Sana Din: Lessons from the East

At the 14th European Health Forum Gastein (5-8 October 2011), a group of “Young Gasteiners” are blogging live from the talks. A selection of their blogs are on the BMJ blogsite.

The workshop, “Lessons from the East” provided an interesting overview on how Eastern countries are dealing with issues regarding existing resources, the financing of their health systems, and other problems.

The reforms and models presented by the speakers made me think critically about it. From my perspective as a student not yet not working professionally in the health field, the reforms, plans, and suggestions that were presented seemed a bit too idealistic. Theoretically they sound great and promising, but I doubt whether in practice they can be implemented.

I was asking myself if the implementation is really as “easy” as it was presented and if the expected outcome is realistic and really happening?

I am questioning it because the West had a different past than the East. Now the East is in a period of growth and development and can slowly afford to think out of the box. Therefore these countries can copy and even improve existing western models and implement them into their systems.

In the end, every government is worried about the financing and spending of health systems, especially about the ethical issues. By ethical issues I mean informal payments received by physicians. These so called under the table payments result in a lack of incentives for physicians who receive low incomes. An example is that of Tajik doctors who receive a salary of around $3 per month and are not able to feed their families with that income. Therefore they have to rely on informal payments given to them by patients, who themselves are from low income backgrounds.

Oleg Chestnov said in the workshop: “Not all western lessons fit us–some are even disadvantageous for the East.” I believe this quote contains a lot of truth and is also valid the other way round. Blindly copying reforms will not necessarily be helpful for anyone–they need to be adapted, so that efficient and fair use of existing resources is possible.

You can read more blogs from the Young Gasteiners on the BMJ blogsite. The rest can be read on

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