PHA-Exchange> MSF new report on Health worker shortage in Southern Africa

[claudio at hcmc.netnam.vn]

from Jean-Marc JACOBS <Jean-Marc.JACOBS at brussels.msf.org> -----
and <afro-nets at healthnet.org>
 
MSF new report on Health worker shortage in Southern Africa
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MSF PRESS RELEASE

Health worker shortage limits access to HIV/AIDS treatment in southern Africa: 
new MSF report

Johannesburg - 24 May 2007 – The dire lack of health care workers in 
southern Africa is threatening efforts to expand access to HIV/AIDS treatment, 
warned the international medical humanitarian organization Médecins Sans 
Frontières (MSF) in a new report issued today. The report covers four 
southern African countries - Lesotho, Malawi, Mozambique and South Africa - 
where more than one million people still need life-saving antiretroviral 
treatment but do not have access to it. Lack of action will result in 
unnecessary illness and death.

“In Thyolo district we are treating 7,000 people with HIV/AIDS. We need to 
increase this number to 10,000 by the end of the year, but our programme is 
hitting a wall because there are simply not enough nurses, doctors and medical 
assistants,” said Veronica Chikafa, a nurse/matron working with MSF in 
Malawi.

Severe shortages of health staff are compromising the quality and availability 
of HIV/AIDS care across southern Africa. In Thyolo district in Malawi, a 
medical assistant can see up to 200 patients per day, far too many to ensure 
quality care.  In Mavalane district in Mozambique, patients are forced to wait 
for up to two months to start treatment because of the lack of doctors and 
nurses, and many have died during the wait.

In Lesotho there are only 89 doctors in the whole country.  "Providing HIV 
care in rural clinics depends on nurses, but they are overwhelmed by the 
number of patients” said Dr Pheello Lethola, Field Doctor for MSF in 
Lesotho. “Consultation times are too short, and sick patients suffer 
needlessly. When nurses suffer, patients suffer." The shortage is mainly 
caused by brain drain, There is wide acknowledgement of the human resource 
crisis, but little action on the ground.  MSF is urging governments to develop 
and implement emergency plans to retain and recruit health care workers that 
include measures to raise pay and improve working conditions. In most 
countries this will only happen if donors change their policies and start 
providing financial support for recurrent costs such as salaries. Ministries 
of finance and the International Monetary Fund (IMF) will need to find 
solutions to overcome “caps” on the number of health workers and level of 
salaries. Otherwise, governments will not be able to respond adequately to the 
unmet need for treatment.

Even in South Africa, which has more health care workers who are better paid 
compared to other southern African countries, unequal distribution and 
inadequate numbers of staff are causing delays to expanding 
treatment. "Clinics are absolutely saturated, waiting lists are growing, and 
it feels like we are losing the battle, “said Dr Eric Goemaere, head of 
MSF’s programme in Khayelitsha, Western Cape.  “For people making policies 
in offices far away from patients, our message is that you will be held 
responsible if you are not reactive or flexible enough to find solutions to 
the staff shortages".

To expand access to HIV care in rural settings MSF teams have relied on "task-
shifting" from doctors to nurses and nurses to community workers. But these 
are limited measures that do not remove the need for additional skilled staff.

"It is incomprehensible that donors provide funds for life-long aids treatment 
and the building of new clinics, but refuse support for health care worker 
salaries on the grounds that this is 'unsustainable,'" said Sharonann Lynch, 
Treatment Literacy Coordinator for MSF in Lesotho. "People living with 
HIV/AIDS do not only need drugs and clinics; they need trained, motivated 
health care workers to diagnose, monitor, and treat them."

The full report is available on:
http://www.msf.org/source/countries/africa/southafrica/2007/Help_wanted.pdf
and on http://www.msf.org

In the four countries profiled in this report, MSF is presently providing 
antiretroviral treatment (ART) for nearly 30,000 people.  Worldwide, MSF 
provides ART to over 80,000 patients in more than 30 countries.


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