National Nurses United

Africa should double their nursing work forces, adding at least 620,000 nurses to deal with the spread of AIDS, tuberculosis, and malaria. "The massive outflow of nurses, midwives, and doctors from poorer to wealthier countries is one of the most difficult challenges posed by international migration," according to the U.N. Population Fund's (UNFPA) latest annual report released Sept. 6, 2006. The group said countries losing healthcare providers are facing a healthcare crisis home countries to decent healthcare. It did not say that African governments try to prevent the emigration of healthcare workers, but did recommend that industrial countries not recruit actively in Africa. In 2001, in response to such calls, the British National Healthcare System (NHS) promised not to engage in "aggressive recruitment" of African nurses. However, the National Health Service policy does not cover private facilities and private British hospitals. More than "There would be no need to lure nurses from abroad if we were willing to spend the necessary resources to attract and educate a sufficient nurse workforce and provide the compensation and working conditions to retain it." —Deborah Burger, RN and CNA/NNOC president "unprecedented in the modern world." In its "State of World Population" report, UNFPA said nowhere is the effect of the "brain drain" more acutely felt than in the already fragile health systems of developing nations. "The problem with the brain drain is that health systems are already collapsing in poor countries that face massive healthcare needs. The outflow of doctors and nurses aggravates this situation," Maria Jose Alcala, the report's principal author, told Inter Press Service news agency. She pointed out that while nursing is one of the few occupations that offer migrant women decent work with decent pay, "in their countries of origin, nurses face poor working conditions, while richer countries become appealing destinations for them because of higher wages." For instance, a surgical nurse in South Africa makes about $13,000 a year. The same nurse can earn $66,000 a year in Britain. In May 2004, African countries at the annual assembly of the World Health Organization urged developed nations to compensate them for their lost investment in training nurses, and won a pledge to study ways to reduce the damage from the emigration. Two years ago, the international organization Physicians for Human Rights called on industrial nations to reimburse African countries for the loss of health professionals educated at African expense and to try harder to meet their own worker shortages by training more people domestically rather than recruiting abroad. The group pointed to a trade-off between the rights of African health professionals to seek a better life and the rights of people in their This is the first of several articles that we plan to run exploring the brave new world of nurse migration, a growing phenomenon that's sure to expand even more as our population ages. Future stories include the real-life experiences of nurses who move to the United States in search of work, and of providers who are doctors in their home countries but take jobs as nurses overseas. APRIL 2007 12,000 African nurses have registered to work in Britain over the past seven years. Percy Mahlati, a high official of the South African Department of Health told the British medical magazine, The Lancet, that the NHS is using private agencies to do its recruiting, "so that rather than doing it directly, they [the NHS] are doing it indirectly." A Lancet study found that many nurses from Africa who are recruited by private agencies start off working at nursing homes and private hospitals, but quickly move on to the higher-paying NHS jobs. Despite having the resources to do so, the United States and other developed countries have simply failed to produce enough medical and nursing staff to meet their healthcare demands. A study by the Guardian found that Britain only trains 70 percent of the doctors it needs, and that the U.S. trains 50 percent of the nurses it will need. The increasing migration of healthcare providers represents another facet of the globalization of the healthcare industry. This past summer Sen. Sam Brownback, (R- Kansas), inserted a proposal into immigration legislation that would facilitate increased immigration of nurses into the U.S. The measure was intended to deal with what he described as a nursing shortage in the country. According to a May 2006 New York Times article by Celia Dugger, public health experts in poor countries, "reacted with dismay and outrage, coupled with doubts that their nurses would resist the magnetic pull of the United States, which sits at the pinnacle of the global labor market for nurses." Smita Baruah, senior government affairs advisor for Physicians for Human Rights, said that "Kansas is facing a nursing shortage and the senator saw this would be of great economic benefit to his own state. He was looking for a fast and easy solution." Brownback, who has been a proponent for programs to fight AIDS and malaria in Africa, has suggested that loosening immigration rules for nurses would have minimal effect on the continent. Just over the horizon, however, could be recruiting companies that promote the changes in American immigration law and soon start setting up shop in African countries where healthcare W W W. C A L N U R S E S . O R G REGISTERED NURSE 15

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