Afghan medical students expect to hang up stethoscopes after graduating

Colin Perkel
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KABUL, Afghanistan - In two months, Ahmad Shoaiv and his classmates will graduate as desperately needed doctors in a country where average life-expectancy barely touches early middle age.
Most likely, he and several of them will never reach for their stethoscopes once they say goodbye to Kabul University.
"I want to work as a translator with Americans or another organization, because of the salary, because of the economic problems," said Shoaiv as he and a group of colleagues sat outside their school in the sunshine.
"Medicine does not help me."
It's a terrible waste of seven years of intense training and overcoming obstacles such as outmoded textbooks, they readily agree.
Still, they say, the US$60 a month the government will pay them as doctors - if they can find work in public health care - is simply not enough to survive on.
What few spots might be available to them in government hospitals in Kabul are doled out based on cronyism or bribery, they say.
Many of Afghanistan's brightest young minds - those with a command of English and literacy skills - are already working for foreign organizations.
The lure of earning US$600 and more with NGOs or the international militaries doing non-medicine is huge - an internal brain drain exacerbating an external one.
For its part, the struggling Afghan government is urging medical students to head out into the provinces and rural areas, where even the most basic health care is barely available, but equipment, clinics and physician supports are in desperately short supply.
In addition, there are fears of getting kidnapped or killed given the bleak security situation in much of the country.
Shakila Rahmani, 25, in her sixth year and one of a handful of female medical students, shared the bleak sentiments.
Many women doctors, she said, simply end up working in the media, doing administrative jobs or teaching high school.
"It's a waste of knowledge," Rahmani said.
"It's depressing for them that ... they are standing at the same stage as a Grade 12 student doing the same job."
When she began studying, Rahmani set her heart on one day working as a doctor.
But, she said, the odds are high she won't find work in medicine despite cultural imperatives that females handle female patients.
"Then, I'm going to sit at home, because I spent a lot of my years getting educated, so I don't want to work anywhere else."
The students say opening a private clinic is out of reach given the expense, while Afghanistan has little culture of family practice.
The handful of mostly foreign private clinics, which cater to the rich and where salaries are far higher, provide precious few employment opportunities for Afghan doctors.
Dr. Asmat Naebkhill, who returned to Afghanistan from Windsor, Ont., to set up the country's first academic cardiac clinic, said he understood the frustrations.
He, too, earns in a month what he made in 30 minutes in Canada.
Although he tells a select group of students that studying cardiac diagnostics with him will eventually boost their pay packets, an equally big part of his pitch is patriotism.
"We lecture them: 'This is your country; you're a doctor of this country; if you can't do this, no one can do this for us. We have to sacrifice'," he said.
Omid, another final-year medical student who already runs a business on the side, is sympathetic to the argument but dubious.
"We have to help our people, but we have to support our families," Omid said.

Organizations: Kabul University

Geographic location: Afghanistan, KABUL, Windsor Canada

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