Saturday, June 11, 2011

the health exodus

The global shortage of health workers is estimated at 4.2 million by the World Health Organization (WHO), but the migration of doctors, nurses, midwives and pharmacists from poor to rich countries means the shortfall is not evenly distributed - of the 57 nations identified as having reached a crisis point, 36 are in sub-Saharan Africa.

In some countries with fragile health systems and heavy disease burdens, over half of all highly trained health workers have left for job opportunities abroad. In some of the worst cases rural hospitals have been left with just one doctor and a handful of nurses to attend to thousands of patients. Skilled professionals whose salaries are so low that they have to struggle to make ends meet will obviously look for better paying opportunities elsewhere, either in the private or NGO sectors, or overseas. Some have pointed out that the Global Code of Practice, as well as other interventions designed to reduce health personnel migration, infringe on the right of health workers to leave their countries like any other workers in search of a better life. Martha Kwataine of the Malawi Health Equity Network described it as a potential abuse of human rights. “Why should we make agreements just for health workers?” she said. “As human beings, they have a right to seek employment where they want.”

More money is not usually enough to keep an overworked, under-supported nurse in a rural clinic where she lacks the essential drugs and equipment to do her job properly, there are no good schools to send her children, and no opportunities for further training or career advancement.

“One of the biggest de-motivators - if you’re trained to provide care and save lives - is to find yourself in a remote, under-resourced location and your hands are tied by a lack of equipment, personnel and drugs,” said Dr George Pariyo of the Global Health Workforce Alliance.

In South Africa there are about 67 doctors per 100,000 people, but only 22 of those work in the public sector and a mere 5 are in rural public health facilities, despite the introduction of special allowances for health professionals working in rural areas.

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