ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Guidance for Government - Health

Updated on July 1, 2016
vrdm profile image

Born without a clue. A lifetime later, situation largely unchanged. Nevertheless, one perseveres.....

Part 3 of 4 - Health

"barefoot doctors"

In the early days of bright rational thinking in the new nation state of Tanzania, some of the strategists noticed that their programmes for improving the peoples’ health were flawed. They were paying good money to subsidise some of their more hopeful students of medicine to go abroad and study at some of the best medical schools in the world. The students duly went and duly became enormously qualified because they were, indeed, good students.

However, two problems emerged. The first was that these students became aware that their hard earned skills could earn them much more money and a better standard of living just about anywhere else but Tanzania. So many of them decided to work in rich first world countries, abandoning the people they were funded to serve.

The second was that, among the ones who did come back, there was soon a clamouring for up to date/state of the art equipment to be placed in large expensive central hospitals. These highly educated students now wanted to practice the arts they had spent so much time and trouble learning. They wanted to do lung transplants and open heart operations. They wanted to do brain scans and re-constructive surgery. In short, they wanted to deal with all the sexy, frontline problems being encountered in the sexy, prosperous, fast living first world in which they had studied. They didn’t want to deal with ingrown toenails and sleeping sickness or advise on nutrition and basic hygiene which was what the bulk of the population needed. That was beneath them and they wouldn’t get the international reputations they deserved if they stuck with that kind of work.

So, the Tanzanian strategists responded by cutting subsidies to first world medical schools. Instead, having noted that the bulk of the population suffered from variations of three basic diseases, they reasoned that a network of very basic community clinics staffed with people versed in the diagnosis and treatment of these three main diseases would be a better service to the people than a glitzy hospital in downtown Dar Es Salam geared up for the latest techniques in heart surgery. Anything that couldn't be diagnosed by these people would be sent "upline" to regional or national clinics where more diversified skills were retained. The number of fully qualified first world doctors declined dramatically. The number of "barefoot doctors" serving the outlying communities through basic, no frills community clinics increased dramatically. And as they increased, so did the overall health of the nation improve.

So, here in the UK, just about everybody suffers from colds and flu every year. They have to go down to see their highly trained GP – a person who can diagnose perhaps a thousand different types of ailment – to get him or her to confirm what everybody already knows and prescribe a cure that a good nurse or pharmacist could have prescribed in half the time, with significantly less hauteur, and at considerably less cost to the nation. We don’t need highly trained and whingeing specialists to deal with the bulk of our ailments.

Let us have basic community clinics staffed with good and dedicated nurses as the frontline. If the ailment cannot be diagnosed as a cold or flu or one of perhaps a couple of dozen other of the most common ailments afflicting UK citizens, then send the patient "up line" towards more specialist care.


See also....





Deacon Martin on Youtube

For more by Deacon Martin:

© 2010 Deacon Martin


This website uses cookies

As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

Show Details
HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
LoginThis is necessary to sign in to the HubPages Service.
Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
AkismetThis is used to detect comment spam. (Privacy Policy)
HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
MavenThis supports the Maven widget and search functionality. (Privacy Policy)
Google AdSenseThis is an ad network. (Privacy Policy)
Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
Index ExchangeThis is an ad network. (Privacy Policy)
SovrnThis is an ad network. (Privacy Policy)
Facebook AdsThis is an ad network. (Privacy Policy)
Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
AppNexusThis is an ad network. (Privacy Policy)
OpenxThis is an ad network. (Privacy Policy)
Rubicon ProjectThis is an ad network. (Privacy Policy)
TripleLiftThis is an ad network. (Privacy Policy)
Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
ClickscoThis is a data management platform studying reader behavior (Privacy Policy)