a mayor’s bold appeal to foreign doctors

It’s not every day that a medical desert like the town of Decize sees a dozen doctors arrive for a day. On November 19, it was time for excitement in this town of Nièvre where the inhabitants had chosen to form a guard of honor to greet their visitors arriving in the village hall. Loud applause, cries of joy… The practitioners concerned – from countries outside the European Union – probably did not expect such enthusiasm.

Called Padhue* in administrative language, these doctors come from far away (mainly from the Maghreb and sub-Saharan Africa) already working in French hospitals where they represent a quarter of the practitioners. They earn only a minimal salary, between 1,500 and 2,200 euros per month, and, moreover, are prohibited from working outside the hospital that employs them. A rule that prevents them from coming as reinforcements to other establishments.

A crazy decree

It all started on October 8. Justine Guyot, the young mayor of Decize, decides to publish a false, facetious decree to shake up people’s minds: “Forbidden to fall ill. » Around sixty elected officials from the region are following suit. A group of Padhue people let this creative city councilor know that they would love to move in with her. The idea then emerged of organizing a “field hospital” in this town of nearly 6,000 inhabitants. We agree on a program: free prevention workshops, consultations, etc. But the Council of the Order is opposed to the latter, on the grounds that they cannot intervene outside their home establishment. “I took my blood sugar sensors in the trunk,” regrets Abdelhalim Bensaidi, diabetologist. We will therefore stick to the speeches, in the hope that the public authorities become aware of the benefit of calling on these practitioners in neglected areas.

In Decize, as in many other places, the situation is reaching a critical point. Fifteen years ago, the city had ten general practitioners. There are only two left. Specialists are also becoming rare. “I have been looking for a dermatologist for two years,” says Monique, who came that day in the hope of consulting one. She has spots on her skin, like her mother who was diagnosed with skin cancer. An appointment did open up, but in Dijon (Côte-d’Or), two hours away. And Monique will have to wait twelve months. Alain, too, has been looking for a dermatologist for four years. “They tell me to go to Vichy (Allier), but it’s expensive by train,” he complains. He doesn’t have a car and his job as a night watchman doesn’t pay him enough to cover this cost.

Alain votes for RN, the party of the new deputy for his constituency, elected last July with 54.82% of the votes. “I don’t care if a doctor comes from elsewhere as long as he is qualified,” he says. The one who looked after my father best was from India. I don’t vote RN because of immigrants but because I’m fed up. The politicians don’t care, they have their little comfort in Paris. »

Deleterious consequences

According to INSEE, the life expectancy of people from Nivernais is two years and three months lower than the national average. A difference linked to lack of access to care? The elected officials are convinced of this. Justine Guyot lists the series of measures taken in recent years by public authorities to attract white coats to rural areas: health centers, scholarships offered to students, increased numerus clausus… “Without results for our territory, doctors do not come in Nièvre. They settle in territories that are already over-endowed. » Hence the idea of ​​turning to the Padhue. And to demand a status allowing them to settle in the countryside. “If I am given authorization, I will pack my bags in Decize tomorrow,” assures Karim Bendamardji, emergency doctor in Marseille, wearing a jacket decorated with a “Covid-19 medal” received for services rendered during the pandemic.

Do these foreign practitioners really have the required skills? The mayor brushes aside concerns. “The fact that hospitals have been using them for years means that their department heads are satisfied with them. Two of them gave birth to me in Moulins (Allier). They were very efficient. » For her, this suspicion, often expressed by the government, hides the desire not to regularize them, in order to continue to make savings. Justine Guyot is not giving up: she intends to renew her “field hospital” operation every year. And will do everything so that, next time, his “saviors” can obtain the right to consult.

* Practitioners qualified outside the European Union.