As Howard Catton, chief executive of the International Council of Nurses, suggests in your article, nurses are, quite understandably, becoming angry in countries across Africa (Recruitment of nurses from global south branded ‘new form of colonialism’, 27 March). This is both because of their working conditions and because a number of their colleagues are being recruited by wealthier nations, causing workforce shortages and harming already fragile health systems.
Indeed, globally, the vast majority of nurses are frustrated by their working environments. In simple terms, many countries have failed to train enough staff and retain them. To fill the workforce gap, they resort to international recruitment, so a cycle of shortages, recruitment and migration continues. The current World Health Organization code of practice, with its traffic light system where countries are placed in “red”, “amber” and “green” categories, is not working. Witness the patterns of nurse recruitment from Nigeria by some health boards in the UK.
International recruitment could be seen as a “new form of colonialism”; or, in economic terms, interpreted as global labour market integration; or, from a human rights perspective, it can be argued that it’s about a nurse’s right to mobility. However it is seen, it is frustrating, at best, to see that healthcare policymakers are not valuing the nursing workforce. Making ethical arguments is not enough to address workforce challenges.
All governments across the world need to develop and implement robust retention strategies for nurses and other healthcare workers. The only way to address shortages is by valuing nursing and retaining this workforce, and avoiding international recruitment.
Radha Adhikari
Lecturer in adult health, University of the West of Scotland
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