HEALTH-SOUTH AFRICA: Solidarity With Developing Nations – At a Cost

By Moyiga Nduru Reprint | | Print |

Moyiga Nduru

JOHANNESBURG, Nov 14 2006 (IPS) - As concerns continue to be expressed about the departure of African medical professionals for wealthy countries, South Africa says it is not recruiting health workers from developing nations – something that also reflects the country’s own experience of the medical “brain drain”.

“Many of our doctors are, for example, moving to Canada,” said Sibani Mngabi, a spokesman for the Department of Health.

Health workers typically find work abroad through recruitment agencies. But, “If there is a movement of health professionals, it should be structured between the Canadian and South African governments,” Mngabi told IPS.

“In the same breath, South Africa should not be seen as recruiting from African countries. It will disadvantage countries which do not have enough health professionals,” he added, also noting that exceptions could be made: “We can consider looking at specific cases such as family reunions. If, for example, a spouse is working here, his or her partner can be considered for recruitment.”

In August this year, Britain announced a similar plan to stop recruiting nurses from developing countries.

“We also signed an agreement with the United Kingdom in 2003 (for it) not to recruit health professionals from South Africa. As a result, we have experienced a 50 percent decrease in the number of nurses going to the United Kingdom,” said Mngabi.

This comes as health workers who remain in Africa often find themselves overwhelmed by the tasks facing them.

“Right now in Africa, a mere 1.3 percent of the world’s health workers struggle to care for people suffering 25 percent of the global disease burden. In Malawi, only10 percent of the physician slots are filled, while 10 people die every hour of AIDS,” Physicians for Human Rights, a non-governmental organisation (NGO) based in the U.S. city of Boston, said in a recent statement.

“Across Africa AIDS has killed thousands of health care workers, and large numbers of doctors and nurses are migrating to the West, driven out by impoverished health care systems and lured by elaborate recruiting packages by hospitals in G8 countries,” the NGO added. The G8, or Group of Eight, comprises the eight leading industrial nations: Canada, France, Germany, Italy, Japan, Russia, the United Kingdom, and the United States.

But Mignonne Breier, chief research specialist at a Cape Town-based think tank, the Human Sciences Research Council, sounds a note of caution.

“I do not believe that closing our doors to doctors from elsewhere in Africa will keep them in their countries. They can go overseas to places like…the United States or Canada,” she told IPS. “If we say ‘Don’t come to South Africa’ we will lose them from the continent.”

In a study published in June titled ‘Doctors in a Divided Society: The Profession and Education of Medical Practitioners in South Africa’, Breier noted that there were 5,277 registered foreign doctors in South Africa – about 16 percent of the total 33,347 doctors in the country. They had come from as far afield as Zimbabwe, Zambia, Kenya, Ghana, Nigeria, Pakistan, India, Bangladesh, Sri Lanka and Eastern Europe.

Keeping African medical staffers out of South Africa also has implications for the country’ own health sector.

South Africa has less than seven doctors for every 10,000 people, said Breier (the World Health Organisation recommends a minimum of one doctor per 5,000 to 10,000 persons). And, “With the majority of these doctors opting to work in urban centres, rural areas have been heavily reliant on foreign doctors,” she added.

Health officials have tried to address health workers’ reluctance to take up jobs in rural areas through incentives, while there has also been talk of increasing the number of medical graduates to help make up the shortfall.

But, “I don’t think that a doubling of the intake of medical students will necessarily solve the problem of maldistribution,” Steven Reid, associate professor of rural health at the University of KwaZulu-Natal, told IPS from the coastal city of Durban.

“We have a reasonable doctor-to-population ratio in the whole country, but they are not in the places where they are needed the most.”

Ironically, the same South African doctors who do not want to work in rural areas may find themselves deployed to far-flung parts in countries they emigrate to.

“Some of our doctors go to Canada and work in rural areas. There, the infrastructure is good and they are paid better,” said Breier.

Still, she’s not without hope: “I think doctors with families might be prepared to go to rural areas when their children are still small. When they are bigger, (the medics) will prefer to live in urban areas where education facilities are available.”