3 July 2002, keralamonitor.com

How underpaid health staff survive

Geneva; Public health doctors in some developing countries earn at best only
20% of what their colleagues in private practice do, a recent study
reports. In rural areas they suffer additional disadvantages. Most health
staff naturally do all they can to avoid these hardships. "The brain drain
is not merely a matter of Congolese doctors moving to South Africa or
Philippine nurses to the United States; it also means migration from
public to private practice and from rural to urban areas," Wim Van
Lerberghe and colleagues report in this month's Bulletin of the World
Health Organization.

Those who do not migrate in one of these three ways compensate with
"coping strategies". Demanding under-the-counter fees, pressurizing
patients to attend private consultations, and selling drugs that are
supposed to be free are examples of "predatory" approaches. More
acceptable ones may simply involve staff switching between public and
private practice to top up their incomes. Administrators may have
fewer opportunities than clinicians, but they can also be better placed to
misappropriate funds. They can also pursue legitimate alternatives
such as teaching, taking other work outside office hours, or doing short-term
contracts for development agencies.

"Staff struggling to make ends meet is a major difficulty faced by
more than half the national health systems of the world," says Orvill
Adams, WHO's Director of the Health Service Provision department. "Yet until
recently it has been treated mainly as a problem of corruption rather
than the systemic challenge that it is for health services."

Topping-up helps to retain valuable expertise in public service but
It also raises financial barriers for access to health care, makes staff
Less available, and jeopardizes users' trust. In the long run, too, many
of the best clinicians end up in private practice and many of the best
managers in development agencies. Simple solutions will not work. For instance
closing the gap between private and public sector salaries is not
affordable for civil services as a whole, and politically difficult
to do for only selected parts of them. Downsizing the civil service itself,
even where this is achieved, is seldom followed by a narrowing of the
salary gap.

An unregulated health service will not be a less predatory one.
To prohibit seeking alternative income only drives the practice
underground, making it harder to control its ill-effects. The first step, the
authors say, is to bring the problem out into the open and recognize its
complexity. For further information contact Dr Mario Dal Poz, tel. (41 22) 791 35
99. Email dalpozm@who.int.

Multimillion Islamic Television channel from London.

The channel will be launched soon from London to air a positive image about Islam and the Arab world. An SR600 million English-language Arab satellite TV station will be launched from London soon to help clear misconceptions about Arabs and Muslims after the Sept.11 attacks. According to Prince Mansour ibn Naser, a Saudi businessman,the station, ATV, would be on the air "after finalizing some necessary procedures." The station has received funds from some charities and loans from international banks, the prince said. In the first phase, the station will broadcast in English mainly to viewers in Europe, the United States and Canada. It will broadcast in German, French, Spanish and Italian at a later stage, Arab News quoted him.

"The station will monitor the misconceptions and distortions broadcast by enemy stations" against Arabs and Muslims and try to refute them, Prince Mansour said. "The non-profit station will be the voice of Arabs and Muslims in the West. It will rely on sponsorships and advertisements for Arab and Islamic products," the report quoted him as saying..

"It will help improve the image of Muslims in the West, which was damaged" and linked to terror following the Sept. 11 attacks in the US, Prince Mansour said The station was also designed to help attract foreign investments to the Arab and Islamic worlds by highlighting investment opportunities and explaining investment laws in force in Arab and Muslim countries."ATV will help repatriate Arab funds worth $800 billion invested abroad," he said, adding that the repatriation of funds would lead to strengthening Arab economies and creating new job opportunities for Arabs, Arab News Report said.