Saving Africa's dying from the 'brain drain'

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By Jane Elliott Health reporter, BBC News Sixteen women die every day in Malawi in childbirth, or from related complications.

Miriam, a 19-year-old mother bled to death in her hospital bed cradling her newborn baby. There had been no one to check on her.

But in countries like Malawi, it is estimated there are now just two doctors and 26 nurses for every 100,000 people.

Africa requires 800,000 health workers by 2015 and there is a critical shortage of workers in more than 50 countries.

The problem is particularly acute in Angola, Liberia, Mozambique, Sierra Leone and the United Republic of Tanzania.

The so-called "brain drain", where trained medics leave their homes for higher wages and better standards of living, has stripped Africa bare.

But volunteers organisation VSO (Voluntary Services Overseas) says the UK should start giving more back.

Although the NHS does not actively recruit from these vulnerable African states, there are still economic migrants and those who come to work for private firms.

In its new report, Brain Gain, VSO calls on the UK government to make vital changes that will still enable migration but then make it easier for workers to go home, if they wish, with even more skills.

It also says it should be made more attractive for people to return home, through investment in Africa's health system and by encouraging returning health workers to take up training roles.

VSO also wants to see the UK expand its Medical Training Initiative, which brings a limited number of staff (just 12 from sub-Saharan Africa in April 2009-March 2010) to work for the NHS and trains them for a period of just two years.

Kathy Peach, from VSO, said: "The current problem is the migration of health workers from Africa to rich countries like the UK is really undermining the efforts of organisations like the UK and the government," she said.

"We feel that it doesn't have to be like this, that migration can and should work better for the UK and Africa.

"We just hear so many heart-breaking stories."

Preventing fatalities

A spokesman for the Department for International Development (DfID) said it already had some procedures in place to try to protect Africa.

"The UK implements a code of practice for the international recruitment of health care professionals to ensure that we do not recruit health workers from low to middle-income countries.

"We have announced a new fund to enable UK health professionals to share their skills with health workers in developing countries through teaching, training and practical assistance. This builds upon our support to VSO and other UK organisations to enable UK health workers to volunteer to work overseas."

But Dorothy Ngoma, of the National Organisation of Nurses and Midwives of Malawi, said the "brain drain" had disastrous effects on her country.

"We lost the majority of registered nurses at their prime. In a country with about 1,000 registered nurses, we lost about 600 of them.

"I believe those who left were the most assertive ones, the ambitious ones, those who would have made really good mentors and strong leaders… that just weakened our system and our profession very much and I would say we have not recovered from that.

Pam Llewellyn, a VSO volunteer in Uganda, said she had witnessed the shortages at first hand but that she understood why medics would want to come to the UK.

"Who can blame people from going abroad if they are given the opportunity, not only to get a better way of life for themselves, but also their family?"

She said the important change needed was to make it easier for nurses to return.

VSO will now be sending its report to the appropriate government departments.