Year 25+

One of the most difficult aspects to practicing medicine (anywhere in the world) is uncertainty. The new mantra in medicine, and appropriately so, is "evidenced-based medicine". For some areas of medicine, such as cardiology, there are large randomized controlled studies that guide decision making. Even so, these studies generate statistical averages, and it is always hard to say if an individual patient will experience the statistical benefit, or the statistical harm. Many areas of medicine do not have these evidenced-based tools, and that is where experience and the art of medicine come to play. But imagine working as a doctor where even in areas of medicine where scientific knowledge exists, you don't have the means to bring the fruits of this knowledge to your patients. And so with some certainty you know your patient could have lived, only if they had the proper medicines. With more marginal cases, uncertainty still hovers, but much of that doubt is whether more effective tools would have made a difference. Then imagine you have doubts about being able to properly raise a family, providing an education for your children, or- in worn-torn countries- having basic security. But you are certain that a better life exists somewhere else. So you leave.

With the announcement of the first Global Forum on Human Resources for Health, the world is finally awakening to the crisis in human resources in health care. Until now, the vast majority of the energy and money spent on health in the developing world has not been in this direction. Maybe because the remedies are so complex, or it isn't a sexy enough topic, or it is linked to such an elaborate web of social, cultural and economic factors. As a recent commentary in The Lancet put it: "That the workforce was the engine of health work- obvious to practitioners and leaders on the ground in affected countries- was simply invisible to global leaders."
The Joint Learning Initiative has been one of the organizations at the forefront of bringing this issue to light. The WHO has also launched the Global Health Workforce Alliance (GHWA), which announced the upcoming Global Forum on Human Resources to be held in Kampala, Uganda on March 4-7. As The Lancet article points out, GHWA is launching four global task forces to address human resource problems: 1)Fast-tracking training and education 2)Ameliorating harmful aspects of migration 3)Harmonizing HIV efforts with health systems (so 'vertical' programs don't steal from Peter to pay Paul, i.e., drain health workers from public health to specialized NGO programs) and 4)Develop feasible financing options.
No easy task. 'A Year in the Life: Healing Africa' has one simple goal: to humanize these often abstract concepts. Just one part of a changing tide.