LOCRI, Italy, Oct 4 (Reuters) – Doctors from Communist Cuba are used to being dispatched to assist in medical hotspots in Africa, Asia and South America. But much less so to well-off Europe.

Highlighting the strains going through well being providers in Italy, the southern area of Calabria has signed a three-year deal to draft in virtually 500 medics from the Caribbean island to assist overcome a extreme staffing scarcity.

“It was a surprise for me to think Italy had a healthcare problem,” mentioned Elizabeth Balbuena Delgado, a heart specialist from Santiago de Cuba. She accepted a short lived task to work in Locri, a seaside city on the underside of Italy’s toe.

“None of us had ever been to Europe,” Delgado mentioned of the primary wave of 51 Cubans who arrived in Italy’s poorest area in January.

It isn’t just Calabria that faces manpower issues. Health Minister Orazio Schillaci has mentioned workers shortages nationwide represented “a real emergency”. Italy wants to draw extra overseas clinicians to its thinly staffed wards, he mentioned.

“We must strike agreements with foreign countries to have an adequate number of nurses,” Schillaci advised a information convention on Sept. 15, including that he was near reaching a cope with India, which has a whole lot of 1000’s of its nurses working overseas.

Italy’s well being ministry declined to offer additional particulars. A senior Indian Health Ministry official mentioned {that a} memorandum signed after Italian Prime Minister Giorgia Meloni visited India in March contemplated easing labour mobility for nurses and paramedics, together with with language coaching.

Without swift motion, the scenario in Italy’s hospitals might worsen, shortly.

Almost 1 / 4 of the 102,000 medical doctors working within the public well being service are eligible for retirement by 2025, unions say, which means directors will face an ever-growing battle to maintain wards, clinics and even entire hospitals open.

Authorities are more and more trying to rent from overseas to fill the various gaps — one thing Italy has historically shied away from, not like different rich nations.

The Paris-based Organisation for Economic Co-operation and Development (OECD), a gaggle of 38 member international locations that goals to ascertain worldwide requirements, says foreign-trained medical doctors made up simply 0.9% of all medical doctors in Italy in 2019 — the latest 12 months for which information is on the market. This in contrast with 11.6% in France, 13.1% in Germany and 30% in Britain.

While Italy has beforehand succeeded in coaching the overwhelming majority of medical doctors and nurses it wanted, a mixture of low salaries and burnout have thinned the ranks — particularly in demanding specialities like accident and emergency care.

Reuters spoke to greater than a dozen medical doctors, union leaders and well being officers who mentioned that makes an attempt to ramp up abroad hiring is just not proving simple, with the issues that plague Italy’s well being service — together with uncompetitive salaries, crumbling infrastructure, lengthy hours and forms — making it exhausting to draw overseas expertise.

Part of the issue can also be cultural. Unlike English or Spanish, comparatively few foreigners be taught Italian at school or communicate it fluently, which means there has by no means been a prepared pool of expert overseas staff.

“Italy is not a multi-cultural society. It isn’t used to this dynamic,” mentioned Andrea Filippi, a medic and nationwide secretary of the CGIL union of public service medical doctors.

Previous governments, trying to defend home staff, have additionally made it troublesome for outsiders to get recognition of their {qualifications}.

“In Italy it takes a year, or a year and a half to get (international) diplomas recognised. People are leaving Italy because of it,” mentioned Professor Foad Aodi, head of the Italian affiliation of overseas medical doctors.

“Italy always looked to hire domestically even when it was obvious they faced shortages in key areas … It was a major mistake that other countries didn’t make.”

“DESPERATION”

Roberto Occhiuto, president of the Calabria area, advised Reuters he needed to look overseas for physicians after failing to draw sufficient Italians to fill an array of empty posts. But it was not as simple as he had hoped.

“I tried with Albanian doctors, but they told me that while they can earn five to six times more in Italy than back home, they could make much, much more than that in Germany,” he mentioned.

He then contacted Havana, which sends 1000’s of medics overseas on worldwide missions every year in alternate for badly wanted money or items.

“The idea came to me out of desperation,” Occhiuto mentioned.

The COVID-19 pandemic laid naked the failings of the nationwide well being service in Italy, which suffered the second-highest dying toll from the pandemic in Europe after Britain. Italy registered 191,469 deaths.

Politicians of all colors promised on the time to spice up well being spending and reverse a decade of cuts. However, with the virus receding, spending is once more in decline because the faltering economic system forces the federal government to make troublesome finances decisions.

Meloni’s right-wing coalition has mentioned state well being care spending this 12 months will are available in at 6.6% of gross home product (GDP), down from 6.8% in 2022 and can fall to six.2% subsequent 12 months, leading to an actual drop in spending.

Health professionals say a decade of austerity has had a devastating impression on workers morale, inflicting an exodus from the general public well being system into smaller, however higher paid, non-public clinics, or else into extra profitable freelance contracts.

“Our salaries are among the lowest in the world. You can’t always work for the glory,” mentioned Rosanna Curinga, 41, a surgeon who works in Locri alongside the Cubans. “You work so much that you easily burn out, yet you hold people’s lives in your hands.”

NOT ATTRACTIVE

The OECD database says a specialist physician earns on common $82,000 a 12 months in Italy in opposition to $99,000 in France, $156,000 in Britain and $175,000 in Germany.

This discrepancy means different locations are extra enticing for oversees medical doctors trying to construct a profession in Europe, says Aodi, the overseas medics chief, who’s Palestinian.

During COVID, Italy eased restrictions for hiring overseas medics, suspending the principles that mentioned they might solely come from European Union states or else needed to have residency papers — a prolonged bureaucratic process that deterred many outsiders.

The emergency guidelines stay in place for now, however that does not imply there’s a queue of certified well being staff on the door.

A small hospital within the city of Morbegno, north of Milan, is absolutely outfitted however can not open as a result of it can not discover 9 nurses. Administrators had hoped to rent them from Peru, however the deal fell via in July and no new resolution is in sight.

The 15-bed hospital solely requires a group of 17 workers to open.

“This is an out-of-the-way spot and not considered attractive. Furthermore, just cross the border, you find yourself in Switzerland where you earn more,” mentioned Lorenzo Grillo Della Berta, head of healthcare in Morbegno.

“If here a nurse earns 1,500 euro (a month), in Switzerland you earn more than double that.”

Higher salaries and higher working circumstances elsewhere are additionally proving a lure for Italy’s personal medical professionals, Italy’s well being unions say, exacerbating workers shortages.

OECD information says that 11,358 Italian medical doctors had been working overseas in 21 OECD states the place information was obtainable for 2021, together with 1,644 in France and 1,408 in Germany. By distinction, simply 107 French medical doctors and 316 Germans had been working in Italy.

Italian medics are additionally being lured to non-OECD nations.

The Nursing Up union – which had greater than 24,500 members final 12 months – mentioned final month that 550 Italian nurses had put their names right down to go and work in Abu Dhabi, the place they earn 3,400 euros internet a month, plus housing and journey prices.

“The geography of world healthcare has changed. Countries in the Middle East are investing around 10% of their GDP in healthcare and the gap with nations like ours is in danger of becoming unbridgeable,” mentioned Nursing Up chief Antonio De Palma.

In Calabria, the arrival of the 497 Cuban medics will solely present momentary aid. They are on account of depart in 2025 and the area is just not relying on them placing down roots.

“I will stay for as long as the agreement between Italy and Cuba stipulates, but I don’t want to stay here. I want to go back with my mum, to my home,” mentioned the heart specialist Delgado.

($1 = 0.9323 euros)

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