07 April 2004
Port of Spain:
For some time now the government of Trinidad and Tobago has been struggling with health sector reform. By the end of 2002, with health services decentralised, the health system was faced with acute administrative woes escalating to the point of backlogs, work stoppages and personnel shortages. This situation meted its harshest impact on the poor and government was forced to consider solutions for the poorest in the society to access proper medical care and attention.
While the government was considering importing the services of Cuban doctors, the United Nations Development Programme (UNDP) was also undertaking an internal review of its operations with respect to servicing this middle-income country in a more meaningful way. Inspired by the success of a similar initiative in Tanzania, the UNDP team in Trinidad and Tobago presented a proposal to introduce 100 United Nations Volunteer (UNV) doctors in a range of specialties, as prioritized by the Ministry of Health.
"We presented a win-win situation," says Inyang Ebong-Harstrup, Resident Representative of UNDP Trinidad and Tobago. "Our plan was cost-effective; it would save the government resources and provide neutral, high quality technical advice. It would also create breathing space to improve the health sector."
Working with UNV in consultation with the Ministry of Health and the Pan American Health Organization, the team conducted a worldwide search via internet and the global press for both general practitioners and specialists. Of the latter, ophthalmologists were most critically needed, since the country was experiencing a serious backlog in eye surgeries. Other sought-after specialties included paediatrics, obstetrics and gynaecology and oncology. Each successful UNV doctor was given a one-year contract renewable over three years.
The first wave of doctors arrived in September 2003, hailing from such distant areas as Ethiopia, Myanmar, Sierra Leone and Mongolia. A thorough pre-assignment orientation lasting one week, covered everything from the peculiarities of the local health care system to the Trinidadian Creole language they would encounter. They were subsequently assigned to urban and rural health facilities across the country.
In some areas, the programme’s impact was felt right away. One doctor was put to work as a programme officer for a new government initiative to test for hearing, sight and learning disabilities in pre-schoolers. A rural clinic saw its response rate to paediatric cases leap to 100% upon arrival of its new specialist. All 100 doctors are expected to be deployed by the end of March 2004.
Four months into this programme, the team at UNDP is pleased with the results to date. "We get the sense from the public that the doctors really are alleviating the pressure," says Sandra Baptiste-Caruth, Programme Specialist for Poverty and Social Policy. "Initially we had met with some skepticism from local doctors. But once it became clear that the UNVs were not here to take over anyone’s jobs, and weren’t getting any richer than those working in the national system, the newcomers were more readily accepted."
"This is a stepping stone to health sector reform," says Ebong-Harstrup. "Our goal is to help Trinidad and Tobago in its quest to achieve developed-country status by 2020, not only by achieving the desired numbers, but in ensuring high quality results."
Baptiste-Caruth adds that the profusion of UNVs has helped put a new face on volunteerism in Trinidad and Tobago. "We plan to capitalize on the momentum and goodwill of this project to raise awareness on volunteerism locally. We’ll give broad exposure to the work being done, especially leading up to International Volunteer Day 2004. By then we hope to be able to say that this programme has helped make the idea of becoming a volunteer really take root in this country."
Photo shows Inyang Ebong-Harstrup, UNDP Resident Representative in Trinidad and Tobago
From: United Nations Development Programme
Originally published 27 January 2004 in the UNDP Intranet