Romania's Health Care System Is So Broken, Doctors Are Fleeing the Country
Romanian doctors are so poorly paid that many of them have to take money from their parents to live, and Romanian hospitals are so broke that they ask patients to buy medical supplies.
Last summer, my dad was in the hospital while he was being treated for pancreatic cancer. Because this is Romania, that meant that a doctor gave me a list of supplies I would need to buy for him: drugs, syringes, IV equipment, cannulas, catheters, bandages, and plasters. All this stuff cost me between $140 to $280, and in a country where the annual per-capita GDP is hovering around $13,000, that's a lot of money. Many families in that situation would have to choose between buying medical care for a loved one or feeding themselves.
Over the last five years, nearly 14,000 doctors have left Romania, a trend that shows no sign of stopping. The patience of resident doctors was tested to its limit last month when Prime Minister Victor Ponta promised them an extra monthly allowance of about $200 on top of their salaries, only to hold off giving it to them (not that it would have been of much use anyway, given how low their salaries were in the first place). Along with low pay comes corruption—employers sometimes solicit bribes from people who want to work in their hospitals.
To get a better idea of what’s going on, I joined about 300 doctors—who were holding a protest outside the prefect’s office in the city of Cluj—and asked them why the health care system is in such a state.
Delia and Darius Tăchilă are both residents. She works in the orthodontic and orthopedic section, and he works as an oral and maxillofacial surgeon. After I took their picture, they told me, “We're smiling, but we are desperate.”
VICE: What are you protesting?
Delia: The first thing is the lack of money. There are things we're missing, and we can't afford to buy good books. My residential course involves continuous practice, but how can we buy everything we need to do that?
Darius: We're living on a university campus. The rent and the utilities take up one of our salaries, and we use the other—which is €250 [about $350]—to live. We have low salaries, and sometimes we work unpaid shifts on the weekends. But people should realize that it's not just about us—doctors will leave and citizens will suffer from the lack of medical assistance.
Are you planning to leave yourselves?
Yes. We have some options, like Germany, England, Australia...
Maria, another resident, holding a sign protesting the low salaries of doctors
What difficulties are you having as a resident physician?
Maria: The salary is alarmingly low, the families of the people we're treating—and the rest of society—show us no respect, and we're always frustrated because we're unable to do our jobs at the highest level.
Why did you become a doctor?
To help people. And for this I need to practice during my residential course. If the state doesn't help me, what can I do? I will leave the country.
VICE: Why are you here today?
Andreea, resident physician: Let me tell you a story. One time, I needed gloves to do something, so I asked the nurse to hand me a pair. She gave me one glove. "Do you think I can pull this off properly with one hand?" I asked her.
"You have to—these cost money," she told me.
So you can't even buy the equipment that allows you to do your job properly?
No. I'm young, and I need help being convinced not to leave this country. I want decent work conditions in the hospital—my own toilet, space, equipment, a normal schedule. It's not OK to have 24-hour shifts... when the next day you have to start a new shift and be fresh. You can't make any mistakes, like having shaky hands. You have to pay a lot of attention to what you're saying, to what you're writing down, and to the diagnoses you give. The responsibilities are very high when you're working with people's lives.
What's your salary like?
It went up from €222 to €244 [from about $310 to $340] a month. Half of the students in my generation left the country before their residency exam, and the other half are starting to leave now. I don't know how long I'll be stubborn enough to remain here for—to fulfill my moral duty to people here. But if they keep on putting the stops on us, I'll think about moving on to more promising horizons.
VICE: How do you see your future as a resident physician?
Silviu, medical assistant: I'm not optimistic. The word that best describes my future prospects is terror. As students in Romania, we're pretty unlucky—we have to choose between putting up with the situation or leaving. Both choices are bad.
Why do you want to leave?
The health care system is neglected, but staff just have to deal with it and suck up all their frustration. Patients and their families don't understand that we're not guilty, and they're blaming us for all the problems. It’s hard to bear.
VICE: What's the most difficult thing about working in the Romanian health care system?
Andreea, medical student: Thinking about the welfare of your patient when you know your electricity at home might be turned off, that you might be pregnant and that you need to eat more, but that you don't have the time or money to do so. I'm a student, and I want to stay in this country, which is why I joined the protest.
What are you hoping to change?
I want decent work conditions. It seems humiliating for me to take money from my parents at the age of 30. When you can't be financially independent and responsible for your own life, how can one be responsible for another's?
VICE: Why are you protesting?
Vlad, resident physician: There are many reasons: We're not given food, and we have to bring it from home; the extra shifts aren't paid; we're working overtime, and some doctors don't respect the residents. We all get help from our parents. We can't dream of going on vacation. We need to buy our own expensive manuals. Another thing is the scholarship—besides the fact it hasn’t been paid yet, we don't know how long we'll get it for.
How are patients affected by the system’s shortcomings?
They have to buy the medicine themselves, and the food isn't so good. There are hospitals that, when you enter, you have a mental breakdown. The beds are old, the walls aren't painted, and the toilets look awful. The patients need rest and better conditions. And for us, no matter how committed we are, it's hard to keep a positive attitude.