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Recruiting African health workers a crime -Lancet

Thu Feb 21, 2008 6:30pm EST
By Maggie Fox, Health and Science Editor

WASHINGTON, Feb 21 (Reuters) - Rich countries are poaching so many African health workers that the practice should be viewed as a crime, a team of international disease experts said on Thursday.

More than 13,000 doctors trained in sub-Saharan Africa are now practicing in Britain, the United States, Canada and Australia, leaving behind colleagues struggling to cope with impossible caseloads.

African nurses and pharmacists also are targeted by clinics, hospitals and drug store chains offering better pay, legal assistance with immigration and moving expenses, said the experts, who include the heads of several schools of pharmacy or medicine in African countries.

"They are systematically seeing their recruits being enticed away," Dr. Edward Mills of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, one of the authors of the commentary, said in the Lancet. They are also seeing people dying en masse because of a lack of health-care workers.

"What we are saying is that if one of these countries that is being systematically poached were to pursue it as a crime, contributing to unrest ... then they would have some leg to stand on," Mills said in a telephone interview.

Mills and colleagues from Uganda, South Africa, Ireland and Argentina and including current and former heads of the International AIDS Society used Ghana as an example.

They cited estimates showing Ghana had spent $70 million training health professionals who then left to work in Britain.

"In comparison, by recruiting Ghanaian doctors, the U.K. saved about 65 million pounds ($130 million) in training costs between 1998 and 2002, while their contribution to service provision is estimated at around 39 million pounds ($80 million) a year," they wrote.

While many doctors and nurses were leaving freely, Mills and colleagues said they were also being actively recruited.

"In many countries health workers are seeing as many as 300 patients a day," Mills said. "After putting in 15-, 16-hour days and getting text messages and being recruited by other physicians who come on vacation to Africa, we can understand why people at a particularly weak point should choose to leave.

"We shouldn't be taking advantage of these people's weaknesses."

The experts projected what might happen in fighting the AIDS virus, which infects more than 20 million people in Africa.

"Between 2006 and 2012 there could be an almost three-fold increase in the number of patients per physician (from about 9,000 to 26,000) and an overall decrease in the number of physicians treating patients with HIV from 21,000 to about 10,000," they wrote.

This compares to about 2,000 patients a year for a U.S. doctor, they said.

But Mills and his colleagues said countries that benefit from the recruits should "make amends" by offering training, building and staffing new health schools and providing ways for health workers to stay in their own countries.

(Editing by Bill Trott)





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