By Henry Kyambalesa
I wish to comment on the statement made in Parliament recently by Health Minister Kapembwa Simbao about the extension of a Medical Retention Scheme to nurses and paramedics—a scheme which currently provides medical doctors with such incentives as further training outside the country, new vehicles and school fees for their children.
This is a progressive idea for a country that has been losing significant numbers of locally trained health personnel through the brain drain.
However, the Medical Retention Scheme may not be adequate to curb the exodus of health personnel. The provision for new vehicles, for example, is really not an incentive to individuals who are keen on securing jobs in developed countries where their services would fetch adequate salaries and allowances which would make it possible for them to buy vehicles on their own. And formal education (from Grade 1 through Grade 12) in such countries is generally free!
The Scheme, however, is likely to give incentive to those who wish to emigrate to other developing countries in search of higher incomes, a better standard of living and/or a less-hostile environment, among a host of other reasons.
It is essential for the authorities to discern the causes of the brain drain in order to devise viable ways and means of curbing the phenomenon. There are currently many factors obtaining in Zambia which have contributed to the exodus of skilled talent. One of such factors relates to poor conditions of service, including inadequate wages, salaries and fringe benefits. The second factor pertains to human rights abuses and violations, including the violation of individuals’ freedom of speech, and the repudiation of freedom of the press.[quote]
Third, many technical and professional personnel have decided to “vote with their feet” upon finding that the rewards of their labor in Zambia are generally measured on the basis of political patronage rather than excellence, and that corruption, nepotism, tribalism, and other similar forms of behavior have permeated every level of work life, particularly in the civil service.
Fourthly, the common tendency among local and national leaders to scout for expatriate scientists, technologists and consultants from industrialized nations has made indigenous experts to feel disregarded, and has made many of them to migrate to countries where their qualifications are appreciated.
Fifth, the high interest rates, income taxes and value-added taxes in the country have, among other factors, adversely affected investment in new enterprises, and have consequently hampered the creation of jobs for streams of graduates from local schools, colleges and universities. And the government cannot absorb many locally trained citizens due to the lack of financial resources. In 2004, for example, about 9,000 trained teachers were roaming the streets as they anxiously awaited their postings to schools. In 2005, around 1,000 out of 7,000 needed teachers were employed through financial assistance rendered by the Netherlands.
Sixth, access to life-saving healthcare in Zambia today is seriously hampered by inadequate, dilapidated and antiquated healthcare facilities, among other things. In November 2005, for example, Ms. Inonge Wina secured “ox-cart ambulances” for the country’s Nalolo constituency during her tenure of office as MP for the constituency in order to curb maternity-related deaths occasioned by delays in the transportation of expecting mothers to healthcare centers. And, of course, we still remember First Lady Thandiwe Banda’s call in November 2009 for developing innovative transportation schemes like “bicycle ambulances” to help women reach health facilities from distant places!
And seventh, unprecedented and widespread poverty and unemployment in the country have made burglars, thieves and robbers more daring, thereby contributing to the emigration of skilled to safer countries. Besides, Zambian migrants who are resident in affluent countries, where there is generally greater safety and security, are fearful of becoming obvious targets of perpetrators of such crimes upon returning to their countries of origin.
Clearly, there is a need for policy initiatives designed to address the brain-drain problem because, without large pools of skilled professionals to facilitate and expedite the process of socio-economic development, Zambia will not likely attain meaningful levels of growth, development and competitiveness. Such initiatives could include the following:
(a) Tax proposals requiring native professionals trained through the public treasury to pay a certain percentage of their incomes earned abroad to the Zambian government;
(b) Generation of restrictive policies aimed at delaying emigration – such as by adding extra years to medical students’ training, requiring doctors and other professionals to stay on for a number of years to ‘pay back’ what they ‘owe’ to society, or to incorporate the delay within the training period, thus ensuring that certification follows rather than precedes a spell of public service;
(c) Taxation of the earnings of emigrants by the Zambian government, although this would depend largely on emigrants’ continued citizenship in their native country, Zambia;
(e) Initiation of international agreements requiring employers in foreign countries who may hire professionals trained through public resources to reimburse the Zambian government for financial and material resources committed to the training of the professionals; and
(f) Provision for attractive retention allowances, research grants for academic staff, car-ownership and home-ownership schemes, and adequate upward salary adjustments.
In this regard, Zambia will need new leaders with a desire to pursue radical, practical and comprehensive change designed to uplift our beloved country from the current socio-economic decay and backwardness. Superficial schemes like the Medical Retention Scheme are not likely to help the country in its quest to stem the exodus of technical and professional personnel. Only the creation of socio-economic conditions that will lead to a higher quality of life for all citizens will, by and large, mitigate the exodus of the country’s skilled personnel.
