Young doctors confront challenges in the frontlines of Albania’s aging rural areas 

GJIROKASTER, Albania, Aug. 9, 2023 — Nestled amidst the rugged mountainous landscapes of Albania, providing efficient healthcare services to remote rural areas has emerged as a formidable challenge due to demographic shifts and geographical constraints.

In recent times, a new generation of doctors has taken up positions at local medical centers, embracing the complexities of their profession as well as the unique dynamics of rural practice.

The prevalence of elderly individuals within the majority of rural regions further amplifies the demand for medical practitioners, intensifying the call for adequate healthcare provisions.

In the picturesque village of Picar, ensconced within the Gjirokastër mountains, Elvis Guçe, a young doctor, plies his trade at a local health center catering to the adjacent regions.

Having completed his initial studies in Greece, Guçe returned to his homeland, dedicating himself as a general practitioner for a year now.

“I came back because I yearned for my people, my hometown. I returned to witness firsthand the tangible progress I had heard about in the news. Fortunately, I find that these advancements are indeed materializing,” he says.

Guçe emphasized the distinctions between the Greek health system, within a European Union member state, and the Albanian counterpart he is currently navigating.

“Greece had established robust structures a decade ago. Here, the challenges are multifaceted, driven by demographic nuances and varying degrees of health awareness within the communities. The scarcity of doctors is felt acutely, not to suggest Greece is immune to the issue – doctors there too are leaving, but the scale here is more pronounced,” he added.

Guçe expounded on the hurdles that young doctors, particularly in rural areas, encounter.

“Our region spans a vast geography. Given the demographic fluctuations, I believe the situation is surmountable. Despite the prevailing notion that challenges here are insurmountable, my experience contradicts that. Whatever I’ve requested or required at the health center has been addressed or earnestly pursued by my superiors,” the young physician said. 

He highlighted two crucial aspects foreign-trained doctors must adapt to within the Albanian context: “Newcomers shouldn’t harbor grand expectations. Instead, they must be prepared to give their utmost to attain excellence. Moreover, they must engage in persistent community outreach, especially towards the elderly, to foster health awareness and regular check-ups.”

A disconcerting trend of newly graduated doctors leaving Albania has emerged. Guçe underscored that bolstering salaries within the healthcare system is pivotal for retaining medical professionals.

“Undeniably, salaries are a vital factor. Ultimately, one’s work revolves around the compensation received. As doctor specialization and remuneration improve – both in primary healthcare and across the medical hierarchy – I believe more doctors will return and a larger proportion of recent graduates will opt to serve within their homeland,” Guçe said.

Local Health Care Unit Director Edi Sinojmeri noted that numerous rural health centers have undergone enhancements in recent years, attracting recent medical graduates.

“Through extensive refurbishments, we have nearly met the doctor and nurse requirements outlined by the Ministry of Health and Social Protection,” he said.

Sinojmeri outlined the challenges doctors in these areas face due to rugged terrains and a predominantly elderly population.

“In Gjirokastër, particularly its mountainous pockets, I witnessed the commitment of young doctors catering to the elderly. This demographic often lacks familial support due to emigration. It’s heartening to observe these young medical professionals closely attending to patients, collaborating with specialist doctors at the regional hospital in Gjirokastër,” Sinojmeri said. 

Official data shows that within the first half of this year alone, 195 general and specialist doctors were recruited within Albania’s public health system. 

However, the demand remains substantial across multiple regions.

Speaking before the Albanian Parliament in July, Minister of Education Evis Kushi reported that the nation’s health institutions employ approximately 5,400 doctors. However, this figure falls short per capita when compared to regional counterparts.

“Presently, our health institutions host 5,400 doctors. This translates to a ratio of 1.93 doctors per 1,000 inhabitants. While this marks an improvement from the 1.2 ratio a few years ago, we still strive for better. In the broader region, the ratio stands at 2.6 doctors per 1,000 inhabitants, whereas developed OECD countries boast a ratio of 3.6 doctors per 1,000 inhabitants,” Minister Kushi said.

The minister noted that around 20 percent of freshly graduated doctors opt for emigration.

“The trend of healthcare professionals migrating to Western and developed nations is not unique to Albania but extends to other regional nations and even some European Union countries. Presently, 1,200 Albanian-trained doctors contribute to health institutions across the EU and OECD. This emigration rate is nearly 20 percent,” the minister told parliament.

In a noteworthy development, the parliament passed a law in July mandating a five-year post-graduation stay within Albania for students graduating from the state medical university.  This decision has sparked vigorous protests from the students. The most recent data shows the law immediately lowered the number of students opting to register for the public medical school.

With information from VOA Albanian.

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