1191 



is 1.9 doctors for every 1.000 residents. In some areas of the country 

 the ratio is lower. The basic Federal Government criterion is^one ]M.D. 

 for every 1,500.'**^ 



The doctor-to-population ratio for other advanced nations is also 

 high. In 1960, Austria had 560 inhabitants for every doctor; Belgiiftn, 

 700 ; West Germany, 650 ; Italy, 610 ; and France, 840."« 



The ratio for the LDCs is in sharp contrast with those from the 

 advanced countries. In 1960, the doctor-inhabitant ratio in the LDCs 

 of Africa was one M.D. for every 10,100 inhabitants; Asia, 5,700; and 

 North and South America, excluding the United States and Canada, 



I'SOO.''*^ ^ . , , . 



LDCs with the lowest ratios were Burma with 11,«00 inhabitants 

 for every M.D.; India, 5,800; Iran. 3,220; Indonesia, 35,000; Haiti, 

 15,000; Ecuador, 5,100; Bolivia, 3,680; Ethiopia, 69.000; Ghana, 

 21,000; Nigeria, 32,000; Tunisia, 9,400; Pakistan, 6,400; Thailand, 

 8,600; Korea, 2,850; China (Taiwan), 2,420; Colombia, 2,470; Peru, 



2.230."^° . ^ 



The above ratios do not necessarily reflect the actual ratios for 

 specific areas within the LDCs. In rural areas the ratio is much lower 

 than in the urban areas where physician concentration is the highest. 

 Sources on brain drain combine ratios in unique ways that show the 

 actual situation and suggest the pressing needs of the LDCs. "We have 

 1,250 doctors for 25.4 million people in East Java," explained Dr. Wog- 

 sokusumo Bahrawi, who directs health care in East Java, Indonesia. 

 "That sounds like one doctor for every 20,000 people, but it's a dis- 

 tortion because most of them are in big cities. So really, in rural areas, 

 there is only one doctor for every 180,000 people." *^^ Closer scrutiny 

 of ratios for the Philippine Islands reveals a similar imbalance. Manila 

 has a ratio of 1 phj'sician for 671 people. In the rural areas the ratio 

 lowers to 1 for every 4,979; and for Southern Mindanao, the ratio 

 drops still further to 1 for every 10,700.*^- Similar imbalances would 

 no doubt be revealed if the ratios for other heavy losers in medical 

 brain drain among the LDCs were broken down regionally or accord- 

 ing to specific areas. 



Undoubtedly the imbalance would be accentuated still more sharply 

 if only native doctors were counted in ratios rather than including 



*" The New York Times, June 15, 1973, p. 33 and Mav 27, 1972, p. E16. For a discussion 

 of the influx of FMGs into the United States, see Chapter II. According to Margulles and 

 Bloch, in 1969 approximately 75 percent of the FMGs came from the LDCs of Africa, Asia 

 and Latin America, (p. 9) In many instances the LDCs with the lowest ratios are the highest 

 contributors. Of the 14, S2S FMG trainees (residents and interns) in the United States at the 

 close of 1967, four-fifths came from 15 countries and 56 percent came from 6 developing 

 Asian nations : I'hilippines (25.5 percent) ; India (11.9 percent) ; Korea (6.8 percent) : Iran 

 (4.4 percent) ; Thailand (4.4 percent) and Taiwan (3.1 percent). See below for the ratios of 

 M.D.s-to-inhabitants. (Henderson, op. cit., p. 63.) 



"« Report of U.N. Secretary General, Outfloic of Trained Personnel from LDCs, Nov. 5, 

 1968, Table III. pp. 70-71. 



"" Ibid., p. 40. In commenting on the shortage of physicians and health workers In Africa. 

 Prof. Cnaire Nader referred to Dr. Alfred Quenum, African regional director of the World 

 Health Organization, and his statement that in Africa the ratio was one M.D. for 25,000 to 

 50,000 persons and this includes foreign physicians and missionaries. (Nader, Technical 

 Experts in Developing Countries, pp. 455-456.) 



<5o Report of U.N. Secretary General, Outflow of Trained Personnel from LDCs, Nov. 5, 

 1968. Table III, pp. 68-71. 



<5i The New York Times, Mar. 21, 1973, p. 12. In underscoring the Inadequacy of health 

 care, the reporter, writing from Triwung Kidal, Indonesia, observed : "There Is a good 

 chance that no one In this village will see a doctor this year. It Is almost certain that 

 no one will appear to teach the people about the virtues of sanitation and hygiene." 



*^ UNITAR, Brain Drain from Five LDCs, 1971, p. 103. 



