On World Health Day, the British medical aid agency, Merlin, is highlighting the impact of a global shortage of four million health workers on some of the world's poorest countries.

The agency is listing countries which have the lowest ratios of health workers to patients, such as Ethiopia, where there is only one qualified doctor for every 37,000 people. In the UK there is one doctor for every 434 people.

"Comparing the number of doctors with the total population gives a crude indication of the paucity of health care in some of the world's poorest countries," said Carolyn Miller, Chief Executive of Merlin. "The effect of such ratios means that millions of children die from preventable diseases, women risk death during childbirth, and elderly patients endure debilitating illnesses without treatment."

Ethiopia has a population of 74 million, the third highest in Africa, yet there are only 1,936 practising doctors. Each year, half a million children there die from diarrhoea and one in six do not survive beyond their fifth birthday.

In Liberia, a country recovering from a devastating civil war, a recent government report confirmed that more than half the population are unable to get help from professionally trained medical staff. A quarter of all children there die before reaching the age of five.

Merlin has been working in Liberia for the past five years, re-establishing hospitals and rural clinics in collaboration with the Ministry of Health. But despite millions of pounds of aid funds put into the health sector there are still only 168 doctors serving a population of 3.5 million. With only one doctor for every 21,000 people, many desperately sick patients never get the opportunity of professional care.

"A vital strategy in combating this statistic is to establish more medical schools in the country. Yet a desperately needed facility to train doctors is struggling to receive funding from international donors," explained Carolyn Miller.

Another country struggling with a chronic shortage of health workers is Afghanistan. Because of a desperate lack of midwives, women there face a one in six chance of dying during pregnancy or childbirth in their lifetime. There are currently 2200 midwives in the country, serving a population of 6 million women of child bearing age. This number needs to increase three fold in order to achieve the most basic standard of maternal care.

In response to the shortage, Merlin has opened a training school to increase the number of midwives in Afghanistan. Over the past three years, this and other similar programmes have helped to increase the numbers by 400.

The World Health Organisation, which has calculated the worldwide shortage of health workers as four million, estimates that a 70 per cent increase in numbers is needed if the world is to achieve the United Nations targets for world development.

"Increasing the number of qualified health workers is the most important goal in preventing deaths in the developing world," said Carolyn Miller. "In recent years, we have seen huge funds gone into building hospitals, providing vaccines and distributing anti-retroviral drugs, but these measures have limited impact unless local people have the skills to implement and monitor them. More international aid needs to be put into the vital task of training doctors, nurses, and midwives."

Worst countries to find a doctor

Latest figures Doctors* Population Patients per doctor 1. Tanzania 2002 822 36.8m 44,800 2. Malawi 2004 266 12.1m 45,500 3. Ethiopia 2003 1936 73.0m 37,700 4. Mozambique 2004 514 19.4m 37,700 5. Niger 2004 377 13.9 m 37,021 6. Sierra Leone 2004 168 6.0m 36,700

*Source: WHO

Ends

Notes World Health Day is celebrated on April 7th each year by the World Health Organisation. For further details visit: http://www.who.int/world-health-day/2007/en/index.html

The following spokespeople are available: Carolyn Miller, Chief Executive, Merlin Fiona Campbell, Head of Policy, Merlin

Merlin is the only specialist UK charity which responds worldwide with vital health care and medical relief for vulnerable people caught up in natural disasters, conflict, disease and health system collapse. Each year, Merlin helps more than 15 million people in up to 20 countries.

Please look at our website www.merlin.org.uk

If you would like more information please contact:

Louise Hill Communications Officer Merlin 12th Floor 207 Old Street London EC1V 9NR Tel: +44 (0)20 7014 1703 Out of office hours: +44 (0)7092 382421 Email: louise.hill@merlin.org.uk