Brain Drain

Brain drain is the migration of highly educated and skilled workers moving away from low-income countries to higher income countries. Brain drain is a major problem in health care in sub-Saharan Africa. Nurses and doctors are enticed by higher salaries, better working conditions, more opportunities for education and career advancement, and the prospect of a better life for their family. In their home countries many of the nurses and doctors are overloaded with patients, don’t have enough supplies or drugs to treat their patients, and not only witness many of their patients dying from AIDS-related illnesses, TB, or other infectious diseases but their colleagues as well. As you can imagine, more out-migration only compounds the problem of over-burdened health care workers.

Malawi feels the effects of brain drain acutely. In the entire country there are somewhere around 100 doctors and 2000 nurses to care for a population of 12 million. I experienced the ‘brain drain’ personally this week. My lead study nurse is leaving this weekend for the U.K. She is smart, diligent, and thorough; her absence is going to be felt acutely. While it’s officially illegal for the British Government’s National Health Service to recruit from Africa, there are no regulations for private hospitals and clinics, which still recruit aggressively. I can’t blame her, she just wants better opportunities for her children. And I’m happy that she is getting this chance. However, I can’t help being angry at her new employers. She just got her work visa a week ago, and they told her she had to start on February 1 or the offer would be rescinded. There was no opportunity for any kind of handover, as she only worked one day after she gave her notice.

And, to make things worse, one of our counselors was reassigned to work as a field worker on the malaria vaccine study…which means I currently have no lead study nurse, and will have to train a new nurse AND a new counselor who didn’t participate in either of the weekend trainings or the pilot data collection. All while trying to 1) collect quality data and 2) not fall too far behind our recruitment targets so we don't run out of money before we finish.