Refugees can fix Europe’s doctor crisis. Poland’s showing how

Throughout Europe and Central Asia, health systems are stretched like never before. Pushed to their limit by the COVID-19 pandemic, health and care workers are burning out.

Coupled with the cost-of-living crisis, job dissatisfaction levels have hit new heights. Hundreds of thousands of health workers have resorted to strikes and work stoppages across multiple countries, including the United Kingdom, France, Ireland, Portugal, Spain and Germany.

At the same time, in many of the 53 countries that make up the World Health Organization’s European region, more than 40 percent of doctors are above the age of 55. They will eventually retire — which could further push the healthcare systems in these countries to breaking point.

It is clear that the existing health and care workforce is no longer sustainable. With ageing populations regionwide, chronic diseases surging and the future threat of disease outbreaks, our health systems are only as good as the capacity of their workforce.

The war in Ukraine has added extra challenges. For 16 months now, many European countries have warmly welcomed more than eight million refugees who have fled the war in Ukraine. But the generosity of spirit comes with additional pressures on public services, including health.Poland has long hosted the highest number of refugees from Ukraine, with 1.5 million currently granted temporary protection. This means Poland’s population has effectively increased by 4 percent in the space of just one year. Yet in at least one major way, the county is turning what is often viewed as a strain into an advantage.

A win-win cure

Among the refugees are many well-trained health and care workers who want to continue practising their professions, but currently lack the necessary licence. Recognising this missed opportunity, the Polish government joined forces with the WHO Country Office in Poland to launch an initiative facilitating the integration of qualified Ukrainian refugees into the health workforce.

In November 2022, a Ukrainian language information hotline was launched for doctors, dentists and nurses with medical qualifications obtained outside the European Union. It provides comprehensive information on obtaining a temporary medical licence and supports Ukrainian refugees, among others, in navigating the health system by providing clear guidance on how to access treatment and medicine in Poland. More than 4,200 Ukrainian health professionals have already been granted a temporary licence in Poland.

Meanwhile, the WHO has collaborated with the Polish Ministry of Health and the Centre of Postgraduate Medical Education in Warsaw to develop a free, online course providing essential information about the national health system for Ukrainian doctors and dentists.

The WHO, together with the Polish Nofer Institute of Occupational Medicine (NIOM), has also developed information material and online lectures on occupational health in Poland to facilitate the health protection of Ukrainian refugees as well as migrants working in Poland.

This is not the first time that refugees have stepped forward to help the health systems of the countries hosting them.In Turkey, Syrian health professionals have worked closely with their Turkish colleagues to support refugees in the country. During the COVID-19 pandemic, the United Kingdom introduced a new medical support worker scheme. Under this initiative, refugee doctors who might have been out of work and needed to gain experience to pass General Medical Council practical exams were able to perform medical tasks under supervision.

Lessons learned

Poland’s innovative approach to incorporating refugees into health systems builds on these experiences and offers valuable teachings to other countries.

First, for refugees navigating an unfamiliar health system in a new country, having access to medical care in their own language is a huge relief. Not only can refugee health workers communicate fluently with people from their own country, but their own situation means that they can empathise better with those they serve.

Second, the integrated health workers maintain their skills, which means that they will be in a stronger position to help rebuild the health system of their own country as and when it is possible to return.Third, integrating refugees into the health workforce ultimately has advantages for the host country itself. With the right training and support, the local standard of treatment can be ensured, health system capacity increased and the host community benefits as a result. For that, refugees need support to acquire necessary skills such as local language and local medical protocols and procedures.

The scale of healthcare gaps is huge across the European region, and we are running out of time. Although interventions such as integrating refugees cannot by themselves solve the mounting health workforce crisis, the clear benefits show that this is an approach we can learn from — and one we must support and encourage.

Countries and governments need to act fast, tapping into innovations and potential win-win solutions like the one Poland is attempting.