In a recent article for the Reuters news agency, a senior doctor in Ethiopia bemoaned that he is the only dermatologist serving around 6 million people in his country. Dr Kassahun Desalegn, who works for the College of Medicine and Health Services at the University of Gondar in northern Ethiopia, highlighted the woeful situation that overall Ethiopia has just one doctor for every 40,000 people. This compares with one doctor for every 360 people in the UK and one for every 410 in the USA.
Better conditions abroad
Part of the problem is that many African doctors seek work abroad once they are trained, lured by the prospect of better working conditions, equipment and of course, salaries. So for example, in 2011, more than 10,000 medical graduates born or trained in sub-Saharan Africa were registered to practice in the USA in 2011 (an increase of nearly 40% from a decade earlier). This number is greater than all the doctors working in Ethiopia, Ghana, Liberia, Tanzania, Uganda, Zambia and Zimbabwe combined.
In his article, Dr Desalegn calls on Western and other rich nations, as well as wealthier African countries such as Botswana and South Africa, to stop recruiting doctors from developing regions. He cites the chronic shortage of doctors in Ethiopia as the reason why many of his countrymen turn to traditional healers. The patients he sees have frequently tried spiritual or herbal remedies before becoming desperate enough to seek him out. Often their skin diseases have progressed so dangerously that they are suffering greatly and from related complications.
The former director of the World Health Organisation (WHO) said that the brain drain of doctors from Africa was severely hampering the continent’s ability to deliver better health care services and fight diseases such as HIV/AIDS, leading to countless deaths and unproductive lives due to ill-health. The director urged more developed countries to adopt the WHO’s Global Code of Practice on the International Recruitment of Health Personnel. So far, only Norway has done this.
Like Ethiopia, which is training up thousands of community health workers, a number of African countries are trying to offset their shortage of doctors by using lower-level staff to fill the gap. Some countries also recognise that they need to pay health workers better salaries in order to keep them from going abroad or leaving the profession.
In the meanwhile, should charities be helping by offering incentives for doctors to practice in their own countries? Certainly, many charities are already active in supporting the health systems of developing nations and expanding training systems for healthcare professionals. So for example, in Makalle, in northern Ethiopia, SOS Children has set up a training school for nurses, where a new scholarship programme is providing more places for girls to train as midwives and nurses. When qualified, it is hoped these young trainees will go back and improve the care offered to women and children in their home communities.
SOS Children is also exploring pilot programmes which could offer online education to students in Africa. The idea behind this thinking is that the provision of quality online education courses will encourage the brightest students to study and remain on the continent, rather than pursuing training and jobs abroad.
However, it should be remembered that even when African nationals decide to pursue careers abroad, many send money back home to support grandparents, parents or siblings. Such remittances make up an important part of developing nations’ economies. And it is also arguably a matter of personal happiness and fulfilment that young African graduates should be able to seek and find work in other countries – a freedom which people in the West take for granted.