Africa's Brain Drain
The loss of capacity hinders the fight against AIDS in Africa
The root of Africa's brain drain, surprisingly, lies in the international community.
Capacity building in Africa is an integral component of the AIDS solution. The mass exodus of health professionals from African countries is impairing the continent’s ability to adequately deal with its burgeoning AIDS problem. Health professionals are an integral part of the health care system’s infrastructure and a key component to stopping the spread of HIV by providing both treatment and preventive measures. Without an adequate number of health professionals serving the population, bringing in other measures to stop AIDS will not be effective.
Although it is difficult to obtain exact numbers of health professionals who leave Africa, the available statistics are alarming. The International Organization for Migration has calculated that since 1990, over 20,000 professional Africans leave the continent annually. The UN Development Programme estimates that Ghana has lost 60% of its doctors that were trained during the 1980’s.
Medecins Sans Frontieres (MSF) has stated that in a study of four African countries, South Africa was the only one to meet the minimum level of health professional per capita as prescribed by the World Health Organization (WHO). The WHO’s guidelines states that a country have a minimum of 20 physicians, 100 nurses, and 228 health providers per 100,000 people. In MSF’s report, “Health Worker Shortage Limits Access to HIV/AIDS Treatment in Southern Africa', the organization looked at the countries of South Africa, Lesotho, Malawi and Mozambique. The latter three countries were particularly vulnerable with Lesotho having only 89 physicians, Malawi having only 10 percent of the needed number of doctors, and Mozambique getting by with 2.6 doctors, 20 nurses and 34 health providers per 100,000 people.
The opportunities open to African health professionals in North America and Europe have proven to be an attractive draw. The chance to live in an economically and politically stable environment with a wider array of career opportunities and lower crime rates continues to lure professionals away from Africa. However, North America and Europe have been remiss in taking advantage of the situation in Africa and addressing their own personnel shortages by actively recruiting African health professionals. In an article published in the Journal if International Affairs, Jonathon Crush cites the aggressive tactics used by the Albertan government to draw South African physicians to their rural communities. The doctors were feted with free stays at world-class resorts, financial incentives, expensive dinners, and charted flights for themselves and their families. Numerous articles have cited the dependence of the province of Saskatchewan on South African doctors. Twenty percent of Saskatchewan physicians, or the equivalent of all the students in the University of Saskatchewan Medical School, are South-African trained. Canada’s recruiting strategies of South African doctors has become such an issue that South Africa has asked Canada to refrain from “poaching” their physicians.
However, there are hopeful examples of countries providing health professionals to Africa to alleviate the critical shortage. South Africa has agreements with Cuba and Germany for these countries to provide physicians. Cuba currently has approximately 500 physicians working in rural areas and townships of South Africa. Cuba also has a strong presence in the rest of the continent with more than 1000 physicians, dentists, and psychiatrists. The 200 Cuban doctors in Ghana comprise 7% of that country’s physicians, which show not only the dire straits that Ghana is in, but also the strong commitment of Cuba to providing support to Africa. With the largest number of doctors per capita, a strong health care system, and an enviable medical education system, Cuba is in a strong position to aid Africa. Other countries have a responsibility to, if not follow the example of Cuba, at least refrain from contributing to Africa's brain drain.
