Medical migration

Worldwide, an estimated 4.3 million doctors are needed, according to the WHO.

Dr Kassahun Desalegn serves as department head and assistant professor of dermatovenereology at the University of Gondar, College of Medicine and Health Sciences, in northern Ethiopia. He explains “I practice in a university hospital where I am the only dermatologist for 6 million people. Ethiopia as a whole has a population of 80 million, but only one doctor for every 40,000 people. The United States, where many African health workers end up practicing, has one doctor for every 500 people...Where are all the doctors? When I started practicing medicine in 2004, there were 200 newly graduated doctors all over the country. Only a third of them are now in practice. A third work in international organisations in the country and a third have moved to practice abroad...This shortage of doctors and other health professionals has led many people to turn to alternative medicine as a treatment option. As a result, 80 percent of Ethiopians prefer traditional healing, which can often be harmful when used as the only treatment. Most of my patients have used spiritual healing such as drinking holy water, for diseases they believe to be caused by evil spirits, or applied traditional herbs before coming to me.”

Nearly 30 percent of African doctors leave to work abroad after graduation. Dr Lee Jong-Wook, the past director general of the World Health Organization (WHO), has said that brain drain from Africa is severely hobbling the continent’s fight against HIV/AIDS. Africa loses billions of dollars and countless lives because of doctor migration. Poor countries have attempted to tackle this problem through task-shifting - training middle- and lower-level healthcare providers to do higher-level tasks - developed nations insist on high-skilled and specialised care, which continues and accelerates the medical brain drain from developing to developed countries. Destination countries should  avoid recruiting doctors from countries with critical health manpower shortage. In May 2010, the WHO developed the Global Code of Practice on the International Recruitment of Health Personnel to mitigate damage to low-income countries struggling to meet the basic health needs of their populations. Unfortunately, its implementation, both by developed and developing countries, has faced enormous challenges. Only Norway has formally adopted this code.

“African governments should provide much better compensation for doctors. Improved wages, pension, housing, tax benefits, childcare, and medical insurance will bring immediate and dramatic results. My colleagues earn monthly wages ranging from $150 in Ethiopia to $2,000 in Botswana, though many employers can pay more. The same doctor can earn up to 50 times more in a Western country...