Recruiting doctors? Others don’t see it that way

Opinion

Hey there, time traveller!
This article was published 02/09/2022 (845 days ago), so information in it may no longer be current.

Manitoba needs more nurses and doctors, and one way of addressing the shortage is by luring medical professsionals who are trained in other countries. We call it “recruiting”; some others, however, prefer the term “poaching.”

“The poaching of doctors, nurses and pharmacists from sub-Saharan Africa by developed countries ought to be viewed as an international crime,” stated an editorial in the medical journal The Lancet.

The article, by a group of leading health researchers from Canada and other countries, said the active recruitment of doctors, nurses and pharmacists is “a violation of the human rights of the people of Africa.”

Although the editorial was published in 2008, the issue is more relevant than ever as the medical crises associated with COVID-19 have resulted in burned-out health staff, overcrowded emergency rooms and unacceptably long waits for people needing surgery such as knee and hip replacements.

It’s all led to a public clamor that politicians fix it. For Canadian provinces, the fix includes enticing trained professionals from disadvantaged countries with offers that include moving expenses and legal help with immigration red tape.

The offer is hard to resist. Doctors in Kenya earn an average of Cdn $8,000 per year; general practitioners in Manitoba earn an average of $296,700.

The University of Manitoba helps welcome foreign-trained doctors with an array of services, including its International Medical Graduate program, which offers assessment and training to help license physicians from other countries. One program prepares physicians specifically to practise in rural areas of Manitoba that are considered under-served.

The provincial government of Heather Stefanson would be well aware its re-election chances in the Oct. 3, 2023, election could be curtailed by the persistent anger of Manitobans who receive less than the exemplary health services to which they feel entitled. To get more nurses, the province in July ordered the College of Registered Nurses of Manitoba to remove its requirement that internationally educated nurses already licensed in other jurisdictions in Canada need further testing to work in Manitoba.

While medical migration has been good news for Canada, the news isn’t so good for the low- and middle-income countries that trained the professionals and desperately need their best and brightest to stay home and practice.

Canada has 242 physicians and 881 nurses per 100,000 population. Compare that with the 47 countries of sub-Saharan Africa that have an average of 20 doctors and 110 nurses per 100,000 population. This is the context in which Canada seeks to attract its medical staff.

In rural areas of Zimbabwe, some people pay for health service with chickens or goats. In Rwanda, many nurses have little more than high school training. In some areas of Nairobi, medical services are provided by mobile clinics transported by camels.

Meager medical treatment in such countries is literally a life-and-death matter. As many as 1.5 million Africans die each year of illnesses such as malaria, tuberculosis and HIV-related causes that, as rich countries have shown, can be largely eradicated by the efforts of an adequate medical system.

The taking of medical professionals from poor countries — it’s been called foreign aid in reverse — is not new. The World Health Organization addressed the problem in 2010 with the Global Code of Practice on the International Recruitment of Health Personnel, an ethical framework that is voluntary but encourages member states, which include Canada, toward “principles and practices for the ethical international recruitment of health personnel and the strengthening of health systems.”

In other words, the privilege enjoyed by rich countries — 26 per cent of Canada’s physicians, and 29 per cent of nursing and support occupations, are internationally trained — should come with responsibility.

Restitution could include reimbursing the countries for the training of medical professionals recruited by Canada. Going further, countries like Canada could look beyond our own requirements and help needy countries build schools that train more health workers of their own.

For Manitoba, a longer-term solution to fill gaps in the health-care system might be less recruiting of foreign-trained professionals and more training of people who are from here. The provincial government moved in the right direction when it announced last December $19.5 million to help provincial post-secondary schools add hundreds of new nurse training seats over the next several years.

The made-in-Manitoba solution won’t bear results as quickly as a recruiting trip to South Africa, but medical students who have local family and friends are more likely to stay upon graduation and spend their careers in this province.

Also, by developing more homegrown medical talent, Manitoba would be able to break the dishonorable habit of poaching medical professionals from countries that need them more than we do.

carl.degurse@freepress.mb.ca

Carl DeGurse is a member of the Free Press editorial board.