Developing countries often spend more than half their entire health budget on modern hospitals and medical centres in capital cities, i.e., on expensive, individualized curative services for a small urban elite. Consequently, among rural populations, millions suffer from preventable disease. Inequality is further perpetuated by the prevalence of private practice and the draining of doctors from the developing to the developed world. A 1969 survey in Pakistan showed 55 of its medical school output had left the country. Viable auxiliary health systems do, however, exist. In Sri Lanka care is equitably distributed through a system of auxiliaries. Health services in centres manned by auxiliaries tend to be more dedicated to the interests of the communities they serve. |