Unhappy with conditions, health workers seek opportunities in the UK

To fast track visas to healthcare workers to go to Britain, the UK launched a special visa, and Kenyan nurses and clinical officers are applying in large numbers.

The National Nurses Association of Kenya (NNAK) told HealthyNation that in the last two months, more than 600 nurses have applied to leave the country. This is a number higher than the usual 200 every quarter.

The window of application opened this month. Information on the UK website details is used to attract the workers: the Health and Care Visa, announced in July by the UK government, has reduced fees to £464 (about Sh66,000) per person from the usual 610£; the fees for immigration health surcharge, an insurance of sorts, has been abolished; those who had paid for the surcharge up to March 31, will get a refund; the waiting period and the earliest one can get the visa has also reduced from three months to three weeks.

UK has also placed healthcare workers in a special category — alongside vets, physicists and other scientists — which allows them to have extended stay in the country.

High traffic hospitals

Kenyan healthcare workers, especially those who have worked in high traffic hospitals such as Kenyatta National Hospital, are a hot commodity right now due to their experience in responding to infectious diseases and in intensive care units. Kenyatta has especially lost its nurses in intensive care and neonatal wards to countries like the US, Canada and the UK.

Alfred Obengo, the president of NNAK, cited poor working conditions and lack of career growth for the nurses wanting to leave the country. During the Covid-19 period, health workers have decried the lack of protective equipment, health insurance and hazard allowances.

The country has lost about five healthcare workers and hundreds are infected with the virus. There have also been complaints of delayed salaries, temporary and unstable work contracts. The workers have responded to this through strikes.

The strained relationship between workers and their employers has demoralised them, says the NNAK president. The Kenya Health Workforce Survey also cited South Africa, Botswana and Namibia as attractive destinations for health workers. Kenya Union of Clinical Officers reported that there are 518 clinical officers seeking to move out of Kenya, the majority (480) seeking to go to South Africa.

In 2010, the World Health Organization (WHO) established the code of practice on the recruitment of health workers to ensure there is equity in their employment between the North and South. Some of the recommendations were that the wealthier nations pay the origin countries. However, recruitment from Kenya occurs without honouring the pleas to discontinue such efforts from local and ministries of health.

Huge disparities

Poorer nations such as Kenya suffer the most even as the whole world experience a shortage of healthcare workers. By 2035, WHO estimates that the global shortage of healthcare workers will move from the current 7.2 million to 12.9 million. Kenya has 8.3 clinical officers, doctors and nurses per 10,000 as opposed to the WHO-recommended number of 25 per 10,000 people. 

There are also huge disparities between rural and urban areas where parts of Kenya have 12 times fewer doctors than the national average. In this inequality, Kenya and other countries in the developing world, are short changed: they train the health workers to fill the gap and a large proportion of the newly trained professionals are enticed by higher incomes to work in developed countries, particularly Britain, Canada and the US, or in more advanced developing countries.

This move costs Kenya billions in hard money and social costs. A 2006 WHO analysis, and the only one so far, of what it costs to train healthcare workers reported that it costs Kenya about Sh43 million to train a graduate nurse and Sh65 million to train a doctor. The paper concluded that for every nurse that left, Kenya lost approximately a Sh452 million.

Dr Mardi Steere, the former Chief Executive Officer of AIC Kijabe Hospital tweeted: “the juxtaposition of Kenya prepping for mass #COVID19 deaths alongside the UK aggressively recruiting LMIC health workers is extraordinary. Every man for himself, but especially the wealthy”