Georgia: Newly Trained Village Doctors are Medical ‘Jack-of-All-Trades’

September 10, 2009 — The only physician in her village of Tsoniarisi, Mzevinar Bolkvadze sees patients all day in a newly built and equipped ambulatory. The village is in a high mountainous area that is cut off from the rest of the country for 6 months a year because of the adverse weather conditions. In the evening, she makes house calls—on foot despite a bad leg, clocking over ten kilometers up and down mountains.

Doctor to 1,600 people, she needs a smattering of training in geriatrics, pediatrics and much more. She just completed a course in emergency medicine. She hates to be away from her patients—who are free to call her day and night, and says retraining has made her feel like a new doctor.

Georgia aims to improve the quality and coverage of its health care, as well as its usage. As part of an ambitious reform program, the government—with help from international donors, including the World Bank—is giving specialized training to hundreds of primary care doctors and nurses. Apart from the training the Bank has also supported the rehabilitation and construction of Primary Health Care facilities, and has helped to equip them. Adjara autonomous republic was the first pilot region where the new facilities were introduced. This Bank supported project covered almost the whole region with newly refurbished or, in some instances, newly constructed and equipped facilities, as well as trained medical personnel.

The emergency medicine course taught at Batumi Family Medicine Training Center in western Georgia is part of an overhaul of primary care that includes intensive retraining of physicians and nurses. Courses of all kinds have been designed. Nurses are learning hands on how to care for patients at home and training centers outside the capital make it easier for doctors in remote or rural areas to attend.

“They are very interested to improve their skills, knowledge and attitudes,” said Dr. Tamar Mkhatvari, Family Medicine Expert of the Ministry of Labor, Health and Social Affairs of Adjara Autonomous Region. “ Better doctors and nurses with new equipment will provide better health care to patients.”

Three doctors at one clinic in Adjara that once had no running water but was renovated through the program are taking the emergency training in stages. Dr. Leila Jikhashvili took it first. “Mainly I learned better skills and up to date information, and lots of novelties,” said Dr. Jikhashvili. Her colleague, a more recent graduate, hopes retraining will make her more independent.