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What is the health of the healthcare sector?

'People get sick because they are poor. And they get poorer because they are sick', this was a statement made by Dr Nicole Segue, a medical coordinator for Doctors Without Boarders working for the poorest of the poor in Asia. It is a medical practitioner's guileless pronouncement of despair and helplessness for the poor people's lack of access to quality medical services at affordable prices.

This is just one of the millions of impressions and opinions the world is looking at on World Health Day 2006 observed on 7 th April. Feeling of frustration and defeat in not being able to properly work on the mission that comes with their profession. What the people, who give health care to those who need it, feel about their work and how, if given the necessary support facilities and required medical aid, they could be more effective in providing services to the people who are in desperate need of them.

World Health Day is a day dedicated for health care providers and workers, the heart of health care systems all over the world. An industry, which, according to Dr. Tim Evans, Assistant Director General of the World Health Organisation (WHO) is in a stage of alarming crisis.

There is not enough of them to take care the growing need for health care professionals all over the globe. On this day, a comprehensive study on the appalling situation of global health work force is being release by the WHO in Geneva, Switzerland. The report points to a severe shortage of health workers in 57 countries.

This shortage is impairing provision of essential, lifesaving interventions such as childhood immunization, safe pregnancy and delivery services for mothers, and access to treatment for HIV/AIDS, malaria and tuberculosis. More than four million additional doctors, nurses, midwives, managers and public health workers are urgently needed to fill the gap in these countries, which include India.

According to Dr Samlee Plianbangchang, regional director, WHO, South and Southeast Asia, health systems all over the world are highly dependent on their health workers to provide skilled, effective, efficient and compassionate care.

While the human resource is a strategic capital in any organisation, it is more so in service-oriented organisations dealing with health care. In most countries, the health sector is a major employer of human resources, with the wage costs estimated to account for 65-80 per cent of renewable health system expenditure. Health workers are people whose primary interest is to improve, protect and maintain the health of people.

According to latest estimates, there are over 39.2 million health care providers in the world. Although WHO's South-East Asia Region accounts for 26 per cent of the total world population, only 12.8 per cent of those providers are working in the region.

With its growing geriatric population, Europe is looking South for their need for experienced health care professionals. The continent desperately needs nurses and doctors, lots of them. Health care experts estimate the requirement to be anywhere between 30,000 to 50,000 for nurses and about 10,000 to 20,000 for doctors. Lack of family support systems is forcing the geriatric population to seek the services of private health professionals.

The overseas boom has hit the country's domestic health care sector infrastructure. Lucrative overseas assignments, exposure to advance facilities and modern technologies and proper treatment by the society and the public in general lead to mass exodus leaving hospitals in India wanting for qualified and well-trained doctors and nurses.

A study revealed that thousands of young Indian doctors and nurses, 85 per cent of them are from South India, migrate to countries like the United States and United Kingdom every year, leaving the country in a very difficult situation. Compared to the west, the health care manpower in India is pathetic. According to a survey, the doctor-patient ratio in India is one doctor to 2,460 patients, while the ratio in developed countries ranged from 1:40-60. Nurse population ratio in India is one nurse to 2,198 people, while it is from 1:150-200 in countries in Europe and North America.

'Many of our doctors and nurses would have stayed and serve their countrymen, but the harsh situation faced by the health work force in the country is in a very pathetic situation. They are often faced with challenges on how to provide proper care given a very limited resource and inadequate medical support and facilities. Leaving them in state of thwart and frustration', said S Sridhar, coordinator of a city-based medical personnel sourcing company.

The United Nations advocate that solutions to this crisis be worked out at local, national and international levels, and must involve governments, the United Nations, health professionals, nongovernmental organizations and community leaders.

Without enough workforce to pump the heart of the health care industry, it will die. Action must be taken now, for results to show in the coming years.



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