Nurses Brain Drain – from Within

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By Surihe Gaomas WINDHOEK Though Namibia is one of the fortunate countries that do not experience a massive brain drain of nurses to foreign countries for greener pastures, the private sector within is poaching these professionals from State-run hospitals. This is largely because of the nature of the local labour market, where the private sector is perceived to offer higher remuneration and better conditions of service. At the recent commissioning of medical interns in Windhoek, the Minister of Health and Social Welfare Richard Kamwi said he was concerned about the constant loss of qualified nurses and social service personnel to the private sector, due to the highly competitive labour market. Out of 104 registered nurses, 65 moved to private health centres in the country between 2001 and 2004, while only 39 have left the country for the UK. This in essence means that only about 10 nurses migrate outside the country every year. However, the minister cautioned that even though the number is far less than what other African countries experience, “we must do all in our power to retain all these human assets in our country”. Yet, the challenge still remains that about 22 nurses each year have been deserting the public sector for perceived greener pastures in the private sector between 2001 and 2004. Faced with unfavourable working conditions and no room for advancement in their careers, nurses are said to be resigning in droves from the public health sector. “It is difficult to climb the ladder,” complained one nurse. “If anyone goes up, it is only up to a point when they earn N$77 000 per annum and cannot move anymore. The highest a registered nurse could get is to the position of Chief Registered Nurse, before one can be considered for a Project Manager position. “Even with extra qualifications such as a Master’s degree, one is given a one-off cash bonus of around N$2 700,” said the nurse, who preferred anonymity. New Era also learnt that some nurses finish their working shifts at a state hospital and continue working extra hours at private centres for more income. While some cite money as a factor contributing to the exodus from the public health sector, other nurses blame it on the rather stifled working environment. One nurse who has been in the profession for the past 25 years says: “working conditions are fine, but nurses need a change of environment to get them out of the demoralised state of affairs that they’ve been in for years and they also want their pensions.” “That is why nurses at most state hospitals resign as the only way to get their pension money to pay off their numerous debts. Some nurses are in such a desperate situation that they get cash loans and to pay back they resign and get their pension money,” said another. Over the years, some nurses have resigned from the state health facilities, but returned to the fold after having received their pension payouts. Although there are indications that nurses are leaving the public sector due to low wages, Kamwi said Namibian nurses are the best paid in the sub-region. “But on social amenities we beat the private sector,” he says. However, as part of its ongoing strategies to retain their health personnel, the ministry has implemented a number of measures. These include ready and prompt acknowledgement and recognition of good work performed by staff members, investing in personnel through staff development and training and improving the working environment through strengthening and improving resource management, logistics and support services such as transport and accommodation. In light of the negative public outcry about nurses’ alleged bad treatment to patients that contributes to their demoralised state, the minister said that the time has come for positive comments and for praise as well. “Our health workers are humans and not machines. They need human support, praise and encouragement. Give them praise when praise is due and you will see them growing and taking on more and more responsibilities,” noted Kamwi. Training of nurses is also part of the strategies undertaken by the ministry to address the shortages. From this year up until 2010, the ministry intends to train 40 doctors, 20 pharmacists and five dentists, while an additional 300 nurses would also be trained. Recently, 11 Namibian trainee doctors who studied abroad joined the ranks of the health profession.