Migration of Health Workers is Sickening Africa’s Healthcare System that is Chronically Underfunded

The global migration of healthcare workers fueled by a global shortage of healthcare workers is considered a crisis in the health sector human resources. Over the past half century, the need for skilled healthcare workers has increased in wealthy countries, which have not been able to keep up training and retaining a sufficient labor force to fill their demands and, thus, have increasingly relied on foreign-trained healthcare workers. 

According to the WHO, the international migration and mobility of health workers is increasing in volume and growing in its complexity.

Migrants are motivated by push factors in their home countries and pull factors in receiving countries. While some countries are capitalizing on the global market demand to facilitate export of their workers, some poor countries who lose their skilled workers to more developed countries are concerned about “brain drain.” 

Widening chasm

This is from a report by the World Health Organization: “The chasm is widening between what can be done and what is happening on the ground life expectancies have collapsed in some of the poorest countries to half the level of the richest child.

The African region has 24% of the burden [of disease] but only 3% of health workers commanding less than 1% of world health expenditure.”

Africa has 15% of the world’s population. But if it has 24% of global disease, it should also have 24% of both health professionals and world expenditure. Africa’s healthcare system is chronically underfunded.

While the West averages 1 doctor for 350 citizens, developing countries only manage one per 6,000 inhabitants.

That still does not portray the full gravity of the situation because, with the difference in population densities, one doctor per 6,000 people in Africa is far worse than in the UK. To cover that number, a doctor in Africa has to cover 69 square miles compared to a doctor in the UK.

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Add to those appalling roads, and you can conservatively treble the African doctor’s area to over 200 square miles. And because doctors gravitate to urban areas, if only because the biggest hospitals are there, some in rural areas could be covering over 500 square miles or an area 55 times as large as in the UK. 

If you translate the African situation to the West, there would only be 14 doctors for the whole of London or 34 for New York. 

These statistics back up a statement by the WHO that: “Africa is facing a severe crisis of doctor shortage, on a scale almost unimaginable in the U.S. and Western Europe.

The magnitude of the health workforce crisis in the world’s poorest countries cannot be overstated”.

Migration of Health Care Workers

The British Medical Association (BMA) and the British Royal College of Nursing jointly appealed to the British government to ask the G8 to do something about the drain from developing countries, using very direct language: 

“The migration of healthcare workers from developing nations had led to serious shortages of staff in [developing] countries. The lack of healthcare workers in developing countries, particularly those in sub-Saharan Africa, is an emergency that demands urgent action.”

The WHO agrees: “The exodus of skilled professionals in the midst of so much unmet health needs places Africa at the epicenter of the global health workforce crisis .The result is that many Africans will never see a health professional in their lives. 

Western employers who recruit African health professionals know very well that they are sacrificing African lives in order to save Western ones. Private, for-profit recruitment firms are increasingly entering this market and shaping migration patterns. 

The report from the BMA and Royal College of Nursing then said: “Many developing countries are currently subsidizing our own systems by providing qualified healthcare professionals.”

Yes, you read that right. Training health professionals is expensive and something African nations find hard to fund. Yet the West accepts them from Africa. The report went on: “We would like a commitment from Western countries to look at ways they can support and build health systems in some of the poorest countries in the world”.

Even if there are health professionals within reach, Africans often cannot afford to see them because lack of investment in healthcare means they have to pay either for or towards their medical expenses. Finding the money for healthcare often means a family has to go without food or is unable to pay for their children’s education. 

A further example is that malnutrition can reduce people’s immunity to disease. Food shortages may force people to spend money on food rather than healthcare or their children’s education. In turn, health hazards impinge on the continent’s educational standards.

A recent report by WHO and UNICEF outlines the enormity of Africa’s malaria problem and calls on the global community to step up its efforts to combat the disease. Noting that the death toll remains outrageously high.

The Africa Malaria Report says that sub-Saharan Africa faces continued malarial devastation unless swift action is taken.  No country in Africa south of the Sahara for which data are available shows a substantial decline. 

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The WHO-UNICEF report also describes malaria as a brake on development.  Sub-Saharan Africa’s GDP is 32 percent lower than it would have been by now had malaria been eradicated in 1960, the World Bank says.

If seven Boeing 747s full of children crashed into a mountain every day, would not the West actually do something about it? 

Who has the cure? According to the book, Africa-The Enslaved Continent, there is only one reason all advanced nations have excellent healthcare and disease prevention and treatment, and that is because the taxes they raise from business and personal incomes (the latter requiring a well-paid citizenry) give them the large amount of money needed to provide it. 

As that is the only solution that can possibly work, it means that creating a strong business and well-paid jobs base should be made a priority in every African country.

Not least, being able to pay Western-style incomes would halt the migration of health workers to the West.

According to criminologist Vincent Kibet, the irony is stark: “African countries that were once colonized and exploited are now exporting their labor to build economies that appear to stand on the foundation of African sweat and toil. While international labor exchange can have its benefits, it’s vital to critically assess the opportunity cost of sending away a skilled workforce that could be at the forefront of our own progress”.

By Peter Ongera a guest contributor for The Kenya Times, and an award-winning entrepreneur, journalist, experienced business trainer, coach, and mentor. You can reach him at [email protected].