By 2030, there will be a global shortage of 18 million health workers and the world will need roughly 80 million health workers to cater for the global population. Health workers are almost always women, and almost always from low and middle-income countries. With such a critical global demand, the question remains: where the supply will come from and what are countries currently doing about it?
In 2018, close to 6,000 nurses in Zimbabwe (around a third of the total number of the country’s nurses in the public health sector) went on strike. During the strike, Zimbabwean authorities sought to fire all striking nurses, while attempting to backstop the health service with unemployed, retired and on-leave nurses. Additionally, the government looked to cancel all official leave of current staff.
By 2020, while Zimbabwe was fighting the COVID-19 pandemic, the Zimbabwe Nurses Association, which has more than 16,000 members, called for industrial action to force President Emmerson Mnanagwa’s government to pay them better salaries. With salaries significantly lower than the living wage, a wage increase was a necessary step to equitable work conditions. Little, however, has improved. This year, the Zimbabwean Nurses Association claims that most nurses earn $53 a month (for perspective, the World Bank’s official poverty index is $1.9 per day).
Back in 2020, strikers met hostility from government agencies. Reports of police in Zimbabwe arresting nurses shadowed strikers’ activities over the three months of the strike. Nurses would eventually win concessions from the government to propose a new pay offer for the health sector and, crucially, for the government to stop paying medical bills for cabinet ministers and senior officials who seek treatment abroad. But two years have passed and still, Zimbabwe’s healthcare system continues to worsen. Against a backdrop of worsening economic crises, uncontrolled inflation, stagnant salaries, widespread poverty and shortages of essentials such as water and electricity, Zimbabwe is haemorrhaging health workers and losing the trust of its citizens.
Health worker strikes are a common feature of many African health systems. South Africa, Senegal, Kenya, Nigeria, and Guinea Bissau, for instance, have all reported frequent strikes over the past few years. The specific reasons for healthcare strikes differ from country to country, but the cause is generally the same—weak and underfunded public health systems.
Decades after African governments pledged to allocate at least 15 per cent of their annual budgets to the health sector, only Rwanda and South Africa have made progress to reach that target. Further, the exodus of capable and willing healthcare workers out of lower- and middle-income countries towards richer nations like the United Kingdom, United States and Australia will continue to mean that the continent’s own health burdens come second to wealthier nations’ health issues. For a newly graduated nurse, it is more profitable to take care of an ageing population in a Western country than young patients in Africa. The Zimbabwe Nurses Association, for example, frequently organizes webinars for health workers seeking opportunities in other countries.
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