Disappearing Doctors

Gia and I have been working at Martha Tubman Memorial Hospital (MTMH) for almost two full weeks now. MTMH is a seventy-bed government-run hospital for southeastern Liberia. Before we arrived, there were only two physicians, including the hospital administrator who is an ophthalmologist and a surgeon who is funded by an NGO named Merlin. As the hospital administrator has many competing duties, the Ethiopian surgeon, Dr. Tekle, essentially became the only physician making rounds on patients. Before we arrived, Dr. Tekle rounded three times a week on the inpatient wards, including all female, male, obstetric, pediatric and surgical patients. Twice a week, he is in the operating theatre performing elective surgeries. He is the on-call physician 24 hours a day, 7 days a week, staffing the entire hospital, including the emergency department. Since Gia and I have arrived, Dr. Tekle jokes that he has finally some time for rest and relaxation.

Our first morning at MTMH, we joined him on his rounds and were left astounded and overwhelmed at how this one physician could be a pediatrician, general internist, obstetrician, and surgeon. Many African countries are suffering from “brain drain,” a term given to the luring away of African doctors to practice in Westernized nations like the United States. Liberia suffers from this, but its “brain drain” is also compounded by the small numbers of students pursuing medicine as a career. Approximately twenty Liberian doctors graduate each year from one medical school that is currently not officially accredited. So it is not surprising that here in Zwedru at MTMH, there is only one physician practicing who is not a native Liberian. While no country’s healthcare system is perfect, Liberia’s continues to lag behind not only in material resources, but more importantly, human capital. Without a steady supply of trained Liberian physicians, the Liberian healthcare system will continue to depend on expatriates, who also have rapid turnover and burnout from the overwhelming healthcare needs and devastation of infectious diseases, including HIV/AIDS, tuberculosis, and malaria. Human capital is vital, and currently, Liberia is lacking that resource post-civil war.

The $1,000,000 question then is this: What can we do?