Dr. Ryszard Jankiewicz is a specialist surgeon who trained in Poland. Before leaving for Africa he
worked for 18 years in Poland in a Regional Town Hospital. After shorter periods of work in Nigeria
and Haiti, he has been working in Mission Hospitals in Tanzania as a Head of Department and
periodically as a Doctor in Charge of the Hospital since 1991 (23 years).
He will present examples and evidence from his vast experience in the field.
When I learned about the Symposium, “Surgery in low resource settings” I thought that it would be
an excellent forum to share my long experience working as a surgeon in Tanzania. At the time I was
asked, "it will be interesting to know why surgeons from western countries should come to work in
LRS. Or why not?” My answer of course is concerning Tanzania, but similar situations apply in all of
Sub-Saharan Africa and in many other LRS countries.
Why they shouldn’t come?
- To achieve surgical specialization is a long and difficult process. To leave your home country
is to withdraw from the natural professional competition.
- It may also mean a lack of good schools for children, a less diverse social and cultural life and
withdrawal from the many other benefits of living in a developed country.
- There is also a higher risk to health and life expectancy (traffic accidents, tropical diseases,
etc).
- Work in LRS countries it is not only about fighting diseases in a growing number of patients
but also facing everyday difficulties arising from shortages of instruments, surgical materials,
medication, staff and coping with common interruptions of electricity and water supply etc.
Why they shouldn’t come?
- To achieve surgical specialization is a long and difficult process. To leave your home country
is to withdraw from the natural professional competition.
- It may also mean a lack of good schools for children, a less diverse social and cultural life and
withdrawal from the many other benefits of living in a developed country.
- There is also a higher risk to health and life expectancy (traffic accidents, tropical diseases,
etc).
- Work in LRS countries it is not only about fighting diseases in a growing number of patients
but also facing everyday difficulties arising from shortages of instruments, surgical materials,
medication, staff and coping with common interruptions of electricity and water supply etc.
Even the most dedicated professionals from western countries who decide to work in rural areas of a
LRS country for a long time are not able to change the general situation they encounter. A possible
solution for the improvement of a surgical care is to increase the number of local surgeons, to
distribute them more evenly and to create acceptable conditions for their work and personal lives. In
order to achieve this effective training systems and economical incentives in rural areas are needed.