Resisting the African ‘brain drain’ that has created a health care crisis
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Resisting the African ‘brain drain’ that has created a health care crisis


JUDY WOODRUFF: But first: Across the continent
of Africa, a brain drain sends many of its highest-skilled professionals abroad. But as Fred de Sam Lazaro reports from Uganda,
one organization is trying to build a pipeline to keep medical professionals working in their
native country. It’s part of Fred’s series Agents for Change. FRED DE SAM LAZARO: This class of 30 soon-to-be
nurse midwives are training in Lira in Northern Uganda, a new university set up to address
this country’s severe shortage of trained medical professionals. Key members of the faculty are American volunteers
with a program called Seed Global Health. Over the past five years, it has sent 184
medical professionals to five African countries, training nearly 14,000 students. Emergency room physician Vanessa Kerry founded
the nonprofit. DR. VANESSA KERRY, CEO, Seed Global Health: If
you look at sub-Saharan Africa, it has 24 percent of the world’s global burden of disease,
and only 3 percent of the world health care work force with which to address that disease. That’s a huge disparity. FRED DE SAM LAZARO: Kerry, who is the daughter
of former Secretary of State John Kerry, first became interested in global health as a teenager,
when her father, then a senator, took her to Vietnam. DR. VANESSA KERRY: That trip was game-changing
for me, I mean, just the absence of resources, no electricity, no running water, no shoes
on kids. FRED DE SAM LAZARO: In 2012, some two decades
later, with degrees in medicine and public health, she founded Seed in partnership with
the Peace Corps, sending U.S. doctors, nurses and midwives for one-year stints in rural
Africa. Midwife Linda Jacobson from Olympia, Washington,
served a year in Tanzania and is now Uganda conducting specialized seminars. LINDA JACOBSON, Midwife: There’s incredible
satisfaction about making what would be a small difference in the United States is a
huge — can make a huge difference in the lives of women and babies in these settings. FRED DE SAM LAZARO: The curriculum, the first
to offer bachelor’s degrees, is meant to radically upgrade the way nursing is perceived and practiced
in Uganda to revive a profession that currently gets little respect and resources, with predictable
results, says Okaka Dokotum, deputy vice chancellor of Lira University. OKAKA DOKOTUM, Lira University: You have mothers
who die in childbirth because of neglect or nurses were late. There is lack of kindness. And I see that — a lack of professionalism. It’s an ethical issue. And over and over, we talk to our students
and say, we want you to do something different. Third-year student Patience Nafulla says the
clinical experience has already given her a fulfilling experience, recalling one new
mother’s deep gratitude after a difficult delivery. PATIENCE NAFULLA, Student Midwife: I talked
her through it. When I came back the following day, she knelt
down for me. She knelt. FRED DE SAM LAZARO: She knelt down before
you. PATIENCE NAFULLA: That really touched me. And I knew from that moment I can make a difference. FRED DE SAM LAZARO: The emerging crop of nurses
and midwives have been trained under conditions that would be considered normal in the West
or in private clinics here, things like access to clean water, stable electricity, adequate
supplies. The problem is, these basics are far from
guaranteed in much of the workplace they’re going into, especially in rural areas. Lira University’s Dokotum does worry that
Uganda’s public health system is not yet fully equipped to absorb the new highly skilled
graduates. OKAKA DOKOTUM: It’s like having a Ferrari
and then just going at 20 kilometers per hour, you know? So it’s going to take changing policy. We will have to try to influence policy to
make sure that room is created for this new coterie of nurses and midwives. FRED DE SAM LAZARO: Geoffrey Odong would certainly
like to see that policy change. The recent graduate from the Seed program
is interning at a public hospital and says he often feels resented for his higher-level
skills. He’s allowed mostly to just observe, he complains. GEOFFREY ODONG, Midwife: What we’re trained
on, we are not being allowed to practice. FRED DE SAM LAZARO: So you could be doing
much more than you are doing? GEOFFREY ODONG: Absolutely. FRED DE SAM LAZARO: For its part, the Seed
Global Health program faces a threat of its own. The Peace Corps recently announced it would
exit starting this fall, citing a change in its approach to such partnerships. The Corps declined our request for an interview. DR. VANESSA KERRY: I’m really, really proud of
what we have done. And I am frustrated. FRED DE SAM LAZARO: Dr. Kerry blames the Peace
Corps decision politics and says the resulting cutbacks will force a significant scaling
back from five countries to two, including Uganda, and far fewer American medical volunteers. DR. VANESSA KERRY: There’s been I think, a real
concern, around global health funding, a worry that global health funding is going to be
at risk. FRED DE SAM LAZARO: As she and colleagues
regroup and seek other funding, Uganda’ health care system must contend with a different
kind of threat: poaching. Well-trained nurses are in high demand in
the West, Middle East, Gulf states and elsewhere in Africa, where salaries and working conditions
are far better than in Uganda. As university officials and advocates work
to improve conditions here, students, such as Patience Nafulla, face a fraught personal
dilemma. PATIENCE NAFULLA: I prefer being here. If we have everyone go out, who will then
stay to help our country? The temptation is there. There is better pay. The resources are there. Why not go? Why stay? So, that’s the challenge. FRED DE SAM LAZARO: The challenge for Uganda
will be to improve its health care system and coax students like these to stay and work
here, particularly in rural areas. It’s estimated that one of every four midwife
positions in the public health system is unfilled. For the “PBS NewsHour,” I’m Fred de Sam Lazaro
in Lira, Uganda. JUDY WOODRUFF: Fred’s reporting is a partnership
with the Under-Told Stories Project at the University of St. Thomas in Minnesota.

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