African doctors abroad need to work together to improve health care at home
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7544.744-b (Published 30 March 2006) Cite this as: BMJ 2006;332:744Data supplement
African doctors abroad should coordinate their efforts to improve health care at home
LondonTessa Richards
African healthcare professionals working abroad could play a pivotal role in improving health care in Africa if they pooled their knowledge and commitment and harnessed both to support the development of nationally led health programmes.
This was the key message that emerged from a two day conference held in London last week by AfricaRecruit. The organisation was set up four years ago by the New Partnership for Africa’s Development (a body which wants to eradicate poverty in Africa); its aim is to "connect the diaspora to Africa and Africa to the diaspora."
The conference also heard speakers emphasise that the migration of healthcare professionals fuelled by globalisation was unstoppable—the challenge was to manage it creatively.
Currently there are thought to be more than a million African healthcare professionals working in the West; a figure close to the number of professionals that the Commission for Africa said should be trained in Africa by 2015 (BMJ 2005;330:622, 19 Mar). Many of these professionals have set up individual and small group initiatives, several of which were described at the meeting, to improve health in their countries of origin.
"But scattered initiatives won’t lead to the transformation that is needed," warned Neil Squires, from the European Commission’s directorate general for development. "Tackling the health crisis in Africa requires concerted effort by national governments and the international community."
The ideas, initiative, and expertise of the diaspora are needed to inform national and international policy development, he said, and help develop local systems of accountability. Doctors, nurses, and other health professionals from Africa should also focus their energy on putting pressure on donors of aid and on African ministers of health to deliver on their promises, he added.
Doctors who have trained in Africa make up a large minority of doctors in the NHS. Michael Pelly, the associate director for global health at the Royal College of Physicians, said that a third of the doctors in the United Kingdom (and over 40% of senior house officers) had trained overseas, and that figure did not include European Union graduates.
Most African healthcare professionals leave to pursue postgraduate training and economic security. This was the finding of a recent survey by AfricaRecruit in African doctors predominantly in the United Kingdom, but also based in the United States, Australia, Canada, Germany, Greece, Ireland, the Netherlands, Ireland, Sweden, and Switzerland. It found that a third of the 416 respondents had been recruited while in Africa. Speakers from the UK pointed out that this statistic suggested that the Department Of Health’s code of practice on ethical international recruitment, which banned recruitment from certain countries where health professional were in short supply, was not effective.
AfricaRecruit estimates that more than $1bn (£573m; €833m) is contributed annually to the West in "personnel value" from the migration of trained health workers. Restitution for this loss should include the establishment of many more sustained linkages between Western and African health institutions, Dr Pelly argued. In the UK, NHS trusts should do more to facilitate these links and support reciprocal training.
Mandela Thyoka, a senior registrar in paediatric surgery at the Royal Aberdeen Hospital, outlined the daunting problems facing Malawi, where health services are skeletal and life expectancy is less than 40. "We need to reshape our medical workforce and train cadres of ‘para’ health professionals to meet our development needs. We then need to retain them by providing good terms and conditions of service."
As a rider to this, Malegapuru Makgoba, the vice chancellor of the University of KwaZulu in Natal, suggested that the tendency for African medical schools to follow Western style undergraduate training programmes was an unrecognised driver for the brain drain. Musicians and poets don’t leave Africa in the numbers that doctors do, he asserted; could colonial style medicine be to blame? (See News Extra at bmj.com)
A full account of the conference is at www. africarecruit.com. More details about the New Partnership for Africa’s Development can be found at www.nepad.org.
Related articles
- News Published: 17 March 2005; BMJ 330 doi:10.1136/bmj.330.7492.622
See more
- Introductory AddressProv Med Surg J October 03, 1840, s1-1 (1) 1-4; DOI: https://doi.org/10.1136/bmj.s1-1.1.1
- Report of the Meeting of the Eastern Branch of the Provincial Association at Bury St. Edmond'sProv Med Surg J October 03, 1840, s1-1 (1) 10-13; DOI: https://doi.org/10.1136/bmj.s1-1.1.10
- Mr. Warburton's Bill for the Regulation of the Medical ProfessionProv Med Surg J October 03, 1840, s1-1 (1) 13-15; DOI: https://doi.org/10.1136/bmj.s1-1.1.13
- An Atlas of Plates, illustrative of the Principles and Practice of Obstetric Medicine and Surgery, with descriptive LetterpressProv Med Surg J October 03, 1840, s1-1 (1) 4; DOI: https://doi.org/10.1136/bmj.s1-1.1.4
- A Practical Treatise on the Diseases peculiar to Women, illustrated by Cases, &cProv Med Surg J October 03, 1840, s1-1 (1) 4-5; DOI: https://doi.org/10.1136/bmj.s1-1.1.4-a