The price of centralization of human resources for health

This article was exclusively written for The European Sting by Mr. Rosmeri Beatriz Serrano Pérez, a 21-year-old medical student from the Dominican Republic. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

---

It’s 2 in the morning, on a dark road in Tamayo, municipality of Barahona province, Dominican Republic, 2 teenagers are on a motorcycle on their way to their homes, after one night, that only they could narrate. On the unlit road, a horrible accident occurs, seriously injuring 4 people, 3 of them under 18. At that moment a journey begins to try to know their lives. It was necessary to transfer to 3 health centers and more than 32 hours so that those affected could receive adequate care. This lack of timely attention, accessibility to health services, charge invoice at the end of the life of two teenagers. What would have happened if they had received adequate attention, in a timely manner? Would the results be different? We cannot answer for sure, but we can ensure that these types of stories are repeated over and over again, both in my country and in many others. These situations are a reflection of the lack of accessibility to Human Resources for Health (HRH) and material resources that predominates in rural areas, due to their centralization in urban areas. We know that the deficiency of accessibility to HRH is one of the main barriers that we must overcome to achieve national health coverage. To solve this, we must ask ourselves about the effectiveness of the current distribution of HRH, are they practicing healthcare wherever the aid is needed or where their lifestyle can be better? The data shows that most prefer to remain in their comfort area. To understand the reason, I raised the idea of ​​leaving the comfort of my home, to work on the Dominican Republic border with the Republic of Haiti, an area known for its economic precariousness and its great need for health care. I had to get away from my home, family and professional, economic and personal growth opportunities, to move to a hungry area of ​​health professionals, but scarce in growth opportunities and with low economic remuneration. I knew that, in my home, in the capital there are dozens of people who could cover my absence, while, on the border, there are dozens of people waiting anxiously for someone who could do what I know, for what I am training, The reason why I decided to dedicate my life to the medical career, to help people in the worst moments of their lives. Convinced to go to the border, I remembered that the true work of a doctor has always been to dedicate his life to the service of others, although the state should be in charge of offering incentives to favor the migration of HRH to the most needy areas, the greatest incentive It should be the satisfaction of helping and even saving a life, because what constitutes good healthcare is given by the benefits it can provide, not by those it can receive. About the author Rosmeri Beatriz Serrano Pérez, is a 21-year-old medical student from the Dominican Republic. He is currently pursuing his 4th year of career at the Instituto Tecnológico de Santo Domingo (INTEC), belongs to the International Federation of Medical Student Associations (IFMSA), where he is a member of the Permanent Committee for Professional Exchange (SCOPE) at INTEC. He is also part of other student committees such as: American Medical Student Association (AMSA) INTEC and Committee of Medical Students (CEMED) of INTEC. Among his interests are research, writing and neurosciences. With his writings, he wants to help improve the health system of his country.