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Gambia News : Health worker flight
The
Gambian government loses up to half of its trainee health workers every
year to the private sector or to jobs abroad, causing dangerous
shortfalls in patient care in some government hospitals, health workers
say.
Half of government-trained public health workers
in Gambia – including doctors, nurses and managers – have left public
hospitals and clinics over the past decade and the departure rate is
rising, according to Mamat Cham, of the Gambia Department of State for
Health.
The Royal Victoria Teaching hospital lost 250 nurses between 2003 and
2005 according to a Gambian Department of Education August 2008 report.
“My class had 26 students, but only two now work as government
doctors,” said a public-sector doctor who asked not to be named. “All
the rest work for NGOs or have left the country.”
Most leave to join private clinics or international NGOs in The Gambia
or to go abroad, particularly to the United States, Australia and the
United Kingdom.
The high attrition rates lead to overworked doctors and dangerous
patient neglect, in some cases even death, the doctor said. “If you are
left with only one doctor when you’re supposed to be three, patients
will have to wait too long for care.”
Cham said shortfalls hit rural areas particularly hard. “Our rural
health centres and hospitals are now left in the hands of junior nurses
because the seniors and other highly skilled nurses and doctors have
left.”
Why the exodus
Gambia’s health workers leave the public sector because of low
salaries, poor training, a lack of career development opportunities,
difficult working conditions, and a lack of equipment, according to
ex-government nurse Yero Jallow, who now works in the private sector.
And they leave because they have somewhere to go. In the private sector
and in developed countries there is a high demand for skilled medical
workers for relatively high-paying jobs.
A government doctor can expect to earn US$ 226 in The Gambia, the
unnamed doctor told IRIN, adding that at a private clinic or NGO the
same person can earn “up to eight times more”. In the UK the most
junior hospital doctor will earn $48,723 a year, and general
practitioners can expect to eventually earn $118,000 to $178,000.
Incentives to stay
Governments of both The Gambia and the UK are taking measures to help keep Gambian health workers in their home country.
The Gambian department of health recently introduced a hardship
allowance of $22.30 per month, plus additional monthly risk and on-call
allowances, and a responsibility allowance for health officers in
charge. It has also put in place hardship allowances for rural
postings.
But the health department’s Cham said recruiting countries also need to do more by agreeing to limit recruitment numbers.
In February 2008 the UK government was the first country to pass a law
limiting the number of doctors from abroad – specifically the
Commonwealth – seeking postings in the National Health Service (NHS).
The legislation was passed to preserve health service jobs for British
graduates and is accompanied by a push to train British medical
students, with medical school places having doubled since 1997.
The UK government also enforces a code of practice for all NHS
employers to prevent developing countries being targeted in
international recruitment drives.
“[The code] is concerned with the protection of developing countries
such as Gambia and seeks to prevent targeted recruitment from
developing nations that are experiencing shortages of healthcare
staff,” said an NHS spokesperson.
Among the 247,000 doctors now registered with the UK General Medical Council, 27 percent come from outside of Britain.
For now the UK is the only country to put such recruitment restrictions
in place and the move might help slow Gambia’s brain drain. Still the
laws affect only government jobs and those who choose to join the
private health sector are as free as ever to do so.
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