Romanian Doctors Torn Between Emigration and Duty With Low Pay

In room 213 of a Bucharest hospital, Florentina Fulga, whose 14-year-old son suffers from a severe bone disease, worries about what will happen if more doctors leave the country.

Romania is struggling through a severe economic crisis and doctors and nurses are increasingly torn between the wish to emigrate and the call of duty to treat local patients, despite low pay and spartan conditions.

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In the paediatric orthopaedic surgery unit of the Marie Curie hospital, where Fulga's son Sebastian is being treated, almost all medical staff admit they have pondered emigration.

"Who will take care of our children if all doctors go abroad?" said Fulga.

Wages in the Romanian healthcare system have always been low and were further axed by a quarter in an austerity package adopted by the government in June, as the country strives to curb a swelling budget deficit.

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After having worked for 25 years in this unit as a nurse, Eugenia Udrea earns around 162 euros a month, down from 255 euros before the June cuts. The average net monthly wage in Romania is around 350 euros.

"A lot of our colleagues have gone abroad because the wages are much higher there," she told AFP.

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One out of seven Romanian doctors was working abroad in 2009, according to statistics given by doctors's organizations.

Professor Gheorghe Burnei, a reputed children's orthopaedist, has himself thought of emigrating.

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He was lured by a sky-high salary and, more importantly for him, by working conditions that were a far cry from the ageing equipment and shortages he has to put up with daily.

"This operating table where we will try to straighten the leg of a young man is outdated and not suited for paediatric surgery," he told AFP.

"And the sterilizing equipment should have been replaced 16 years ago. Instead, we keep on mending it, and worry about the risk of infections."

The 58-year-old specialist is struggling to keep afloat this unit crucial to children suffering from malformations, bone tumors or scoliosis.

"At this pace, we risk going back 20 years and waste the progress we have made in paediatric orthopaedics," he said.

Fortunately, sponsors and a charitable organization have come to the rescue by donating most of the equipment in the operating theatre and helping to repaint and modernize the ward.

But the unit is short-staffed, employing barely two doctors, and underfunded, forcing patients to pay for some implants themselves. "The hospital cannot afford them," Burnei said.

"Practising on a daily basis is like trying to make soup for lots of guests by using just a carrot and an onion," Burnei's colleague, Doctor Constantin Ciobanu, said.

Ciobanu admits he has encouraged his son, a medical student, to emigrate.

But Burnei has decided to stay and carry through his ongoing projects, including early identification of scoliosis and training specialists throughout the country. Provided they, too, stay.

"Today all patients come here, even those who could be treated in departmental hospitals, so we have a two-year waiting list," Burnei said.

"We have no time left to do research and make progress on the treatments."

The scores of letters from grateful patients and messages of support posted on the internet have also convinced him to stay.

But things will remain difficult as the healthcare budget accounts for less than four percent of GDP, according to the Ministry of Health compared to 11 percent in France and an average of 9.0 percent in OECD countries.

"Very few people contribute to national medical insurance but everybody wants to benefit from it," Radu Tabacaru, the hospital's director said, comparing the "unfair and anachronistic" health system to a sinking ship.

Currently, barely 6.7 million people, out of a total population of 21.5 million, pay insurance contributions. In order to remedy the underfunding problem, the center-right government has decided to extend the payment system, so as to include some pensioners so far exempted from it.

Source-AFP