General commentsThe UPIGO’s survey covers countries with very different economic situations. In Europe, the GNP varies from US$2,600 to US$65,630 per inhabitant and per year. In Africa, Tunisia enjoys a privileged situation with US$2,890 per inhabitant. For the other fourWest African countries, the GNP goes from US$ 350 to US$700 per inhabitant.
It goes without saying that the health situation in each country is strongly dependent on its economic possibilities.
If theoretically everyone agrees to say that the rich countries have the moral obligation to help the poor countries, the reality of this help is often left to be desired and progress is to be made here. Our profession meets with difficulties everywhere. There are often conflicts with the state, with the health insurance. In some countries there are many conflicts with neighbouring specialities and even with mid-wives. To manage as best as possible the difficulties of the profession, a strong and representative union is an advantage of utmost importance. The union has the vocation of being an inescapable interlocutor for the political decision-makers or the health insurance administrators: in any constructive negotiation, you have to give to receive.
It is imperative for the profession to commit itself to a process of quality. It must actively take part in the organisation of continuing medical training. It must be able to prove the quality of the health care given by each of its members.
In return, it is authorised to ask for satisfactory working conditions, a good level of fees and a minimum of freedom in its therapeutic choices. Our liability should not be committed if we have the freedom to choose the necessary treatment for our patients and if we have access to a proper technical support centre.