Feature: Zambia acts to combat brain drain among health workers

An increased exodus of skilled health workers from Zambia has forced the country's leading health institution, the University Teaching Hospital (UTH) in Lusaka, to introduce incentives to retain labor and provide improved health care services.

Having lost more than 50 percent of its medical personnel to Europe and neighboring countries, the UTH has decided to offer an additional 18,000 U.S. dollar package per month in allowances to doctors, nurses and paramedic for part-time work to reduce the impact of the brain drain on the institution. The money earned by the medical workers is an addition to their monthly salaries.

The initiative is a compliment to the government's commitment to paying doctors on-call allowances, providing housing and car loans annually although the facility is not extended to nurses and other health workers.

"Despite these measures, we have continued losing essential medical workers as they are over burdened," UTH managing director, Tackson Lambart said. "Very few are willing to do part-time work."

He said free medical services had contributed to the poor health delivery and exodus of professional health workers from UTH and other government institutions.

"We can't pay our professionals what they are asking for and now we are losing them to neighboring countries as well as the local private sector," said Lambart.

The country's largest hospital, with a bed capacity of 1,800, also suffered from the shortage of drugs and equipment.

A visit to the institution reaffirmed the need to boost manpower, to replace the aging equipment and to acquire more drugs.

The poor condition of service has paralyzed the institution, leaving it with a staff of 1,015 out of the planned establishment of 2,023.

The hospital has critical shortage of manpower, mainly nurses, anesthetists and paramedic staff to service patients within and outside Lusaka.

Understaffing has resulted in one "overworked" nurse attending to an average 30 patients per shift. The development was forcing nurses to seek help from untrained hospital personnel, according to Zambia Nursing Association president, Perpetual Mwanawasa.

Congestion in all wards is a common scenario with an average three children often occupying one bed at a time, despite suffering from different ailments.

"Understaffing is the main problem at the hospital and this has led to most of the patients being forced to sleep on the floor because there are no enough beds," said one nurse who opted for anonymity.

Some nurses complained at the poor staffing levels at the institution forcing them to shuttle between jobs, giving injections, dressing and stitching wounds, and providing HIV/AIDS counseling as recommended by doctors.

Most of the health workers contend that Zambia has failed to retain skilled health personnel because of poor conditions of service compared to neighboring countries and Europe.

A 2004 study by the USAID-funded Health Systems Services Program found that a Zambian doctor employed by the Zambian government earned 425 dollars per month, compared to 10,554 dollars in the United States and 2,836 dollars in neighboring South Africa.

The Health Workers Union sympathized with the plight of the health workers and appealed to the government to review the working conditions to motive health workers and enable them provide acceptable services for patients.

"The government must act decisively and improve the conditions of service for the workers, and curb the brain drain," said the union chairperson Ozias Kaundula.

The UK Department for International Development (DFID) in Zambia said the brain drain in undeveloped countries was unstoppable and urged the government to implement the 2006-2010 Human Resource Strategy plan intended to retain skilled labor.

"The government must quickly implement the Human Resource Strategy because once the health workers realize their entitlements, they will leave the country," said DFID 's health and HIV advisor, Jane Miller.

Zambia's Health Minister, Sylvia Masebo, said the government was determined to retain adequate human resources in the sector in the next decade through improved working conditions, availability of drugs, medical supplies and appropriate equipment.

Source: Xinhua