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Last Updated: Friday, 8 July 2005, 16:43 GMT 17:43 UK
What can the health service offer?
Barber shop
Africa Live takes a trip to the barber shop to discuss the health service
On Thursday 7 July, Africa Live is in Milton Keynes and Dar es Salaam, with BBC Three Counties and Kiss FM, Tanzania, as part of our week-long community conversations.

We are in a traditional talking place - the barber's shop - to discuss the thing that everyone, everywhere wants to talk about. What can you expect from your health service?

The British and African health services are now so interlocked and the NHS fills more and more of its vacancies with staff from Africa.

About 12,500 doctors currently registered to work in Britain are from Africa.

And, over the last six years, nearly 16,000 African nurses have registered to work in the UK.

We will also be joining up with doctors and nurses in Tanzania to explore how this brain drain is putting a strain on health systems and asking what can be done about it.

We're asking:

What health services are available to you? How has the brain drain affected you?

Here are a selection of views on the subject from Britain and Africa.

Scott from Luton


I believe I should get a prompt health service.

For example, when I go to the hospital I shouldn't have to wait three hours just to be seen for fifteen minutes. I want to get there and get out as soon as possible.

I understand that doctors and nurses have a hard job, but surely the government can raise money to employ more staff to help us.

The problem is that we don't have enough doctors and nurses working in hospitals here and I think the government needs to increase the wages in this profession.

I personally don't have a problem with doctors and nurses from Africa or any other continent.

They are helping people by providing much needed services.

I believe people are entitled to make choices about where they want to work.

I know there are British experts who go to work in Africa, so I think that works out evenly.

Sia Maro from Tanzania


It is most unfortunate for doctors to travel abroad but it is the reality.

The conditions are hard here, the pay is low and the government has not been able to meet their needs.

For a start the Tanzanian government needs to look at its priorities.

It should find a way to pay the doctors well since they are overwhelmed in our hospitals.

But at the same time these doctors who have gone away should make a point to come back home and maybe serve for six months to impart the knowledge they get out there to upcoming doctors who remain in Tanzania, since to some extent we, Tanzanians, paid for their initial medical skills.

Jenny from Luton


My concern is health provision for the elderly. It seems to have slumped over the years because there are simply not enough nurses and doctors to take care of everyone.

I don't however think that hospitals should be poaching for staff from Africa.

It's wrong because they need them as much as we do.

I think the government needs to invest in the health sector.

I am not sure what is the best way to address this situation.

Luton has grown so much, there are so many people living here, yet the hospital is still the very small structure it was a long time ago.

Sharon from Luton


I haven't been living in Luton for very long, but my local surgery is very good.

I get all the assistance I need and have no problems whatsoever. I haven't seen any shortage of nurses or doctors.

I think, because there is freedom of choice, doctors and nurses should be allowed to go where they want to. We all live on one planet and should help one another.

This debate is now closed. Thank you for your comments.

Your comments:

I am a medical doctor from Nigeria and I came to China in 1997 to specialise in orthopaedic surgery. I got a job in China but turned it down and returned to Nigeria. Unfortunately, my colleagues there thought I wanted to take their job and become the boss of the unit. I was frustrated after a year of job hunting and left for Hong Kong. I have no intention of going back home because Nigeria won't welcome a specialist doctor. Besides, I am able to send money home to my family; something that would have been impossible, had I been working in Nigeria.
Abbah, Nigerian living in Hong Kong

With the chaotic situation in the African health system, I can't condemn doctors who leave to look for pastures greener. Even if they remained, their knowledge would be of little help, as people would continue to die from lack of medicine. Our corrupt leaders are quick to travel abroad for quality health care and they don't care about us.
Kapinga Ntumba, Harare/Zimbabwe

Most African governments are reluctant to invest in the health service
Mwai Makoka, USA
I think we ought to get the best when we go to the hospital. But it is not the case, especially in state-owned hospitals, where you see people queuing for long periods for sub-standard treatment. Our governments must make the health sector attractive, because professionals are free to work anywhere in the world.
Omilia Moses Rubn, Uganda

If all the African medical professionals decided to return home, many of them would become unemployed because the African health system cannot absorb all of them. But governments in Africa should create a mechanism to curtail the massive exodus of skilled doctors and nurses to the West.
John Teye, Dover, Delaware

Most African governments are reluctant to invest in the health service. It seems some of them think they would be enriching doctors and nurses. It is sheer hypocrisy to ask doctors to make sacrifices while political leaders themselves refuse to scale-down their opulence. Doctors and nurses are also entitled to fair wages and humane conditions of service.
Mwai Makoka, USA

I feel very sad for the poor people who are left behind without quality health care
Zebayel Baye
If I stayed in my country Malawi, only a few people would benefit from my service because of insufficient drugs, lack of diagnostic equipment and little food for patients. If I worked as a registered nurse here in the USA, my own family would have access to a better health service and I would get paid more money, some of which I could send back to help my extended family in Malawi. I have to weigh up the advantages and disadvantages of staying in Malawi. My family come first, so the choice is simple: I work in the USA. Our leaders always travel abroad for medical services. If they were using the same poor services as other Malawians, they would perhaps invest more money in it and pay health workers better wages.
E Shaba, Little Rock, USA

There is really no other way to stop the problem of a brain drain other than helping African countries to develop. It is all very well to criticise doctors for leaving their kith and kin, but a doctor still has to care for his own family first. Developing countries should realise that doctors cannot be paid like other civil servants.
Dev Goel, India

I blame African leaders who think only about themselves and not the people who vote them into power
Benjamin Dedjoe
I have been working in a hospital in south west Ethiopia as a general surgeon for almost three years now. I work something like 16 hours a day for $200 a month. Beside the poor salary, how long can a person go on working 16 hours a day with no holidays throughout the year? I can understand it if doctors look for a place with better pay and reasonable working hours. But I feel very sad for the poor people who are left behind without quality health care.
Zebayel Baye, Ethiopia

If a doctor is qualified, he should remain in Africa where he is urgently needed.
William Hoff, USA.

I blame African leaders who think only about themselves and not the people who vote them into power. If conditions were reasonable, many African doctors and nurses would prefer to live and work in their home countries.
Benjamin Dedjoe, USA

It is sad to see how the health of my people has deteriorated because the health service has broken down
Zainab Momoh

The debt relief that our homeland is now begging for is partly what helped to pay for our doctors to train in the first place, almost free. They have a moral duty to serve their people at least for a certain period of time. I am a Ghanaian schooling in the USA. I paid for every aspect of my education in the USA. I plan to work in Ghana as a physician. I read BBC health news on Africa regularly. It pains me that our doctors are ungrateful to mother Ghana for giving them the opportunity to become who they are. In Ghana they receive education free and finish school with no debt, while their counterparts in the USA finish with debts ranging from $200,000 - 300, 000. The only panacea to the brain drain is attitudinal change.
John Asare, USA

I was born in Sierra Leone. It is sad to see how the health of my people has deteriorated because the health service has broken down. Basically if you do not have money to pay for a simple illness like a common cold, then the outcome doesn't look good.
Zainab Momoh, United Kingdom

Here in Cameroon we have one doctor administering about a thousand patients. I really sympathise with those involved in this exodus for greener pastures. Some of my school mates are still in their fourth year of specialist medical training, while I am already employed. Before you start to criticise, think of the sacrifices they make before they finally settle down in life.
Israel Ambe Ayongwa, Cameroon

The only thing that keeps those that stay is "home"
Cpoku, Ghana
As a health researcher, I know the devastating impact of brain drain on health delivery in Africa. But I would still argue against any attempt to completely prevent African doctors or nurses from working in countries outside Africa. What I would like to see is a well-managed migration process, where African governments and their western counterparts enter into a formal agreement, which allows a small number of doctors/nurses at a time to work in western health institutions for a specific period. At the moment, western governments, as greedy as ever, are reaping the benefits and want things to continue as they are.
Asante, Ghana/Australia

My worry has been the attitude of some of the doctors and nurses who stay in Africa to work. Often service only comes at a price which will go into their pockets. The only thing that keeps those who stay is the fact that they can't take 'home' with them if they go. However home is always the best place to be.
Cpoku, Ghana

If a doctor or nurse finds the working atmosphere in Africa not good, he or she has the right to go. Our politicians show no concern for this problem, what matters to them is how much they steal.
Tafie Tsamoh Terry, Cameroon

There are more Malawian doctors in the city of Manchester than in Malawi
Steve Mannion, UK
Between 2000 and 2003 I was the only orthopaedic surgeon in the entire northern and central region of Malawi, with a population of over six million. Many District hospitals were without a single qualified doctor and often wards would be without a qualified nurse for much or all of the day. The former President of Malawi is quoted as saying that there are more Malawian doctors in the City of Manchester than in the entire country of Malawi! However, the exodus of health care staff from the state sector was not only abroad it was also to work for HIV/AIDS NGOs within Malawi where they earned the "donor dollar" and were in receipt of other perks such as trips overseas. It might be said that doctors and nurses should have a right to work where they wish, but what of the right of the Malawians' right to quality health care? And why did I leave Malawi?...for the same reason many Malawian health workers leave...
Steve Mannion, UK

The brain drain from Africa is nothing new. I was a senior banker in my own country, but now struggling in the U.S.A. for a "better" life. It is time we wake up to the plight of our continent and its people. I am even ashamed to call myself a Ghanaian - and for that matter an African.
Agama Lotsu Tulasi, Ghanaian/American



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