Year 25+

A good place to start understanding the human resource problems in health care, particularly in regard to HIV/AIDS in southern Africa, is a special report available on the Doctors Without Borders website. "Confronting the health care worker crisis to expand access to HIV/AIDS treatment", at www.doctorswithoutborders.org, profiles the experience of this NGO in a number of key sub-Saharan countries, including Malawi and South Africa. Of course, every country is different, and each country has its own set of problems and potential solutions. While some countries have very limited capacity to train health care professionals, others train adequate numbers, only to see them leave or move out of the public sector- the phenomenon of "brain drain." One of the purposes of the documentary film "A Year in the Life" is to see the point of view of providers, and understand their motivations for staying, or leaving.
Ultimately, though, it's always important to look at the causes of the causes. Lack of overall infrastructure, poverty, civil strife and the rest all come into play. A good place to understand these dynamics is the new book by Paul Collier "The Bottom Billion." The poorest countries need a critical mass of things to work, from transportation, to education, before their economic situation can improve. In health care, that critical mass doesn't include just money, but also infrastruture and human resources. How that might be achieved is the subject of future blogs.