London
22 February 2008
A team of international disease experts has accused rich nations of committing a crime by luring African health professionals away from their home countries where their services are badly needed. From London, Tendai Maphosa has more in this report for VOA.
An article published by the British medical journal The Lancet, says recruitment agencies in rich countries, which actively recruit health workers in Africa, are guilty of what the authors of the report call an "international crime."
The experts accuse countries, such as Australia, Canada, Saudi Arabia, the United States, the United Arab Emirates and Britain of sustaining their relatively high physician-to-population ratio by recruiting medical graduates from developing regions, including countries in sub-Saharan Africa.
Dr. Elly Katabira of Makerere University is one of the authors of the article. He told VOA that criminalization may be difficult but the idea is to go beyond the well-worn debate of the brain drain.
"What we are trying to say is that at least the developed countries are in better position to provide solutions for the brain drain than the individual countries," he said. "Certainly even countries within Africa they have their responsibilities, they have to provide incentives for people to stay."
Dr. Katabira suggests that Western donor countries could help by making their aid conditional on some of it being used to help upgrade medical infrastructure in Africa.
The experts charge that as a result of the recruitment of health professionals, over half of the countries in sub-Saharan Africa do not meet the minimum acceptable physician- to-population ratio of one per 5,000, the World Health Organization's Health for All standard. The article reveals that an estimated 13,000 doctors trained in sub-Saharan Africa are practicing in Australia, Canada, Britain and the United States.
The article names Western recruitment agencies that have set up offices in South Africa to facilitate recruitment. It says recruitment strategies include advertising in national newspapers and journals, text-messaging to health workers, personal e-mails and Internet sites, and recruitment workshops. Offers of employment are accompanied by legal assistance with immigration, guaranteed earnings, and moving expenses.
Nurses, pharmacists, and other health workers are systematically recruited from a region struggling with the greatest burden of infectious and chronic illness and HIV/AIDS. The article says that in some African countries, the exodus of health workers to rich economies now exceeds the number of graduates emerging from medical schools.
Abby Smith, a spokesperson for the British Medical Association said criminalization could be a problem. But she agrees with Dr. Katabira that more needs to be done to keep health personnel in their own countries.
"I think the problem has to be addressed at its roots rather than at what appears to be a symptom," she said. "We need to concentrate on why people are leaving the countries and make sure that we are addressing the core problem in terms of the push and pull factors."
Smith said if better working conditions, pay and further training are provided in sub-Saharan African then there would be nothing to attract health professionals to developed countries.