Toronto Globe and Mail Examines Health Care Workers’ Exodus From African Countries, Impact on Fight Against HIV/AIDS
The Toronto Globe and Mail on Tuesday examined how some African physicians and nurses are leaving their native countries in search of better-paying jobs and how "the steady trickle of health care talent is undermining the ability of countries' already impoverished health care systems to respond to the AIDS pandemic." Health care workers cite several different reasons for leaving their home countries, according to the Globe and Mail. Research conducted by South Africa's national nursing organization shows that many nurses would prefer to remain in their home country if they earned a better salary, the Globe and Mail reports. However, nurses also say that some of the factors contributing to their decisions to leave home include political insecurity, poor management and infrastructure, a deficiency of housing and education facilities for their children in rural areas, difficulties in administering high-quality care, insufficient access to medicines and equipment, inadequate access to doctors and a lack of emergency transportation, according to the Globe and Mail. Antoinette Ntuli of the South Africa-based Health Systems Trust said, "[T]he biggie in Southern Africa is AIDS," adding, "It has an impact on health workers in many ways: their own vulnerability to infection themselves -- theirs or their families', needle-stick injuries, the excessively high demands being made on them, their patient loads going up. And they are doing palliative care work all the time when that is not what they came into the system to do."
Lucille Auffrey, head of the Canadian Nurses Association, which opposes the hiring of health care workers from developing countries, said, "We have an atrocious situation in terms of our own health human resources, but, compared to people in Southern Africa, we're still light years ahead. And with the reality that they're facing, especially around HIV/AIDS, how can they cope if we keep on doing this?" However, Delon Human, secretary general of the World Medical Association, disagreed, saying that some of the blame must be placed on the developing countries. "If you don't create an environment where professionals who take care of patients are at least given an optimally safe environment and reimbursement in line with world standards in general -- and I know this is very difficult -- then you can't blame professionals for looking at other opportunities."
According to the Globe and Mail, the "question of who has the right to go and who decides is one problem. Another is what obligation the richer countries have to the places from which they recruit." Physicians for Human Rights, which recently released a report on the exodus of health care workers from developing countries, said that developed countries should donate money to keep physicians and nurses in their home countries or reimburse nations for the health care workers they attract. Ted Schrecker, a political scientist at the University of Saskatchewan in Canada, said that a global fund for health systems development -- similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria -- could help alleviate some of the strain on developing countries. However, "the solution may ultimately lie in fixing the 'push' factors that make workers so desparate to leave the developing world," according to the Globe and Mail (Nolen, Globe and Mail, 9/28).