Do Health Workers Have a Duty to Work in Underserved Areas?
Health worker shortages are a crucial obstacle to relieving the burden of disease in many countries. Their impact is most concentrated in the remote, rural areas of sub-Saharan Africa and South Asia, where a great number of the world’s poorest, sickest, and most vulnerable populations reside. Local health workers are often reluctant to work in these critically underserved areas, preferring instead to work in cities and the private sector. Exacerbating this problem, some of the wealthiest countries allow in, and often actively recruit, health workers from these poorer countries. Large differences in the availability of health workers result. According to the most recent WHO data available, the ratio of physicians per 1,000 population in Malawi is 0.019, whereas in the U.S. it is 2.42, for 2008 and 2009 respectively (WHO 2012a: 14-15). Disparities in the availability of physicians and other health workers inside countries are also extreme.