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July 2004, Volume 11, Number 3

Africa: South Africa, Nurses

South Africa. Some 50,000 white farmers own 87 percent of farm land, and in 2004 the Restitution of Land Rights Act, which allows the Ministry of Agriculture to appropriate land, with compensation, that was taken forcibly from Blacks under apartheid. The government hopes that Black farmers will have 30 percent of the land by 2015, but white farmers complain that 90 percent of the farms already transferred to Blacks have gone bankrupt.

South Africa, with 45 million residents, has one to three million foreign-born residents, many from neighboring countries seeking higher wages. Most South African residents, 80 percent in some polls, want immigration to South Africa stopped, and more done to remove unauthorized foreigners. However, many jobs for professionals are vacant-at least 500,000 in the public sector-and the Immigration Act of 2002 makes it hard for foreign professionals to immigrate, in part because many government bureaucrats believe that employers should train local Blacks for jobs rather than seek immigrants.

White South African professionals continue to emigrate, including 14,000 "officially" in 2003- emigration is probably higher because many professionals say they are leaving temporarily but stay abroad. Web sites have been set up to persuade South African professionals abroad to return.

Nurses. Nurses are leaving the public health systems of African countries that were former British colonies for the British National Health System, where starting pay is $31,000 a year. In May 2004, African countries at the annual assembly of the World Health Organization urged developed nations to compensate them for their lost investment in training nurses, and won a pledge to study ways to reduce the damage from the emigration of nurses.

Since 2001, the NHS has promised not to engage in "aggressive recruitment" of African nurses, but this promise does not apply to private British hospitals, where African nurses often get their first jobs and later apply to the NHS. Since 1998, 12,115 African nurses have registered to work in Britain.

In Malawi, where public sector RNs earn $1,900 a year, almost two-thirds of the nursing jobs in the public health system are vacant because of emigration as well as nurses staying in the country but switching to private hospitals and foreign-financed nonprofit groups. Because of AIDS, many employed people in Malawi support the orphans of relatives, giving them an incentive to emigrate for higher wages. Some fear that, if wages are raised to hire nurses with AIDS donor funds, basic services such as child birth will fall further behind.

South Africa says it has spent $1 billion educating health workers who emigrated- the equivalent of a third of all development aid it received from 1994 to 2000. Public health systems in sub-Saharan Africa should double their nursing work forces, adding at least 620,000 nurses to deal with patients and to spend the money arriving to deal with AIDS and tuberculosis.

Physicians for Human Rights, winner of the Nobel Peace Prize in 1997 for its work to ban land mines, issued a report in July 2004 that called on industrial nations to reimburse African countries for the loss of health professionals educated at African expense and to try harder to meet their own worker shortages by training more people domestically rather than recruiting abroad.

The report emphasized that there is a trade off between the rights of African health professionals to seek a better life and the rights of people in their home countries to decent health care. It did not recommend that African governments try to prevent the emigration of health care workers, but did recommend that industrial countries not recruit actively in Africa.

Other. The governor of Zimbabwe's central bank has been traveling to countries with migrants from Zimbabwe, asking them to remit money via official channels; the exchange rate has been made more realistic.

West African wars producing refugees have ended, but the UN has made little progress disarming former fighters. Most fighters are offered $300 to $700 for each assault weapon they turn in, or more for collectively turning in a larger weapon. There are reports that many fighters buried good weapons and turned in old ones. Bad government, including corruption that uses political power for private wealth creation, make it hard to generate widespread growth.

The Sudanese government was accused of supporting Arab militias who displaced one million Black Sudanese in the Darfur region in Spring 2004; another 100,000 Sudanese fled to Chad. The government said it was acting against rebel movements, not engaged in ethnic cleansing.

Some 13,000 Somali Bantu have come to the US as refugees. A profile of a couple resettled in Tucson, Arizona emphasized that most are successfully integrating. The 500-employee Westin La Paloma Resort and Spa has hired workers who together speak 12 languages, a quarter of them refugees. According to their employer, the newcomers have quickly become valuable service employees.

Americans donate used clothing to charities that sell it to exporters, who bale it and send it to Africa, where it displaces local clothing. South Africa banned used clothing imports in 1999, and other countries are following, including Nigeria, Ethiopia and Eritrea.

Celia W. Dugger, "In Africa, an Exodus of Nurse," New York Times, July 12, 2004. Guest, Robert. The Shackled Continent: Africa's Past, Present and Future. Macmillan.