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.

http://www.irinnews.org/Report.aspx?ReportID=92949

Not so healthy Africa

Poverty and war are harming advances in infant mortality, particularly in sub-Saharan Africa, a new Unicef report on global child health has said. Sub-Saharan Africa is home to 28 of the 30 countries with the highest mortality rates.

Sierra Leone was the worst performer, with 270 deaths before the age of five per 1,000 live births, in 2006 figures. In Sierra Leone one in four children will die before their fifth birthday. In Sweden it is one in 350. In Sierra Leone one in eight mothers will die in childbirth. In Sweden 0ne in 17,400 mothers die in childbirth and one in 8,200 in the UK. Sweden has one of the best staffed health services in the world. It has 320 doctors per 100,000 people compared to two doctors per 100,000 people in Sierra Leone.

In Sub-Saharan Africa the annual average rate of reduction in the child mortality rate between 1990 and 2006 was only 1% per year - meaning the rate will have to increase to 10.5% per year between 2007 and 2015 if the region is to meet the fourth MDG.

26,000 infants under five die every day around the world. They mostly die from preventable causes such as diarrhoea, malaria, malnutrition, mother-to-child transmission of HIV, unsafe water, poor hygiene and neonatal problems.
The solutions to child deaths are well-known, says the report - "simple, reliable and affordable interventions with the potential to save two-thirds of the children currently at risk are readily available". Such interventions that have already been shown to be effective include promoting breast-feeding, immunisation, vitamin A supplementation and the use of mosquito nets.

BOTTOM FIVE COUNTRIES/ DEATHS PER 1,000 LIVE BIRTHS
Sierra Leone: 270
Angola: 260
Afghanistan: 257
Niger: 253
Liberia: 235

A Remarkable Doctor

Samuel Kargbo stayed in Sierra Leone throughout the horrendous civil war. He brought basic health services and vaccines to children who lived in the rebel areas. He had to negotiate his way across checkpoints and his life was frequently at risk. Now he is one of just two doctors in a region of nearly 300,000 people. Having trained in Russia, Germany and the UK, Dr Kargbo could easily get a job overseas. But he refuses to leave.
"A lot of doctors who qualify in Freetown, go abroad", he said. "Some forget that the greatest need is here".
He earns around $200 - £100 - a month.

UNICEF Goodwill Ambassador , the England international football player , David Beckham said: “We can’t turn a blind eye to the tens of thousands of young children who die every day in the developing world mostly from causes that are preventable...Saving these children’s lives is a top priority for UNICEF and as an Ambassador I hope I can help to draw attention to this issue across the world.”

Socialist Banner , however , knows it takes more than well-meaning words from a millionaire sports star to change things . It is socialist revolution , not press releases , that will change how people will live or die .

Health Brain Drain

Many African countries now have more doctors and nurses working in richer countries abroad than they have at home . The study, carried out by the Center for Global Development in Washington, looked at census records collected between 1999 and 2001. It examined nine receiving countries: The UK, the US, France, Canada, Australia, Portugal, Spain, Belgium and South Africa.

Several countries, including Mozambique and Angola, have more doctors in one single foreign country than at home. And for every doctor in Liberia, there are two working abroad.

The loss of doctors often went hand-in-hand with civil strife, political instability and economic stagnation. Angola, Republic of Congo, Guinea-Bissau, Liberia, Mozambique, Rwanda and Sierra Leone all experienced civil war in the 1990s and all had lost 40% of their doctors by 2000.
Countries such as Kenya which experienced economic stagnation in the late 20th Century and Zimbabwe, which saw political repression as well as economic problems, saw more than half of their doctors leave.

At the same time countries with greater stability and prosperity, such as Botswana managed to keep many of their doctors .

But so did very poor countries such as Niger .The researchers speculated this could be to do with destitute countries not producing large numbers of would-be doctors with the financial capital or connections to leave.

UK Home Office figures show that 17,620 African doctors and nurses joined the NHS last year.

The charity ActionAid said the brain drain was "a huge threat" to Africa.

"One of the best way to keep healthcare professionals in the countries that need them is to pay them properly - but currently health systems in many African countries are woefully underfunded," said Nick Corby, policy officer at the charity.

NUMBER OF DOCTORS ABROAD
Mozambique - 75%
Angola - 70%
Ghana - 56%
Kenya - 51%
Rwanda - 43%
Sudan - 13%
Niger - 9%