Pretoria - More and more South African nurses are taking their skills and knowledge abroad for the promise of more pay and better working conditions.
This has plunged the country’s healthcare sector and nursing profession deep into crisis, the Pretoria News learnt on Monday.
The hardest-hit victims of the exodus are children, the sick, poor and elderly and those who live in areas where healthcare was already scarce, stakeholders said.
Hundreds of thousands of well-trained and highly skilled professional nurses were working in countries such as the UK, Canada and Arab countries.
In these countries, the pay was much higher and the standard of work more sophisticated.
“The recruitment of nurses by foreign agents has been successfully attracting colleagues for over 15 years now, and many have taken the opportunity and left the country,” Pretoria nurse Simon Sibunga said.
Local nurses were highly qualified due to the country’s high levels of training. They are equipped for difficult situations because South Africa has a high burden of disease.
South African nurses were also highly sought-after because they spoke English well, and their background of working in a curative health system enabled them to work in all conditions.
Other nurses agreed that the situation in public health facilities was dire and the pay too little.
A nurse from Dr George Mukhari Hospital, who asked that her identity be protected, said crime was a huge factor and often spilled over from the townships into hospital wards.
“But we also suffer badly from working in situations of inadequate equipment and compromised facilities. We have no drugs at the best of times... it is all extremely difficult,” she said. The nurses were over-indebted and struggled to make ends meet. The dream of better living was a strong pull factor.
“We also often work with unqualified nurses, and the workload falls on to the shoulders of a few,” she added.
Incompetence, and in some cases lack of motivation, made the workplace unpleasant.
“Our managers seem reluctant, or unable, to improve our situations.
“While more of us would leave if we could, we are stuck because of families who need us,” she added.
During his address to the parliamentary health portfolio committee last August, Health Minister Dr Aaron Motsoaledi said the department was doing all it could to stop doctors and nurses from leaving South Africa.
He said it was a struggle as countries such as the United States and the United Arab Emirates offered “greener pastures” for local medical professionals. South Africa could not afford to compete, he said.
But the problems were not new; according to a 2008 document compiled by health journal Human Resources for Health, the haemorrhaging of medical staff was noted and raised as a concern.
The report carries detailed comments on the government having frequently pointed to health worker migration as an exacerbating factor in the country’s health crisis.
“In 2002, the South African minister of health (Dr Manto Tshabalala-Msimang) claimed that if there is a single major threat to our overall health effort, it is the continued outward migration of key health professionals, particularly nurses,” the documents reads.
A former senior official of the national Health Department said, since then, nothing had been done to stop this brain drain.
“The problems had not changed since and had instead got worse with the increased cost of living and the shrinking economy, and the extremely high burden of disease.Nurses suffered trauma and stress, because of the excessive workload and little intervention.”
The nurses said: “Because of the shortages of staff across the board, we play porter, cleaner and do our own sluicing, and in-between that we must also care for patients.”
They said they would prefer to leave the public health sector and work elsewhere. They had also been disillusioned, wanting to leave the profession altogether.
A larger majority said they wanted to leave the country for nursing in other countries - and a lot of them actually did.
Strategy after strategy had been formulated and chief among those was addressing identified issues, the nurse said.
The disgruntled nurses spoke of sitting in on the conclusion of a 2010 strategy report in which poor working conditions, long and inconvenient working hours, uncompetitive salaries, and the professional development of nurses were to be addressed.
Also on the list were nurses’ retention, working in unsafe working environments and lack of resources, which threatened the safety and well-being of nurses and patients and contributed to high turnover rates.
But none of that was ever implemented, the former official said.
The crises deepened, depriving South Africans of much-needed nurses, midwives, theatre nurses and other specialised health care providers.
Why nurses leave:
* Long queues in hospitals and clinics and a compromised health care system.
* The loss of life due to the lack of equipment to save patients.
* Unqualified staff being produced by the many bogus nursing schools.
* Exploitation of workers
* Inadequate training which exposes patients to danger.
* Bogus doctors who put their jobs under threat.
* Infrastructural issues, shortages of water and electricity.
* Lack of ambulances and paramedics and failure by provincial and national health departments to step in and make changes.