It’s a reminder that we live in a global world when in Britain you are as likely to be treated by a South African or a national of another developing country as you are by a British nurse.
It’s a trend that the South African government is preparing to take steps to reverse, starting with Health Minister Manto Tshabalala-Msimang’s imminent trip overseas aimed at encouraging South African nurses to come back.
One incentive will be a starting salary of about R100 000 a year for a newly qualified nurse, which is almost R20 000 more than that person would have received before July this year. Although this might compare favourably with the South African private sector, it pales in comparison to the R300 000 a typical state-registered nurse earns in the United Kingdom.
South Africa produces about 2 500 new nurses a year. A 2006 study by the Centre for Global Development found that more than 5 000 South African nurses were employed abroad. The same study indicates that there are at least 12 000 South African health workers — pharmacists, radiographers, nurses, doctors and midwives — employed abroad.
The report also notes that a fifth of South African-born doctors work abroad.
This movement of skilled labour is part of a global phenomenon that sees up to 20 000 of the continent’s most skilled and educated minds going to Europe and the United States every year. The result is that Ethiopia, for example, has only 2 000 doctors, which works out to one doctor for every 100 000 patients, and seriously hampers its healthcare system.
At the Knowledge Management Africa Conference held in Nairobi recently, the subject of the brain drain cropped up. Washington Okumu, an adviser to the Kenyan government, said that, since the Sixties, Africa has exported more than one million skilled people to the West. But Mutahi Kagwe, the Kenyan Information and Communications Minister, said that, instead of looking at it at as a brain drain, it might be time to look at the exodus of skilled individuals moving north as “draining the brain”.
For instance, Kagwe described a hypothetical case of an educated young African man, forced to sit idle on the streets of an African city unable to find employment, who then gets an opportunity to work in Chicago. This, Kagwe insisted, cannot be described as brain drain, because there was no opportunity for the young man to find employment at home. He said, if the continent cannot provide educated and skilled people with opportunities, African states should not cry foul when they leave.
Kagwe’s point echoes an argument raised by Kwaku Asante-Darko, a researcher at the South African Institute of International Affairs, who pointed out the flawed logic that says “Africa would gain more from its professionals if they stayed on the continent rather than if they migrated. This is based on the presumption that conditions exist for the productive utilisation of such skills or, at least, a capacity and political will on the part of governments and researchers to create those conditions.”
Bringing the debate closer to home, Michael Kahn, an executive director at the Human Sciences Research Council, said people leave because “they want to work in an environment they find favourable”.
In the case of South Africa, Kahn said the brain drain is “much more complex because of our history”. He said, for instance, that in the Eighties two groups of South Africans went to study abroad: blacks, the majority of whom came back after 1994, and whites, some of whom left to escape conscription and most of whom did not return.
On plugging the gaps caused by droves of professionals leaving, Kahn said it might be necessary to rethink government’s “altruistic” policy on foreign African nationals. He said the South African government encourages foreign African nationals — who constitute a third of all post-graduate students — “to go back home” after they finish their studies instead of staying in South Africa. He said most don’t go back home, but head for Europe, US and the rest of the developed world.
Kahn said the consequences of the brain drain include an overall decline in output. “One researcher can produce the research of only one researcher,” he said, adding that, as a result, the salaries of the remaining highly sought-after researchers are often inflated. The inflated salaries hide the fact that there is an insufficient number of people who are actively working.
As a result of the brain drain and skills shortages, there are high levels of job-hopping as the few skilled people move between the many positions available.
Bertha Chiroro, a researcher at the Electoral Institute of South Africa, said the reason people leave is that African governments cannot look after their own human resources. “You could blame it on greed, corruption, war, but look at how skilled people leave to do menial jobs in the West.”