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Last Updated: Monday, 27 June, 2005, 16:05 GMT 17:05 UK
Africa reels from loss of doctors
By Nick Triggle
BBC News health reporter in Manchester

Dr Victor Dedjoe
Dr Dedjoe warned that Ghana was struggling to cope
Despite spending more than 4m a year on medical training, Ghana still has only 1,500 doctors for a population of 20m.

Like many African nations, the country suffers from health worker migration as doctors and nurses head to richer countries such as the UK, US and Canada.

Top Ghanaian doctor Dr Victor Dedjoe told the British Medical Association that the exodus of medics had got so bad it was now undermining his country's health system.

We just do not have enough doctors
Dr Victor Dedjoe

Dr Dedjoe, assistant general secretary of the Ghanaian Medical Association, said: "The migration of doctors has a tremendous effect on the successful implementation on the health insurance scheme we are introducing.

"We just do not have enough doctors, but you can't blame them."

Dr Dedjoe, who received a standing ovation from delegates at the Manchester conference, said health professionals were not paid enough in Ghana and were vulnerable to being poached.

Tempting packages

"Two recruitment agencies have set up in my country enticing health workers abroad with all kinds of packages.

"I do not think we should prevent people from working elsewhere, that is their right, but at least if these agencies were not there it would be [up to them].

"We need more spending on health and education [in African nations] and help from developed countries to stop the migration."

The rape of the poorest countries must stop
James Johnson

BMA chairman James Johnson, who invited Dr Dedjoe to the conference, said: I visited Ghana in November last year and since that visit, I have taken every possible opportunity to raise awareness of the skills drain and the calamitous effect it is having on the poorest countries of Africa and Asia.

"Since 1999, Ghana has lost more nurses than it has been able to train - to the UK, USA and Canada. This isn't live aid, it's reverse aid."

Mr Johnson suggested the answer to the problem lay in richer countries ensuring they had enough health workers so there was not a vacuum effect whereby doctors from developing countries ended up working in richer nations despite ethical recruitment policies.

"We are not talking about closing our doors to overseas colleagues. International exchange and collaboration must continue.

"Two way movement and migration is a good thing. But the rape of the poorest countries must stop."

But some doctors have suggested more radical measures.

Transfer fees

Kate Adams, deputy chairman of the BMA's international committee, said she would like to see the issue of compensating poorer nations when their health professionals migrate - a kind of medic transfer fee - explored.

It costs more than 200,000 to train a consultant and 12,500 for a nurse.

"A football team has to pay to get the best players," she said.

"It is about doctors having a value."

But Dr Ahmed Sewehli, of the BMA's junior doctors committee, said there was another side to health worker migration that did not often grab the headlines.

"There are thousands and thousands of unemployed foreign (junior) doctors."

He said many African junior doctors were paid peanuts in their home countries and were attracted by the lure of higher wages in countries such as the UK only to find there was no job when they arrived.


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