British surgeon challenges Tony Blair on Africa's health needs

As world leaders at the G8 summit discussed Africa, Professor Chris Lavy, a British surgeon working in Malawi, has written an open letter, published in this week’s BMJ, to the British Prime Minister.

In it he argues that conditions in many healthcare institutions there are, in reality, getting worse and not better, and he has challenged Tony Blair to “take a lead” on the continent’s health needs.

Lavy, while he does find some just cause for praise in some areas and congratulates the British Prime Minister on the Commission for Africa report, points out some important omissions.

He is disappointed not to see anything on the escalating road traffic injuries in Africa, even though the World Health Organization estimates that around 200,000 people a year, or 500 a day, are killed on African roads.

The report suggests that the key to development is increased, cheap transport and Lavy says it is almost impossible to imagine what that would do to road deaths.

He highlights in his letter, the chronic lack of basic surgery for the hundreds and thousands of children with a physical disability that prevents them from walking, or walking properly.

Lavy believes that conditions in healthcare institutions in many African countries are because those who make policy and govern funding do not use the local health services themselves but instead go overseas , he says changing this would improve African health services dramatically overnight.

Apparently, despite standards of health care dropping, there are some encouraging exceptions to the general rule, such as locally driven schemes that provide surgical training help to save lives which are far more appropriate than scholarships to the West.

He maintains that projects like these bring results but do need the support of G8 countries.

He does not deny that overseas aid can be useful if it is well thought out, but says aid blunders help no-one. He gives the example of two new district hospitals being built in Malawi, when there are no surgeons or other staff to run them.

He challenges the prime minister to “take a lead” and give 1% of the UK’s national income to development aid and asks whether those working in medicine might not also take a lead and expand their global outlook.

Lavy stresses that a closer look is needed at the ethics of research that only benefits rich minorities.

He says that strengthening the medical training in Africa, rather than training African doctors in the UK, might be a way forward, with more encouragement being given by the NHS for UK doctors to spend time in Africa.

This he says would show solidarity with colleagues in Africa.

The full letter is published in the current edition of the British Medical Journal.