Staffing shortages are slowing Rwanda’s Health Care progress!

According to the government of Rwanda, it is home to more than 12 million people, and just like most African countries, Rwanda struggles to give proper access to most of its people. According to a World Health Organization report, two-third of all deaths in Rwanda are preventable ones so what is causing this? It is definitely not because the Rwandan Government doesn’t put in enough effort to see the healthcare system improve for its people. The budget for Rwanda’s healthcare system in 2018/19 was a reported 200.8 billion Rwandan francs which was an increase from the previous year. The country has 499 health centers across the country and if you compare it to South Africa’s 400 public hospitals and 200 private ones it’s pretty low but let’s keep in mind that Rwanda’s economy is still very young. Rwanda has been a country on the up since the devastating genocide of 1994 with a GDP growth rate of 7.18% from 2000 until 2020 yet it has two-third of all deaths in the country being preventable ones and the main reason for this in my personal opinion is brain drain. 

Country’s lack of doctors

According to the Rwanda Medical and Dental Council data, Rwanda has 1,176 general practitioners and 495 specialists and if you put into consideration the population of the country which is roughly 12 million people, there’s an average of one doctor per 12,000 people. These are honestly scary figures for a person who lives in Rwanda and at some point will have to use their healthcare system, what is more, infuriating is that one can not put blame on the people in charge because they are doing the most. Canada alone has 91,375 physicians and if one considers the population of the country there are an average of 241 physicians per 100,000 population. I believe that the reason there is a lack of doctors in the country comes down to two reasons why, either the majority of the population simply isn’t interested in the field of medicine or the amount of brain drain happening in Rwanda’s healthcare system is beyond what people assumed it was. An estimated two billion dollars is lost annually in Africa’s healthcare system alone so one would wonder how much is Rwanda losing? Well, the numbers stand at 36 million dollars. The country on average every year loses thirty-six million dollars which for any developed country doesn’t sound like much but for a developing country like Rwanda, it could make a significant difference as to how much growth happens in the country.  

Effects of brain drain 

Canada's Brain Drain: Figures Show Technology Graduate Exodus - Canada Immigration and Visa Information. Canadian Immigration Services and Free Online Evaluation.

Generally in any sector when there is a lack of staff it creates disgruntled employees who are overworked and tired but the healthcare sector is different let me explain. One of the most demanding jobs in the world is being a doctor because come on they literally have our lives in their hands so it makes all the sense in the world as to why in developed countries doctors are among the best-paid professions in the world but this is different in developing countries particularly in African countries. Just like the country, Rwanda’s healthcare system is still growing so naturally, a doctor in Rwanda doesn’t even get half of what a doctor in Canada makes and they do the same job and in some cases have the same level of education. Nobody wants to live a low quality of life so the next best thing for a doctor is to start seeking a better quality of life and this usually means going abroad and this ladies and gentlemen is brain drain so what are the effects you ask? The biggest effect brain drain has is it limits a developing country’s ability to well develop. Think about it this way, would FC Real Madrid have won the UEFA Champions League three times in a row if Manchester United kept buying all their best players? This is exactly what happens with brain drain. Another major effect brain drain in the health sector has is customer satisfaction declines sharply. Think about it, brain drain leads to staffing shortages which in turn causes overtired employees, disgruntled employees, unhappy employees, and when you add on the fact that they are also underpaid it’s not exactly a formula for great customer service.

Before and while I was writing this I kept asking myself what it takes for a country to genuinely have a stable healthcare system that not only addresses the issue of poor quality service but also looks at customer satisfaction and I have come to the conclusion that this can only be achieved if countries especially those in Africa start holding themselves to their own standards, just think about it, if you grew up with siblings did you ever like being compared to the “good” sibling and how far did this comparison help you in advancing yourself? From my experience it demotivated me. In general most people I have met and interacted with have not taken being compared to others all to well because what people fail to see when they compare others is that you are as Albert Einstein once said “judging a fish by its ability to fly.” This I believe is what is slowing down the progress of the healthcare system, well this and brain drain of course.I know that there are people out there reading this and saying “oohh Kennedy you do know corruption exists right?” or arguing that brain drain does seem all that significant compared to “purging” issues such as corrupt leaders simply not caring enough about the people they are there to look after and caring more about their wants but I put this argument to you what is a healthcare system that has no qualified physicians? A nation can have all the equipment and facilities for their healthcare system through both perhaps private and public funds but what does it all mean if there aren’t any qualified people put to use any of the equipment or make proper usage of the facilities. 

Conclusion

I often enough go visit my grandmother and while I’m there I gain not just weight but insights as to how far behind the healthcare system in Rwanda really is through stories of people from rural areas where the healthcare system lacks not just the right facilities but also the lack of qualified physicians in rural areas, surely rural areas should have a say in how far along a country is developing right? While being at my grandmother’s she once told me a story of how the local area hospital is so drained of qualified physicians that often enough when more than one mother goes into labor the hospital has to call on one of the cleaners who’s been working at the hospital for more than twelve years to come to help them in delivering the babies and to the defense of the cleaner she has never lost the life of any baby and in fact, most mothers who are about to go into labor ask for her to be the one who delivers their child so I guess being able to deliver babies is a talent one can be born with. As I conclude, I’ll say this, I’ve gone to spoke about brain drain and its effects but I’ve also tried to go to great lengths to give you real-life examples that can help you relate to the topic of brain drain, in fact, I think you guys now know more about how the comparison to my siblings has affected me and that my grandmother is a great cook than you do about brain drain is the direct cause to staffing shortages in Rwanda’s healthcare system. However, of the potential solutions given to address the problem of brain drain the best and most feasible solution for me definitely has to be improving the quality of life and this directly means increasing the salaries of people in the healthcare sector such as nurses, doctors, and neurosurgeons. This may also mean giving them some of the benefits such as paid time off, that they are given when they move to these developed countries such as the USA and UK. I urge people especially governments, to take the issue of brain drain seriously because it is a bane to not just Rwanda’s health care progress but Africa’s as well. 

References:

Jean, N., 2019. Kigali (City, Rwanda) – Population Statistics, Charts, Map And Location. [online] Citypopulation.de. Available at: <https://www.citypopulation.de/en/rwanda/admin/1__kigali/

Greene, T., 2015. [online] Apps.who.int. Available at: <https://apps.who.int/iris/bitstream/handle/10665/136986/ccsbrief_rwa_en.pdf;jsessionid=8AE6240F5F08C2CA7BB98BA303B7BA51?sequence=1

Gomez, R., 2018. [online] Unicef.org. Available at: <https://www.unicef.org/rwanda/media/1181/file/Health-Budget-Brief-2018-2019.pdf 

Solenko, S., 2017. [online] Who.int. Available at: <https://www.who.int/alliance-hpsr/projects/AHPSR-PRIMASYS-Rwanda-Abridged.pdf?ua=1 

Andile, J., 2016. [online] Who.int. Available at: <https://www.who.int/workforcealliance/031616south_africa_case_studiesweb.pdf

Davids, R., 2017. Rwanda GDP Annual Growth Rate | 2000-2020 Data | 2021-2022 Forecast | Calendar. [online] Tradingeconomics.com. Available at: <https://tradingeconomics.com/rwanda/gdp-growth-annual#:~:text=GDP%20Annual%20Growth%20Rate%20in,the%20second%20quarter%20of%202020. 

Ndegeya, C., 2018. Rwanda In Need Of More Doctors. [online] The East African. Available at: <https://www.theeastafrican.co.ke/tea/rwanda-today/news/rwanda-in-need-of-more-doctors-1354774#:~:text=According%20to%20the%20Rwanda%20Medical,one%20doctor%20per%2012%2C000%20people