Curbing the brain drain from Africa and ensuring the growth of qualified personnel are essential elements for a real and lasting development. The first step? To provide on-site qualified training for local people.
"It is not an escape, but a real trade". Alpha Oumar Konare, chairman of the African Union Commission, described in this way the "brain drain" of highly qualified young people moving from developing countries to work in the North of the world. Their number is steadily increasing. But when the media talk about immigrants, they do so with reference to illegal immigration, speaking of crime and insecurity, or about job stealing... and no one says a word on this further silent sack of materials or skilled human resources, to the detriment of developing countries.
Currently there are over 300, 000 qualified Africans working in Europe and United States; 40,000 are graduated. Some of them studied in the northern hemisphere, but the real deal is to recruit trained staff on the spot at a cost 1 / 3 lower then the one needed to train them in our countries. England, for example, recruiting African doctors and nurses, saved 85 million Euros, corresponding to the necessary amount to train that staff. In Africa, the health situation looks dramatic: the infant mortality rate is very high and often people die from banal diseases because of lack of health and hygiene education and proper care. There is lack of hospitals, drugs and above all doctors and nurses. In this context, the brain drain is a real theft that hinders any local development possibility. To stop this tragedy, several actions are to be activated almost simultaneously:
1 ) provide free and high quality training;
2 ) establish a moral obligation, specified in a commitment signed by the person supported in the studies, to spend at least 10 years of professional life in his own reality;
3 ) ensure proper sanitary facilities;
4 ) ensure a fair professional reward.
OPAM, in this regard, started a pilot project in one of the poorest and most difficult areas of Congo Democratic Republic, one of three Countries in the world with the highest mortality rate. The selected area is the territory of Bokungu-Ikela in Equateur province. The area is a 42,000 sq km rainforest, hampered by its geographical isolation.
The population is very poor, with a per capita income lower than $ 1 a day. Health situation is so worrying to represent a real medical emergency. Mortality rate in a developing country is 0.5 per
10,000 people per day on average (in industrialized countries it is 0.3); a rate higher than 1 per
10,000 indicates a state of emergency. In this area the overall mortality rate is 2.3 per 10,000 people a day: a real health disaster.
The most common diseases are typical of developing countries: malaria, filariosis, diarrhea, acute respiratory infections, malnutrition, measles, problems related to pregnancy and delivery, HIV / AIDS, tuberculosis. Malnutrition affects 12% of the population. Infant mortality is 120 deaths per 1,000 children born alive. Only 28% births have an assistance.
After the health reform the territory of the diocese was divided in 5 health zones. In fact, taking into account the State inability to address the huge health problem, an agreement between Government and dioceses was concluded, to pass on them most health facilities management. The " Bureau Diocésain des Oeuvres Médicales” (BDOM), the department of health management in the diocese, takes charge of 4 out of the 5 health zones (Busanga, Bokungu, Ikelite and Yalifafu), namely: 48 dispensaries, 15 consulting rooms, 15 nutrition centers and 2 hospitals, one in Bokungu and the other in Ikelite. The State contribution consists in a salary of € 10 per month for nurses, that the diocese integrates to avoide the staff moves to Kinshasa or abroad to live decently.
According to the WHO standards, at least 2 nurses should be provided for each health center and 16 for each hospital of the size of Bokungu or Ikelite. Applying these rules, the territory of the diocese would need at least 276 nurses to grant the service of all health facilities. Currently only 60 nurses are working, which corresponds to 0.5 nurse per health facility. Nursing schools are very far away: ITM Boende : 235 km, I.T.M. Kisangani : > 500 km, I.T.M. Mbandaka : > 700 km, ITM Djolu : > 220 km, and there are no roads for cars. This situation not only hinders staff training, but also makes it difficult recruiting personnel from other areas: geographical isolation and backwardness discourage the acceptance of jobs by people from other provinces.
Birth of the Nurse School
To meet the shortage of nursing staff, since two years BDOM opened a nurse school in Bokungu, which will provide the area with about 25 level A2 nurses per year. Currently the school does not have its own building: lectures are held in three classrooms of Bonsomi high school, which OPAM helped to renovate with the Project 1620/2007. The nursing course lasts four years; in the first three years 65% of hours are theoretic, 35% are practice oriented. The fourth year is almost entirely devoted to practice in the different health facilities of the territory, under the guidance and supervision of teachers identifying the learning needs of each student. The final degree, A2 nurse qualification, is officially recognized by the Ministry. This diploma provides access to higher-level training in medical science and techniques for a 2 years period, with a final degree in A1nursing. At full capacity, the school will train about 120 students per year.
Currently there are over 300, 000 qualified Africans working in Europe and United States; 40,000 are graduated. Some of them studied in the northern hemisphere, but the real deal is to recruit trained staff on the spot at a cost 1 / 3 lower then the one needed to train them in our countries. England, for example, recruiting African doctors and nurses, saved 85 million Euros, corresponding to the necessary amount to train that staff. In Africa, the health situation looks dramatic: the infant mortality rate is very high and often people die from banal diseases because of lack of health and hygiene education and proper care. There is lack of hospitals, drugs and above all doctors and nurses. In this context, the brain drain is a real theft that hinders any local development possibility. To stop this tragedy, several actions are to be activated almost simultaneously:
1 ) provide free and high quality training;
2 ) establish a moral obligation, specified in a commitment signed by the person supported in the studies, to spend at least 10 years of professional life in his own reality;
3 ) ensure proper sanitary facilities;
4 ) ensure a fair professional reward.
OPAM, in this regard, started a pilot project in one of the poorest and most difficult areas of Congo Democratic Republic, one of three Countries in the world with the highest mortality rate. The selected area is the territory of Bokungu-Ikela in Equateur province. The area is a 42,000 sq km rainforest, hampered by its geographical isolation.
The population is very poor, with a per capita income lower than $ 1 a day. Health situation is so worrying to represent a real medical emergency. Mortality rate in a developing country is 0.5 per
10,000 people per day on average (in industrialized countries it is 0.3); a rate higher than 1 per
10,000 indicates a state of emergency. In this area the overall mortality rate is 2.3 per 10,000 people a day: a real health disaster.
The most common diseases are typical of developing countries: malaria, filariosis, diarrhea, acute respiratory infections, malnutrition, measles, problems related to pregnancy and delivery, HIV / AIDS, tuberculosis. Malnutrition affects 12% of the population. Infant mortality is 120 deaths per 1,000 children born alive. Only 28% births have an assistance.
After the health reform the territory of the diocese was divided in 5 health zones. In fact, taking into account the State inability to address the huge health problem, an agreement between Government and dioceses was concluded, to pass on them most health facilities management. The " Bureau Diocésain des Oeuvres Médicales” (BDOM), the department of health management in the diocese, takes charge of 4 out of the 5 health zones (Busanga, Bokungu, Ikelite and Yalifafu), namely: 48 dispensaries, 15 consulting rooms, 15 nutrition centers and 2 hospitals, one in Bokungu and the other in Ikelite. The State contribution consists in a salary of € 10 per month for nurses, that the diocese integrates to avoide the staff moves to Kinshasa or abroad to live decently.
According to the WHO standards, at least 2 nurses should be provided for each health center and 16 for each hospital of the size of Bokungu or Ikelite. Applying these rules, the territory of the diocese would need at least 276 nurses to grant the service of all health facilities. Currently only 60 nurses are working, which corresponds to 0.5 nurse per health facility. Nursing schools are very far away: ITM Boende : 235 km, I.T.M. Kisangani : > 500 km, I.T.M. Mbandaka : > 700 km, ITM Djolu : > 220 km, and there are no roads for cars. This situation not only hinders staff training, but also makes it difficult recruiting personnel from other areas: geographical isolation and backwardness discourage the acceptance of jobs by people from other provinces.
Birth of the Nurse School
To meet the shortage of nursing staff, since two years BDOM opened a nurse school in Bokungu, which will provide the area with about 25 level A2 nurses per year. Currently the school does not have its own building: lectures are held in three classrooms of Bonsomi high school, which OPAM helped to renovate with the Project 1620/2007. The nursing course lasts four years; in the first three years 65% of hours are theoretic, 35% are practice oriented. The fourth year is almost entirely devoted to practice in the different health facilities of the territory, under the guidance and supervision of teachers identifying the learning needs of each student. The final degree, A2 nurse qualification, is officially recognized by the Ministry. This diploma provides access to higher-level training in medical science and techniques for a 2 years period, with a final degree in A1nursing. At full capacity, the school will train about 120 students per year.
