In the week that it was announced that approximately 35 doctors and 245 nurses per day for a year would be taken away from front line health services so they can perform pointless circumcisions on men, comes news that Swaziland’s health service is in such a state that community leaders are being given basic medical training because there are not enough doctors or nurses available.
Doctors Without Borders said that nurses are taking on doctors’ roles and community leaders are receiving rudimentary medical training.
The group said a ‘dire shortage’ of health professionals prompted them to implement a plan using lesser-trained workers to treat people with HIV and AIDS.
Community workers are performing HIV tests and providing counselling in 21 health facilities in the Shiselweni region, the kingdom’s poorest and most remote region with the highest number of HIV cases.
The medical group, which is also known by its French acronym MSF, said vacancies in the health field are dire. In a report released on Wednesday (17 November 2010), they cited statistics from 2004 in which they said 44 percent of posts for doctors, 19 percent of posts for nurses and 17 per cent of nursing assistant posts were unfilled.
MSF said life expectancy in Swaziland has dropped from 60 to 31 in the past 20 years because of AIDS.
MSF reported that of the approximately 170 nurses and midwives who graduate each year, a large proportion emigrate. Staff attrition to HIV is high – at around 4% each year.
‘Currently, the Swazi health system is benefiting from an influx of skilled Zimbabwean healthcare workers. However, if the Zimbabwean economy recovers, many of these workers may repatriate. The staffing crisis is further exacerbated by absences from work due to training courses, holidays or sick leave – there is often only one nurse on duty for a catchment population of between 7,000 and 16,000.
‘In rural areas, in particular, the lack of accommodation for health workers makes recruitment and retention of staff very difficult,’ the report said.