Africa Losing Nurses to Britain
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By Josefine Volqvartz
4 August, 2004
(CNN) -- Concern is mounting in Africa over the growing number
of well-educated and much-needed nurses who are leaving the con-
tinent for better salaries and working conditions in Britain.
The British nursing register shows the number of nurses being
certified from Botswana, Ghana, Malawi, Nigeria, Kenya, South
Africa, Zambia and Zimbabwe -- all former British colonies --
has soared since 1999.
As a result, more than 60 per cent of nursing positions remain
unfilled in countries such as Ghana and Malawi.
"It's been catastrophic," says Dr. William Aldis, who represents
the World Health Organization in Malawi. "The nurses are the
ones to hold the situation together at hospitals and they are
all leaving."
Sub-Saharan Africa's low-income countries need to more than dou-
ble their work forces, adding at least 620,000 nurses to be able
to tackle the severe health emergencies, according to estimates
by the Joint Learning Initiative. The network is coordinated by
Harvard University and consists of more than 100 scholars and
analysts studying human resources for health.
The nursing shortage is intensifying as foreign aid is beginning
to pour into Africa to provide life-saving drugs to millions of
people afflicted with AIDS and tuberculosis.
The money includes the first installment on a total of $15 bil-
lion promised by U.S. President George W. Bush and $2 billion
from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
By 2006, Britain is aiming to increase its aid to Africa from
£711 million ($1.29 billion) to £1 billion ($1.82 billion).
Ironically, African countries need more nurses in order to util-
ize the new funding.
"The money will not be of any use if there are no nurses to ad-
minister the drugs," says Dr. Dela Dovlo, former director of hu-
man resources at Ghana's Ministry of Health.
New rules for recruitment
In 2001, Britain recognized the increasing problems in Africa
and adopted codes to limit the government's active recruitment
of health professionals from developing countries.
But the codes do not apply to private recruitment agencies or
private employers. Nor does it prohibit the National Health Ser-
vice from hiring African nurses who apply on their own. Since
the new codes came into effect, more than 7,000 African nurses
have registered to work in Britain.
"The effects of the outflow of health professionals has led to
the phenomenon of a brain drain," says Dr. Barbara Stillwell, a
scientist with the WHO's department of human resources for help
in Geneva. "The poor African countries are subsidizing the
richer countries with nurses."
Stillwell would like to see more restrictions put in place:
"There should be agreements between countries. Nurses should be
given the opportunity to migrate, but only for a specific length
of time. Two-year contracts could be used to make sure they come
back."
However, Stillwell says she recognizes that it would be against
human rights to stop people from moving.
According to the Department of Health in Britain, there is lit-
tle more the UK government can do to prevent the continued mi-
gration of African nurses.
"They come because of huge push factors and we can't stop this.
Also, it is very difficult to stop private recruiters from re-
cruiting there, but we will soon announce a new clamp down
strategy," a government official said.
Chance to better their lives
While acknowledging the severe shortage, NHS nurse Rose Haldane
says it is only fair that hard-working African women be given a
chance to better their lives.
Haldane, who leads a newly developed overseas nurse adaptation
course for the Guy and St. Thomas NHS foundation trust in Lon-
don, says: "African nurses go through a tough recruitment proc-
ess to get here.... They have made the choice to change their
life and we are pleased to give them this chance."
One of Haldane's students worked as a nurse in Nigeria for three
years before she decided to come to London.
"They have less equipment at home and nursing is very hard
there. Where I was there were 32 beds on a ward with only three
qualified nurses. Here there are 27 beds on a ward with six
nurses. London is much better."
Another student, a nurse from Sierra Leone, added: "The equip-
ment is better in the UK. In Sierra Leone, we had to improvise
due to the lack of equipment. Here in England we have everything
we need to treat the ill."
But the departure of young to Britain, has long been a sore sub-
ject with Britain's former African colonies.
"Its like a vicious circle," says the WHO's Dr. Aldis. "As more
nurses leave the hospitals, the work conditions worsen for the
remaining nurses and as a result they are more tempted to leave
as well."
Dr. Dovlo, the former Ghana health official, says Africa's fu-
ture looks bleak if nurse migration continues. "The shortage is
likely to dismember the whole health system in Africa," he says.
--
Leela McCullough, Ed.D.
Director of Information Services
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