Professionals Brain drain strains Africa


by Samson Mulugeta

Newsday.Com Africa Correspondent


Olifantfontein, South Africa -- In a faceless strip mall 30 minutes outside Johannesburg, next to a pharmacy and a record store, Dr. Taddesse Hailu plies his trade, ministering to a stream of patients from a sprawling, black township nearby.


For the equivalent of about $12 a visit, Hailu, a family doctor, prescribes a drug for a skin rash, or listens to the emotional problems of his patients. Although the living he makes by practicing in one of South Africa's poorest areas is modest by many standards, Hailu compares it favorably to his life in Ethiopia, where he practiced before immigrating to South Africa seven years ago.


"I was frustrated in Ethiopia where working conditions were very difficult, Hailu said. "People had to bring their own syringes and medicines to the hospital. People were dying in my arms, and there was nothing I could do. At least here, I can make a difference.


But the most pressing reason he left his country was financial. With doctors earning less than $300 a month in Ethiopia, Hailu said, it was difficult to make financial ends meet. A decade ago, the Ethiopian government sent Hailu, now 52, to Austria to specialize in orthopedic surgery. He never returned.


Hailu is among thousands of African professionals -- doctors, nurses, accountants, teachers -- who have flocked to South Africa in the past decade, depriving their native lands of badly needed human resources. The influx has come from across the continent, from Uganda, Zambia, Ghana, Nigeria and Ethiopia, places where the need for medical practitioners is acute and where the governments spend scarce resources training doctors.


Ethiopia, where the government fully subsidizes the training of doctors, has 2,678 doctors for its population of 60 million people, according to 1995 figures, the latest available. That's one doctor for every 22,404 people, compared with South Africa's rate of one doctor per 1,370 residents.


"African countries have been losing their brains to Europe and the United States for decades, and now South Africa has come to deliver the killer blow to their economies, said Lawrence Schlemmer of the Center for Development Enterprise, a Johannesburg think tank focusing on immigration issues.


After the end of apartheid seven years ago, so many doctors from the rest of Africa headed south that the Organization of African Unity a few years ago persuaded former President Nelson Mandela to put a moratorium on the hiring of doctors from other African countries.


But the moratorium, which was lifted seven months ago, did not stop African doctors from coming. It just drove them underground. Hundreds of doctors, unable to get licenses to operate legally, work in the private practices of South African doctors for a fraction of what they could earn if they were registered.


One African doctor working under such an arrangement in Port Elizabeth, on the Indian Ocean coast, said he earns about $500 a month. "The guy I work for, another African with a license to practice, drives a BMW and a Mercedes Benz, said the doctor, who asked not to be named.


Asked about leaving his country where he received free medical education, the doctor said, "It's about survival. I have to take care of myself first.


South Africa lacks trained professionals -- particularly in medicine because so many have been lost to AIDS or have left for wealthier, less-crime ridden societies. More than a quarter of South African doctors who graduated between 1990 and 1997 are working abroad -- many in Europe, the Americas or Australia -- according to a study by the South African Medical Association.


In all, the government says it loses about 4,000 skilled workers a year, although independent analysts say it could be three times that many.


The South African government has tried not to poach doctors from other African countries, instead importing hundreds of doctors from Cuba to work in underserved rural areas. For the past six years, more than 400 Cuban doctors have worked in South Africa, earning annual salaries of $20,000 to $60,000, 30 percent of which goes to the Cuban government.


But the Cuban doctors have not solved South Africa's shortage.


Skilled immigrants are a relatively small segment of the estimated 3 million foreigners living in South Africa. Most of the unskilled immigrants come from poor neighboring countries such as Mozambique and Angola, and now Zimbabwe, where a deteriorating economy is pushing tens of thousands to cross the Limpopo River and head to South Africa.


In scenes akin to those on the U.S.-Mexico border, South African police daily deport hundreds of illegal immigrants to neighboring countries. Most return within days.


While it forces out the unskilled, South Africa's government has proposed legislation to ease the granting of work permits to the well-trained.


"The proposed law firmly states that we should let people in, unlike the old one which was all about keeping people out, said Schlemmer, the researcher. The bill, which is pending in parliament, would make it easier for companies and organizations to recruit foreigners, but will require them to pay a fee to the government for every outsider they hire.


However, the weakened economy and escalating crime, may make it difficult for the government to attract and retain skilled immigrants. Hailu, the doctor from Ethiopia, is eyeing the exit. "If conditions don't improve here, especially crime, I am on the way out, he said. "I'm being interviewed by an Australian hospital.



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