By Johannes Marisa
IN 1963, the first medical school in then Rhodesia was established and was affiliated to the University of Birmingharm. This followed the establishment of University of Rhodesia in 1952, which was funded by grants from the British and Federation of Rhodesia and Nyasaland governments, the British South Africa Company, Beit Trust and many more. Many medical practitioners were trained from 1963 until today with the first community nurses being trained in 1975.
Thousands of nurses have been trained through government grants and today, the nation could be boasting a robust health delivery service that has adequate staff. Unfortunately, brain drain has creeped in, with many of the experienced health professionals leaving our country for greener pastures.
Our days at University saw us receiving pay-outs from government. We would use the money to purchase basic groceries and the change would buy one-CD changer radios by then.
In essence, government would spend millions of dollars on students so that one day, they would bring much needed input to the economy. Nurses are trained at schools of nursing dotted around the country.
Hundreds of them graduate every year. Unfortunately, the country continues to lose many of our skilled health personnel to economic giants like the United Kingdom, Australia, New Zealand, Cyprus, Germany and the United States of America.
Many African countries are merely training grounds for rare skills while the bigger economic giants are there to snatch the same away. How much are we losing in training the health staff?
The public health system in Zimbabwe has been bedevilled by incessant strikes and demonstrations emanating from the same grievances. Top on the list are issues of poor remuneration, poor working conditions, lack of incentives, poor management characterised by ill-treatment of the health workforce, to mention but a few.
These are now known as chronic problems that are prevalent. So many attempts have been made in order to stem the massive brain drain but some of the strategies have naturally fizzled out and the cycle continues.
The rate at which nurses are leaving the country is alarming and if something is not done to correct the situation, I foresee the departure of special area nurses like intensive care nurses, theatre nurses, midwives which will culminate in poor health service delivery for the nation.
Government this week noted that there was, indeed, massive brain drain in the health sector and the inter-ministerial committee identified some of the causes of brain drain.
The unavailability of non-monetary incentives, shortage of accommodation, transport quagmire, lack of vehicle loans, absence of cafeteria facilities, lack of wi-fi were some of the identified causes of the deth of motivation among the health personnel.
There is no question about the adequacy of the remuneration that the health workforce is getting if comparison is done with colleagues in the region. Salaries ought to competitive if we are to retain the few remaining staff. The private medical practitioners have stood tall to keep the health of the nation Robust and at least everyone put their maximum efforts in order to tame the deadly COVID-19. Many global giants thought Africa would be decimated by the coronavirus but the astute health workforce worked diligently to save as many people as possible.
In view of the unprecedented mass exodus of the critical skills, it is, therefore, worth to consider some of the following:
- Since the causes of brain drain have been identified by our own inter-ministerial committee, there should not be any delays in the implementation of the recommendations that are aimed at stemming brain drain.
Government should not delay to issue car loans or other incentives to medical staff or duty-free facilities for some of the requested items. This would help motivate the health workforce, and move towards skills retention.
- Private-public partnerships are of great importance as they can result in improved infrastructure especially in public clinics and hospitals.
It should not be mere talk but action which should see our health delivery service getting better.
- Leadership checks should be routinely done if we are serious about stemming brain drain. So many people have left government service because of ill-treatment at the hands of the superiors who include matrons-in-charge, district medical officers, provincial medical officers, chief executive officers. It is time the Health ministry investigated cases of abuse of offices at hospitals.
Some matrons attend workshops on Jadelle insertion which should be attended by a practising nurse. Because it is a funded workshop, everyone would want to be there including unnecessary people. Where are we going as a nation?
Many health workers are disgruntled in the peripheries of the countries not because of government but because of being frustrated by local management.
- Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.