Newsbites

Iraq

Hospitals struggling

A man wounded in a bomb attack waits for treatment at a hospital in Tikrit,Iraq

Iraqi hospitals remain short of staff and are ill equipped to cope with large numbers of casualties.

“It is shocking to see how Iraqis today lack the most essential needs in terms of health services,” said Pascal Olle, the International Committee of the Red Cross’s health programme coordinator for Iraq. “Many patients that reach hospitals could and should be saved. However, emergency rooms and operating theatres are often not able to cope with the number of casualties,” he added.

Attacks in Iraq have fallen 60% since last June, US and Iraqi officials say. The Red Cross’s spokeswoman Dorothea Krimitsas said that although security had improved in some areas it remained poor or had deteriorated in others (www.reuters.com).

United Kingdom

No training for non-EU doctors

Doctors who graduated outside Europe will be prevented from coming to the United Kingdom for postgraduate training under new British immigration rules.

The move follows the collapse last year of the system for allocating training jobs under the weight of thousands of international graduates. Ministers say that from next year only junior doctors who have graduated from UK or European medical schools will be allowed to apply for training jobs.

The new rules will not affect the estimated 10,000 junior doctors from outside Europe who are already working in the NHS. They will be able to apply in open competition for training posts this year.

The health secretary, Alan Johnson, said, “It can cost up to £250 000 [€330,000; $500,000] to train a UK medical student, and, with the rise in UK medical schools, we are moving to a policy of self sufficiency. If UK medical graduates cannot access specialist training because of a large number of applicants from outside Europe, then it is only right that we should consider what needs to be done.

“I cannot stress enough that we are not closing the door to international doctors working in the NHS. These new rules only apply to training places in the UK” (www.telegraph.co.uk).

Developing world

UK criticises maternal health

As many as one million pregnant women die each year worldwide mostly from avoidable causes. British legislators criticised the lack of political will to tackle maternal health problems in developing countries.

The House of Commons’ international development committee said in a report that for every woman dying in childbirth in the UK as many as 1000 die in the world’s poorest countries. It added that the millennium development goal of cutting the number of maternal deaths by 75% between 1990 and 2015 seemed unlikely to be met, noting that there had been little progress in reducing deaths in the past 20 years.

Francisco Songane of the World Health Organization said, “The report rightly concludes that insufficient political will has been a key factor behind the shocking lack of global progress in reducing preventable maternal deaths.

“In 2008 we have a crucial set of opportunities, including the upcoming G8 [a summit of eight key industrialised democracies] to be hosted by Japan, where political leaders can demonstrate their commitment to strengthen health services for women, newborns, and children” (http://news.bbc.co.uk).

Africa

Brain drain continues

Industrialised countries are poaching so many African health workers that the practice should be seen as a crime, an international team of disease experts has argued.

Sub-Saharan Africa has lost more than 13,000 locally trained doctors to the United Kingdom, the United States, Canada, and Australia, say the authors of an article in the Lancet journal, including leading medical academics from Africa (2008;371:623; doi: 10.1016/S0140-6736(08)60274-3). Nurses and pharmacists from Africa are also sought by employers in rich countries, the authors say.

One estimate, published in 2004, is that from 1998 to 2002 Ghana lost about £35m (€46; $70m) of its training investment in health professionals who moved to the UK. This recruitment saved the UK £65m.

“The resulting dilapidation of health infrastructure contributes to a measurable and foreseeable public health crisis,” the authors write. “The practice should therefore be viewed as an international crime” (www.afp.com).

Paraguay

Yellow fever outbreak

A boy recieves a vaccination against yellow fever in Paraguay

Paraguay has had its first outbreak of yellow fever since 1974, joining neighbouring Brazil, which has been battling the mosquito borne disease since the end of last year.

William Perea of the World Health Organization said that the disease could spread particularly fast in suburbs and cities. He added that mosquitoes thrive in built-up areas with poor hygiene and sanitation.

Paraguayan authorities have declared a national emergency and begun a large scale vaccination campaign that has already reached some one million people, backed by shipments of vaccine from France, the United Nations, and neighbouring South American countries.

In the meantime health officials are urging the public to avoid stagnant water, where mosquitoes breed. Critics have attacked Paraguay’s government for not being prepared, especially after the Brazilian outbreak was widely reported in January (www.ap.org).

China

Tighter drug control?

China’s government wants to scrap its scandal plagued food and drug watchdog. The State Food and Drug Administration will be integrated into the Ministry of Health, sources told the South China Morning Post.

The watchdog has a troubled safety record, and its former head Zheng Xiaoyu was executed last year for accepting bribes in exchange for approving substandard medicines. Under Mr Zheng’s tenure, from 1998 to 2005, at least six approved drugs turned out to be fakes, and one contaminated antibiotic was blamed for killing at least 10 people.

“China’s current food regulation is too fragmented,” said Liu Guoen, a professor of public health at Peking University. A new “mega health ministry” would strengthen safety supervision by coordinating the duties of competing government agencies, he said (www.scmp.com).

Student BMJ 2008;16:135 | 17