Africa’s Healthcare Sector Faces Brain Drain

The healthcare system in Africa faces dire working conditions, leading to a catastrophic situation. As medical professionals continue to leave the continent for Europe and North America, the healthcare situation in Africa worsens as reported by D+C Development and Cooperation. However, recent developments offer a glimmer of hope, as migration can also bring long-term benefits to the sector, such as the return of health professionals or investment in modern facilities.

Doctors in sub-Saharan countries are confronted with a difficult choice: watch helplessly as patients suffer and die in African hospitals or pursue opportunities abroad to save lives. Healthcare professionals from English-speaking countries tend to migrate to cities like London, Sydney, or New York, while those from Francophone countries often choose Paris or Montreal. Regardless of the destination, the consequence remains the same—a deepening shortage of medical personnel in their home countries.

Doctors in Africa frequently go on strike to protest health care’s decline and poor working conditions. Nigeria has experienced such strikes, among other countries. Paradoxically, there is also a significant number of unemployed medical school graduates. In Côte d’Ivoire, for instance, 40 out of 3,000 unemployed doctors were arrested while demanding employment in the public sector. They received a suspended sentence of four months from the court.

The poor working conditions and low pay contribute to a lack of appreciation for medical professionals, leading to widespread disillusionment. Doctors in North America earn up to 25 times more than their counterparts in West Africa. Consequently, many choose to leave their home countries, benefiting high-income nations.

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Official statistics reveal that approximately 10% of all physicians in France come from abroad. Ireland and Canada have an even higher share, with around 35% of their foreign-born physicians. In 2022, over 66,000 healthcare professionals working in British hospitals came from foreign countries. Ten years ago, it was reported that there were more Ethiopian doctors in Chicago than in Ethiopia.

Rich countries often face significant personnel shortages in their health systems, which they attempt to fill through immigration. International agencies are increasingly recruiting healthcare workers from Africa for positions in faraway places.

The migration of African healthcare workers to Europe or North America is not a recent phenomenon. The first waves of brain drain occurred in the 1960s and 1970s, as many recipients of international scholarships for medical studies did not return to their home countries after completing their education, often due to political circumstances.

Since then, medical education at African universities has expanded, resulting in waves of migration of medical professionals holding African degrees. Doctors seeking specialisation opportunities are particularly prone to move, as they see Europe and North America as places where they can further develop their skills and gain international recognition.

Some exceptional African physicians who live abroad have been recognised for their contributions to science and innovations in clinical practice. It is doubtful whether they could have achieved similar accomplishments on the African continent.

The latest exodus of African medical professionals began in the 2000s, and now nurses are also migrating. They are enticed by attractive salaries and opportunities for professional development.

The process of integrating African-trained health staff into the systems of wealthy nations is complex and often involves professional demotion. Some doctors, despite their medical degrees, find themselves working as care workers. Others pursue additional degrees to secure suitable employment. Furthermore, they often earn less than their native-born colleagues, which adds to their grievances.

Nonetheless, many professionals continue to emigrate from Africa, hoping that their professional status will improve over time. Some aspire to accumulate enough financial capital and knowledge to eventually establish private clinics in their home countries.

For a long time, those who sought employment abroad were viewed with disdain in Africa, accused of lacking patriotism and prioritising their own well-being over their countries development. Today, even nurses working abroad face similar judgments. Undeniably, migration creates enormous gaps in African healthcare systems.

However, recent developments indicate that the labour migration of African professionals can significantly contribute to modernising health care at home. Expatriates frequently send money to invest in establishing private hospitals and clinics in Africa. Some also choose to return from abroad to work in these facilities.

Consequently, first-rate institutions are emerging, reducing the need for wealthy elites to seek “medical tourism” in rich countries. The African diaspora often supports the establishment of healthcare stations in rural areas. Training facilities play a crucial role in transferring the knowledge gained abroad.

Charitable missions are also carried out by members of the diaspora, benefiting patients who would otherwise have limited access to medical services.

Initiatives to establish local-level health insurance schemes with funding from the diaspora are gaining momentum. Consequently, African medical professionals’ success in high-income countries fosters new models of international cooperation and facilitates knowledge transfer. Hopefully, these developments will lead to long-term improvements in the health of people on the continent. Currently, however, good private hospitals mostly benefit the urban upper classes.

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Photo: Health and Allied workers Indaba Trade Union – HAITU