Setfree Mafukidze has been working as a nurse in Northern Ireland for the past four years.
Originally from Zimbabwe, he is part of a growing wave of healthcare professionals leaving the African country in search of better career opportunities, safer working conditions and better pay.
“I loved my job at home, but circumstances made it impossible to continue,” Mafukidze told DW. “You reach a point where you feel like you’re giving everything and getting nothing back.”
Low wages and poor working conditions appear to be the main reasons for this migration. Zimbabwean nurses earn about $250 (€216) per month, while doctors earn on average almost double that. Strikes and protests in the past have not led to any improvement in the overall situation.
In contrast, nurses in the UK can earn up to £3,150 (€3,590, $4,150) monthly. According to the National Health Service (NHS)This not only helps them maintain a high standard of living in their new home countries, but also helps them send money back home to support their families,
Thousands of skilled nurses face trouble
Before relocating, Mafukidze worked as a head nurse at a rural clinic in Chivu, located about 140 kilometers (87 mi) south of the capital Harare.
The facility, which serves an area of about 10,000 people, had only two nurses, a situation becoming increasingly common in Zimbabwe’s public health system.
Zimbabwe’s understaffed hospitals and clinics still have a declining number of nurses to fill the gap.
“There is a lot of burnout. Some clinics have one or two nurses serving a catchment area of 8,000,” says Enock Dongo, president of the Zimbabwe Nurses Association. He highlighted that “where the nurse-patient ratio should have been one to five or seven, it has increased to one to 20.”
Zimbabwe is facing a shortage of at least 14,000 health care workers, according to the country’s health ministry, which officials warn is disrupting basic service delivery and pushing the region to the brink, especially as communicable diseases such as cholera and measles are rampant in much of the region.
Zimbabwe’s nurses are now more abroad than at home
All these factors combined mean that more and more trained health care professionals are moving to countries such as the UK, Australia, Ireland and New Zealand. Others move towards Botswana, Namibia and South Africa within the region, although they may not always be welcomed with open arms amid rising xenophobia.
There are currently an estimated 16,000 Zimbabwean nurses abroad, with the largest numbers in Australia and the UK.
Following the impacts of Brexit and the COVID-19 pandemic, the UK relaxed specific recruitment rules for foreign health and social care workers, creating new entry routes amid a shortage in the UK.
In 2019, the NHS said it employed more than 4,000 Zimbabwean health professionals, an increase of 169% on previous years.
WHO’s Red List is not sufficient in the long term
As a result of these developments, Zimbabwe was placed on the World Health Organization (WHO) list of health workforce support and protection measures in 2023. The list, known as the Red List, includes 55 countries facing significant challenges in their health workforce.
Some countries, such as Britain, have, in response, stopped actively recruiting health care workers from Zimbabwe, although this measure has so far had limited impact on the ground.
“Putting Zimbabwe on the WHO red list is not working. Nurses are looking for other avenues,” Dongo told DW. “Some people go [abroad] As a nurse assistant and still earn more than a qualified nurse here.”
Zimbabwe now effectively bans young nurses from leaving
In an effort to stop public sector health professionals from leaving, Zimbabwe has now banned the issuing of attestation letters, which thousands of nurses and doctors need to secure jobs abroad, despite paying fees of around $300 to obtain.
Warren George, a 31-year-old nurse, is trying to immigrate with his wife in 2023, but his paperwork has been put on hold.
“We almost gave up because of the verification issue,” George told DW. “Given the chance, I’ll go. Talking to colleagues who have had good opportunities abroad inspires you, but I can’t go without papers.”
The government then went a step further: under new rules, Zimbabwean nurses must now be attached to the health care system for 20 years before being released to work abroad, a move that has been heavily criticized by unions.
‘We want to bring our skills back home’
Despite the exodus, many Zimbabwean professionals abroad, like Mafukidze, also say they would be willing to return home if conditions improved.
“The idea is not to live abroad permanently,” he said. “The idea is to learn, grow and take it back home.”
Meanwhile, Health Minister Douglas Mombeshora says the government is working to rebuild the sector.
“We will build a resilient, equitable and high-performing health system where quality care is a right, not a privilege,” he said. He said that domestic funding should also increase.
To this end, a National Health Insurance Bill is being drafted to expand equal access to all in Zimbabwe and improve financing for health care – in addition to launching a divisive government PR campaign that seeks to undermine public perception over the state of affairs in Zimbabwe’s hospitals and clinics.
But for now, the few nurses left in the country will have to continue to bear this burden.
Edited by: Serton Sanderson