Entire African countries are being left with less than 500 doctors each because of the ongoing “brain drain” of healthcare staff to the developed world. Developed countries find it cheaper to recruit from abroad than to train enough of their own citizens, delegates were told at a BMA conference last week.
The meeting of delegates from the United States, Canada, Africa, the Commonwealth, and the United Kingdom was convened to discuss the growing crisis in developing countries caused by the escalating migration of doctors and nurses.
James Johnson, chairman of BMA council, criticised developed nations for failing to make adequate provision for their own needs: “The number of healthcare workers in many African countries is actually shrinking. The effect of this brain drain on the health of those in developing countries is incalculable and catastrophic. There is literally in some parts of these countries no health care of any sort.”
Ghana, with a population of 20 million, has only 1500 doctors, and more than two thirds of young Ghanaian doctors leave the country within three years of graduation. In Mozambique, a nation of similar size, there are just 500 doctors.
Mandela Thyoka, a specialist registrar in general surgery at the Aberdeen Royal Infirmary, but originally from Malawi, told the conference that there were just 350 doctors in his home country, which has a population of 12 million. Malawi's one medical school has managed to train 203 doctors since it opened 12 years ago. Now 100 are abroad in postgraduate training. Mortality for children younger than 5 years is 250 per 1000. “I trained in Aberdeen. This temporary migration is welcome for people of Malawi. In the long term I will be able to help the people of Malawi. But most people stay permanently,” said Dr Thyoka.
Figure 1.
Mozambique has only 500 doctors for a population of about 20m, yet developed countries are happy to recruit its doctors
Credit: JORGEN SCHYTTE/STLL PICTURES
The US, the UK, and Canada have recruited widely in the developing world. The conference heard that although the UK has at least recognised the problem, the US government does not even have a policy on overseas recruitment.
Richard Cooper, of the Health Policy Institute at the Medical College of Wisconsin, said that demand for doctors and nurses from abroad was set to rise. He said that the problem was “not even on the radar screen” in the US, even though it employs almost half of all English speaking doctors and nurses in the world. As many as 22% of doctors in the US, a total of 170 000, were born and trained abroad.
Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, said that there was booming demand for nurses in the US. But nursing schools turned away 150 000 Americans last year because they did not have the capacity to educate them. “We can solve the shortage problem in the US... but there is not the political will.”