FOr these With money, Lebanon’s healthcare system was once the envy of the Middle East. Private clinics and hospitals had doctors trained in the top western locations. A wealthy patient from the Arab world jumped in for treatment. But today, it’s the doctor who gets on the plane. One surgeon says his salary paid in local currency is worth about $ 200 a month and less than $ 1 an hour. Another says his hospital was wrecked in the August 4 explosion at the port of Beirut. Both are applying for work abroad and are participating in the long outflow of Arab doctors.
The Middle East, like many in the Northern Hemisphere, is declining as the number of cases of covid-19 increases. In Lebanon, which occupies more than 80% of the intensive care unit, the government has ordered most companies to close on November 14. Tunisia has imposed a curfew and suspended travel between regions. Other countries are considering similar measures. However, the closure provides a small relief for doctors who have been forced to fight the virus briefly.
Although there is no universal standard for a well-staffed healthcare system, the World Health Organization proposes a minimum threshold of 45 skilled personnel (doctors, nurses, midwives) per 10,000. .. At least nine Arab countries are below that benchmark. Some shortages are especially serious (see chart). The number of doctors in Egypt increased from more than 11 in 2014 to less than 5 per 10,000 in 2018. The number of doctors in public hospitals serving the majority of the population has declined by a third during this period.
This is not due to lack of talent. Arab universities produce many doctors. About 7,000 people graduate each year in Egypt. This is 15% more than in the United States, adjusted for population. Medical careers provide fame and stability. The competition for the location of the university is fierce. (Nursing is not a very desirable career and many Arab countries rely on nurses hired from abroad. This is not just a problem in the Middle East.)
However, after graduation, many doctors want to leave. Money is the most obvious reason. Newly coined doctors in Egypt can expect to earn just £ 2,000-2,500 ($ 128-160) a month. For a typical family, it doesn’t even have a living wage. The average Egyptian household spends more than £ 4,000 a month on living expenses. This has skyrocketed since the pound was devalued in 2016. In Tunisia, professionals with decades of experience can bring home the equivalent of $ 15,000 a year when working in a public hospital. She was able to earn the same amount every month by practicing in the rich Gulf countries.
Working conditions are good overseas as well. State hospitals in many Arab countries are notorious for being crowded and lacking in facilities. Iraq has only 13 beds per 10,000 people, 22 in Saudi Arabia and 28 in Turkey, adjacent to the north and south. Iraq’s health system has been shattered by decades of war and sanctions, and successive governments have invested very little in rebuilding it. In 2017, the World Bank estimates that Iraq spent only $ 210 per person on health care (regional average was $ 459).
The Egyptian Constitution, approved in 2014 after the coup, promised the country to spend 3% of the year GDP About healthcare.That provision was ignored: 2018 spending was only 1.4% GDP.. The Constitution also promises freedom of speech and does not prevent police from arresting doctors complaining about the improper treatment of covid-19 by the government. The disease has killed an estimated 200 medical staff. Underfunded hospitals cannot keep up with the rapidly growing population. In the three years since the Constitution was approved, the number of beds per 10,000 people has decreased by 8% from 15.6 to 14.3.
In Lebanon, the worsening economic crisis means that even basic medicines are in short supply. Chemists have run out of everything from blood pressure pills to paracetamol. An estimated 400 Lebanese doctors, almost 3% of the total workforce have left in the past year. The National Council of Tunisian Medical Associations says that 40% of its members are practicing outside their home countries. In Egypt, this figure is close to 50%. The escape allowed us to hire a large number of doctors in rich countries. But that has caused them to lack much of the Arab world — only when they are most needed. ■■
This article was published in the printed version of the Middle East and Africa section under the heading “Out of practice”.
Out of Practice-Most of the Arab world lacks doctors | Middle East and Africa
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