Page last updated at 13:56 GMT, Friday, 27 May 2005 14:56 UK

Inside Africa's healthcare brain drain

Image of an overseas doctor
Almost a third of UK doctors have been trained overseas
A doctor who has worked in teaching hospitals in Johannesburg for more than 20 years believes the brain drain of medical workers from sub-Saharan Africa is not easily solved.

"We do see large numbers of young doctors, and those of all descriptions, going overseas - a number will come back but a number won't," said Professor Peter Cooper, head of paediatrics at Johannesburg Hospital, South Africa.

The UK granted 5,880 work permits to South African healthcare workers in 2003 alone.

"Twenty to 30 years ago it was unusual for nurses to go overseas and spend any time, but large numbers go now," Prof Cooper added.

Fair exchange

The 53-year-old himself spent six months working in the UK in the 70s and said he supported people today gaining the same "valuable" experience.

But he said it would be good if it could be done on a "reciprocal basis".

"We used to get many doctors coming from Britain and Europe for short-term periods to this country to work, but our government has made it very difficult for doctors coming from those countries," he said.

A policy aimed at stopping health workers relocating from other African countries with their own shortages has had the effect of also keeping out those from developed countries, he said.

There is a huge amount of work to be done in terms of improving work conditions and salaries
Professor Peter Cooper
Johannesburg Hospital
"We could be looking at much more creative ways of getting young doctors from developed countries to come here for short periods.

"I am sure a lot of them would be happy to come."

He also suggested the developed countries attracting African health workers should impose a limit on how long they can stay.

But both these moves would not solve the deep-rooted problems in South Africa's public healthcare system, Prof Cooper said.

While just 20% of South Africans can afford private care, that sector accounts for 60% of the country's health workers.

"The public health sector has been chronically under funded for many years, so even doctors who don't go overseas are not particularly attracted to working there.

"There is a huge amount of work to be done in terms of improving work conditions and salaries."

Threat to services

Many medics head overseas just two years into their career in an attempt to clear student debts.

They can earn two to three times more in developed countries, Prof Cooper said.

"Those of us who have remained in the public sector were hoping that we would see improvement after the democratic elections of 11 years ago, but it hasn't happened. It's very discouraging."

And the situation looks set only to deteriorate further, he warned.

"We have enough staff now to keep going, but if numbers continue to decline we may be offering fewer services in five years' time."

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