SOUTH AFRICA: Remedying the medical brain drain

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5-30-05, 10:12am



JOHANNESBURG, 27 May 2005 (IRIN) - The migration of doctors and nurses from Africa has taken a heavy toll of the continent's desperately overstretched health sector, according to a new study published in the British medical journal, 'The Lancet'.

Each migrating African health professional represents a loss of US $184,000 to the continent; the financial cost to South Africa, 600 of whose graduates are in New Zealand alone, is estimated at $37 million.

Researchers say the United Kingdom is especially to blame for the medical brain drain, with up to a third of practising doctors and 13 percent of its nurses born outside of Britain. By comparison, the figure for France and Germany is only around five percent.

The Democratic Nursing Organisation of South Africa has said that more than 300 specialist nurses leave every month, most of whom complain of poor working conditions and low wages at home. After four years' study, fully trained public-sector nurses in South Africa earn a starting salary of US $296 a month, rising to a maximum of US $716 a month.

Migrating health professionals are not unique to South Africa: in the last five years medical personnel have increasingly left the Southern African region as a whole to seek greener pastures in the more affluent West.

One of the worst cases of regional brain drain, cited by the Paris-based Institute for Development Research, is Zambia. A few years ago the country had 1,600 doctors; now there are only 400 in practice.

Lured by higher salaries and training, Zambian doctors have migrated to Europe, the United States and neighbouring Botswana, and according to a leading Zimbabwean financial newspaper, large numbers of doctors and nurses are also leaving Zimbabwe every month. In 2003 UK health officials and their South African counterparts agreed to tighten the screws on recruiting health professionals, including 'back-door' recruitment into Britain's National Health Services via the private sector.

Last year South Africa introduced a set of incentives aimed at retaining key medical staff, especially in under-resourced regions of the country.

The rural allowance targets professional nurses working in designated areas. Under the scheme, nurses working in underserved areas are entitled to additional stipends, ranging from 8 percent to 22 percent of their annual salary, depending on area and occupational category.

The scarce-skills allowance, which ranges from 10 percent to 15 percent of annual salary, applies to full-time health professionals in specified categories, such as dentists, pharmacists, radiographers, and nurses specialising in oncology, or intensive care.

Health department spokesman Sibani Mngadi told IRIN that while a 'comprehensive analysis' to gauge the success of the incentive schemes has yet to be undertaken, 'general reports suggest that it is paying off'.

One of the concerns raised in the Lancet report was the acute lack of adequate medical training facilities across the continent.

It was found that in sub-Saharan Africa, 24 out of 28 countries surveyed had only one medical school and 11 of them had no medical school at all.

Britain recently provided Malawi with US $193 million to increase the number of doctors and nurses in training by 50 percent, and raise salaries and pay for volunteer doctors and nursing tutors to cover the large number of open positions.