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[ Health sector ]

Dangerous brain drain

For many countries, health-personnel migration has reached critical proportions. The World Health Organisation (WHO) estimates that there is a shortfall of around four million doctors and nurses. 57 countries – most of them in Africa and Asia – are acutely hit by the lack of trained staff.

According to the WHO, health services are no longer guaranteed in many places, with gaps affecting screening and public information, distribution of medicines, vaccination campaigns, care for pregnant women and the acutely ill. In the medical journal The Lancet, doctors recently argued that poaching medical personnel from developing countries is a crime. Ghana, for example, is said to spend around $ 70 million on training doctors and nurses who then migrate to Britain – saving the UK some $130 million that would have to have been spent on these people’s education. On the other hand, the OECD, in a report published in March, reckons that health-sector brain drain is not as bad as generally assumed.

A need for action was seen by participants in the first Global Forum on Human Resources for Health convened by the WHO’s Global Health Workforce Alliance (GHWA). The conference took place in Kampala at the beginning of March. Uganda’s health minister warned of the consequences of foreign recruitment. Uganda, he said, now has one doctor for every 100,000 patients because too many health professionals had left – mostly to South Africa but also to Sudan and Rwanda, where aid agencies pay much better salaries than the state-run health service in Uganda. At home, Ugandan doctors often struggle to even pay their rent.

In a conclusive declaration, the GHWA conference demanded that all countries train enough health-care professionals as well as make sure that pay is appropriate and working conditions good. Moreover, the WHO is called upon to develop guidelines for the recruitment of foreign professionals. After all, said GHWA Executive Director Francis Omaswa, what is at stake is quality of life and human dignity. Therefore, it should be the duty of every society and its government to make sure that medical help reaches all those who need it. (sz)

D+C, 2008/04, Monitor, Page 139