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Training the Middle East’s Future Health-Care Professionals

BOSTON – The Middle East’s public-health challenges are enormous, especially when one accounts for the region’s transient population of refugees and guest workers. The refugee population alone now numbers in the millions, and is straining health-care systems in Jordan, Lebanon, and Turkey nearly to the breaking point.

Affluent Gulf Cooperation Council countries would be mistaken to assume that they are exempt from their neighbors’ public-health problems. While GCC countries have made major improvements in hygiene and maternal and child health, they form the global epicenter of chronic non-communicable diseases – such as obesity, diabetes, heart disease, and, increasingly, cancer – that result from lifestyle and diet.

Worse still, GCC countries’ national health systems have a shortage of local clinicians and trained professionals working in local public-health services. This results in high turnover owing to overwork, and an increased need for foreign health-care workers to fill sorely needed positions. GCC policymakers have been right to focus on increasing access and subsidies for quality health care. But the fair distribution of health-care services across native and migrant populations is often a thorny policy issue. And now policymakers must also devote more attention to the health-care workforce itself, to ensure that it is properly educated and trained for the challenges that await the region.

Training programs in GCC national health systems today do not focus nearly enough on innovation or systems thinking to improve efficiency and effectiveness. If clinicians and health-care workers do not receive multidisciplinary training, they will be unequipped to recognize and address local public-health needs throughout the region. Specifically, to improve delivery of services and care, GCC countries will need to develop a new policy framework that spans both the education and public-health sectors.

Higher education has expanded rapidly in the Middle East over the past decade. Governments have created educational free-trade zones – such as the “Knowledge Villages” and “Education Cities” in the United Arab Emirates and Qatar, respectively – and invested billions of dollars in new and existing universities, such as in Saudi Arabia. As a result, new universities, research institutions, and educational programs have attracted scholars and other professionals to the region.

However, too few local students – and far too few young men – are pursuing public-health careers. While the overall number of students studying public health is increasing, most come from outside the region, which will only intensify GCC countries’ current over-dependency on foreign workers.

Many of the region’s universities have put a premium on innovation, which bodes well for improving health-care services. But, though public health is a major regional challenge, so far universities have been placing far greater emphasis on subjects in engineering and technological fields.

Within health-care education itself, according to my own analysis of local institutions, students are learning to treat individual medical conditions, but they are not learning enough about larger public-health issues, and current curricula do not expose students to issues affecting refugees, migrants, or the wider population. While institutions such as Weill Cornell in Qatar and the Gulf University of Science and Technology in Kuwait have launched innovative research and training programs that focus on these types of health challenges, much more is needed.

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Another problem is that the region’s education and training programs do not encourage enough systemic thinking. Worldwide, public-health policy is moving toward more multidisciplinary integration of engineering, medicine, social and management science, and the humanities. By not yet embracing an integrated approach, GCC institutions risk falling behind the global standard.

Technology and new approaches to public health are important; but they will be ineffective if they are not tailored to meet the real needs of local people. This is why GCC countries should encourage and invest in technological development at the local level, and create room for engineers to work with local public-health professionals. Such partnerships are necessary for confronting the infectious and chronic diseases that threaten communities throughout the region, and they have the added benefit of providing entrepreneurial opportunities for the region’s youth.

Middle Eastern countries need fully integrated, innovation-oriented frameworks for training health-care professionals, so that they can address their current public-health challenges and prepare for new, unexpected ones, such as Middle East respiratory syndrome (commonly referred to as MERS), Ebola, and other infectious diseases that can appear with little or no forewarning.

The Middle East’s population will continue to grow; but whether the region will also grow in global importance as a hub for trade and economic development will depend in part on its governments’ ability to reform public-health education and practice. Muhammad Hamid Zaman is a professor of biomedical engineering at Boston University.

By Muhammad Hamid Zaman

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