Young Emiratis will be shot in the arm for health care

Mitya Underwood

• Last Updated: December 01. 2009 9:10PM UAE / December 1. 2009 5:10PM GMT

An injection of young Emirati vitality into the health care sector could do much more than simply boost numbers, say experts.

Benefits would spill over into the community through an increased awareness of the health problems that plague the country, such as obesity and diabetes, as nationals would be better placed to spread the message of preventive measures and healthier living.

Numerous initiatives to boost recruitment, however, have been frustratingly ineffective and barriers remain stubbornly in place.

The vast majority of the healthcare workforce – nurses, doctors and technicians – are still from countries such as the Philippines, India and Egypt, while some of our largest hospitals and clinics are run by international health-management firms.

The benefits of having a greater Emirati presence in the health sector are manifest.

“Of course, there are areas, such as preventive medicine, where UAE nationals would be a help; they understand the culture and problems,” says Dr Ali al Numairy, the president of the Emirates Medical Association.

While exact figures are hard to establish due to a lack of centralised records, only a minority of industry professionals are thought to be Emirati.

Dr al Numairy, a plastic and reconstructive surgeon, estimates that no more than 10 to 20 per cent of the health workforce are nationals.

He says a number of barriers keep numbers low, and although some obstacles are being removed, it is a slow process.

One reason why the Emirati ratio is so low is simply that the sector has developed so fast that it has outpaced the nation’s ability to provide the necessary manpower.

“The expansion of the healthcare sector in the Emirates was faster than the influx of Emirati health professionals. Many of the jobs were initially taken by expatriates,” says Dr al Numairy.

“The second reason is the number of students getting into medical school, or studying medical sub-specialties, is less than the medical industry in the Emirates requires. There is always a shortage of newcomers.”

Another factor, says Dr al Numairy, is the perception that remuneration from a medical career doesn’t measure up to other professions, which often pay more.

“Unfortunately, and wrongly, the real world of medical professionals is seen as much less rewarding than other roles. A doctor, for example, has to study for up to six years before beginning a trainee programme. In other roles a person can have a well-paid, full-time job in half the time.”

The salary for a junior doctor depends on training, nationality, age and experience, and whether they work in the private or public sector.

Dr al Numairy says a junior doctor in a Government hospital could earn anything from Dh15,000 to Dh30,000 (US$4,000-$8,000) a month but there is no set standard.

By comparison, a graduate with a civil engineering degree could expect to command a monthly income of between Dh20,000 and Dh40,000.

As well as a heavy reliance on foreign talent within the health system, both the Government and private sectors work with international firms to manage and develop hospitals and clinics.

In Abu Dhabi, for example, the company responsible for operating Government hospitals has contracts with firms including the US-based Cleveland Clinic and Johns Hopkins Medicine and the Thailand-based Bumrungrad International.

Private health companies operating in the country include the California-based UEMedical, which in June announced plans to establish a network of premium outpatient health centres in Abu Dhabi. It is currently building a women’s and children’s hospital in the capital, and has joined forces with ParkwayHealth, a Singaporean operator.

According to Dr al Numairy, another factor limiting the appeal of health care as a career among Emiratis is the perceived low status of medical professionals, especially in nursing. The Ministry of Health estimates only four per cent of around 18,000 nurses in the country are Emirati.

McKinsey & Company, the global management consultancy, was quoted in the World Economic Forum’s Arab World Competitiveness Report 2007 as saying that 96 per cent of nurses and 82 per cent of physicians in the UAE were expatriate, the highest of all GCC countries.

In Bahrain, by contrast, 70 per cent of physicians and 52 per cent of nurses are Bahrainian nationals. The GCC average for expatriate nurses and physicians is 79 and 75 per cent respectively.

Various initiatives are under way to address the issue. According to the Health Authority-Abu Dhabi (HAAD), by October last year it had 30 nationals enrolled on a five-year international leadership development programme with the Johns Hopkins Bloomberg School of Public Health.

In June, a spokesman for HAAD said it would actively recruit at universities to encourage more Emiratis to take jobs at the authority and in other government healthcare institutions.

Meanwhile, the Dubai Health Authority (DHA) is providing scholarships for Emirati students in nursing and dentistry. It also offers clinical attachments to specified healthcare facilities for doctors wishing to gain specialist experience.

Until 2007, Emirati doctors were required by federal law to work at a Government hospital for three years before being allowed to pursue scholarships in other countries.

Now, scholarships for young Emiratis to train at medical universities overseas are widely available.

The Scholarship Co-ordination Office (SCO) in Abu Dhabi, for example, offers young Emiratis two scholarship programmes: the Distinguished Student Scholarship and the Study Abroad Scholarship Programme.

“By means of these prestigious scholarships, a new generation of Emirati students are selected to travel abroad in pursuit of their education at prestigious international universities,” the SCO website says.

But training is only one side of the problem. Encouraging medical professionals to return, and stay, once they have qualified is another.

According to a report in September by TalentRepublic.net, a Middle East jobs website, around 70,000 Arab university graduates emigrate annually.

It also reported that 54 per cent of Arab students who study abroad do not return to their home country to work.

There are a number of accredited universities and medical colleges in the Emirates that aim to reduce the number of Emiratis travelling abroad to study medicine, including the Dubai Women’s College, the University of Sharjah, Ras al Khaimah Medical and Health Sciences University, UAE University and the Gulf Medical University in Ajman.

RAK University, for example, which was granted university status last July, offers bachelor of medicine and bachelor of surgery degrees, as well as courses in nursing and pharmacy.

Strengthening the education opportunities is a vital part of the push to attract more Emiratis into health care, says Prof Gita Ashok Raj, the vice chancellor of the Gulf Medical University.

“Before, anyone wanting to do study to work in health had to travel abroad, but now they expect universities to offer these programmes and make them available within the country. Why should they go elsewhere?”

The DHA has put in place policies designed to help stem the flow of talent abroad. Alison Ramsay, the director of nursing at Al Wasl Hospital in Dubai, says adjusting working patterns has helped address some of the cultural issues that can put Emiratis off considering a career in the health sector.

“We adjust working hours as we are aware of what is available in other industries,” she says. “We are happy to be flexible to help encourage people to work in the sector. There may also be some issues about women providing nursing care for men, which we also take into account.”

She says such an approach is one of the reasons the authority has such high staff retention rates. “We have good support systems in place within nursing and we support and encourage professional development.”

Dr Punitha Ezhilarasu, the chairwoman of the RAK College of Nursing, says she thinks cultural issues may also put off many Emiratis. Of the 85 students at the school of nursing, only eight are Emiratis.

“Many women students from other GCC countries attend our nursing college at our university, probably because women are encouraged more to join nursing in such countries and are liberated a little more compared to the UAE,” she says.

Overall, while change may be painfully slow, there are signs of improvement, say experts.

“The Emiratis are becoming increasingly interested in jobs in health care,” says Prof Raj.

“Some of the students say they feel they must do something good for their own country. The impression of healthcare jobs is changing and we hope to get more UAE national students in the future.”

And, with more Emiratis working in healthcare, there are hopes that the whole country will benefit: “If you have Emiratis treating people, they know all there is to know, and Emiratis are more likely to listen to them,” says Dr al Numairy.

“God willing it will happen, over time.”



munderwood@thenational.ae