Romania’s health care exodus | The larger picture

Sonia Papiu began her first year of residency as a psychiatrist in the Romanian city of Cluj in January, but she plans to go abroad within the year, in search of better learning opportunities and better hospital conditions. .

She will not be alone.

. Cluj-Napoca, Romania. Reuters/Andrea Campeanu

“I don’t think any of my colleagues are planning to stay,” she said. “I think I could learn more abroad. You have greater responsibilities as a resident there.”

In the Romanian system, physicians spend six years in medical school and then three to five years as a hospital resident, treating patients while working under the supervision of senior managers.

Finding a job abroad will be easy. Cluj, one of the largest cities in Romania and a university and business center, hosts several recruitment agencies for hospitals in Western Europe.

. Borsa, Romania. Reuters/Andrea Campeanu

Romania has bled tens of thousands of doctors, nurses, dentists and pharmacists since joining the European Union ten years ago, lured abroad by what the country lacks: significantly higher salaries high, modern infrastructure and functional health systems. France, Germany and Great Britain are among the most popular destinations.

. Cluj-Napoca, Romania. Reuters/Andrea Campeanu

The consequences are disastrous. Romania is one of the EU states with the fewest doctors. Nearly a third of hospital posts are vacant and the Ministry of Health estimates that one in four Romanians does not have sufficient access to essential health care.

“Medical personnel leaving Romania at an almost massive rate are compounding the problems of the healthcare system,” said former health minister Vlad Voiculescu. “Entire hospitals are facing a major staff shortage and entire towns are without a family doctor.”

. Cluj-Napoca, Romania. Reuters/Andrea Campeanu

Students study at the University of Medicine and Pharmacy in Cluj-Napoca.

This despite the fact that Romania is a leading state in the EU when it comes to the number of medical graduates. But the system – plagued by corruption, inefficiencies and politicized management – ​​has been unable to motivate them to stay.

Shortages are even more acute in rural areas.

. Viseul De Sus, Romania. Reuters/Andrea Campeanu

“Because we have one doctor per section for most specialties, when a doctor goes on vacation, we have to close the section,” said Cristian Vlad, director of the hospital in Viseul de Sus, a small town near the Ukrainian border.

Vlad said three hospitals in the region shared an anesthesiologist until last year, when his hospital brought in another from neighboring Moldova.

“I live in hope that our resident doctors will change their minds and also stay in smaller hospitals,” Vlad said.

. Salistea De Sus, Romania. Reuters/Andrea Campeanu

Dr. Gabriela Dromereschi performs an ultrasound on a patient in her office in Salistea de Sus.

Romania is taking steps to solve the problems. The salary has increased significantly, although it is still not up to western standards. The average net monthly salary in the health system was 2,609 lei ($606) at the end of 2016, almost double what it was three years ago.

In 2016, the Ministry of Health created a multi-year plan for the medical profession, including a simpler recruitment process, education reform, better promotion opportunities and subsidies for doctors wishing to move to remote villages. .

. Bogdan Voda, Romania. Reuters/Andrea Campeanu

Women stand in front of a traditional wooden door after the Epiphany mass, in Bogdan Voda.

The strategy still needs to be approved by Social Democrat Prime Minister Sorin Grindeanu’s two-month cabinet.

“Measures to improve healthcare are in place, but the system suffers from inefficiencies, limited accessibility and corruption,” the European Commission said last month.

. Turéni, Romania. Reuters/Andrea Campeanu

Yet not all physicians fear remote areas. Originally from the village of Tureni, Andreea Kis has been a family doctor in five villages for nearly five years.

“I chose to be a family doctor because it’s compatible with family life,” said Kis, a mother of two. “People in villages preserve their humanity better.”

Written by Luiza Ilie

Helen D. Jessen