Three decades of dedicated service

Chinese doctors have brought their expertise to bear in the hospitals of Botswana

China started sending medical teams to Botswana 32 years ago, and the first included 11 specialists from Fujian province in southeastern China. Forty-six Chinese medical specialists now work in the country, doing three-year stints.

"We have all grown up here over the past 30 years and witnessed each other's deeds," says Zheng Shounian, administrative team leader of the 13th China Medical Team in Botswana. "When we sent our first medical team to this hospital in 1981 there was not even such a thing as specific departments."

Zheng and her 46 colleagues in the team are, like the pioneers of the 1980s, all from Fujian province. They are allocated to two of Botswana's biggest public hospitals, 22 in the Princess Marina Hospital in the capital, Gaborone, and the rest in Nyangabgwe Referral Hospital in the city of Francistown in northern Botswana.

Princess Marina Hospital was founded in 1965 and provides services that cover all branches of medicine. It has a capacity of 600 patients and receives patients mainly from the south of the country.

In the 1960s and 1970s hospitals in Botswana were so rudimentary that Chinese medical teams were sent to remote areas to treat patients, Zheng says.

"Things have greatly improved, and many hospitals have advanced facilities and equipment. What we bring to bear is technology and skills, and can make the most of our expertise by building up such facilities when we work with them."

Zheng says that before the sixth medical team came to Botswana, Chinese doctors were required to see patients with all kinds of ailments. Later with steady improvement and progress, many specific departments, disciplines and special treatments were established or supported by Chinese doctors and nurses, for example neurological and cardiac surgery and kidney dialysis.

Zheng Lin, a Chinese nurse and anesthetist working in the intensive care unit, says that when she came to Princess Marina Hospital in the late 1980s there was no nurse in the ICU and she also had to do anesthesia procedures.

"After my Botswana term finished they sent the invitation letter direct to my hospital hoping I could return to the country to help them," she says. "Considering my attachment to this place and opportunities to shape my diverse expertise, I decided to come back, and that was 20 years ago."

Good work by all medical teams has made essential improvements to local hospitals, says Kelebogile Motumise, deputy hospital superintendent of Princess Marina Hospital.

"It was very challenging before the Chinese doctors came in because many good doctors were leaving the country. It was very difficult without our Chinese partners at the time so the government had to recruit doctors from abroad and send a lot of Botswana students to study medicine around the world."

The Chinese medical team has been critical to the hospital because it has provided specialist services, he says. Before that, people had to leave the country to obtain such treatment, something few could afford.

"The Chinese help has been great not only for this hospital but also for the country as a whole. Now after more than 30 years we treat them as our own employees. For instance when we have outreach services to remote villages, they are quite willing to go, to do operations, procedures and teaching. The Chinese medical team has become an inseparable part of the hospital and its system, the culture of Princess Marina and Botswana medical culture."

The country still needs more specialized equipment from China to make the most of the expertise of the Chinese staff, he says.

What has impressed him and his colleagues about them, apart from their expertise, is their great dedication.

Bina Mmopi, nursing superintendent of the theaters and sterilization unit, says the Chinese are hard-working, loyal and reliable.

"We do sometimes have language and communications problems, but they are eager to learn whatever we teach them.

Working with Chinese doctors is a great opportunity for local staff to pick up knowledge and learn skills," Motumise says.

"Due to the shortage of specialists in our country, they have to work more, including traveling extra miles and they do without complaining. And then there is their eagerness to learn and integrate into our Botswana culture. We have seen a significant increase in the number of Chinese medical staff during the last few years but the demand is also increasing."

Increasing demand for specialists is a challenge when screening candidates in China because of the stringent requirements set by the governments of China and Botswana.

"They must be specialists with good English skills, and the personalities and families of candidates are regarded as vital elements to be taken into account when selecting people," Zheng says. "Family is the most difficult part to ignore because at the age when you are a specialist you normally have a spouse and child."

Three years' work in Africa is just a part of being a qualified medical specialist in African countries, as it also takes another year or a year and half of full-time intensive English courses before being sent out, which means that anyone selected needs to be prepared to dedicate five years of his or her life to the project, Zheng says.

"These days younger people are more comfortable with the language because of improving education backgrounds, but it's still very hard to find people who want to come to Africa and devote such a long time here as they have better opportunities in China."

To improve communications, Motumise says, staff training exchange programs need to be strengthened. In his hospital, three doctors have been sent to China to learn medicine.

Moabelo Ramabu, orthopedic surgeon at Princess Marina Hospital, said having a specialty is a priceless advantage for Chinese doctors, as is medical training, which may help his hospital staunch the brain drain in the future.

He completed his master's degree in medicine at Fujian Medical University between 2009 and 2012 after gaining a bachelor's degree from a medical school in Denmark.

"All the knowledge that was taught in China was no different from any other Western country," he says. "What is special is that Chinese students start specializing very early on and have more in-depth knowledge and practical experience when they graduate from the school."

In a country such as Botswana confronted with skills shortages, it would be better to shorten the time for doctors to become specialists, he says.

To make the most of the Chinese medical teams and their country's progress in health, Zheng says, changes are needed in the way long-term medical teams are formed.

"We do need people to settle locally for longer terms, but that by itself is not enough. We are also in dire need of short-term specialist teams that can do intensive operations or carry out special examinations on local patients."

Wider partnership is also needed between cities and hospitals to allow for more working flexibility, she says.

"Whatever approach we use, we have to continue our support for and exchanges with African countries. It is clear to me that they need us."

Lilianxing@chinadaily.com.cn

(China Daily Africa 07/05/2013 page8)