Healthy Alternative

By+Gitonga+Njeru

A happy mother of twins born in February last year in the C？te dIvoire capital of Abidjan， Patricia Quamarra， 31， is today a proud parent. The twins， a boy and a girl， were delivered at the Central University Hospital in Abidjan with the assistance of a Chinese gynecologist.

“A successful caesarian section only took eight minutes in the operating theater. It was pain free and I thank the doctor who gave me a chance to be a mother as infant mortality is high in this country，”said Quamarra whose children are now a year old and walking.

She still continues to receive postnatal services from Chinese doctors during regular checkups for her children at various hospitals in Abidjan.

Quamarra is one of many people in C？te dIvoire benefiting from the services of Chinese doctors. The country is currently facing a shortage of doctors. Given the situation of increasing medical needs and few experts in specific areas of medicine， many Chinese doctors have come to the West African country. Latest figures from the countrys Ministry of Health and Public Hygiene show there are about 400 registered Chinese doctors working in both public and private hospitals in the country.

C？te dIvoires former Minister of Health and Public Hygiene Aya NDri Yoman， who is now an associate professor of medicine at the University of Abidjan， told ChinAfrica that before August this year， the country plans to hire additional Chinese doctors in an ongoing process. Gynecologists and pediatricians are most needed to deal with the high infant and maternal mortality rates， much of which is preventable.

“I am one of the people who initiated that foreign doctors be hired [during my time as a minister]，” she said. For example， with improved relations between our country and China， we hired several Chinese doctors. In return， our doctors would go to China for refresher training to enhance their careers. There is an expectation to have more Chinese doctors [working in C？te dIvoire]，” she added.

Integrated medical care

That expectation is also seen as part of a bigger picture. Solomon Kalu， a health expert and consultant with Syagga and Associates Ltd.， a business consulting firm， said C？te dIvoire needs development similar to that in Asia in the recent past.

“If we can build roads that match those of Europe， for sure we can improve our medical services. The country [C？te dIvoire]， has， for the last few years， been looking East. Its close relations with China is obvious because of the roads built by the Asian giant along with a 60，000-seater stadium. C？te dIvoire plans to hire 700 trained and specialized Chinese doctors over the next two years，” said Kalu. The figure and timeline was confirmed by the Ministry of Health and Public Hygiene.

Kalu noted that there are a number of Chinese doctors working in the country as consultants.

Yuan Xujing is one of them. He has been in C？te dIvoire since 2010 and is an expert in assisted births.

“I specialize in matters to do with reproductive health. I am a consultant gynecologist and I have my own clinic. My specialty is in vitro fertilization. In addition， I specialize in all matters related to maternal health. I occasionally offer my services to government hospitals such as Abobo Sud Hospital located here in [C？te dIvoires capital] Abidjan，” said Yuan.

A growing number of Chinese doctors are also employed at big hospitals such as Centre Medical La Rochelle and Center Medical Chenal， most being gynecologists and general physicians.

Maternal deaths challenge

Maternal deaths are of major concern in C？te dIvoire.“There are 371 mothers out of every 1，000 giving live births who die each year in labor in C？te dIvoire，” said Dr. Nana Traore， an independent consultant with the Nana agency， which partners with the Ministry of Health and Public Hygiene in various health projects.

That figure is down from 470 in 2010， according to Traore. The mortality rate of children under five also dropped slightly from 121 in 2015 to 111 last year， she said.

“Figures I have compiled further show that neonatal deaths have remained stunted at 33 per 1，000 live births since 2010，” she said.

While giving birth is free at all public hospitals in C？te dIvoire， the biggest obstacle facing patients at these facilities is that there are just four doctors per 1，000 births. This figure clearly shows the hospitals are crowded and the doctors are overwhelmed， said Traore， who confirmed the growing presence of Chinese gynecologists in the countrys public and private hospitals is contributing to the decrease in maternal and infant deaths.

Traore said one of the main reasons for the shortage in doctors is that most university students choose careers in law， business studies and architecture over medicine. The shortage of doctors is especially severe in the field of reproductive health， where the need for specialized and experienced doctors is vital， she said.

Apart from just a lack of doctors， Professor Yoman said a lot of public hospitals still lack proper equipment， in many cases simple equipment such as incubators in nurseries and oxygen generation machines， and this is also contributing to high infant deaths.

“For instance， Central University Hospital， located here in Abidjan， lacked ultrasound machines， and several other machines such as the ones used for dialysis and so on，” she said.

Low doctor numbers

Health experts also point to the World Health Organization （WHO） figures of life expectancy in C？te dIvoire at just 52-54 years of age as being exacerbated by the shortage of doctors in relation to the population. The Ministry of Health and Public Hygiene estimates that there are less than 20 doctors per 100，000 people. While the WHO notes that a low doctor to population ratio is very common in most African countries， there is a great need for improvement of health services on the continent and for this ratio to improve， the organization has said.

Yoman agrees that high levels of maternal deaths in C？te dIvoire still remain a concern. She said as the former health minister， she encouraged using foreign medical personnel and received many applications from Chinese doctors. She said the skills of local doctors have also improved with them taking up training opportunities in China. “About 50 of our doctors have graduated from Chinese universities since 2011，” she said.

Another reason seen by observers for the increase in Chinese doctors is the growing number of Chinese heading for the country.

“C？te dIvoire has one of the highest numbers of Chinese living in Africa. There are many who decide to settle here and own property，” said Ministry of Tourism spokesperson Halikan Bayou， adding that there are now more than 60，000 Chinese tourists who visit C？te dIvoire each year.