DREAM / The Prime Minister resigns and wakes up under the Parisian bridge!

 Kliko këtu për të tjera
Voxpress:

We lose 150 doctors a year, Albanian healthcare is suffering from the unstoppable exodus of white shirts

2023-04-03 09:58:48Aktualitet SHKRUAR NGA REDAKSIA VOX

We lose 150 doctors a year, Albanian healthcare is suffering from the

On December 7, 2018, Enkelejda Rexhepi from the northeastern city of Bulqiza suddenly started labor pains and waited in vain for an ambulance. At the time, 31 years old, Rexhepi was six months pregnant and expecting triplets.

Together with her husband, they took a taxi and went to the hospital, but there was no gynecologist there.

The woman says that she was forced to give birth with the help of a midwife and a general practitioner, while a specialist doctor was flying by helicopter from Tirana to save her life.

"He kept asking if there was an anesthetist, if there was an operating room or a doctor to help him, but none of this was in the hospital," recalls Enkelejda five years later.

Faced with large shortages in the hospital, the doctor told Enkelejda to "be strong" and performed the intervention without anesthesia. The first two babies were born alive, but died two hours later in the Bulqiza hospital, while the third was stillborn.

Enkelejda told BIRN that this was the biggest trauma of her life.

"I couldn't handle that loss, it was very difficult. An indescribable pain,” she added between tears.

Albania produces 150-200 specialist doctors every year, but their number is insufficient to fill the vacancies created over the years - especially in the hospitals of distant municipalities such as Bulqiza. On the other hand, the country loses an almost equal number of doctors every year in an unstoppable exodus of white-collar workers to the West.

'Brain drain' is one of the most neglected phenomena of the Albanian turmoil, reflected during the last decade with the massive departure of health personnel from the country.

Since 2014, Albania is estimated to have exported around 1,500 doctors to Germany alone, while there have also been departures to Italy, England, the United States, Canada and France.

The exodus maintains an upward trend even over the past three years, when according to the Physician's Order 490 doctors were provided with a 'certificate of good conduct' – a document that enables them to be employed overseas.

"We are losing 100-150 doctors a year," says Arben Gjata, rector of the University of Medicine in Tirana with concern.

"This is a movement of the 'brain' that goes from places where they are paid less to those who are paid more," he added, while emphasizing that the remote areas of the country are suffering more from this situation. 

The Albanian Prime Minister, Edi Rama, relativized for years the problem of doctors and nurses leaving the country - considering this a global side effect of free movement.

But Rama changed his stance in recent months, as his government is introducing policies to stem the exodus of white shirts.

During a Health Congress held at the beginning of March, Rama announced an increase of 50,000 lek per month in the salary of specialist doctors and promised an increase for other categories as well. But he also introduced conditions, warning of increased study costs for students who will not agree to contribute to the country.

"Albania cannot finance the German health system. We cannot compromise our interest, we cannot accept that 1 student pays 1/16 of the cost and in the end, the student receives the diploma and runs away to Germany," said Rama.

Although overdue, such moves have been welcomed by a section of the country's medical community.

"When at first I said 'we are running out of doctors', they told me that there are as many doctors as you want...," recalls the rector of the University of Medicine, Arben Gjata.

He calls it a good omen the fact that politics has become aware and "is drawing up policies to keep the health brain in the country".

Others have doubts whether the small Balkan country can devise successful strategies to address all the causes that push doctors to leave.

Gazmend Koduzi, a lecturer at "Aleksandër Xhuvani" university in Elbasan, once coordinator of the Democratic Party for Health, told BIRN that the government would have to carry out a real reform of the health system to ensure higher salaries, better conditions jobs and better career opportunities.

"If the relevant measures are not taken, the preparation of a human resources development strategy based on evidence and the implementation of essential reforms in the health system, the situation after some time will be sad," said Koduzi.

Shaqir Qerama is among the few young doctors of his generation who aims to build a career in Albania. After completing his studies at a private university, Qerama is doing his hematology specialization at the "Mother Teresa" university hospital center.

"Of the 40 people who were in the class, only 3 of us remained in Albania. Everyone has fled to Germany," he says regretfully.

To stem the bleeding of doctors to the West, the government has set up a payment for specialist doctors in return for having to work for three years where there is a greater need, but Qerama has rejected this offer.

"Medicine in the districts is more than 20 years behind," said Qerama, while adding that if he had to work outside of Tirana, he would not have the opportunity to practice his profession as he should.

If they do not emigrate, they stay in Tirana

Albania holds the last place in the region for the number of doctors in relation to the population, and the emigration crisis makes it even more difficult to raise sufficient human resources to meet the country's needs.

Also, doctors are unevenly distributed, penalizing the poor population living in the deepest areas of the country.

There are 42 public hospitals operating in Albania, divided into university, regional and municipal hospitals. Municipal hospitals provide services with difficulty, mainly due to the lack of a sufficient number of specialist doctors.

To cover vacancies in regional and municipal hospitals, the Ministry of Health has for years introduced a patronage system and encouraged the transfer of doctors to remote areas in exchange for a generous financial bonus.

But data obtained through Right to Information requests show that only a limited number of doctors have responded to these calls.

The Ministry of Health told BIRN that it had hired 314 doctors during 2022 to cover vacancies, 140 of them specialist doctors.

The new hires have brought the number of doctors engaged in the hospital system of all levels to 2800 doctors, while the number of vacancies according to the Ministry is currently 76 positions.

The Ministry also added that there were currently 47 doctors of various specialties engaged in the patronage program, while 24 doctors were supported through the bonus program.

"..The program of financial incentives, the bonus for doctors, which supports doctors who provide specialized health services far from the place of residence, is an effective program that has provided more services close to the place of residence for citizens across the country and has supported 24 doctors," said Ministry in the written response.

However, the partial data obtained through right to information requests show that regional and municipal hospitals continue to have significant shortages of specialist doctors and have uncovered very important services for patients.

The regional hospital of Elbasan told BIRN that there were currently 86 doctors on duty and 22 vacancies or 25% of the total number of doctors. Even the regional hospital of Korça - the most important in the southeast of the country - said that it had 76 doctors at work and 6 vacancies; among which 1 orthopedic doctor, 1 hematologist, 1 cardiologist, 1 neonatologist, as well as 2 emergency doctors.

The country's municipal hospitals suffer even greater shortages and are unable to recruit specialized staff.

Health experts are concerned about the many vacancies in regional and municipal hospitals and consider filling them a difficult challenge to meet.

Rector Gjata says that even if they don't go abroad, most of the medical students or specialists want to stay in Tirana, despite the financial offers presented by the Ministry of Health.

"Financial offers to leave Tirana with a contract are very favorable, but not everyone accepts this idea," he said.

For lecturer Koduzi, the lack of doctors directly affects the health of the population.

"The lack of doctors reduces access to health services and consequently worsens the health condition of the population," says Koduzi, while warning that Albania will face even greater departures of doctors with the advancement of EU integration.

Patients in the emergency room of the Durrës regional hospital

The city of Shkodra has one of the most important regional hospitals, but the Orthodox priest, Aleksandër Petani, makes his way to Tirana every time he needs to calibrate the cardioverter [ICD] that keeps him alive.

Petan has survived spinal damage and several heart attacks, while his heart beats regularly with the help of an implanted device.

"I have the apartment placed in my body, I am connected with five wires. Every time the device makes a stroke to get the heart back to work, after two days at most I have to go to the doctor to calibrate the device again," says Petani. But Shkodër lacks a doctor for this specialty.

The frequent trips to Tirana are an added physical and economic cost for the Orthodox priest and his wife.

"We need to get a car at our disposal, which costs around eight thousand lek, as well as reserve a hotel room for 25 euros. He cannot bear the journey and the fatigue. It is impossible for us, both financially and physically," says Vjollca, his wife.

About 130 kilometers southeast of Shkodra, the Bulqiza hospital faces multiple traumas due to mining accidents, but lacks specialist doctors.

The general practitioner, Fatos Hoxha, also says that the working conditions leave much to be desired.

"Even for us as doctors, it's very difficult when we don't have the opportunity to offer help to patients because of the shortages we have," Hoxha told BIRN.

After the serious event of 2018, the Bulqiza hospital signed a contract with a gynecologist, but she left after a short time. The reason, according to one of the midwives, was the difficult working conditions.

"We need a gynecologist and a resuscitator. We must have some conditions so that the doctor does not end up doing my duties as a midwife," says the midwife who has been working at this hospital for 29 years.

Two years after the loss of three babies, Enkelejda Rexhepi became pregnant again and found the hospital again without a gynecologist. She was forced to travel to Peshkopia for her periodic check-ups, but the trauma was still fresh.

"After what happened to me, I was afraid to travel to Peshkopi to visit. We as a city should also have a gynecologist," she said. "People's lives are at stake and I don't want any mother to go through what I went through," she concluded./ Rreporter.al

Galeria fotografike (
)


Në përputhje me standarded JTI

Video

SHIKO KANALIN NE YOUTUBE
×