in Tunisia, the exodus of doctors weakens the health sector

AFP, published on Thursday 01 April 2021 at 11:04 am

Abdelwaheb, emergency doctor on the front line against Covid-19 in Tunisia, has not been paid for months. At 35, he is preparing to go abroad in search of better working conditions, like the majority of Tunisian doctors.

The proportion of young graduates going into exile at the end of their studies, mainly to France, Germany or the Gulf countries, is constantly increasing.

“In 2019 and 2020, nearly 80% of young graduates went abroad,” warns surgeon Slim Ben Salah, outgoing president of the Council of the Order of Physicians, sounding the alarm on the aging of doctors in public service.

“They are so disgusted, these elites of the country who had their baccalaureate with more than 17 on average, and who find themselves marginalized by the authorities after 10 years of studies. But what has the state done to keep them? ? I too can not take it any longer and I am going to leave! “The surgeon loses his temper.

Tunisia continues to train 800 doctors each year, whose skills are recognized internationally, but the infrastructure is degraded, equipment and drugs are lacking and staffing is sometimes insufficient, the result of mismanagement and corruption.

“In Tunisia I feel buried alive,” says Abdelwaheb Mghirbi, 35, emergency doctor in a public hospital in Tunis.

Married for five years, he deprives himself of having children, believing that he does not have the means to take on this responsibility.

“The biggest problem here is the material side, our salaries are humiliating,” he said.

An internal doctor receives 1,200 dinars (365 euros) per month, it is above the average salary but just half of the minimum budget necessary for a family with two adults and two children to live “with dignity”, according to a recent study NGOs and a research institute.

“It is unacceptable and revolting”, deplores Abdelwaheb, especially as “the obligations are there”, with overtime due to the lack of staff in crowded hospitals.

– “Anxiety and anguish” –

“But in return, there are zero rights,” adds Mr. Mghirbi. He has not been paid since his recruitment on a fixed-term contract in December 2020, has no social coverage and works in the absence of basic equipment to treat the sick.

“I can neither enjoy life, for lack of resources, nor work in good conditions, nor do anything,” he regrets.

This year, was added the fear that the State “will be unable to pay us”.

Health represents 6% of the state budget, and Tunisia is still seeking funds to finance the 2021 fiscal year, especially as leaders are struggling to agree on a reform plan demanded by international donors.

“At a certain moment, you say to yourself + but what am I doing? +”, Abdelwaheb laments. For him, “the situation in Tunisia has become a source of anxiety and anguish”.

Political quarrels, social tensions and economic difficulties contribute to the “stifling” climate of the country, underlines the doctor.

“I no longer see any hope here, I want to leave to have better morale,” he explains, he who has already had several offers and is preparing his papers for abroad.

– Ill-being –

Sign of doctors’ unease: protests erupted in December 2020, after the accidental death of a 27-year-old internal surgeon due to a faulty elevatorin a hospital in a disadvantaged region in the northwest of the country.

A study published in 2020 by a young doctoral student in medicine underlines that the brain drain affects all types of doctors and paramedical executives, accentuating the deficiencies “in particular in the less developed regions”.

Countries that hire staff with such skills “benefit from highly qualified human capital free of charge,” laments Ahlem Belhaj, general secretary of the doctors’ union.

“This flow calls out to us”, recognizes the Director General of Health, Fayçal Ben Salah, estimating the total cost of training a doctor at more than 150,000 dinars (46,000 euros).

The brain emigration can be considered as an “export of services, but it must be controlled so that the State and the people find their way there”, he underlines, calling for these migrations to be organized by conventions. between states.

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