U.S. Doctors to Fill Vast Medical Gap in Africa

The shortage of trained health personnel in Africa is an ongoing problem, but one of the oldest organizations of African-American physicians wants to help. Dr. Kebreten Manaye, of Howard University College of Medicine, and Dr. Mohammad Akhter, of the National Medical Association, discuss a new initiative.

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MICHEL MARTIN, host:

We want to turn now to another story about Africa, about an effort to fill the chronic need for health workers on the continent. In the U.S., it's an exciting time for students in their final years of medical school as they learn which residency programs they will join. But some feel the many opportunities for medical training in America contribute to a brain drain in Africa since many of its prospective doctors leave and don't go back. Now, the National Medical Association, the oldest and largest African-American physician's organization, is trying to reverse that trend with an initiative to send doctors to train and support their colleagues in Africa.

Here with me in the studio in Washington to talk about this are Dr. Mohammad Akhter, executive director of the National Medical Association, and Dr. Kebreten Manaye, associate professor at Howard University's College of Medicine. Welcome, and thank you both for stopping by.

Dr. MOHAMMAD AKHTER (Executive Director, National Medical Association): Thank you for having us.

Dr. KEBRETEN MANAYE (Associate Professor, Howard University College of Medicine): Thank you for having us.

MARTIN: Dr. if you - Dr. Akhter, if you could start by telling me the scope of the need for doctors in Africa. For example, what's the ratio of patients to doctors?

Dr. AKHTER: Well, in many countries in Africa, there's shortage of physicians, but some of the rural areas really are the worst ones. There may be one physician for 200,000 people. And then the distances, of course, are enormous for them to travel, and so it creates a problem, even if the government has the money, how to take the services to the people.

MARTIN: And how did the idea for this initiative come about? And how's it going to work?

Dr. AKHTER: I think the basic idea - the people always had this idea of really going back to Africa, trying to help back the people there. But more recently, there's been a very bright spot in Africa, which is the creation of African Union. And as all these countries came together, they had a permanent representative here in the United States. He contacted us and said, wouldn't it be nice if we could do this health manpower development piece together in Africa in an organized way where we could continue systematically to build the infrastructure in those African nations, so that they'll have their own doctors, their own nurses, their own technician to serve the people?

MARTIN: And so, initially, what's it going to be? It's some 200 doctors initially are going to go for how long?

Dr. AKHTER: Well, the way the process works is that the - an African country makes the request through the African Union. And as the request comes, we have 30,000 members in the United States. We represent all specialties. We're all over the country. We also have four African-American medical schools that we have all come together. And so, we then take the requests from the country, and we match with the resources that we have, and then work with the country to make the arrangement, where our people go down there for somewhere from two weeks to six months, and just sort of provide the training, teach people new skills, but more importantly, systematically participate in their training programs, so their training programs are of quality, and they can scale up and train a lot more people.

MARTIN: Dr. Manaye, it's my understanding that you have volunteered to be part of this initiative. What drew you to it?

Dr. MANAYE: Yes. Being Ethiopian, my native country needs a lot of physicians. And like Dr. Akhter just alluded, we have disparity in health as well as a low number of physician per patients. So I am really excited going back, taking even my family, my daughter, to get in touch back to motherland as well as also help give back the opportunity I have been given to. So I am interested in teaching medical skills to the physicians as well as the health professionals back home.

MARTIN: It's your thought that you will be there for what? A year, a couple of months?

Dr. MANAYE: It will be between six to a year, six months to a year.

MARTIN: You know, Dr. Akhter, I'm wondering if this is in fact perhaps a little bit more emotionally complicated than we are in fact, you know, really revealing here? For example, you worked in the District of Columbia before you took this position with the National Medical Association. And you well know that there are health disparities among minorities in this country. And I'm wondering if perhaps some of your physicians who would be available for this service are torn because they're saying on the one hand, there are dire medical needs overseas, but there are medical challenges here, particularly for people of color. What - has that issue come up, and what do you say?

Dr. AKHTER: Oh yes, absolutely. The issue has come up, and our physicians have really looked at this very carefully. They've been taking these medical missions. All they do in their summer vacation or their vacation time, they take the time off, and go overseas, and provide medical care. They've been doing that for many, many years. But more recently, as they looked at their work, you know, it's like throwing bricks around and not really building anything. So now what they want to do is to build the buildings, build the institutions.

And this is what the change is. The change is from being individual going out there and trying to provide the services to the people during their own time versus really doing it in a systematic way. So it's the same amount of time, the same amount of energy, but properly directed towards building the institutions back in Africa. Rather than going somewhere and providing care to the people, it'll be a lot more important if you could train also the health professionals who can carry on the service and the work that people so desperately need.

MARTIN: So you're building institutional frameworks for doing what, in fact, you're saying people have been doing as individuals...

Dr. AKHTER: Yes.

MARTIN: For quite some time. But Dr. Manaye, I wanted to ask, for you, might this be a little complicated? On the one hand, do you have - I'm wondering if you have family members there who say why don't you stay?

Dr. MANAYE: Yeah.

MARTIN: Why don't you come back, and stay all the time instead of just coming for six months?

Dr. MANAYE: That's a good question. They do. And I'm happy to stay there. However, I have also responsibility for my students at Howard University, that I'm committed to train more African-American physicians. And these students can also be helpful to African countries, and give there training to our physicians back home. And I'm sure that's a question in many peoples' mind. Why we have all these African people go and stay abroad? However...

MARTIN: And what's the answer?

Dr. MANAYE: It's complicated because of the political situation back home. And also that home is here now for me because I have been over 22 years. And I have family here, my daughter. We are comfortable. However, we like to go back and, you know, serve our people, the native people. I would like, eventually, to go back home.

MARTIN: Dr. Akhter, what are some of the most critical needs that you're trying to fill overseas? Are there particular specialties for which you have a particular need, or is it just across-the-board?

Dr. AKHTER: In medical specialties, the basic need is for family practice, for pediatrics, and for OB/GYN - gynecologists are desperately needed. And so, these are the specialty. But we need people also in technical side. We need nurses. We need technicians. We need physician assistants. So that the demand is so great, the need is so great, that you just simply don't have enough people to really fill in all the slots.

MARTIN: Is there - is it anticipated that as some point perhaps medical students from the U.S. might sort of focus their interest on serving overseas as a part of their training? And how will they do that in a way that it doesn't, forgive me just for asking, disadvantage them when they come back here?

Dr. AKHTER: I think this is one of our goals, is to really go to the medical students at their National Medical Association, Student Medical Association, had the meeting in New York. And we made this presentation to 500 of them. And saying this is an opportunity, and students can do it two ways. One, during their vacation time, they can go down, and work, and learn about Africa, learn about the diseases that are common in Africa.

But there's another way. Most schools now offer electives that a student can take in Africa, get credit for the work when they come back. And institution building in Africa is geared towards that. So that a student when goes over there, there is the faculty. There are the patients. There are the organized system of evaluation, so the students get their proper grading when he or she is visiting Africa.

MARTIN: And why, may I ask, the focus on African-American physicians and African-American medical schools? Is there a sense that there is more of a cultural affinity, or what?

Dr. AKHTER: Well, there is a historical connection. There's historical connection. We all came, and I just want to tell this brief story that Dr. Adams and I were in Ghana visiting the slave castles. And at the dinnertime, the president of the College of Physicians and Surgeons in Ghana stood up and said, Dr. Adams, our president, you are the Joseph coming back to help his brothers. And you know, my neck spread out, and what a historical connection.

And so, there are many Josephs around here. There's nothing that created more excitement among our membership than really going to Africa. And I'm very proud of what our organization is trying to do. And this is one way of really helping the folks in Africa who have so little, and yet they are trying to survive.

MARTIN: Dr. Manaye, what will be the focus - we only have about a minute left, what will be the focus of your work when you go back to Ethiopia?

Dr. MANAYE: The focus will be mainly in training physician and medical students in the new technology that I have acquired in this country. And reaching back and make sensitivity to the culture, ethnics, values we have in Africa. And that we can implement this modern medicine in addition to their traditional medicine. So it's really to encourage more to continue the traditional medicine and also add the Western medicine into it.

So people have lived with traditional medicine for a long time, that I want to encourage it to continue and also teach them the new technology.

MARTIN: That's interesting. I bet there are things that we could learn, right?

Dr. MANAYE: Yes.

Dr. AKHTER: Right.

MARTIN: Dr. Kebreten Manaye is associate professor at Howard University's College of Medicine. We're also joined by Dr. Mohammad Akhter. He's executive director of the National Medical Association. They were here to talk to me about a new initiative to support medical training in Africa. They were kind enough to join me here in our Washington studio. Thank you both so much for coming.

Dr. AKHTER: Thank you for having us.

Dr. MANAYE: Thank you for having us. Thank you.

Martin: I'm Michel Martin, and you're listening to Tell Me More from NPR News.

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