Developing countries have lost thousands of skilled health care workers to developed countries. One way to redress this imbalance is to develop innovative methods for training and developing the skills of health care staff in developing countries. Volunteers from developed countries can help to train and motivate health care workers who remain. They are also important in emergencies and in filling vacant posts.

Increased aid for health care in Africa will not be effective unless weak infrastructure is strengthened and unless health care workers feel valued and can progress professionally. Shortages are alarming; one famous medical school has two thirds of teaching posts unfilled. The poorest and the voiceless rural people suffer most, because rural posts are lost first as staff leave for other areas.

Volunteers can contribute to health care in:

• Emergencies and disasters. A major agency, for example Médecins Sans Frontières, will recruit workers to respond immediately. The benefit to the country is incalculable; without the volunteers’ skills the disaster escalates.
• Specific named posts. An agreement is made between a volunteer agency, for example VSO, and a government or institution; the volunteer posts depend on the current policy of the agency. An inappropriate request by a southern partner or an inadequate volunteer mean that benefits, though very often substantial and sustained, particularly when a post is filled repeatedly, are inconsistent.
• Long term partnerships or links between developed country training schools or hospitals and their counterparts in developing countries. There are now many links between hospitals in different countries that are growing in authority and value, such as those successfully sustained through The Tropical Health and Education Trust.

Partnerships and links are potentially highly cost-effective because they enable the southern partner to:

• make long term plans for staff development and continuing education
• improve care and its audit in hospitals or communities
• run new courses or strengthen weak ones.

Hospital and institutional links should be designed, monitored, planned and advised by link committees at each end, and receive long term financial support by the northern partner.  Costs are low because the link does not depend on much bureaucracy for recruitment, but on voluntary help within the source hospital. Links are thus highly cost-effective. Volunteers are selected, briefed, supported by and accountable to their source hospital or school.

All volunteers' activities are driven by the needs and requests of the southern partner and based on an open agreement.  Wherever volunteers go, they work to carefully defined objectives within a disciplined framework for a variable length of time, establish their credibility, get to know the country and, ideally, return year after year. They derive great professional and personal benefit and potentially witness genuine health service improvements, planned to the needs of the southern partner.

In order for developing country health services to make the most of volunteers, developed country governments must:

• recognise the contribution volunteers can make
• promote institutional links
• encourage volunteers through appropriate leave and other arrangements
• recognise that volunteers develop professionally, and such work is subsequently also an investment in the source health service.

Source(s):
id21 insights health #7, August 2005, Responding to the health workforce crisis Full document.

id21 Research Highlight: 13 July 2005

Further Information:
Eldryd Parry
The Tropical Health and Education Trust
210 Euston Road
London NW1 2BE
UK

Tel: +44 (0) 207 6798129
Fax: +44 (0) 207 6798190
Contact the contributor: eldryd@thet.org 

The Tropical Health and Education Trust

Other related links:
'Responding to the health workforce crisis'

http://www.id21.org/health/InsightsHealth7art2.html

'Filling the gaps: introducing substitute health workers in Africa'

'Committing donors to building health workforces'

'The Joint Learning Initiative Report: overcoming the crisis'

'Finding the answers to Chad's health workforce crisis'

Eldis/HSRC human resources for health dossier