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‘I had to find batteries to power the lights before I could operate on the woman’

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Dr Khine Hay Mar was the only doctor at a hospital in Mese – a town in Myanmar, near the border with Thailand. During her time as the sole physician there, in order to save lives, she relied as much on her ability to scrounge supplies as she did her medical expertise.

Dr Khine recalls a time when she was treating a woman in labour, with no power in the hospital, no anaesthetic in stock, and just one nurse to assist. Believing the woman and child would die if she did not act quickly, she went with her instincts and did all she could think to do.

She called for help from a military doctor post nearby, found batteries to power the lights, and found local anaesthetic drugs to apply to the woman’s spine. Then, she began the operation.

Luckily, both mother and baby survived.

However, this was not always the case, and Dr Khine was regularly frustrated at how limited she was in her ability to help patients due to lack of provisions. She says that no matter how well-trained you are, knowledge is not enough, and saving lives is impossible without the necessary tools and equipment.

Despite 40 million new health worker jobs set to be created worldwide by 2030 – according to the World Health Organisation – there is still an expected shortfall of up to 18 million. The largest deficit of health workers (in a 2013 report) was in South-East Asia, where Dr Khine is based. The shortfall there was 6.9 million.

In the coming years, this huge shortage is expected to be felt all over the world, particularly in low to lower middle income countries.

Population growth and changing demographics are expected to contribute to the future gap in numbers needed versus numbers available – as the concentration of healthcare workers will be in higher income areas, leaving those who need it most, without.

Over the last decade, there has been a 60 per cent increase in the number of migrant doctors and nurses working in Organisation for Economic Co-operation and Development (OECD) countries – generally, the wealthiest countries in the world – further contributing to the uneven distribution of workers. This ensures that there are fewer healthcare professionals available where there is a greater need. And that need is probably greatest in many parts of Africa.

Marjorie Mukukula is a university lecturer and former midwife from Zambia.

Once, while travelling to a rural area to pre-test Community Health Assistant Supervisory tools, she and her group found themselves assisting a nurse attending to a woman in labour.

“We could see that the woman was losing a lot of blood and was going into shock,” says Ms Mukukula. “The nurse was eager to assist the patient, but lacked clinical skills and didn’t know how best to access help from health workers in bigger health facilities where the patient should have been referred for specialised care. Time was running out.”

Having started resuscitating the patient, they contacted an obstetrician and were advised to move the patient to the nearest referral health facility, and the patient was evacuated there as soon as was possible. “This experience completely changed my thinking regarding the support nurses and their frontline teams in rural facilities should receive and ultimately this incidence contributed to significant insights in the way the Certificate in Leadership and Management Programme in Zambia is delivered.”

While the lack of vital skills and tools is responsible for failing medical care in some parts of the world, social issues can also contribute to the inconsistencies in healthcare in some parts of the world..



Lots of big-hearted folks working in dark corners of the world to bring life saving services to those in need.  May they continue to be inspired.

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