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Africa's Healthcare Worker Shortage Reaches Severe Proportions


Every year, untold numbers of African doctors and nurses leave the continent, seeking better employment opportunities in wealthier nations. The exodus is taking a heavy toll on Africa's over-stretched and under-funded health sector. Now, an alliance of international organizations is calling for the world to focus attention on halting what is commonly known as "medical brain drain" in Africa.

The World Health Organization says 36 countries in sub-Saharan Africa are suffering a severe shortage of healthcare workers.

U.N. Special AIDS Envoy for Africa Stephen Lewis says the idea behind the new alliance is to target countries where the situation is especially desperate.

"The effort is to plow enough resources into those countries, so that salaries can be increased, benefits can be improved, working conditions can be improved, housing can be provided and training can be done, so that we can finally overcome this tremendous gap in human capacity," said Lewis. "It is an effort to deal with the interlocked realities of poverty and disease, which so compromise the future of Africa."

Malawi has one of the most serious shortages of trained health workers in the world, with an estimated one doctor per 60,000 people and one nurse per 28,000.

Malawi Minister of Health Hetherwick Ntaba says, it is rare for Malawians who study medicine outside the country to return to practice at home.

"Human beings, being what they are, they know what they are coming back to: they are going to get a salary, which is 10 times less, [than] if they worked in the United States or the United Kingdom," he summarized.

Given that grim reality, Minister Ntaba says, his government has put in place policies to lessen the burden of patient load on the few doctors and nurses in Malawi.

"One of the things we have had to do is to train more doctors and nurses,' he said. "So, we have tripled the output of our doctors, for instance, and we are doubling or increasing even more the output of our student nurses from our nursing institutions. We are also improving the conditions of services, trying to make sure they have the medical supplies, the drugs. These are some of the things we are doing to try to minimize the hemorrhage of our health workers."

Other African nations are also trying to address the serious crisis. Policy analyst Eric Friedman, of Physicians for Human Rights, a member of the new WHO, sponsored alliance, says, in many cases, some basic medical training can go a long way toward boosting access to health services.

"In Ghana, for example, there is a program where Ghana has been training healthcare workers for about 18 months, so not very long, but long enough to learn the basic needs of the communities," noted Friedman. "And that has made just an enormous difference. In one district, over a period of three years, child immunizations tripled. The rate of people receiving tuberculosis treatment who defaulted, who, in other words, did not complete their treatment, went from 73 percent to zero percent."

It is well understood that money is key to ending Africa's medical brain drain. But UNAIDS envoy Lewis says the most important element is international commitment. He noted the pledge last year by leaders of the G-8 countries to do more for Africa, but he said they must follow through.

"The absence of political will among the leading politicians in the western world lies at the heart of the dilemma," he said. "So, unless pressure is put on the really wealthy G-8 governments to honor their commitments, Africa will always be struggling."

Lewis says failure to meet those commitments means millions of Africans will not receive even the most basic care for the most serious healthcare crises, like AIDS, malaria and tuberculosis, diseases that are killing ordinary citizens, as well as future healthcare professionals.

The new alliance is sponsored by the World Health Organization, and includes UNAIDS, the Bill and Melinda Gates Foundation and the World Bank.

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