SS+Health+Workers+neg+-+US+CP

==CP: The USFG should provide resources for the training of medical auxiliaries and nurses in Sub-Saharan Africa and end recruitment of health care workers from this region. Funding for salaries should not be increased. The US will develop a partnership with these countries in which medical workers can work in the US for a short period of time on the condition that they return to their home country.== Pooja **__Kumar__**, M.D. resident at the Harvard Affiliated Medical Residency. 6/21/**__07.__** “Providing the Providers — Remedying Africa's Shortage of Health Care Workers” The New England Journal of Medicine. Volume 356:2564-2567. No. 25. http://content.nejm.org/cgi/content/full/356/25/2564

__There is a win-win solution__ to this apparent conundrum. __Properly structured, a partnership approach between the developing and developed worlds can result in increased staffing for developing countries'__ health systems __while__ at the same __time it facilitates subsequent recruitment of paramedical personnel to industrial countries__. . Industrial countries must recognize their interest in providing financial assistance to developing countries to train nursing and paramedical workers, since many will ultimately work in industrial countries. In effect, the interests of industrial countries' health departments and aid agencies can coincide. . Developing countries should recognize that for the foreseeable future, __a balanced approach is required that trains different kinds of workers for the various medical and public health needs confronting these countries. .__ __For the rural and urban poor, the diseases of poverty and the absence of effectively functioning basic health systems__ outside the major urban centers __must both be confronted.__ These are problems that can be addressed by basic paramedical workers. . __Relying on fully qualified doctors to work in these environments has always proved problematic, since they seek more glamorous__ and remunerative working __situations.__ At the same time, to address medical care emergencies, chronic conditions and the principal noncommunicable disease problems, developing countries' medical care systems still require a cadre of medical and paramedical staff trained toan international standard. . A partnership approach can be envisioned. __Developing countries would continue to finance first-level training for medical auxiliaries, nurses and maternal/child health workers. .__ Medical auxiliaries are particularly important, since __they can provide primary care for the kinds of common illness and health problems experiencedby the poor,__ while also being pivotal in identifying patients needing more sophisticated medical carein hospitals. __They can also monitor antiretroviral treatment for HIV/AIDS, provide immunizations and administer medications for tuberculosis and other infectious diseases. . The effectiveness of such basic paramedical workers has been demonstrated in many developing countries —__ for example, China's "barefoot doctor" concept. Such workers should be seen as highly valued members of the medical system and should receive remuneration and status sufficient to make these jobs as attractive for secondary school graduates as teaching positions or other civil service appointments. . The key factor is that these workers, while fully effective and functional in a primary health care system, would still have less than the professional training required for overseas medical work. __. The role of developed countries would be to finance and partner the training of nurses and paramedical workers to internationally approved standards__. The candidates for such local training programs would be those paramedical workers described above who have worked several years in the public health system and demonstrated competence and effectiveness. . __Graduates from this higher-level program would be expected to serve several years, either in the private or in the public health sector of their country. Such workers would then, by agreement between the partnering countries, be eligible, if they wished, to apply for positions in the partnering industrial country__. . __Such an approach would scale up significantly the staffing of developing countries' medical care systems while ensuring that industrial countries contribute to the provision of the medical care skills they absorb from developing countries__. . Of course, such a partnership approach would need to be adapted to the specific developing country medical care system and the recruitment characteristics of the partnering industrial country. But this approach addresses the present failure to recognize that the status quo, while advantageous to the industrial countries, runs counter to global goals for poverty alleviation.