This Week's News 2-6 November 2009



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This Week's News
2-6 November 2009

Weekly news clippings service featuring articles on the Global Health Workforce Alliance and selection of articles from around the world on the issue of the health workforce crisis





The Global Health Workforce Alliance ¦ Africa & Middle East ¦

Asia & Pacific ¦ North America ¦ Europe ¦ Latin America & Caribbean ¦ News from WHO and partners

This compilation is for your information only and should not be redistributed



Global Health Workforce Alliance

Date

Headline


Publication

02.11.09

Countries and partners call for a multisectoral response to human resources for health at the meeting in Ghana 


The Alliance

03.08.09

Lord Nigel Crisp - Champion for Global Health Workforce Alliance



The Alliance


Africa & Middle East


Date

Headline


Publication

02.11.09

Health minister visits tindumba



Swazi Observer

03.11.09

Challenges of poaching in the ICT world 


Sun Daily, Nigeria

03.11.09

"Be Careful When Considering Migration"


Peace FM Online, Ghana

30.10.09

Bastonário da Ordem dos Médicos pede mais formação


Angola Press

30.10.09

Parteiras tradicionais recebem kits de trabalho no Sambizanga 


Angola Press

05.11.09

'Doctors And Other Health Workers on Same Grade Level Must Earn the Same Call Allowance'


Daily Trust, Nigeria

04.11.09

Zain and Ericsson join forces to provide 3.5G in rural Ghana


IT News Africa

04.11.09

Health Institutions Operating At 17% Capacity


Peace FM Online, Ghana

03.11.09

Prof Mwaikambo: Tanzanian who earns top Harvard accolade



The Citizen, Tanzania

Asia & Pacific


Date

Headline


Publication

03.11.09

Taiwan moves up date of swine flu shots for students 



Taiwan News

03.11.09

AICUFers embark on rural exploration camp



Mangalorean.com, India

03.11.09

Clear ideas on migrant workers’ safety demanded



Jakarta Post

05.11.09

Health costs far scarier than bill for super



New Zealand Herald

03.11.09

Cash incentives to lure doctors



Fraser Coast Chronicle, Australia

30.10.09

Health staff shortage 'cripples' regions



The Age, Australia

02.11.09

Overseas nurse search for Peninsula hospitals



Morning Peninsula Leader, Australia

02.11.09

Massey University to scrap midwifery degree



Radio N. Zealand News

02.08.09

Attracting People To The Front Line 



Voxy.co.nz, N. Zealand



North America


Date

Headline


Publication

30.10.09

Child mental health workforce may shrink, report says

Boston Globe

01.11.09

Obamacare Threatens U.S. Medical Education System



NewsMax.com

01.11.09

Valley may soon be a health care nexus



The Desert Sun, CA

30.10.09

Kent State opens enrollment for public health bachelor’s, graduate degrees to follow 



MedCity News

30.10.09

New York's Gov. Paterson declares H1N1 state of emergency



CNN

02.11.09

Royal College calls for federal investments to support stable, specialty workforce to meet growing health demands



Newswire, Canada

29.10.09

Latinos pueden ser profesionales de la salud



La Opinión, USA

02.11.09

Carrières méconnues dans la santé



Métro Montréal, Canada

04.11.09

Health Reform Needs Stronger Focus on National Workforce Strategy

PR Newswire



Europe


Date

Headline


Publication

27.08.09

Call to act on maternal mortality 

BBC News, UK



30.10.09

Ghana targets health tourism boom



BBC News, UK

26.10.09

Maternal mortality across the world



BBC News, UK

27.10.09

UNICEF responds to lack of health care for mothers and newborns in Sierra Leone



ReliefWeb.ch

03.11.09

New lease of life for birth centre as private care home



Portsmouth News, UK

24.10.09

The suffering of physicians



The Lancet, UK

02.11.09

Distinctions between health and social care could fade under new national care service



BMJ, UK

04.11.09

Innovative financing of health care



BMJ, UK

31.10.09

Profesionales de Enfermería de Senegal visitan el Complejo Hospitalario Universitario de Albacete 



La Cerca, Spain

02.11.09

El SATSE se concentra para exigir más personal en Urgencias del Virgen Rocío

ADN, Spain


Latin America & Caribbean


Date

Headline


Publication

29.10.09

Need for more Public Health Inspectors 



Radio Jamaica



03.11.09

Hospital habilita residencia, pero necesita más médicos 



Última Hora, Paraguay

30.10.09

Por denunciar carencias…



Expreso Chiapas, Mexico

02.11.09

Migración de médicos venezolanos: ¿Exilio o avalancha?



El Nacional, Venezuela

01.11.09

Cómo contrarrestar la falta de enfermeros 



Diario Democracia, Argentina

30.10.09

Situación cada vez más crítica



El Nacional, Venezuela

29.10.09

'O Rio terá que fazer um milagre para 2016' 



O Globo, Brazil

30.10.09

Lúdio elenca alternativas para saúde na capital



Olhar Direto, Brazil

04.11.09

Saturación y falta de personal en el sistema de salud de Yucatán: Codhey 



La Jornada, Mexico

News from WHO and partners


Date

Headline


Publication

28.10.09

Lawmakers Commit to Women's Health and Rights by 2015



UNFPA

03.11.09

*Are vaccination programmes delivered by lay health workers cost-effective? A systematic review 



HRH Journal

02.11.09

PSI demands justice for world’s 200 million migrants 



PSI

27.10.09

Private sector in West and Central Africa explore strategic partnerships for improved health outcomes



UNAIDS

16.10.09

Grappling with Health Worker Shortages



World Bank

27.10.09

The 16th Annual Canadian Conference on International Health 



CIDA

* All links to HRH Journal will be to an external web page - copy is not reproduced in this document.

Global Health Workforce Alliance

2



Countries and partners call for a multisectoral response to human resources for health at the meeting in Ghana

The Alliance

02/11/2009
For the first time, over 170 delegates from fourteen African countries and development partners gathered in Accra, Ghana, for a meeting on "Good Practices for Country Coordination and Facilitation."
The meeting brought together delegates from Ethiopia, the Gambia, Ghana, Kenya, Lesotho, Liberia, Mozambique, Nigeria, Sierra Leone, Sudan, Uganda, Tanzania, Zambia and Zimbabwe. Partners attended include the African Development Bank, DFID, GAVI, Global Fund, JICA, PEPFAR, USAID, UN Agencies, the World Bank and regional bodies (West African Health Organization and East, Central and Southern Africa Health Community).
The meeting aimed to spur a dialogue among countries and partners around a guiding document - Human Resources for Health: Good Practices for Country Coordination and Facilitation (CCF). The document was drafted basing on the Kampala Declaration and Agenda for Global Action. It includes a set of good practices for effective coordination among all stakeholders involved in and or affected by the need to strengthen the health workforce.
The draft CCF document proposes that for success in coordination, country coordination mechanisms or 'national alliances' can be set up involving all partners working on HRH issues in the country. In countries, where such mechanism or 'national alliances' exist, they can be further developed to ensure that all partners collaborate with one comprehensive HRH plan, consistently implemented by all stakeholders, including a unified monitoring and evaluation framework.
Here are some of the messages the countries and partners shared at this meeting:

Full-text: http://www.who.int/workforcealliance/media/news/2009/ccfghanastory/en/index.html

3

Lord Nigel Crisp - Champion for Global Health Workforce Alliance

The Alliance

03/11/2009


Lord Nigel Crisp has been a passionate and tireless advocate for health workforce issues since 2006. He has been acknowledged as "A Champion advocate for Global Health Workforce Alliance" by the Alliance Board Chair Sigrun Møgedal on 26 October 2009.
We met Lord Nigel Crisp in Accra, Ghana, where he presented his current initiative "Zambia UK Health Workforce Alliance" at the first meeting with countries and partners on "Good Practices for Country Cooperation and Facilitation".
Lord Nigel Crisp, congratulations for being named a Champion Advocate. Please share with us why issues around shortages of health workers are important today, and why did you come to choose the issue as your mission?
When I was running the health service in the UK, I was very conscious that there were a lot of people coming from developing countries to work in the UK, which gave us a great deal of variety and experience to draw on. But when I left the health service and went to countries in Africa and South Asia, I saw that how these migrating health workers were missed in their own countries. But then when you look at the figures you discover that even if every African health worker who migrated went home, that will only deal with 10% of the problem. There is only about 180 000 health workers moved abroad, but in Africa, you need about 1.5 million more health workers. So the biggest challenge is in producing more health workers through training and education. And ever since then I have been concentrating on how we can scale up training and education for the health workforce in Africa and other developing countries.
We are here in Accra, where fourteen African countries have come together to a first consultation of its kind to exchange and build on "good practices". Countries agree that health workforce issue is an issue broader than the health sector and it requires a coordinated response involving a multitude of players. What are the key lessons that we should take away?
I am going to limit myself to three comments. The first is to congratulate GHWA for bringing people across the sectors: health, education, labour, finance, private sector and academic institutions. Everybody is going to work on this together. And this is the biggest single message. The second one is that what you do actually depends on the country. You can learn from other people but whatever you do is going to be rooted in the needs of the particular country. It is no good bringing in a lot of radiologists into a country where may be that is not the issue that they want to do. The third is that whatever you do should be transformative. It needs to be about creating workforces needed, using approaches that will work locally. We focus on this principle in setting up the Zambia UK Health Workforce Alliance. Here in Accra, I hear masses of creativity all over the meeting and we need to build on this new energy to find solutions.
Lord Crisp served as a co-chair of the Alliance Task Force on scaling up training and education of health workers in 2007-2008. Appointed as a member of the group of "Champion Advocates" for the Global Health Workforce Alliance, Lord Nigel Crisp is an Independent Member of the House of Lords, the United Kingdom. Alliance "Champions" are prominent figures within the health and development community, who can influence political agenda at the decision-making level in global, regional and country levels.
A Cambridge philosophy graduate, Lord Crisp worked in community development and industry before joining the National Health Service (NHS) in 1986. He worked in mental health and acute services and was the Chief Executive of the Oxford Radcliffe Hospital NHS Trust, one of the UK’s leading academic medical centers.
Among many of his international and domestic health initiatives, Lord Crisp chairs Sightsavers International, a charity working to prevent avoidable blindness in developing countries. Lord Crisp is also a Senior Fellow at the Institute for Healthcare Improvement in Cambridge Massachusetts and an Honorary Professor at the London School of Hygiene and Tropical Medicine. From 2000 to 2006, Lord Crisp was the Chief Executive of the NHS - National Health Service in the UK, and Permanent Secretary of the Department of Health.

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Africa & Middle East

1



Health minister visits tindumba
Swazi Observer

02/11/2009


By Njabulo Dlamini
MINISTER of Health Benedict Xaba will visit traditional healer’s houses (tindumba) soon to ascertain the extent of compliance to hygiene and how these structures could be integrated to the (health) system.

The minister said it was erroneous to exclude traditional healers when coming up with interventions for the health sector because a majority of the populace does consult them from time to time.

“In fact, most patients consult traditional healers prior to visiting hospitals and clinics. It should be know that present minister of health does not have a problem with traditional healers hence the intention to visit them soon,” Xaba said.

He was speaking at Mkhuzweni Health Centre on Friday when he visited the institution following several complaints from the community and MPs David Shongwe (Mayiwane) and Jeniffer Shiba (Timphisini).

Both legislators had informed the minister in parliament that Mkhuzweni faced challenges ranging from falling ceiling, shortage of nurses and drug shortages.

The minister said drug shortage was not a problem but the administration hopping ministers and MPs will support his bid to engage a private company to take over management of drugs at Matsapha Medical Stores. He also promised to employ pharmacists for the health centre even if it called engaging expatriates for it.

“It is an anomaly that nurses dispense medicine here for they were never trained for this. One could encourage Swazis to study pharmacy for there are very few locals qualified in this field and that’s why the ministry would go to the length and breath of Southern Africa to look for pharmacists.

“We would go as far as Zimbabwe since it is many of them possess qualifications in various medical fields,” he said.

He received a round of applause from the gathering when he promised that all vacant posts would be filled at the health centre.

These posts include a laboratory supervisor, additional nurses, midwives, two pharmacists and another officer for the X-ray department.

Also the number of days for treatment of patients suffering from hypertension and sugar diabetes will be increased to two per week.

Accompanying the minister was Deputy Chief Nursing Officer Mavis Nxumalo, Hhohho Regional Health Administrator Dudu Mbuli and other senior officials.



2

Challenges of poaching in the ICT world
Sun Daily, Nigeria

03/11/2009


By BISI OLALEYE
Poaching has become a sort of worry in the ICT sector of late and in this piece, BISI OLALEYE examines the economic and social implications for Nigeria.
Some years back, Nigeria experienced the problem of brain drain especially in the health sector, but it is now in every sector.
Recently, now what obtains, is poaching.

Already, the Information and Communication Technology (ICT) sector is mostly affected because many people are not growing on the job rather they are moving from one company to another in search of better emolument.


Within the initial paradigm of a brain drain, there was a clear answer to the question of who wins and who loses. It’s generally accepted that countries suffered from the brain drain, while some countries benefited by experiencing a “brain gain”.

The advantage of this type of approach is that, while providing access to expatriate human and social capital, it does not deprive host countries of useful human resources. However, its viability and effectiveness still have to be established as well as possible.


Observations

Industry watchers have noted that while an individual may enjoy job change due owing to newer comfort zone in terms of the welfare and social package. The implications are not too favourable to the country.

According to one of them, Juliet Webster, one may not need to blame individuals who migrate from one ICT company to another but itself.
She added that 70 per cent of core network engineers are expatriates and they drive the network, which should not be. She disclosed that many companies have shielded from the responsibility of training their staff, owing to bureaucratic management decisions.

“Age is another area where many ICT companies only focus on certain groups. “Age” starts early in this sector. Over forty? Even experienced workers have difficulties finding a new job. They are up against such arguments as not being so healthy, having difficulties learning, being overqualified and therefore too expensive, and no longer being highly productive. Just 20 per cent of all ICT employees are under 45 – much lower than in other industry sectors”.


Matthew Nwaezemefune, also an industry watcher stressed that many companies are now reluctant to train staff on the job since many would still go for higher ‘pay’. Citing as an example, one of the leading network operators, he explained that though this company has a passion for training and re-training of staff but many of its workers have migrated to other networks owing to different reasons.
He revealed that reasons network providers have challenges is that trained network engineers are hard to come by. Many of them are expartrates, they require much money, and at the same time, much money is needed to manage the operations.

This, he insisted is a major challenge in the development of network areas. Asides this, he indicated that IT service providers like Cisco, Microsoft and other equipments providers are also not left out in this uphill task. Many of their driving forces are expartriates who drive the network.


Effects on the economy

In the global knowledge-based economy, the international mobility of skills-holders has become viewed as a natural extension of the traditional cosmopolitan character of the world’s scientific community. At the same time, however, since research and development has become a major source of wealth and of socio-economic development, there is intense competition between nations to attract qualified scientists and technologists.


Without much ado, it is believed that there is now a massive drain of skilled hands in the sector. It appears that it is only the highest paying and secured ICT companies that gets the best skilled hands. However other recruits are not privilege to enjoy the kind of training and experience many of them must have had in the past

3

"Be Careful When Considering Migration"
Peace FM Online, Ghana

03/11/2009


The Health Services Workers' Union of the Trades Union Congress (TUC) on Tuesday advised nurses, midwives and other health workers to weigh the benefits and consequences when considering migrating.
The Rev Richard Kwasi Yeboah, National Chairman of the Union, said this at the launch of a journal, captioned Pre-Decision and Information Kit (PDK) on migration and women health workers in Koforidua.
The journal was jointly produced by the Health Services Workers Union (HSWU) of the TUC and the Ghana Registered Nurses Association (GRNA) both affiliates of a Global Trade Union Federation known as the Public Services International (PSI).
It is specifically intended to provide aspiring migrant health workers information on required documents before travelling, recruitment procedures, migrant health worker rights, information on illegal recruitment practices, support services for migrant health workers and contacts of Ghanaian Embassies and High Commissions abroad.
The Rev Yeboah told prospective migrants to take into consideration some questions relating to international migration such as the credibility of the recruitment and recruitment agencies, the terms and conditions of overseas employment, information on pre-departure and departure orientation before making a decision to embark on migration.
He said the HSWU and the GRNA had decided to network to minimize the high attrition rate of trained women health workers and other health professionals in the country through advocacy actions and campaigns that is "health care workers are not for sale".
The Rev. Yeboah said he was happy to note that currently the attrition rate had reduced significantly.
He said that was due to enhanced sector salaries implementation in 2006, the provision of saloon cars for health professionals and the mandate given to the Nurses and Midwives Council on bonding, not to issue verification certificates to applicants who intend to migrate internationally.
The Rev Yeboah said despite the enhanced consolidated health sector salaries, stakeholders still had the major challenge to deal with the question of the push factors that were still inherent.
These include the relatively poor working conditions of service, the frustrations and stress resulting from inadequate basic materials and equipment at the facility level, the heavy workload resulting from inadequate skilled health staff and free deliveries for pregnant women policy.
He suggested to government to increase the health sector budget to enable the health authorities procure the retractable syringes to reduce the risk that health care providers in the country are going through with the hypodermic needles and syringes.
He also suggested that motivation is fairly distributed to cover all health workers and not but a few who consider themselves "as key health workers".
Dr Anthony Baah, Deputy General Secretary of the TUC, who launched the journal urged workers to form strong unions to fight for their rights and good working conditions. He commended the two unions on their initiative and called on them to print more of the booklets. Dr Baah also called for the printing of the French version of the journal to cater for members in the French speaking countries.
He challenged young health professionals to accept postings to the rural areas where their services are mostly needed.

Source: GNA



4

Bastonário da Ordem dos Médicos pede mais formação
Angola Press

30/10/2009


Luanda - O bastonário da Ordem dos Médicos de Angola, Carlos Alberto Pinto de Sousa, defendeu hoje (sexta –feira), em Luanda, a necessidade da formação de mais médicos para cobrir a carência existente no ramo de saúde.
Carlos Pinto, que foi um dos palestrastes da quarta jornada da Clínica Multiperfil, disse que a solução, para redução da carência de médicos, passa pela abertura de mais faculdade para aumentar o número de médicos em Angola.
“A formação de profissionais de saúde no exterior e outra alternativa e, provavelmente, a curto e médio prazo, teremos mais médicos especialistas em diversas áreas”, disse.
O bastonário disse também que se deve pensar na formação de outros profissionais, por a acção na área da saúde ser multidisciplinar e exigir dos técnicos de diagnósticos, enfermeiros e especialistas, qualificação e profissionalismo em todas as vertentes, por formas a melhorar a qualidade de atendimento da população.
A qualidade de estar sempre presente nos temos bons profissionais de saúde, particularmente médicos temos muitos bons profissionais, agora a que melhorar toda os aspectos que influência directa ou directamente no exercício da medicina em Angola em termos de qualidade de atendimento.
Quanto ao tema das jornada realizada pela Clínica Multiperfil, disse que humanizar significa melhorar o atendimento, ter uma relação com o paciente paternalmente e de irmandade, valorizar o paciente e dar muita importância naquilo que se chama história clínica.

Sobre a abertura do Gabinete do Utente, o médico reconheceu que veio melhorar a relação entre paciente e instituição. “Os pacientes colocam ai as suas preocupações as suas sugestões.


As quartas jornadas científicas da clínica decorreram sob lema “Qualidade e Humanização no Atendimento”, visando promover o debate em torno da ética na prestação de cuidados de saúde.
Participam nestas jornadas professores universitários, especialistas angolanos, brasileiros e cubanos, bem como enfermeiros, médicos e altos funcionários do Ministério da Saúde.

5

Parteiras tradicionais recebem kits de trabalho no Sambizanga

Angola Press

30/10/2009
Luanda – Cinquenta parteiras tradicionais do município do Sambizanga, em Luanda, receberam hoje vários kits de trabalho, numa iniciativa da Direcção Provincial da Promoção da Mulher.

De entre os bens oferecidos constam luvas, resguardes, álcool, algodão, compressas e clampcis, que ajudarão no exercício do trabalho das parteiras.

Segundo a chefe de repartição social da administração municipal, Cândida Dias dos Santos, a intenção é potenciar as profissionais com meios adequados e proporcionar-lhes melhores condições de trabalho.

Cândida Dias dos Santos informou que o uso de utensílios apropriados para a prática de partos facilita o trabalho, garante higiene e segurança de vida quer dos recém nascidos, quer das parturientes.

A responsável louvou o desempenho das parteiras nas comunidades, que têm facilitado e desafogado o fluxo de gestantes nas salas de parto existentes nos centros de saúde do município do Sambizanga.

Algumas parteiras reconheceram terem efectuado vários partos em condições precárias, por falta de material apropriado para o efeito, mas sem causar problemas de saúde, dada a experiência adquirida ao longo dos tempos.

“Estamos conscientes de que os kits não colmatarão todas as dificuldades, mas acreditamos que vão ajudar a minimizar as carências”, disse Cândida dos Santos, acrescentando que as parteiras realizam entre 10 a 15 partos por semana, apesar de existir nas três comunas salas de parto nos centros de saúde.

6

'Doctors And Other Health Workers on Same Grade Level Must Earn the Same Call Allowance'
Daily Trust, Nigeria

05/11/2009


interview
Abuja — In this interview, the Federal Capital Territory (FCT) Chairman of the National Association of Nigerian Nurses and Midwives (NANNM) Comrade Abdullahi Yayaha speaks on potential threats to NANNM current negotiations with the Federal Government on the "discriminatory Call Duty Allowance" and the recent recall of health workers sacked by former FCT Minister Malam Nasir El-Rufa'i in 2006, amongst other issues.
The FCT Administration recently recalled some of your members who were sacked in 2006. What is your take on that?
We thank God and we thank the government of the FCT under Senator Mohammed Adamu Aliero for that magnanimity. Like we said before, people just asked for improvement in salaries and the government of El-Rufa'i under the Obasanjo administration laid them off and since then the health sector of the FCT has not been the same. We are happy that last month the minister approved the recall of about 50 health workers; most especially those of them with specialist certificates and who still have some years to go in service. We want to thank the minister for that magnanimity.
But there are some clauses or areas we are not satisfied with; for instance, these people were laid off not out of their own making but from government's perceived lapses. So, if government is saying they should come and pay back some money which they had been paid knowing full well that that would be impossible or that they would not give them promotion for these three years that they have been away, then, those areas we believe need to be looked into.
We expect that government would say, well, we are sorry for removing you from your job for no fault of yours, let us sit down and see how much we are owing you and how much have been paid to you and at the end of the day, we look at who is having an edge; if what we have paid you is more than your entitlement, we receive from you and if what we have paid you is not up to, we pay you back. But coming to say that they would be deducting from what the workers are supposed to get, that is the area that we are still finding difficult. But we want to thank government all the same for that effort.
What reason was given by the El-Rufa'i administration for the sack?
There was no reason, if you go to the master list of the retrenchment, they just put redundancy, redundancy and redundancy; no any other reason and we are saying that how can a health worker be redundant? The same people that are now being recruited in Britain, Europe and other countries, you say they are redundant. Just because they asked for improvement in salary and because there was no communication from the government, the workers decided to go on strike; the authorities just decided to retrench them in their numbers.
You said about 50 were recalled, how many were actually retrenched?
They were over 100 but you know from 2006 and now, some of them whether by age or by status would have retired normally. Some of them were at their bar, they don't have any specialist certificate to improve on their knowledge, so some of them were allowed to go. In the health sector the moment you refuse to go for further studies, you become obsolete and in fact a danger to the patient. Some of them who refused to improve on their studies and for instance have just one certificate for over 20 years were allowed to go.
Are you saying that the El-Rufa'i administration used that exercise as an excuse to punish some of your colleagues?
Yes, most definitely because most of the people that have been recalled now were in the leadership of the health workers union then.
Recently the Federal Government released a Medical Salary Structure (MSS) for medical doctors which your union protested against, leading to the setting up of a negotiating committee comprising your members and the Federal Government. What is the position now?
I am the State Chairman of the union in Abuja here, I am not a member of the negotiating team but on daily basis I call my national secretariat to enquire about what is happening and I am reliably informed that right now the three areas that were initially very controversial; Call Duty Allowance, Administrative Allowance and the Specialist Allowance for health workers have been narrowed down to only the Call Duty Allowance where the minister of health is still not ready to harmonise with the union.
What we are saying in Call Duty especially is that a doctor who is on level 12 receives the same amount of money with a physiotherapist, nurses, pharmacist, the laboratory scientist and everybody who is on that same grade level. They must be paid the same amount of money and that is just what will bring equity. That is the area right now where the ministry of health is still having difficulty affecting and if that is not done, no matter the other things that might have been done, that will not create the harmony that we are looking for.
In specific terms, where is the problem with the call duty?
The doctors always assume that they are the leaders of the hospital or the health team and they must earn higher than the others and we are saying no; if you are coming out fresh from school and you are on level 12 and these others will take 10 to 15 years to get to level 12, we have already closed the gap on length of service or length you spent in school. That is one; no doctor can perform alone in the hospital. Medical profession is not like the law or a surveyor or an engineer, the doctor, for him to diagnose you properly, will need the services of a radiographer, laboratory scientist, physiotherapist and others.
If a surgeon opens up a patient, immediately he opens you up and sews you back, you need continuous services of the nurse for the wound to heal and for you to go back home. That shows you the hospital work is a team work. if you pay doctors alone, the implication is that patients will suffer because when a patient comes, of course the doctor will not always be there and every other person will say well, since you are paying the doctors all the money, we will all wait and let the doctor do all the work and everybody knows that doctors cannot do all the work and that is the fear; that is why we are already shouting out and calling on the public to also join us to shout and say, please pay all the relevant health professionals the same quality of money for them to be able to give qualitative service. If there is disparity especially in Call Duty, or Shift Duty, then the crisis and the disharmony will continue.
Are you saying that only the doctors receive the Call Duty Allowance?
In the past, there was this glaring disparity where doctors were collecting four percent, the pharmacists were collecting two and a half percent of their basic salaries and the nurses were collecting one point seven percent; government did a job evaluation and discovered that other health workers have seriously closed that gap. But the ministry of health has abandoned that job evaluation to go for a straight forward table. The same table now is what the other health workers are saying well and fine, the table you have adopted for doctors; use it for other health workers. If a doctor on level 12 is for instance earning N1000 per unit call, let the pharmacist on level 12, a nurse on level 12 and a physiotherapist earn N1000.
We are not saying that a doctor that is on level 12 and a nurse that is on level 7 should be paid the same money. We are saying health workers on the same level should earn the same amount of Call Duty. Anything short of that will bring disharmony and even if government force people to accept it, the work in the hospitals will not move because all these people will leave the work and say if the doctor earn all the money, let him do all the job and it is obvious that the doctor cannot do all the job; why are we deceiving ourselves?

7

Zain and Ericsson join forces to provide 3.5G in rural Ghana
IT News Africa

04/11/2009


Working with the Millennium Villages Project, collaboration between The Earth Institute at Columbia University, Millennium Promise and the United Nations Development Programme (UNDP), Ericsson and Zain have deployed mobile communications services in the Amansie-West district of the Ashanti region of Ghana. The Bonsaaso cluster of Millennium Villages consists of 6 distinct villages namely; Bonsaaso, Watreso, Datano, Keniago, Takorase and Asamang, with an estimated population of 5,000 residents per village. These villages are in a largely rural area of the country and are some of the poorest regions of Ghana. The project will enable them to work towards achieving the United Nations Millennium Development Goals (MDGs) which were endorsed by all world leaders in 2000.
Chris Gabriel, CEO Zain Africa says the company is collaborating with Ericsson to provide communications solutions that will help to improve the quality of life for people in one of the remotest parts of Ghana. “The concept of the Millennium Villages Project reflects the Zain core value belonging. The introduction of the latest 3.5G mobile networks to these villages will empower the residents to climb out of the poverty trap and create a sense of belonging by enabling them to connect with each other and the rest of world by phone and using ultra fast internet connections.”
The villagers in the Bonsaaso cluster are faced with a myriad of problems. Community members have to travel between 2 and 40km to access the few functional health facilities and there is only one hospital within 40km of the villages which has proper facilities to treat all the common health problems experienced by the community. The inadequate number of healthcare workers and the poor conditions of the road, coupled with the lack of adequate transport for the workers, makes healthcare outreach in the communities very difficult. Additionally, from an educational perspective, not only do learners have to walk up to 5km to go to school, but there are not enough primary schools to support the population of this cluster alone. Additionally, as most schools do not have the basic equipment and the adequate number of qualified teachers, there is a large disincentive to many students to attend school.
Economically, most of the fertile lands, which are closer to the communities, have been used for cocoa production, pushing food crop production to remote areas. As a result, farmers have difficulty in finding a ready market for their farm produce due to the long distances from market centers and the poor condition of the road network, which can be very difficult to navigate.
Says Lars Lindén, President of Ericsson sub-Saharan Africa, “Together with Zain, we have developed a comprehensive and end-to-end communication solution by providing state –of- the art 3.5G mobile communications and Internet access for these clusters. This includes not just the underlying infrastructure, but mobile applications that will enable access to health, education, information on weather and agriculture, and in general improve livelihoods, while at the same time support the achievement of the MDGs.”
Since the beginning of the project in Ghana, three new clinics have been constructed and two renovated and Zain, together with Ericsson , are supporting these clinics with fixed wireless terminals for schools and clinics, and toll-free numbers for the emergency services and healthcare workers – allowing for a quicker and more efficient delivery of such services. Zain is also providing SIM cards with a closed user group facility, allowing the healthcare workers to consult each other free of charge with Sony Ericsson is donating the mobile handsets to the community health workers and emergency services. Ericsson has also provided solar powered chargers for the mobile phones – ensuring that these healthcare lifelines are available at all times. Furthermore, by providing fixed wireless terminals and Internet access at learning centers in each cluster, Zain and Ericsson are bringing the outside world to the teachers and pupils – providing them with limited Internet access and valuable teaching aids.
The establishment of a 3.5G network in the clusters also provides farmers with the opportunity to access information about availability of goods and pricing from vendors without having to travel – mitigating risk and diversifying outputs while increasing income.
Jeffrey Sachs, director of the Earth Institute, adds; “The power of access to mobile communication to potentially transform lives in rural African villages and ultimately to help eradicate extreme poverty is beginning to be well documented across the world, and we are bringing this to life with Ericsson and Zain in the MV project. We are convinced that the benefits and potential of this project will fast-track transformation of the lives of the residents of Bonsaaso, and all the Millennium villages, in ways that we could never have imagined just a few years ago.”
“We are creating enormous opportunities for this community and by working with Zain; Ericsson is able to focus its contribution on bringing mobile voice and Internet services to the community which enable access to health, education and small businesses. The project is another concrete example where we are realising our commitment to the MDGs, while at the same time stimulating positive business impacts in Africa,” concludes Lindén.

8

Health Institutions Operating At 17% Capacity
Peace FM Online, Ghana

04/11/2009


Health institutions in the Upper East Region are operating at 17 per cent capacity due to inadequate infrastructure.
Mr. Lucio Dery, Acting Regional Director of Health Services, who made this known in Bolgatanga during the inauguration of the boards of governors of health training institutions in the region, called for collective local initiative to solve the problem.
He noted that a local midwifery training school could not admit students due to lack of classrooms and accommodation. "The structures and the deplorable conditions there are a disincentive to successful candidates," he said. Mr. Dery said due to the National Health Insurance Scheme, the medical facilities were recording a large number of patients, hence the need to train more health workers and also attract postings to the region.
He said refusal of personnel to accept postings to the area was hampering health delivery. Mr. Mark Woyongo, Regional Minister, who inaugurated the boards, announced that he had directed all municipal and district assemblies in the region to sponsor the training of at least four medical students and other health professionals who would be bonded to serve in their localities after graduation. "This, I believe, is the only way by which we can have medical doctors and critical health professionals in our hospitals on sustainable basis," he added.
He stated that government had resolved to provide the necessary infrastructure and equipment to enhance efficient service delivery of health workers. Mr. Woyongo said government was also keen to improve on the service condition of health workers in the rural communities as incentive.
Each of the five health facilities in the region had seven- member board of governors sworn into office by the Bolgatanga Municipal Magistrate, Ms Vivian Lariba Yamusah. They also took the oath of secrecy.

9

Prof Mwaikambo: Tanzanian who earns top Harvard accolade
The Citizen, Tanzania

03/11/2009


BOSTON, Tuesday

In the United States, the doctor-to-patient ratio is roughly 1 to 400. In Tanzania, the ratio is upwards of 1 to 50,000.


That astonishing disparity prompted Prof Esther Mwaikambo, this year�s Harvard Distinguished Africa Lecturer, to address the topic head-on.
Prof Mwaikambo is a physician and professor of pediatrics and child health at the Hubert Kairuki Memorial University, a teaching hospital that she helped to found in Dar es Salaam, Tanzania�s principal commercial center and de-facto government seat.
Appearing at the Center for International Studies October 20, Mwaikambo discussed Doctors for Africa: The Challenges of Establishing a Medical University in a Resource-Poor Country like Tanzania.
The needs are great in a country where the gross national income is $660 per capita, and where almost two-thirds of the population lives below the poverty line, defined as earning less than $1 a day.
''It is a grim picture indeed,'' Prof Mwaikambo said after citing those and similar statistics, ''but probably not all is lost.''
Tanzania is hardly unique among African countries in its shortage of medical schools.
According to a 2004 paper by Amy Hagopian, of the University of Washington�s School of Public Health, there were only 87 medical schools in the 47 nations of sub-Saharan Africa; 11 of those countries had no medical school, and 24 had only one each.
Many physicians who do graduate from African medical schools end up leaving the continent to seek higher-paying, less-frustrating jobs in the West.
The area�s shortage of doctors � along with nurses and other health care personnel � contributes to the dearth of quality health care for the region�s 800 million people.
In addition, sub-Saharan Africa has high infant and maternal mortality and morbidity rates, rampant HIV, and higher rates of developmental disorders and preventable diseases, such as malaria and cholera.
Besides Tanzania, African nations with some of the world�s worst doctor-to-patient ratios include Malawi, Ethiopia, Mozambique, Niger, Chad, Rwanda, and Somalia.
To ease the crisis in medical training, care, and health-related research, Harvard is working in partnership with several nations across the continent.
Lecturer on Medicine David Bangsberg and the Harvard Initiative for Global Health have begun a Global Health Scholars Program, providing advanced training for health professionals in Uganda who are committed to continuing to work in their home countries.
Harvard-affiliated researchers are also working in state-of-the-art laboratories in Botswana's capital of Gaborone and in a similar facility at the Nelson Mandela Medical School in South Africa to get a better handle on those nations� Aids pandemics.
In addition, physicians from Harvard-affiliated hospitals are assisting in a variety of health-related projects, from improving Aids and TB care in the mountains of Lesotho to probing the roots of the violent rape crisis occurring amidst the turmoil of the eastern Congo.
Prof Mwaikambo was speaking metaphorically of �the picture� in Tanzania � but a slide that she showed was indeed grim.
Taken in a Tanzanian pediatric ward, the photograph showed a dark, dormitory-style room with little equipment, scarce privacy, and miserable-looking children slumped two to a bed.
Unfortunately, such a scene is not atypical in her country or in others in the region.
Until her teaching hospital was started in 1997, there was only one medical school in Tanzania, graduating 25 to 40 doctors annually. ''As if that was not enough,'' Prof Mwaikambo said, �a lot of these doctors would run away from the country.''
The ''brain drain'' is understandable, she said, in a nation where it is so difficult to practice medicine, and where the pay is so low.
''We can forget about them, because a lot of them wouldn�t consider coming home.''
Though the government still has not addressed the brain drain, it has liberalized education policies, which is one reason why her teaching hospital was able to get off the ground.
In 1996, when the government passed a law to encourage the establishment of private universities in Tanzania, there were only three such institutions. Now there are 25, and Kairuki Memorial is one of the oldest and most respected.
But the hospital still faces many constraints, including finding qualified academic and administrative staff, maintaining adequate financial incentives for employees, and upgrading inadequate infrastructure.
The entire university � lecture halls, labs, offices, and hospital � is housed in one nine-story building.
''It is an interesting process, starting a medical school from scratch,'' Prof Mwaikambo said.
''All the little things that, coming from a government university setting, you never had to worry about � phones, computers, pens, and paper, things that were just there automatically � you now have to make appear. And those are just the little things.''
Though the school has collaborative relationships with the University of Utah and Duke University, telemedicine is impossible because Tanzania�s electrical service is too unreliable.
Other challenges include teaching medical ethics � ''It's difficult to get students to do what they don't see in their seniors,'' said Prof Mwaikambo � and brokering a working relationship between modern doctors and the traditional cultural ''doctors'' with whom most people feel comfortable.
But there is a brighter side. About 560 students are currently enrolled at Kairuki Memorial, and 161 physicians have graduated since 2004.
The university hopes to expand soon by increasing its student base and by opening pharmaceutical and dental schools.
Photographs of the university show neat rows of students concentrating at their desks; stacks of library books in a well-lit, modern facility; and proud graduates in colorful caps and gowns.
''We are facing our second decade with a lot of expectations of sustained growth and development,'' Mwaikambo concluded. ''In my opinion, the future looks assured.''
This article was first published in Havardgazette

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Asia & Pacific

1



Taiwan moves up date of swine flu shots for students
Taiwan News

03/11/2009


Taipei, Nov. 3 (CNA) Taiwan's health authorities have moved up the dates for young students to get vaccinations for the new influenza A (H1N1) after parents complained the youngsters had to wait too long, especially as the number of infections continued to rise, with nearly 1,000 classes suspended so far.

The Central Epidemics Command Center (CECC) -- an ad hoc committee organized by the Executive Yuan to tackle the outbreak of swine flu -- announced that the date for swine flu shots for elementary school students will be moved up to Nov. 16, from Dec. 1.


The immunization date for junior high school students will be moved up to Nov. 23 and that for high school students advanced to Nov. 30, according to the CECC.
On Tuesday, Hsieh Kuo-ching, chairman of the National Alliance of Parents Organizations, complained that while the nationwide immunization drive against swine flu kicked off on Nov. 1, waiting until after Dec. 1 to give students shots might not meet the urgent need to avert the spread of the virus.
The demand from the parents' association came as the Department of Health's Centers for Disease Control (CDC) said Tuesday that the number of people seeking medical attention after developing fever has been growing noticeably as the weather is getting cooler.
Of those who were screened through a fast screening process at the hospitals, 95 percent of them were found to have contracted the H1N1 virus, and a majority of these people were elementary and junior high school students, CDC officials said.
The nationwide H1N1 immunization program currently puts priority on vaccinating victims of Typhoon Morakot, as well as medical workers.
To determine whether the priority list should be revised, the epidemics command center will look into factors including the results of clinical trials on minors of the H1N1 vaccine developed by the local pharmaceutical company Adimmune Corp., the company's vaccine production schedule, and the vaccine's distribution nationwide, the center said.
So far only 500 hospitals have been registered to participate in the H1N1 inoculation program, compared to 3,500 hospitals that signed up to offer free shots for seasonal flu.
While only 2.99 million doses of the seasonal flu vaccine are being distributed, the CDC is expecting to give 12 million shots of the H1N1 vaccine by the Chinese New Year holiday in February next year.
That has led health authorities to conclude that there will definitely be insufficient health care workers at the 500 contracted hospitals to carry out the immunization program, according to CDC officials.
A shortage in health workers nationwide was also another factor affecting the smooth implementation of the immunization program, the CDC said.
The DOH has ordered 10 million doses of the vaccine from Taiwan's Adimmune Corp. and another 5 million doses from the multinational pharmaceutical company Novartis to cover an anticipated nationwide demand of 12 million doses.
Due to the spread of H1N1, a total of 936 classes at 511 schools nationwide have been closed as of Monday night, accounting for 0.62 percent of the total, according to CECC statistics.
Hsieh said that as the number of infection cases among elementary and junior high schools continued to rise, the government's contingency "325" policy is creating pressure for parents, teachers and students.
Under the "325" policy announced on Aug. 18, classes at kindergartens, primary schools, junior and senior high schools, as well as cram schools and day-care centers, must be closed for five days to prevent cluster infections, if any two students in the same class are diagnosed with H1N1 within three days.
Parents complained that there is currently no standard policy on when the classes can be made up, with some schools requesting students make up the classes in the evenings, on weekends or during school breaks.
Hsieh urged the Ministry of Education to persuade the CECC to review and change the "325" class closure policy to minimize inconvenience for parents, students and teachers.
To date, Taiwan has recorded 504 hospitalization cases of swine flu, including 27 deaths and 41 people remaining in hospital.
(By Chen Ching-fang and Deborah Kuo)

2

AICUFers embark on rural exploration camp
Mangalorean.com, India

03/11/2009


By Roydon D’Souza, Team Mangalorean, Mangalore
Mangalore, November 3, 2009: The students of AICUF (All India Catholic University Federation) unit of St. Aloysius College (Autonomous), Mangalore embarked on a Rural Exploration Camp which began with the Eucharistic Celebration in Loyola Vikas Kendra (LVK), Mundugod in North Kanara district, followed by the orientation program by Fr. Francis D’Souza S.J, Director of Loyola Vikas Kendra.
Fr. Francis D’Souza S.J, Director of LVK welcomed the students and gave a brief description about Loyola Vikas Kendra and its operations in Mundgod and Hanagal Taluks. He said “You are going to explore a different type of India here in this Exploration Camp and understand the real struggle of the people for existence”. Congratulating the students for making up their mind for the exploration camp he wished their exploration camp be happy, educational and memorable as possible.
Later, the students left to Loyola Vikas Kendra (LVK), Hanagal which is 31 Kms away from Mundgod, where they had lunch and Fr. Joseph Monteiro, S.J, grouped the students and assigned different villages to them.
A group of 38 students along with 2 animators will participate in the Rural Exploration Camp which will be focusing on understanding the real struggle of the people for existence in villages of Mundugod taluk of Uttara Kannada and Hanagal taluk of Haveri District.
The Mundgod Mission is situated in Uthara Kannada district, in Karnataka state and covers 75 hamlets. In close collaboration with the committed team of social animators, the Jesuits of Karnataka Province have been engaged in social action, formal, non-formal and technical education and poverty alleviation programs in these Talukas.
Loyola Vikas Kendra, a leading NGO in both Mundgod and Hanagal Talukas of Uttara Kannada and Haveri Districts respectively has put in sustained efforts to work for the integral development of these people, fight for justice, build pride in them, restore human dignity, create awareness, promote health and hygiene conditions, release them from the fetters of money lenders, and eradicate poverty from the lives of these people.
Standard of Living

The people belong to different backward, neglected and exploited communities. Mostly they are migrants from far off places. These communities include- Gowlis (cattle rearing tribe), Gollars (migrants) Lamanis (Gypsies from northern India), Siddis who are the descendants of an African tribe that came to India during the period of slave trade; Vaddars and Korwars (the natives from other State of India) who migrated during the severe famine of 1911. The people live in remote villages in the forests and work as agricultural and unskilled laborers. Their houses are made of thatched roofs with mud walls. Due to lack of employment opportunities and absence of health and educational facilities the parents are unable to meet the basic needs of their children.


Health Services

The project conducts health services through diagnostic check up camps, immunizations, awareness and training camps. Training and orientation programs are organized for midwives and health volunteers on preparation of herbal medicine. They are given safe delivery kits and, first aid kits to provide support at the doorstep to the target families. In coordination with local government, the project has attempted to address the need for toilets, improved housing conditions, drainage facilities, and hygienic maintenance of water sources like bore-well. The project has been making efforts to address the problem of malnutrition among children through provision of supplementary diet, training of mothers for preparing nutritious food and regular health check up camps.


Education Services

Most of the children identified for assistance are first generation learners. Believing that every child has the right to develop and prosper through education, the project has provided temporary residential facilities for the child laborers and school dropouts. To supplement educational needs of village students and ensure quality education the project provides educational materials and has posted additional teachers in the schools, where there is a shortage. To improve the academic performance of the weak students, special coaching classes are organized. Summer camps, talent tests, sports competitions and personality development camps are held regularly to develop the personality of the children. Technical training in various trades such as, carpentry, welding, tailoring, electrical wiring, plumbing and embroidery are also given to younger children for making them gainfully employed when they reach employable age.


Livelihood Services

In order to stop migration and help beneficiaries to earn their livelihood, the project has implemented several sustainable economic development activities. These activities include support for animal husbandry, brick making, de-silting village water tank, rearing fish, preparation of bio manure, flour mill, irrigation infrastructure, training in rope making, phenol preparation and so on. The project has also plans for creating marketing infrastructure to help beneficiaries earn justifiable profit and introduce scientific and sustainable techniques & practices in agriculture and animal husbandry.






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