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The Health Workforce Crisis: In YOUR Words

Over the past month, PHR's Health Rights Advocate blog has highlighted the health workforce crisis in Africa, and how the about-to-be-released Global HEALTH Act can help.

Now, we want to hear from you.

What is your experience with the health workforce crisis in Africa? If you are from Africa or another developing country with a health workforce shortage, tell us about your experience in giving or receiving health care in your country. If you are a health professional who has left your country to practice in the US or elsewhere, we'd love to hear your story: your experience in the health system at home, why you left, and what it is like where you are now.For those of you not from a developing country, have you visited or worked in Africa and seen the impacts of the health workforce crisis first hand? Have you met doctors and nurses from developing countries who are working in the US or going to school and plan to stay here? What have you learned from their experience?Some African health workers have already offered their own insights into the health workforce crisis, its impact on themselves and on their patients, and their advice to policymakers.

The hospital where I work, which serves 100,000 people in the district, averages 2-3 maternal deaths per week due to delayed operations. The two medical officers cannot adequately cope since they have to attend to other emergencies and referrals from the neighbouring districts.” – Nurse, Homa Bay, Kenya

The shortage of doctors and nurses in our hospital has led to one nurse attending to 40 patients at time, a nightmare for those suffering acute conditions. This had led to the loss of patients who would otherwise be stabilised. The quality of service is highly compromised and bordering on unethical practice. This is inhuman treatment of fellow human beings.” – Medical Laboratory Technologist, Nairobi, Kenya

I have a situation at the moment where about 200 patients have to travel for up to six hours to get their ARVs [antiretrovirals] and access related services. Most antiretroviral treatment (ART) centres are in the cities and there are no qualified healthcare professionals in the towns and villages. ARVs are even expiring in some centres because the inconvenience involved is just too much for patients.”– Pharmacist, Abuja, Nigeria

PEPFAR is focused on urban areas. The rural areas are left behind. Patients can’t afford transit. I’ve had five patients die quietly in the last six months because they didn’t have access to AIDS treatment…There’s no electricity where I work, the roads are bad, there’s no equipment. If I get a needle puncture, there’s no prophylaxis. I’m on my own. I’m on call 24 hours; this leads to fatal errors. This is a classic case of marginalization.” – Physician, Niger State, Nigeria

Communities in rural Uganda have a difficult time accessing a health care worker. For example, at outpatient facilities upcountry, there may be 200 people per day who show up seeking care, but only one health worker and one clinic for 25 km. You may see a doctor or a nurse, but quality of care is unsure. It’s different seeing a patient first thing in the morning versus after many, many patients – my judgment may be impaired after so many consultations.” – Medical Student, Makerere University, Kampala, Uganda

There is nothing more demotivating to a worker than being in an office without any resources to do the work. Many of us have worked in hospitals where we were recycling gloves in this era of HIV. We have worked in labour wards and operating theatres where autoclaves could be broken for days, yet we are expected to provide safe motherhood services.” – Physician, Kenya

African Health Workers’ Prescriptions for Policymakers:

Policymakers at country and global levels have to make a deliberate move to recruit and retain health workers in the right numbers based on needs assessments.

Our capacity to deliver health services would be improved by a conducive working environment with adequate basic infrastructure, proper medical supply management, better and regular remuneration and opportunities for continuing education and training.

Donors need to scale up investments in human resources for health, especially in health care workers. Most donors do not fund salaries, which I find self-defeating. For example, a donor will choose to fund only medical supplies without considering how the supplies will be dispensed and by whom.

Western countries recruit health workers and have made it very easy to acquire entry visas and work permits, especially for nurses. This is like picking from the poor man’s pocket.

A healthy nation is a strong nation politically, economically and socially. Investing in health is not only right but a necessity!

We want to hear from you. Use the comment form below to tell your story.

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