In May last year, local nurses met at a two-day summit where they sought to evaluate themselves and the profession generally and look at strategies to improve the sector – not the health sector, but their particular area. The summit, organized by the Nursing Department of the Ministry of Health in collaboration with the Guyana Nurses Association, coincided with the observance of International Nurses Day and may have been one of those events that are put on ‘to mark the occasion.’ However, it did much more than that.
Nurses spoke of the dedication and hard work required by anyone who chooses to be a professional nurse and addressed the myriad shortcomings that were highly visible as well as the other less discernable ones. Anyone paying attention would have learned that the hardships Guyanese nurses face are prevalent throughout all stages of their careers. The nurses disclosed that there was an inadequate number of tutors and those that were available lacked motivation, quite possibly because they are required to work in tiny, poorly ventilated classrooms. Conditions at hospitals, particularly the public ones, are in some instances adequate and in others barely tolerable. And this does not only refer to physical conditions, which are bad enough, but the long hours, lack of support and supervision and the major concern – poor remuneration and benefits. The underlying theme in all this of course is that faced with these obstacles, nurses migrate. It is easy for them to do this because many of the ‘greener pastures’ offer much more in terms of remuneration and better working conditions, and these developed countries have, over the last two decades, seen a massive reduction in the number of people opting to make nursing a career. And because the sector is not only labour intensive, but requires a special skill, they fill the gaps by looking outward; seeking international labour to do so.
The summit in May 2009 was not the first time the issue was raised; it has been expounded on ad nauseam for as long as nurses have been leaving – more than 20 years ago. It appears that no one is listening. On Monday, the Ministry of Health unveiled a study commissioned by PAHO and conducted by Jamaican Human Resource Development (HRD) consultant Una Reid, which said basically the same things.
Some 200 nurses, out of an estimated population of 490 in Guyana, were polled and they gave as the top reasons for nurses’ migration, poor work environment, lack of professional recognition, difficult conditions of work which relate to the workload and the degree of stress nurses work under, the equipment and supplies they have to use and orientation and in-service education.
Unsurprisingly, some of Reid’s recommendations match what nurses have been asking for all along and these include improved working conditions, salaries commensurate with education and experience and incentives – none of which are impossible; none of which have been adequately addressed over the last 20 years.
The migration of nurses and other health professionals is not just a Guyana problem; it is one that plagues the entire region as well as other developing countries farther afield, and it is expensive. Minister of Health Dr Leslie Ramsammy said on Monday that some $600M is spent on nurses’ education annually and about half of that is lost in migration for the same period. In December last year, the Barbados Nation quoted that country’s Chief Nursing Officer Mitchell Clarke as saying that Caricom countries “have estimated losses of US$16 million in training and retraining costs to replace the human capital lost to emigration in order to address this worldwide shortage of nurses…”
However, a pertinent underlying point is the fact that nurses/health professionals who have migrated contribute massively to the huge annual remittances which developing countries have increasingly become dependent upon. Perhaps this is where a study is needed. One might find that it is in fact a quid pro quo, and this would explain the decades of dancing around this issue.
