Nurses seek greener pastures

Swaziland's nursing crisis is deepening as trained nurses leave the country for better salaries abroad and the Swaziland Nursing Association renews a call for strike action. Last month another 29 Swazi nurses left the country for better paying jobs in the United Kingdom - a third of all nurses who graduate each year. "At issue is respect for the nursing profession, and government needs to work to retain nurses," the secretary general of the nurses' union, Thabsile Dlamini, told IRIN. The union did not indicate when it intended to strike again. Their demands include improved working conditions, provision of adequate medical supplies to enable them to do their jobs, and security - some rural clinics have had to close down because of numerous incidents of nurses being attacked, mugged and raped. "We don't even have rubber gloves in the maternity wards, where HIV prevalence is high. There is a lack of other basic equipment, and nurses have not received AIDS training: how to treat it and how to avoid it," said Dlamini. The nurses walked out on a two-week work stoppage in late February, after government failed to deliver promised salary increments and back pay. The local press attributed 60 deaths to the strike, caused by the lack of nursing staff at government hospitals. "The strike was unnecessary, and it distracted [attention] from the programmes we seek to launch this year on HIV/AIDS, malaria, pre-natal care and other vital initiatives", Dr. John Kunene, principal secretary at the ministry of health and social welfare, told IRIN. Although nurses have received 80 percent of their back pay, a new issue of unpaid overtime is simmering. "Nurse's assistants [and] the orderlies are not paid overtime, so they knock off work before evening - there is no one to help nurses turn patients, or do other physical tasks at night," Dlamini said. Nurses also complain of low morale in the profession. "Health care is seen as women's work, and this may be the problem - women are paid less than men in any field," Dlamini remarked. AIDS has also taken its toll on the profession, reducing the number of nurses by 10 percent, according to health ministry estimates. Swaziland has 3,000 nurses, of which about 100 to 150 leave the profession each year, and the training of new nurses has not kept pace - just 100 new nurses graduate annually from the two main government hospitals in the capital, Mbabane, and the central commercial town of Manzini. "You find that in some clinics there is only one nurse per shift, or one nurse the entire day ... [sometimes there] is no nurse at all at night", Dlamini explained. Health organisations note that if all Swaziland's nurses depart, the government will have to spend more money recruiting replacements from other countries. The authorities have already had to resort to recruiting doctors, many of whom work in the country on contract from other African nations.