Arab, African doctors saving French lives
During his visit in early April to the Mediterranée Infection Foundation at La Timone Hospital, a celebrated medical institution in Marseille headed by famous microbiologist Didier Raoult, President Emmanuel Macron was surprised to discover an army of young researchers from the Arab world and Africa working with the iconoclastic professor.
To the dozens of virology and epidemiology researchers he encountered, the French head of state, accompanied by Raoult, now the punching bag of medical conservatives and the Parisian medical establishment, asked them one by one where they were from. “Burkina Faso, Senegal, Tunisia, Mali, Morocco, Algeria, Lebanon,” the answers came, confirming a reality depicted by the professor in one of his video clips where he praised the seriousness, talent and dedication of the Arab and African researchers he was working with.
“Thank you for participating in the collective effort,” said the French president.
The COVID-19 pandemic in France has shed an unexpected light on the crucial role medical doctors, caregivers and researchers from the Arab world and sub-Saharan Africa are playing in the French health-care system.
As their role gains recognition, it has shattered the claims of xenophobes of all stripes who peddle the myth of the “invasion” of France by migrants and foreigners.
The first doctor to fall in the battle against the virus in France was African: Dr Jean-Jacques Razafindranazy from Madagascar. At the age of 67, Razafindranazy did not hesitate to come out of retirement to volunteer his services when the COVID-19 pandemic started to ravage the Department of Oise in the Paris region at the end of February. His death moved all of France.
Since then, the number of doctors and caregivers infected with the virus has skyrocketed. In the Paris region alone, no less than 1,200 medical professionals practising in public hospitals were infected from the start of the pandemic until the end of March. Among them were a high number of doctors, nurses and paramedics from the Maghreb, the Middle East and sub-Saharan Africa.
Ethnic classification is illegal in France, but to get an idea of the increasing weight of Arab-African health professionals in France, it is necessary to make approximate cross-checks.
For example, one can look at the statistics regarding the number of doctors and caregivers holding non-French or non-European degrees. One can also check membership data published by ethnic professional associations grouping doctors according to their nationality of origin (Algeria, Tunisia, Morocco, Lebanon, Syria, Senegal, etc.).
Associations of medical professionals of Algerian origin are the most numerous in France. They claim more than 15, 000 practitioners, against 10,000 practitioners belonging to Moroccan associations and as many as 7,000 to 10,000 practitioners from Tunisia.
The Franco-Lebanese Medical Association (AMFL) claims nearly 2,000 members, even though it is far from representing the whole of the Lebanese medical community based in France, which is estimated at about 7,000 doctors. Moreover, there are 7,000 Syrian medical doctors living in France.
The French health-care system is increasingly benefiting from the massive influx of sub-Saharan African health professionals coming especially from Senegal, Mali, Benin, Burkina Faso, Congo and all French-speaking countries.
The official figures, even if they are far from reflecting the reality on the ground, are no less instructive. According to the website ProfilMedecin, which specialises in recruiting doctors and health workers, “one in every four doctors registered with the French Order of Physicians was born abroad” (https://www.profilmedecin.fr/contenu/le-veritable-poids-des-medecins-etrangers-exercant-en-france/). This is likely to be a conservative estimate since a sizeable chunk of foreign doctors in France are not registered with the Order, for reasons pertaining to the equivalency of their diplomas or regularity of their work and residency status.
As such, and even though they would be doing the same work as their French counterparts, they are overworked and underpaid, with no job guarantees.
This is seen by professionals as an unjustifiable form of exploitation, all the more cruel since France is in dire need of doctors (the deficit was estimated at 20,000 in 2018).
The complexity of the French legislation on the subject explains this glaring injustice. The French public is largely unaware of the situation with foreign doctors.
With the rapid and massive transformation of the French medical landscape, these anomalies have become an underlying factor in the untenable deficit of health professionals in France.
The National Council of the Order of Physicians (CNOM), the real gatekeeper of the established medical profession, and which has so far defended tooth and nail the corporate interests of the profession by limiting the number of people admitted to compete or to practise medicine, is forced to no longer oppose the registration of foreign doctors whose role is vital to keeping the French health-care system going.
Admittedly, a recent 2019 law provided that foreign doctors, pharmacists, dentists and midwives could legally practise under certain conditions. Today, a petition has been launched demanding the automatic regularisation of the administrative status of the health professionals of foreign origin who are at the frontlines in the battle against COVID-19. So far, however, nothing has been done.
During the period of general confinement, one TV station had the brilliant idea of rebroadcasting “Hippocrates,” a 2014 film dramatising the problems of a French hospital and casting an intelligent and moving light on the precarious status of foreign doctors, victims of an arbitrary and unfair administrative system.
Will the thousands of foreign doctors in France, whose overwhelming majority comes from the Arab-African world, and whom the Order of Physicians calls PADHUE (practitioners with diplomas from outside the European Union), finally see the end of their administrative ordeal and their status as fully-fledged physicians recognised? These unknown soldiers in the fight against the pandemic most certainly deserve it.
Despite their “precarious status” and “low salaries,” these soldiers continue to stand “on the front line” of the fight against the COVID-19 pandemic alongside all their colleagues, as underlined by an open letter addressed to French Prime Minister Edouard Philippe made public on April 5.
The letter, co-signed by 13 prominent French doctors, including three of Algerian origin — Amine Benyamina, Sadek Beloucif and Madjid Si Hocine — calls for doctors holding foreign diplomas to be integrated into the French health-care system. These caregivers, they argued, are among those who “selflessly engage in the most exposed positions, emergencies and intensive care services,” thus making possible the continuous “functioning of hospitals in the middle of the storm and are saving lives in difficult material conditions, but also at the peril of their own lives.”
The flip side of France’s success story in bringing in foreign medical professionals is distressing.
It is the countries south of the Mediterranean that are paying the heaviest price. This is the case, for instance, of Tunisia which, day after day since 2011, has been unable to reverse the mass exodus of its doctors, whose training is funded by the Tunisian taxpayers but are often too exasperated by inadequate working conditions to continue pursuing their careers at home.
Tunisia and many other countries of North Africa and the Middle East are finding themselves deprived of the services of their highly competent doctors and other medical professionals during an unprecedented health crisis that is sorely testing their medical systems.