Mayotte is the largest medical desert in France
There is a severe lack of medical forces in Mayotte. If the other departments also suffer from a deficit of health professionals on their territory, the 101st French department is far behind the others in terms of access to care. In 2024, only 33 general practitioners were listed in Mayotte, compared to 1,195 general practitioners active in Reunion. Access to care is logically limited since there is currently only one hospital center (CHM) for the 321,000 inhabitants recorded on Hippocampus Island, while Reunion has nine hospitals, for 885,700 inhabitants. .
Nearly 77% of the population lives below the poverty line
Added to this observation are the countless specificities of the territory which make its management even more complex. Nearly 66% of the population lives in disadvantaged neighborhoods; many island residents do not have access to water and electricity in their homes. Compared to the median income calculated in the 101st French department, the poverty threshold is 160 euros per month in Mayotte. Furthermore, the island of Mayotte has the highest birth rate in France, almost four times higher than in mainland France, where the average number of children per woman is 4.7 compared to 1.9 in mainland France. In Mamoudzou, on average, nearly thirty children are born every day.
“You have to be strong”
These problems have repercussions on the healthcare system which must respond to countless challenges every day, but which often struggles in an emergency, as staff can be difficult to find and keep, particularly in the liberal sector: “ It is often more complicated to recruit in our sector since we are located in a specific municipality, we will travel to patients’ homes, we must quickly immerse ourselves in the territory, we have a real health and field profession, in a territory, with enormous difficulties, you really have to be solid,” confides a liberal nurse.
The ARS races to “health fairs” to recruit
In this context, the ARS is embarking on a vast race to recruit key health forces. The goal: to be noticed at trade shows. By focusing on an attractive scenography, the Mayotte health agency does not go unnoticed. “We are present at six to seven trade shows per year. It is a stand which was identified not as ARS but under the name Mayotte is recruiting in health to recruit in all areas of health, to represent all professionals in the sector and present all of our health projects. » During an exhibition on general medicine on October 10 and 11 in Paris, the ARS insisted on specific needs for sectors in tension, such as CHM emergencies, pediatrics, mental health, mother-child sector, but also in various health professions, in particular specialist doctors, orthoptists, physiotherapists, psychomotor therapists, as well as professionals in social professions. Associated with the Mayotte Hospital Center and representatives of the island’s SMIs, the first feedback is positive. “It works well! Even if we don’t have the figures yet, we are very happy with the result. The objective afterwards is to launch a real monitoring of these initiatives and the fruits borne, with a newsletter on the attractiveness possibly. »
“More interesting” health in Mayotte than elsewhere for professionals?
To convince, the health agency and its partners are banking on the interest of working in Mayotte, a department with extraordinary but exciting challenges. “If diseases or public health issues are boring for ordinary people, they represent a real interest for health professionals,” says the ARS ironically. “We are a very attractive territory in terms of health, particularly in infectious and tropical diseases, traumatology, psychiatry, maternal and child protection. We are a highly educational area, which is not the case for all departments. »
Difficult sustainability of the workforce
If the ARS is already preparing for future exhibitions dedicated to midwives, nurses or even interns, it remains lucid about the difficulty of sustaining staff who come for the first time to the island and who do not yet know the territory. “It’s difficult to convince professionals to settle when they don’t even know where Mayotte is located. » To adapt to the realities of health professionals in the region, the health agency is deploying a vast targeted communication campaign for recruitment. Several video clips will soon be broadcast on social networks to convince professionals from mainland France, but also young Mahorais who have gone to study in France or actors involved in maternal and child protection (PMI), to come or return to work in Mayotte.
“At the national general medicine days, we saw people who had already come to meet us in 2023, they took the time to think about the projects and asked to come to Mayotte, to settle down or do short missions, replacements. » Indeed, one of the main challenges of this recruitment is to retain the loyalty of health professionals stationed on the island to combat time-consuming turnover for teams invested over the longer term. Although essential in a situation of high tension on human resources, the constant turnover of arrivals and departures of professionals within private practices or in hospitals exhausts long-term teams.
During the southern winter, only two emergency doctors were stationed at the CHM, out of the thirty-seven needed. From now on, thirty-two emergency doctors take turns to run the CHM Emergency Department. For some, this result is already the fruit of this vast seduction operation. Hunters, know how to hunt!
Mathilde Hangard
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