Country Doctor

By Christine Gorman

We're used to hearing about the financial aid that industrialized countries provide developing nations. So it's a bit of a jolt to realize how often poor countries end up subsidizing rich ones. Case in point: the accelerating brain drain out of Africa of highly skilled medical personnel to fill higher-paying positions in Europe and North America. A report in 2004 found that more than 5,300 doctors who attended medical schools in sub-Saharan Africa--almost entirely at public expense--now practice in the U.S. (An additional 3,500 or so are working in Britain.) An editorial in last week's New England Journal of Medicine called this exodus "a silent theft from the poorest countries" and estimated that African nations pay $500 million a year to educate and train medical staff who wind up emigrating.

Dr. Leon Ngoma Miezi Kintaudi, 56, is one physician who is bucking the trend. Born 150 miles from Kinshasa, capital of the Democratic Republic of the Congo, formerly known as Zaire, he moved to the U.S. after finishing high school and worked his way through college and medical school in California. But while treating patients in a public-health clinic in Los Angeles, he kept thinking about Congo. He watched the country deteriorate in the 1990s as civil war took hold. On trips to visit his mother, who refused to move, Kintaudi says, "I started dreaming about doing something to help there. You would have to be very selfish not to see the need, especially in rural areas."

But where to begin? Kintaudi moved back to Kinshasa in the late 1990s and eventually directed a medical-residency program for the Eglise du Christ au Congo (ECC), an association of the major Protestant churches that operates more than 80 hospitals and 600 clinics. Half of the 40 doctors he trained in the first graduating class left the country. No doubt, Kintaudi explains, they found they could do better than the $30-a-month salary most doctors are paid in Congo.

Undaunted, Kintaudi and the ECC approached USAID with a plan to revive the country's devastated health-care system. They received a five-year $25 million grant, disbursed through Interchurch Medical Assistance, a nongovernmental organization based in the U.S., to set up 56 health zones located throughout the nation. (An additional 17 ECC-run health zones are funded by the World Bank.) A typical health zone serves 100,000 to 150,000 people with one hospital and about 20 health clinics, generally run by nurses.

The investment is starting to pay off, says Kintaudi, who serves as the collaborative effort's director. In five years, vaccination rates across the health zones have soared from 28% to 75%. More children are being treated for malaria. The number of women attended during childbirth is up. And many of the health zones have potable water. The next big hurdle: winning a second grant from USAID in 2006. But Kintaudi is in it for the long haul. "Success doesn't happen overnight," he says. "We have to act now to make a difference 100 years from now."