More than 3 years ago, a pregnant woman who came to visit me several hundred kilometers back to Hanoi found me asking for an ultrasound of pregnancy with anxiety. I want ultrasound to answer the exact date of the baby. It was impossible for her or to any doctor. Based on the menstrual cycle or calculations by ultrasound, the expected time of childbirth is still fluctuated between and before 2 weeks.

That was the first child, the couple had to make great efforts and wait for a long time, the path of motherhood of the wife was not easy. But that is not the reason why pregnant women are most worried.

The entire mountainous district where she lived only had one obstetrician specialist, at a small town hospital there was not much to do. The district around the same. About 6-8 hours away, there will be a large hospital specializing in obstetrics and gynecology of the province, where there are more doctors and better conditions; but she could not afford to go to province to wait for a birth.

She made the "first" trip to Hanoi in the hope of knowing the exact date of birth and then returning to the district to give birth. If, on that day, the obstetrician is on a business trip or is ill and cannot go to the hospital, the pregnant woman's husband will have to take his wife "to give birth" in the surrounding districts, in case of a bad situation such as a birth difficult or surgery.

I know many women in the districts who used to give birth. Many of them make the first "travel" in their life out of the district is a trip to give birth. They have to go a long way to several hours. Just imagine, motorbikes carrying pregnant women across the forest, no pain control, or the husband not knowing what to do if the baby is about to be born, that's enough for those who have Expertise like I have to obsess.

That obsession is called the "shortage of doctors in the countryside" which I believe every health worker understands. It is most clearly revealed by the obstetric accident that occurred in the Duc Tho General Hospital (Ha Tinh), when a fetus died with a cut in the neck, the maxillofacial specialist was the righteous person at obstetrics that day.

If you just look at the phenomenon, it is clear that the Duc Tho General Hospital has arranged a dentist to do the job of an obstetrician, it will be unacceptable wrong. But a closer look will see that district hospitals have to do the same.

If the hospital has only one obstetrician, it is impossible to make that doctor work 24 hours a day. The hospital has 2 doctors, too, can not be exchanged to work 24/24 hours, which the medical industry still calls "live duty". Other specialties are similar. As a result, district hospitals have to apply the general surgical solution. This means that specialties for surgery, obstetrics, facial teeth, otorhinolaryngology, eyes will be arranged directly outside office hours. For example, maxillofacial surgeons are still involved in the genitals, resolving births in their ability, if they encounter difficult cases, they should invite the right specialist.

It is a fact that district hospitals cannot recruit doctors. I have traveled to many rural areas, which are large areas, especially mountainous ethnic minority people living in a different world than in urban areas. The sparse population makes it extremely difficult to implement health policy, while health care requires equality, one cannot be abandoned just because they do not live in Hanoi or Saigon, even A mountain with only a few households still needs health care, even rural people need more health care.

Lack of doctors in rural areas does not have to happen today. From more than 6 decades ago, there were only 404 doctors in the whole North, although they had been trained in French programs for 7 years, their qualifications were not inferior and even surpassed those of French doctors. But the need for a number of doctors in 1960, the North needs a minimum of 3,000 doctors. Therefore, the medical training program has been shortened to 4 years with full-time physicians, training a series of specialized and in-service physicians to supplement the rural and mountainous areas.

Since then, the district hospitals have had doctors, but most of them are specialists and in-service physicians, they are nurses and physicians from the unit sent to vocational schools and then return to work. District hospitals are difficult to recruit regular system doctors. The reason was given, that is money, that is, the remuneration regime; But I think money is only a problem, and the more important problem is the living and working environment.

It is very difficult for a person from a poor village to study best and pass the Hanoi Medical University, after graduating back to the poor village to practice as a doctor. Going to many district hospitals, my eyes saw the doctor cum more jobs such as cleaning, tilling the grass, hoeing medicinal plants or many other unskilled laborers, to this day. I was told that there was a hospital before, when the patient was in surgery, the surgeon was the guard, because it was a part-time doctor. All that, cannot be a good environment, to appeal to the doctor.

A good environment must be a professional environment of the digital age and broadband Internet allows doctors to connect with the civilized community and world, ensure the material life of doctors and respect people. Doctors instead treat them with punches.

I think that the problem of "shortage of doctors in rural areas" is at the peak of a large iceberg, which is a national urgent problem. Comprehensive integrated solutions are required. Clearly, the health sector over the past six decades has tried hard, but to cure the "rural shortage of doctors" the health still needs to make a real breakthrough.

Tran Van Phuc