Arresting the brain drain of healthcare workers

Samoa and other Pacific island nations have never had it easy over the years when it came to retaining the best of locally-trained medical professionals.

Over the years, the country has seen more of its doctors and nurses move to greener pastures abroad, to add to the brain drain curse that continues to affect national health systems throughout the region.

Tragically, it had to take a measles epidemic and the lives of 83 people comprising mainly of children, to realise that the shortage in health professionals in Samoa is a crisis and warrants immediate intervention.

Now, at this post-measles juncture, we can all agree that our hardworking medical professionals wouldn't have been able to rein in the virus without the support of colleagues from abroad. The fact of the matter is our hard working local nurses and doctors need long-term reinforcement.

The high death toll and infection rate, which currently stands at 5,707 according to the Ministry of Health, justifies the need for an increase in Government investment in medical training, the recruitment of more personnel, and better remuneration as part of a long-term strategy.

The Samoa Nurses' Association President, Solialofi Papali'i, gave us a glimpse of the staffing crisis facing the health sector when she discussed the challenges that the nursing profession has faced.

The good news is the nursing profession is attracting a lot more applicants today compared to 40 years ago, according to Ms Papali'i.

"Remember in the 1970s the intakes would only be about seven or eight students brought in, because it is hard work and it's not something everyone likes," she said reports the Samoa Observer. "These days, because of the marketing of the nursing career, many more have been able to enter into nursing school over the years."

But it is the retention of the best talent in Samoa – to ensure that they continue to work in their home country and save lives – that is proving difficult. 

Most times the medical professional, either a doctor or a nurse, were recipients of Samoa Government and or donor support in terms of their upskilling. And a lot of them eventually leave the country, often in search of higher salaries, better working conditions and clear career pathways.

A number of studies have been done on the issue over the years. 

In July last year, three months before the declaration of the measles epidemic in Samoa, an opinion piece published by the Australian National University warned the Australian government of the long-term impact of its Pacific Step Up Policy.

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The paper’s author, Dr Matthew Bray, was concerned that the Australian government’s new foreign policy priority could lead to the migration of more Pacific island healthcare workers to Australia. 

Dr Bray quoted statistics released in a 2008 study titled “Australia and New Zealand’s contribution to Pacific Island health worker brain drain” by University of Sydney academic, Professor Joel Negin.

The data highlighted in the study, which was sourced from the 2006 Census, showed how 455 Pacific-born doctors and 1158 Pacific-born nurses and midwives were working in Australia at that time. And their numbers increased to 607 (doctors) and 2954 (nurses) in the 2016 Census a decade later.

According to statistics from the same report, in 2006 there were 42 Samoan-born doctors and 469 Samoan-born nurses working in Australia and New Zealand at that time. 

But the doctor shortage crisis is not a new issue facing the health sector in Samoa.

In May last year, the Associate Minister of Health, Tofa Li’o Foleni, announced that he and Health Minister Faimalotoa Kika Stowers have a solution to the country’s doctor shortage.

“The shortage of doctors is not a new issue and so our plan together with the Health Minister is to address the shortage of doctors by focusing on the local students studying medicine," he said. “We are targeting the development of these young students who aim to become future doctors to address the numbers of doctors needed."

Three months later the Oceania University of Medicine (O.U.M.) Vice Chancellor, Toleafoa Dr Viali Lameko, revealed that Samoa needed 40 new doctors within five years.

He said this when announcing that his University will continue to offer five-year programme scholarships to Samoan citizens to study medicine.

We appreciate the initiative by the O.U.M. to step forward to resolve what has been a longstanding issue, which continues to have an impact on our health landscape.

But it is time for the Government to walk the talk when it comes to making long-term investment in Samoa’s health sector, which should arrest the increasing number of our top healthcare workers leaving our shores to work abroad, amongst other related issues. 

A study should be commissioned to identify the factors that are leading to the exodus of Samoan healthcare workers, and what should be done to keep them at home to commit to achieving higher quality health outcomes for our people. 

The measles epidemic and the death toll is the justification for the conversation to be taken beyond public announcements on podiums, and into Ministry meetings and ultimately Cabinet for decisions to be made.

Have a lovely Monday Samoa and God bless.

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