"Govt tames nurses"
January 2, 2006 -- Today the Daily Times (Malawi) posted a story by Anthony Kasunda reporting that there appeared to be some reduction in the number of nurses emigrating from the impoverished nation to the developed world, perhaps as a result of recent foreign aid-financed measures to improve pay and other aspects of local working conditions. Despite the unfortunate implications of the headline above, the short piece is a generally fair look at the problems faced by the "few remaining" nurses in Malawi, and what is being done to address those problems.
The piece appears to be based essentially on recent interview statements by Health Minister Hetherwick Ntaba and responses to them by Nurses Association president Dorothy Ngoma. Ntaba notes that the number of "nurses and other medical specialists" leaving for developed nations, especially the U.K., has been reduced. He states that this can be attributed in part to a health sector reform package funded by the Department for International Development and the Global Fund, apparently at the level of US$100 million each. Ntaba says that health worker morale has improved since the government began providing a "remuneration supplement" in April. He also notes that pay is not the only concern for the nurses, citing "lack of protective gear, medicine and accommodation" as well. He says that the government is training additional nurses to try to ease the workloads of those who remain, and also building houses for the nurses.
Nurses Association president Ngoma reportedly agreed that the reform package had reduced the financial burden on health workers. She stresses that it is important to train more nurses because (as the piece puts it) "the few remaining people [are] overburdened with work." Ngoma also suggests that the houses will help a lot and that when they are built, "a number of nurses will stay home." She questions the idea that the pay raise is a big factor in the apparent reduction in nurses leaving, noting that it was negligible and that salaries still pale in comparison to those in the U.K. Indeed, she says she knows of a number of nurses who have just left or are planning to do so, noting that even if things are not great for the nurses in the U.K., they are making a lot of money, whereas in Malawi "we are not respected as people who do a very big job."
Apart from the headline, the piece is fairly balanced, and on the whole it does not sugarcoat the difficult state of nursing in Malawi, giving Ngoma an adequate opportunity to voice her concerns. It might have included more hard data as to the number of nurses actually practicing in Malawi, and explained the adverse effects on patients when nurses are understaffed. It might also have explored what measures are being taken to ensure the sustainability for the foreign aid-based reforms being implemented. Lastly, it might have discussed in what way nurses in Malawi are"not respected" for doing a "big job," which seems like a pretty clear statement that there is a lack of public understanding of exactly what nurses do for patients.
The desperate situation for nursing in Malawi was the main example in an impassioned September op-ed in the Observer (U.K.) by Jonathan Dimbleby, president of Voluntary Service Overseas, about the need to eradicate global poverty. He urged wealthy nations to honor the Millenium Development Goals, noting in particular Malawi's severe health worker staffing problems and the desperate need for medications. He stated that there were then 300 nurses in all of Malawi--a nation of 12 million people. Dimbleby appeared to give a vote of confidence to the Ministry of Health's reform plans, and while recognizing the risks of corruption, he urged donors not to delay the release of funds based on unduly stringent reform requirements.
We thank Mr. Kasunda and the Daily Times for this piece.
See Anthony Kasunda's article "Govt tames nurses" in the January 2, 2006 edition of the Daily Times of Malawi.