Africa: the brain drain in the health sector
A health care practitioner at a hospital in Cairo, Egypt.
AFP / File
Text by: Sabine Cessou Follow |
Sabine Cessou Follow
5 mins
The Covid-19 pandemic does not prevent the bleeding from continuing among healthcare professionals in Africa.
The brain drain mainly penalizes Egypt, Nigeria, Ghana and South Africa.
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How many Egyptian doctors left their country in 2020, in the midst of a pandemic?
More than 15,000, according to the Egyptian press, including 8,600 between the months of March and May 2020 alone according to
Arab World News
, after the United States appealed to doctors around the world to apply for visas.
The Egyptian Doctors' Union (EMS) indicates that 110,000 professionals work abroad, more than half of the national workforce.
The Ministry of Health, him, gives even more worrying figures: of the 213,000 registered doctors, only 82,000 work in the country - mostly in the megalopolis of Cairo, to the detriment of the regions.
Knowing that a general practitioner can gain in one year in Saudi Arabia what he would gain in thirty years in Egypt, the calculations are quickly made for the candidates at the start.
Consequently, the ratio of doctors per 1000 inhabitants is going down.
An anomaly, since Egypt trains 7,000 doctors per year, but loses its investment.
The atmosphere became tense during the pandemic, treated as a matter of national security.
While 348 doctors died from Covid-19 between February 2020 and the end of January 2021, at least eight doctors deploring on social networks the state of the health system were arrested and thrown in prison.
Those who complained about the lack of protective equipment were transferred to remote hospitals.
At Luxor hospital in February, no gel was yet available to disinfect hands.
The National Security Agency (NSA) raided hospitals to track down absent doctors, qualified as “
traitors
” and “
deserters
” by their hierarchy and ordered to work, even sick.
All of these elements could fuel a new wave of departures after the pandemic.
Nine out of ten doctors in Nigeria dream of leaving
Same scenario in Nigeria, where more than half of the 72,000 registered doctors practice in Great Britain, the United States, South Africa and the United Arab Emirates (UAE).
A disaster for the most populous nation of Africa, which has only 35,000 doctors for more than 190 million inhabitants, or one doctor for 5,000 inhabitants according to the Minister of Health.
It would take ten times more to meet WHO standards (one doctor per 600 inhabitants), and to stem what Nigerians call "medical tourism", to designate the trips that must be made abroad in order to be to heal.
Since the appearance of Covid-19, the question of insurance in the event of the illness or death of a doctor has arisen.
Its amount has increased from a meager 14 to 65 dollars in Lagos, as an "incentive" to go to work, while in Ghana, it stands at 4,322 dollars according to the
Journal of Global Health
.
According to
Africa Check
, the United Kingdom had 5,250 doctors trained in Nigeria in 2018, an increase of 10% compared to 2017. A survey organized in May 2017 by the NOI institute in Nigeria also revealed that 88% of doctors are thinking of leaving, due to low wages and poor working conditions ($ 416 per month in the public sector, compared to $ 18,000 per month for a surgeon in New Jersey).
Investment in training made in vain
In Ghana too, there are said to be more caregivers abroad than at home.
Researchers Frank Nyonator and Ken Sagoe estimate that the country lost 50% of its nursing workforce between 1995 and 2005. The incentives put in place, with free housing and bonuses, were not enough to reverse the trend.
The country had only 3,365 doctors in 2016, or 1 per 8,500 inhabitants.
South Africa, on the other hand, represents a special case, as the land of departure and arrival, since the end of apartheid.
An unknown number of South African professionals - mostly white - left the country after 1994. Lack of reliable data is a problem, on a politically sensitive issue.
There are said to be 8,000 South African doctors in OECD countries, for 11,600 general practitioners and 4,500 specialists established in South Africa in 2017. Between 2005 and 2010, Australia recorded the arrival of 500 southern doctors - Africans under permanent visa, and 1770 under temporary visa - which suggests to researcher Jonathan Crush in his study entitled
Rethinking the Brain Drain Narrative
(2019), that South African doctors come and go between several countries, including their.
A
2018
Mo Ibrahim Foundation
report
states that 13,584 African-trained physicians were working in the United States in 2015, a 27% increase from 2005. The overwhelming majority (86%) of these professionals come from four countries: Egypt, Ghana, Nigeria and South Africa.
According to the same report, the United States, Great Britain, Australia and Canada have thus saved 4.6 billion dollars in training since 2010, on the backs of African medical universities.
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