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News: Royal Tropical Institute, Amsterdam, March 2004 |
| Dysfunctional healthcare means "desperate call" for training |
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Determined to alert the public sector to efficient new ways of funding medical education in emerging nations, senior GE practitioners, government officials and experts at an international development conference in Amsterdam on March 17, 2004, highlighted what's been achieved so far. Even as disease burdens like AIDS, resurgent TB and malaria sky-rocket in sub-Saharan Africa, they called for more money and materiel from governments. Prof. Isidor Segal, a South African gastroenterologist of near-legendary stature who trail-blazed GE training in South Africa, spoke of 30 years of front-line struggle, from his base at the gastro unit in Chris Hani Baragwanath hospital in sprawling black Soweto (read Gastro-Profile) to set up the African Institute for Digestive Diseases. This became, in 1999, the first fully-operational, privately-funded, practice-oriented, train-the-trainers center for GE on the continent.
Prof. Segal's call to governments: "To maintain the standards OMGE has set and to continue developing and applying them at regional levels, as now in Cairo, Rabat and Soweto on the African continent, it is imperative that financial and logistical support by the public sector is forthcoming." |
 Issy Segal MD Soweto's training trailblazer |
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| "In the past 10 years, the gap between economies
and health status of poor and rich countries has widened," Prof. Segal
told the gathering. "150 million children in low and middle economies
suffer from malnutrition." The medical skills level was dwindling in
many countries, he said, as professionals from once-outstanding universities
in sub-Saharan Africa, sick of the hours and chronic shortages, emigrate
to better-paying jobs abroad. Time was pressing, he said, because the disease
burden in sub-Saharan Africa and elsewhere (AIDS, resurgent TB and malaria)
was rising. "There is growing inability to control the major killers",
Prof. Segal said. "70 per cent of the 40 million AIDS sufferers in
the world are from countries with dysfunctional health systems. There is
a desperate call for answers."
The meeting centered on an unabashedly critical Dutch self-assessment of taxpayer-funded development projects around the world and front-line accounts from pioneering physicians of the fight since the 1980s by the World Gastroenterology Organization (OMGE) to set up GE training centers in seven countries.
Senior think-tankers, representatives of industry, embassies and Dutch
ministries gathered at Amsterdam's Royal Tropical Institute to analyze
some innovative funding efforts - and bureaucratic incoherences - in the
struggle to encourage "import capacity", meaning the ability
of emerging nations to utilize needed medical equipment and know-how efficiently.
The conference also marked an unprecedented public
distinction for OMGE: the award of a 70,000 euros (about $ 85,000)
private-sector prize for its worldwide training achievements. |
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The Royal Tropical Institute's Jurrien Toonen PhD unveiled brief case studies on past or current Dutch healthcare projects in India, Uganda, Turkey and Thailand. The effect of some Dutch government export and training subsidies in support of Dutch medical equipment sellers had been at times unexpected, even damaging in the host countries. Improving infrastructure demands far more than "just the export of boxes", including careful attention to real needs of practising healthcare workers and patients on the ground, said Toonen, not just the demand by local government officials for capital investments.
Often, expensive equipment has proved a waste of money for all sides because too complicated for local use and impossible to maintain. Besides, focus on just equipment was one-sided, Toonen said. The "software" of know-how is needed before the right hardware can be selected: "What is the use of providing training for antenatal care", Toonen asked, "if lack of equipment means you can't carry out a caesarean?" |
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| Philips Medical Systems learned this hard lesson
some time ago, said senior manager Paul de Leeuw, who pointed to serious
lack of "organizational strength and implementation power" on
the ground in host countries as a chief cause of failure. Here is where
business-trained project managers could be of help, he said.
OMGE Vice-President Eamonn Quigley points out some recent changes: "Time was when we'd go in, donate five endoscopes, give a few speeches and then go home. Within months, the equipment would become unusable. This approach is all wrong. OMGE's way is, in this example, is to ensure that sustainable funds for training in scope use, maintenance and logistics are written into the agreement from the very start."
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 It's my needs, too, not just my health ministry's |
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| Reference
Papers from the conference, Making Public-Private Cooperation Work for Health and Development, March 17, 2004: Royal Tropical Institute, Amsterdam; contact Rolf Wijnstra, r.wijnstra@kit.nl
Other pages in this news feature OMGE wins major private sector award |
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