In New Zealand, continuity of care has been one of the most valuable assets of general practice since the earthquake in 2011.
Professor Dee Mangin, director of the general practice research group and associate professor at University of Otago, said: ‘Relationships matter. It might be the only constant in someone’s life. How care is given and who gives it matters. General practice is the kind of care that matters most.’
So far there have been 12,000 aftershocks and the adrenalin rush that occurs each time has affected the health of patients.
Professor Ryuki Kassai, chair of the department of community and family medicine at Fukushima Medical University, said the earthquake and tsunami that hit Japan in 2011, and damage to the nuclear power plant, had left healthcare teams suffering exhaustion and hopelessness.
The open-access nature of the Japanese health system and fragmentary primary care provision added to the problems, with secondary care struggling.
Professor Kassai said little had changed since the disaster: ‘We feel uncertain about our future. Ten per cent of people have left, afraid of the possible effect of radiation, including many doctors and nurses, which has resulted in a significant health manpower shortage.’
The lack of medical staff and infrastructure in Africa were outlined by Professor Khaya Mfenyana, executive dean of the faculty of health sciences at Walter Sisulu University in South Africa.
He said partnerships with western countries had helped develop training programmes at the eight medical schools in South Africa. In turn, they were training doctors from countries in east, north and west Africa, where health systems were even more challenged.
‘We have many diseases but we don’t have the manpower to tackle them,’ said Professor Mfenyana. He added that the problem was even worse in Malawi, which had only 0.2 physicians per 10,000 people.
Dr Samar Musmar, from Palestine’s An-Najah National University, spoke about healthcare in a conflict zone. She said: ‘Healthcare workers have died trying to respond to the needs of the people. The beneficiaries’ safety is not guaranteed either. Some have lost their lives while getting healthcare.’
Other challenges included the unwillingness of patients to undergo preventive care because their main aims were finding safe places to live or seeking acute care, but vaccination and the control of infectious diseases had been successful.
The GPs received a standing ovation from the hundreds of delegates in the auditorium.
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