Emigration of Albanian doctors, researchers: Phenomenon, an element of brain drain

2023-05-23 21:24:03Aktualitet SHKRUAR NGA REDAKSIA VOX
Emigration of Albanian doctors, researchers: Phenomenon, an element of brain
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In Albania, the escalation of the departure of doctors from the country, during the last years, has taken on the features of what is called "brain drain". This has encouraged some researchers to conduct a study on the reasons for this emigration as well as the factors that would influence their return. The study was published on the website of the University of Sussex in Britain. Among the main drivers in both cases, the study singles out economic factors, education, political stability and the fight against corruption. The emigration of doctors is also a concern for the countries of the region, but in Albania this phenomenon has more serious consequences due to weaknesses in the health system.

For more than three decades, immigration in Albania has been at a high rate and based on INSTAT data, today about 38% of the population lives abroad. Researchers state with concern that emigration is taking the form of what is called "brain drain", and that about 40% of emigrant flows in the last ten years have this feature.

One of its elements is the departure of doctors from the country. A recent study published on the website of the University of Sussex, in Great Britain, brings a disturbing panorama of what is happening today in the Albanian health system. One of the authors of this study, Ilir Gëdeshi, tells Voice of America that it is based on a questionnaire and interviews with doctors who left the country in the last 30 years.

It brings findings on the reasons for the emigration of doctors, where the main place with more than 50% is economic, followed by education, and uncertainties about the future in Albania.

"If we look at the first group of factors, the standard of living and the improvement of working conditions emerge. And if we look at education, the emphasis is on personal education. While the third factor has to do with how they see the future in Albania. About 10% do not see perspective in Albania and therefore think that emigration is the best solution" - Ilir Gëdeshi, Center for Economic and Social Studies in Tirana, told the Voice of America.

According to this study, the departure of doctors from the country has escalated in recent years. In what he considers the diaspora of more than 2500 doctors, there are those who left in the 90s, mainly in the USA, with few opportunities to practice the profession, students who finish their medical studies abroad and do not return to Albania , which make up 1/3 of them, as well as the doctors who left during the last years, destined for EU countries, mainly Germany and Italy.

"There are at least 2,500 who may be abroad. The numbers can be even higher. The doctor's order during the last 5 years reports, 800 doctors left Albania. The second source of information would be OECD data, which refer to a thousand doctors from Albania who are located in other countries. But those doctors who have obtained the citizenship of the host country are not reported here. Third source doctor's order in host countries. Germany, for example, declares that there are over 980 doctors in 2021, from Albania about 6 times more than in 2012" - continued Ilir Gëdeshi, Center for Economic and Social Studies in Tirana.

The Voice of America talked to several doctors inside and outside the country about the findings of this study. They think he is an alarm bell for the authorities. According to them, the unreformed and poorly financed health system in the country has caused doctors to work in inappropriate conditions and not provide quality service.

The authorities have taken measures by increasing the salaries of employees in the health system, to prevent the departure of doctors, but according to this study, the salary is one of the reasons for the departure, but not the main one.

"Doctors leave, because according to this study and others before it, they are not satisfied with the working conditions, with the safety at work, with the options offered to them in Albania to have a professional career that develops according to the rules of the game and with honesty. If only the salary is seen, the problem is not resolved. Today medicine is not only provided by the knowledge of doctors, today medicine is technology. If there are no clinical practice guidelines adapted to the possibilities of the system, if there are no disease treatment protocols, continuing education to implement these, if there are no last word medications, the doctor cannot practice the profession properly" Erion Dasho, public health expert, said to the Voice of America.

The authors of the study think that the departure of doctors is a serious blow to the health system in conditions where Albania has a low indicator of the number of doctors per inhabitant, 188 per 100 thousand inhabitants, when it is 374 in EU countries and 446 in Germany. ranks among the last countries in the region and Europe.

Another element of the study is related to the reasons that would bring doctors back to the country, which are also more or less the same as those for leaving, among others economic conditions, political stability, the fight against corruption and reforming the health system.

"We need to invest more in the health system, in relation to GDP, we need a reform of this system, to fight nepotism, corruption, to increase the number of medical students, and to make efforts to turn this emigration into circulation, by cooperating with the host countries of doctors" - continued Ilir Gëdeshi, Center for Economic and Social Studies in Tirana.

Erion Dasho, public health expert, who has been working in Germany for several years, when he talks about the political influence in the issues of organization and management of medicine, as one of the conditions that doctors decide to return to Albania, brings the experience his personal.

“Kur flas me kolegët në Shqipëri, për fat të keq më thonë se ndiejnë politizim të tejskajshëm në sistemin shëndetësor dhe mbi të gjitha kontrollin përmes strukturave që ka ngritur partia në pushtet. Madje miq të mi më thonë se edhe kur më ndjekim në rrjete sociale nuk mund të komentojnë ose të bëjnë pëlqime në statuset e mia se i kontrollojnë shefat”- vijoi Erion Dasho, ekspert i shëndetit publik.

Ndërsa mjeku toksikolog në Spitalin Amerikan në Tiranë Alban Haxhi, vë theksin te vështirësitë që kanë hasur ndër vite studentët e mjekësisë për t’u specializuar, megjithë disa lehtësira të kohëve të fundit.

“Janë lehtësuar kohët e fundit, por deri para pak viteve ka qenë shumë e vështirë, të arrije një specializim. Dhe kjo bëhej përmes miqësive, s’ka patur konkurrencë, kishte kritere penalizuese me qëllim që të fitonte ai që ishte paracaktuar. Këta janë faktorë që e vështirësojnë punën por dhe mungesa e trajnimeve e minispecializimeve. Shumë prej tyre mjekët i kryejnë jashtë”- u shpreh për Zërin e Amerikës Dr.Alban Haxhi, mjek toksikolog në Spitalin Amerikan në Tiranë.

Si mjek që disa vite ka drejtuar një prej shërbimeve të urgjencës në vend, zoti Haxhi, veçon disa mangësi të sistemit, pavarësisht përmirësimeve.

“Ajo që vihet re, është mungesa e theksuar e aparaturave, dhe aty ku janë, kanë probleme, s’kemi dhe stafin e kualifikuar për t’i mirëmbajtur. Këto i penalizojnë mjekët për të qenë funksionalë. Shpeshherë ne bëjmë një analizë mjekësore, nuk bëjmë një tjetër, i dërgojmë në sektorin privat, një shërbim e mbulojmë, një jo. Shpeshherë dhe disa analiza të tjera që nuk bëhen fare në Shqipëri i dërgojmë jashtë. Janë disa hallka që e bëjnë shumë të vështirë diagnostikimin e sëmundjes dhe e vështirësojnë punën e mjekut”- vijoi Dr. Alban Haxhi mjek toksikolog në Spitalin Amerikan në Tiranë.

Largimi i mjekëve drejt vendeve të zhvilluara është një fenomen që ka prekur dhe vende të Ballkanit, kjo edhe për shkak të kërkesave në rritje në disa vende të BE, kryesisht në Gjermani.

Por në Shqipëri pasojat e këtyre largimeve janë më të mëdha për shkak të dobësive të sistemit shëndetësor dhe numrit të ulët të mjekëve për banorë.

Sipas përllogaritjeve të ekspertëve të fushës, për të përgatitur një mjek duhen 20 vite, ndaj dhe shqetësimi për largimin e tyre nga vendi, konsiderohet një këmbanë alarmi. Shpenzimet e Shqipërisë për shërbimet publike në shëndetësi, sipas këtij studimi që i referohet të dhënave të Eurostat janë më të ulëtat në Ballkanin Perëndimor dhe në Evropë, 3.2% të PBB-së në raport me 5 apo 6 % në Serbi dhe Bosnjë Hercegovinë, apo me mesataren prej 8.1% në BE.

Sot mjaft qytetarë shtrojnë pyetjen nëse është e drejtë që vende me nivel të lartë varfërie si Shqipëria të paguajnë shtrenjtë për edukimin e mjekëve që më pas ata të largohen për të plotësuar boshllëqet në sistemet shëndetësore të vendeve të pasura?

According to the researchers, the answer to this question is found in the freedom of operation of demand and supply in global markets as well as in the serious efforts of government authorities to prevent the departure of doctors from the country./VOA


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