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Doctors Dilemmas in Romania

Dr John Caroe
Over the last five years, a small group of British doctors has been enjoying increasing contact and friendship with Romanian Christian colleagues.

It all started about five years ago at Burswood, the Christian hospital near Tunbridge Wells. Aware of the stresses faced by UK GPs, a group of friends started the five day 'Doctor's Dilemmas' courses, designed to combine excellent academic teaching with refreshment of spirit in beautiful surroundings. Walks in the woods and laughter over a good meal were as important as professorial updates in Cardiology.

A fundamental principle from the start was to invite to each course at least two medical friends from Eastern Europe. Their presence always transformed the week. Humbled by their courage and suffering, not once did any UK GP complain about our NHS - a rare fact at GP gatherings! Over the years we welcomed friends from Romania, Hungary, Russia, Georgia, Armenia, Albania and Ukraine.

It was the Romanians who first suggested running postgraduate education courses in their country, and this is what we did. Not only was there the chance to share with many more local doctors, but we were also able to introduce so many more UK GPs to that attractive country. The effect of those visits was irreversible for all of us.

We began to see hints of the enormous suffering from which they had emerged only a few years ago at the revolution of Christmas 1989. One in three of the population had been informers for the Securitate terror machine. We met pastors who had been in hiding for years, or who had been tortured.

We shared coffee in cramped flats, high up in crumbling concrete blocks, with people who had stood with 100,000 others in Timisoara's Opera Square for four days and nights, surrounded by tanks. The bonding of such united love opposing the terror was described by a philosophy lecturer as 'Heaven on Earth'.

Their suffering gave those Christian friends such clear, mature spirits, which humbled us westerners. It was a joy to meet so many with faith of such lively immediacy and so little guile, and challenging to see their perseverance in the face of such financial and professional chaos. The Christians are now leading numerous projects to improve Healthcare, and they are honoured for it.

Thus it was that nearly all the UK visitors returned home feeling that they had been blessed more than they had given. For 3 years we arranged formal postgraduate courses there, coinciding with the Romanian Christian doctors' annual conference.

The vision then changed as we sought to explore the fruit of travelling in a very small team to several towns to share half-day seminars with local GPs. We tried to encourage them with the vision of General Practice as in the UK, and emphasised the value of meeting together on a regular basis to support and teach each other. This is a new idea for many whose self-respect and honour in society is very low. They still earn about 50-75 dollars per month (not per week) and may afford meat only once in that time. Specialists do not esteem their peers, and money determines everything. One Christian professor of cardiac surgery was ousted from Bucharest for refusing to accept bribes.

We visitors have been most aware of our inadequacy. British academic or spiritual prowess fades rapidly in the face of such situations. Individual gifts of equipment seem but a breath of air in comparison to the need. Yet we believe that the visits in themselves are a breath of hope in the slough of despair. Any small gift reassures them that they are not forgotten - and the greatest gift one can bring is the repeated visits that speak of commitment of ongoing friendship.

If the work of Doctor's Dilemmas is to grow in Romania, it needs to be organised more formally. We are in the process of creating a charity to channel the administrative and financial support that is so vital.

And what of the future? Our vision is to build up an extended network of UK Christian doctors who would be able to give a week occasionally to travel (not always in comfort) with two or three colleagues around a group of towns, simply sharing their professional experience. Specialists are as important as GPs - indeed the teamwork would in itself speak volumes to those for whom such teamwork is virtually unknown.

For those of us with less time to travel remains the chance to befriend an individual Romanian doctor. Any contact with the West is a great blessing - and we in the UK are familiar with the value of a professional confidential mentor. Regular Email or fax contact is now a reality, and a UK physician might be humbled by how much he learns from these highly intelligent academic Romanian colleagues.

Dr John Caroe

STOP PRESS: Doctor's Dilemmas is now called PRIME - Partnerships in International Medical Education.
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