"MIEDZYCHOD, Poland -- So many new doctors left Poland for better-paying jobs in Europe's west that when Lukasz Rotnicki decided to stay behind he often found himself working 36-hour shifts, sleeping on the pullout sofa of a small-town hospital with too few staff.
That was before Covid-19.
On a recent Monday, the 36-year-old surgeon was on his 74th consecutive hour of treating coronavirus patients, broken by only a few short naps. At the same hospital, a local nurse recently had been hospitalized, feverish and short of breath. Yet, the staffing crunch was so dire that she kept working in the very Covid-19 ward where she was meant to recover before returning to her own bed in the same room.
Europe's Covid-19 crisis is moving eastward, from the wealthiest and best-prepared countries on the continent into the poorer states that have exported doctors for decades. Now, as Covid-19 cases soar, the bill from that long exodus is coming due.
With 238 physicians per 100,000 people, Poland has the lowest such ratio in the European Union, nearly half the level of Germany, whose relative success in handling the virus owes much to its foreign staff. The average age of Polish nurses is 53, just seven years short of retirement.
Largely spared during the spring surge, Hungary, Slovakia, Poland and Romania braced for autumn by stocking up on ventilators. But they lack people to operate the equipment. As cases pile up, shifts that often spanned two full days before the pandemic are now stretching the limits of human endurance.
"It's hard times, I think, it's like the Second World War," said Dr. Rotnicki, who arrived on a recent Friday morning at the Independent State Healthcare Hospital in Miedzychod in western Poland and didn't clock out until the following Monday. Hours later, three of his patients died. "I had to go home because I thought, I will maybe kill somebody," he said.
The shortages, which have prompted strict stay-at-home orders through Christmas in Poland, are the consequence of a borderless Europe that has seen prosperous countries -- particularly in Western Europe -- soak up talent from regions that offer lower pay.
As a result, Italian and British hospitals are coping with Covid-19 with help from Polish, Romanian and Hungarian staff.
Back home, doctors and nurses who stayed behind are working dayslong shifts.
Katarzyn Koch-Brzozowska, head nurse at the Miedzychod hospital, said her nurses threaten daily to quit, but she has successfully fought to keep them. "I call them a million times a day, and I bake them cookies," she said.
In Hungary, physiotherapists can earn five times their $600-a-month entry salary pulling shorter shifts in Germany, and in Estonia doctors can quintuple their pay by crossing over to Finland.
As incomes have risen in the region, nursing has become a less attractive profession. Schools that were once selective are now struggling to recruit enough students. In Slovakia, a third of all graduates immediately leave the country, said Jana Bendova, a board member of the Slovak Society of General Practice.
The staff who remain in the region tend to be older and were educated under communism or have returned after years abroad
At western Poland's Healthcare Center in Boleslawiec, three-fourths of nurses have fallen ill. Nearly half of nurses have contracted the virus at the nearby Drezdenko hospital. Nationwide, about a 10th of Polish nurses were quarantined as suspected Covid-19 cases last month.
Officially, the Drezdenko hospital has 126 beds, but only enough staff to handle about 80 patients, a number they already have breached.
Authorities have drafted troops, nuns and lifeguards to help. At Polish hospitals, soldiers take temperatures of visitors and input data into computers. At one hospital, staff recruited nine lifeguards from neighboring Ukraine. But they were unable to do anything more than basic CPR.
For years, regional governments have tried to entice medical-school graduates to stay behind, sometimes with pay increases. But problems remain. To staff public hospitals, Hungary's government is pressuring doctors to give up private practice and their right to choose which hospital they serve, a move widely opposed by doctors.
A survey from June by the Hungarian Medical Chamber found six out of 10 medical-school graduates intend to leave Hungary.
"We'd rather be cashiers at Aldi or Tesco," said one doctor, who is barred by government rules from speaking out. "We'd earn more and at least have our weekends free." [1]
1. World News: Eastern Europe in Dire Need of Doctors --- Medical personnel
have left poorer states for more pay and better conditions
Hinshaw, Drew; Ojewska, Natalia. Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]28 Nov 2020: A.7.
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