Exil de l'elite

Article paru dans la presse kenyane de ce jour...un probleme sensible au Kenya et dans toute l'Afrique


EU plan to woo health workers from Africa extremely callous

The European Union plan to develop a “Blue Card” to attract highly-qualified migrants to meet its labour needs raises several urgent concerns, particularly for African governments grappling with critical shortages of health workers.

The International Organisation for Migration says Africa has already lost one third of its human capital and continues to lose skilled personnel at an increasing rate, with an estimated 20,000 doctors, university lecturers, engineers and other professionals leaving the continent annually since 1990.

The organisation estimates that currently, 300,000 highly-qualified Africans are in the diaspora, yet at the same time Africa spends $4 billion annually to employ 100,000 Western experts.

The effects of this brain drain are felt directly in key social sectors in Africa, particularly education and health.

Ten years ago, there were 1,600 doctors in Zambia; only 400 are left now. In Kenya, 90 per cent of the medical personnel migrate to the West every year.

There are more Ethiopia-trained doctors practising in Chicago alone than in the whole of Ethiopia, and more Malawian-trained doctors practising in Manchester than in their motherland.

Largely as a result of this massive haemorrhage of personnel, Africa has only three per cent of the global health workforce, despite bearing 25 per cent of the world’s diseases.

The health workforce is undoubtedly the driver of health systems. Immigration of this precious resource from Africa has resulted in severely weakened health systems that can barely provide services, leave alone pursue the aspirations of the Millennium Development Goals.

The proposed EU Blue Card, a special residence permit granted to immigrants, is only bound to aggravate the situation, legitimising labour movements to Europe at the expense of low-income countries in sub-Saharan Africa.

An exodus of health professionals will create even greater global imbalance, with host countries creating reservoirs of healthcare professionals to replenish their ageing workforce, while African countries have to put increasingly greater pressure on health systems that are already stretched to breaking point.

Ultimately, further depletion of Africa’s intellectual property will reverse gains made in eradicating extreme poverty and hunger, reduction of child mortality, improvement of maternal health, and the fight against HIV and Aids, malaria and other diseases.

The EU must consider the moral and ethical implications of its proposal before introducing the Blue Card. I would ask the EU to have an exclusion clause for health professionals.

But free movement is a human right, and African health professionals will move to Europe anyway, with or without the Blue Card.

Moreover, we cannot ignore globalisation, and the need for African health professionals to contribute to ameliorating the global burden of disease while enjoying the fruits of their hard work.

The challenges of stemming the brain drain are daunting, but certainly not insurmountable. But the efforts must be collaborative between African and Western governments and institutions that recruit from Africa.

To contain the health workers still on the continent and attract others from the diaspora, African governments must vigorously address the “push” factors that lead to migration.

They must provide health professions with employment, competitive salaries and incentives such as good housing, and career development, and health facilities with the necessary basic requirements.

Europe, too, must be proactive in ensuring that African health systems are not robbed of valuable human resources without compensation and restitution.

Support could be extended to programmes that train health workers for the African context, such as Amref’s’ Diploma in Community Health course, and the eLearning Programme that trains nurses virtually, allowing them to learn and work at the same time.

If Europe must recruit from Africa, it should invest in building the capacity of training institutions to enable Africa to train enough health workers for itself and to meet Europe’s needs.

With expanded physical and fiscal space, the EU could contract individual African countries to produce health workers for them.

Ultimately, both the EU and African governments must implement policies that address health workforce densities, the weakened African health systems and resultant inequities, and the global diseases burden.

written by : Dr Ngatia, Director for Capacity Building at the African Medical and Research Foundation (Amref)