February 25, 2005

Brain drain: calls for compensation

A call for the British government to financially compensate poor countries suffering a shortage of heath professionals will receive the support of one of the country's unions if it is directed towards filling the gaps left by the migration of Namibian health professionals to Britain. Save the Children said in recommendations after a case study of the health service of Ghana that the UK should acknowledge that poor countries are subsidising its health services through restitution. According to the report named "Whose Charity? Africa's aid to the NHS", despite the latest Code of Practice banning active recruitments from developing poor countries, migration of health workers from these countries had increased. The Namibia Nurses Union (NNU) said just compensation would not make a difference unless the money was used to train personnel in developing countries to enhance their qualifications. "It should be put into training for them to gain knowledge and skills so that if people are leaving some are trained to prevent shortages," Gebhard Timotheus, Secretary General of the NNU, explained.
The Deputy Minister of Health and Social Services, Richard Kamwi, admitted that Sub-Saharan Africa was hard hit by a brain drain in the health sector. "It would not be correct to say we are not affected. We are experiencing some problems especially in Lüderitz, Katima Mulilo and the north," Kamwi said. Timotheus noted that every second month, two to three nurses were resigning to take up well paying jobs in the UK and other developed countries.
According to the case study, Ghana for instance has lost N$385 million in its training investment in health professionals, while Britain has saved N$715 million in training costs by recruiting Ghanaian doctors since 1998. Britain's Revised Code of Practice of December 2004 stipulates that developing countries should not be targeted for recruitment of healthcare professionals. Britain's Department of Health and Department of International Development produced a list of developing countries and other countries that should not be recruited from among which are for example Sub-Saharan African countries such as Namibia, Malawi, South Africa, Botswana, Kenya, Ghana, Mozambique, Zambia and Zimbabwe. The study said poverty remained the root cause of migration because salaries in some countries were low. "They have limited opportunities for training or professional fulfilment in delivering quality health services," the report said.
Kamwi however differed with the notion that Namibian nurses are lowly paid, because he said as of 2003, they were the highest paid in the SADC region, seconded by South Africa. According to Timotheus, however, nurses' salaries were so low that in three years' they reach their top salary notch and earn the same salary for the next 20 to 30 years they work. If a nurse was 25 years old for instance, Timotheus noted that the nurse would earn the same salary for the rest of her life. The small differences in pay between the different categories have also led to some nurses stopping to apply for higher positions. "There is a lot of responsibility while the salary remains the same. Sometimes, the people you supervise earn more money through working overtime," he noted.
The numbers of health professionals poached from developing countries have increased despite the Code of Practice in the UK and recommendations of the World General Assembly of May 2004, to the effect that: "Member states should establish mechanisms to mitigate the adverse impact on developing countries for the loss of health personnel through migration, including means for the receiving countries to support the strengthening of health systems, in particular human resources development in the countries of origin." Whether poverty is addressed on the part of countries of origin or not, the report says, by 2008 the UK will need 25.000 more doctors and 250.000 more nurses than it did in 1997. (New Era, Windhoek)

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