own money because you have to save life.”
On Sunday the Word Health Organization released its report, “World Development Indicators 2005,” saying every year 11 million children under the age of five die from preventable diseases.
The prevalence of such diseases also discourages medical workers who sometimes must work without the benefits of sanitation or basic equipment like plastic gloves and clean gauze.
These diseases are largely controlled in the richer countries that are capable of handling them. A Nov. 29, 2004, Washington Post article said North America has 9.9 health workers per 1,000 people, while Africa averages 1.4 per 1,000.
An Aug. 13, 2004, New York Times article wrote that three-fourths of all doctors in Zimbabwe and Ghana emigrate within a few years of graduating from medical school, and more Ethiopian-trained physicians practice in Chicago than in Ethiopia.
Britain's National Healthcare Service has registered 12,500 doctors to practice in the country, the BBC reported last month. Although the ministry used to recruit staff from poorer countries, the system is under fire for being “morally indefensible,” British Medical Association Chairman James Johnson said.
“If one considers the absolutely catastrophic effect that the current policies are having on the developing world, it seems quite immoral,” Johnson told the BBC.
The migration of educated professionals from Africa is known as the continent's “brain-drain,” and some argue that the ramifications are costly now, but will be even more destructive in the future.
Last week Holly Burkhalter from Physicians for Human Rights spoke to the House International Relations Committee on the “brain-drain” problem, urging Congress and the executive branch to “scale up current health systems initiatives and to envision and administer new ones.”
She cited the United Kingdom's Commission for Africa report which recommended a $10 billion increase in aid and an addition of one million nurses from within and without the continent over the next 10 years, thereby tripling the number of health workers in Africa.
Still, the flow of professionals out of Africa is not all bad, Bediako said. He said one of his classmates returned and established a hospital, and others send money home. He himself returns every two years to visit his family and to give lectures. He said when he retires he intends to return to Ghana and teach.
“You have to import what you have learned,” he said.
“It is no good to die with a brain—you must share it.”