Money, ben­e­fits, qual­ity of life caus­ing docs, nurses to flee Ja­maica af­ter train­ing

Jamaica Gleaner - - FRONT PAGE - Jerome Reynolds Act­ing As­sis­tant News Edi­tor – Ra­dio

WHEN 23-YEAR-OLD med­i­cal stu­dent Au­jae Dixon grad­u­ates next year, he in­tends to stay and work in Ja­maica for the long haul. He doesn’t ex­pect the same for most of the class of 2017. “A lot of per­sons just plan to be here be­cause they have to com­plete their in­tern­ship,” said Dixon. “As soon as it is over, many try to leave to the United States for fur­ther train­ing. And they usu­ally re­main there.” In fact, gov­ern­ment data sug­gest that in re­cent years, eight in 10 Ja­maican univer­sity grad­u­ates, in­clud­ing doc­tors, leave the coun­try soon af­ter gain­ing their de­grees. Money, and the qual­ity of life it af­fords peo­ple, is a ma­jor driver of this trek – at least that is what the ma­jor­ity be­lieve about most of the health-care pro­fes­sion­als who leave the is­land. In­deed, when the ques­tion – in a Septem­ber sur­vey for The Gleaner – as to why doc­tors, nurses, and other skilled health-care pro­fes­sion­als em­i­grated, 73 per cent said it was about com­pen­sa­tion. But that fig­ure would be sub­stan­tially higher if you add the seven per cent who at­tribute mi­gra­tion to the “bet­ter ben­e­fits” these pro­fes­sion­als re­ceive abroad, and, per­haps, the four per cent who say it is “the su­pe­rior qual­ity of life” they get to lead. Sig­nif­i­cantly, only nine per cent of the re­spon­dents in the sur­vey, con­ducted by poll­ster Bill John­son, at­trib­uted the trek to poor fa­cil­i­ties or the in­ad­e­quacy of the equip­ment with which these pro­fes­sion­als may have to work. These views about the mo­ti­va­tions of health pro­fes­sion­als who leave are con­firmed when the is­sue is posed dif­fer­ently: What would be re­quired to keep health pro­fes­sion­als in Ja­maica? Seventy-one per cent say “pay them bet­ter and on time”, while an­other

seven per cent talk of im­prov­ing their ben­e­fits. Only 10 per cent be­lieve that merely im­prov­ing the con­di­tions un­der which they work would keep spe­cial­ists in Ja­maica.

It is not only that. Like other skilled peo­ple, health-care pro­fes­sion­als hope to get jobs abroad. They are be­ing ac­tively re­cruited. Ac­cord­ing to Janet Coore Farr, the pres­i­dent of the Nurses’ As­so­ci­a­tion of Ja­maica (NAJ), be­tween 150 and 200 nurses leave the pub­lic health-care sys­tem an­nu­ally. Over the past nine months alone, at least 170 nurses, mostly spe­cial­ists, have left – mainly for the United States, Canada, and Bri­tain.

That is a third of the ap­prox­i­mately 500 nurses grad­u­at­ing an­nu­ally from four-year de­gree pro­grammes. They are usu­ally con­sid­ered ripe for for­eign re­cruit­ment af­ter three years of work ex­pe­ri­ence.

“As we speak, nurses are tak­ing the ex­ams to go to the United States,” said Coore Farr.

“They just fly up (to the US), take the exam, they come back down, and they wait on a date to go back up. They also have pro­grammes on­line that they can use to help them to pass the ex­ams.”

Ja­maican Hugh El­lis, 44, a psy­chi­atric nurse, wasn’t re­cruited to any of the big three des­ti­na­tions for Ja­maican health-care pro­fes­sion­als. He went to The Cay­man Is­lands a decade ago.

While El­lis said his main driver wasn’t so much money as the wish for new ex­pe­ri­ences, it was clear that pay was also the back of his mind.

“It’s not that Ja­maicans want to leave, but they just have to sur­vive, and you have to sur­vive be­yond the here and now,” he said. “It is dif­fi­cult to be liv­ing from pay cheque to pay cheque and not be able to ful­fil your ba­sic needs at the end of the month.”


Added El­lis: “I have found it to be bet­ter here. The ben­e­fits are bet­ter, the re­mu­ner­a­tion is bet­ter, bet­ter equip­ment, bet­ter work en­vi­ron­ment and avail­able re­sources to carry out the job. The pub­lic health-care sys­tem here is on the level of pri­vate fa­cil­i­ties in Ja­maica. The stan­dards are much bet­ter.” This ex­o­dus, es­pe­cially from the pub­lic-health sys­tem, is of con­cern to Ja­maican au­thor­i­ties, which, ac­cord­ing to Dr Win­ston De La Haye, the chief med­i­cal of­fi­cer in the is­land’s health min­istry, is among the pri­or­i­ties in the Gov­ern­ment’s 10-year strate­gic plan for im­prov­ing the sec­tor. In the mean­time, there are some hard eco­nomic re­al­i­ties still to be faced by her mem­bers, said the NAJ’s Coore Farr. She noted, for in­stance, that the salary of en­try-level staff in the pub­lic sec­tor is be­low J$1 mil­lion, which, af­ter stu­dent loan pay­ments and re­lated debts, leaves the em­ployee with lit­tle money. Said Coore Farr: “They claim that they can’t pay the nurse like our over­seas coun­ter­parts, but we are not ask­ing them to pay what Amer­ica, Canada, or the UK pays. Ja­maica must move to a point where our nurses re­ceive a live­able wage. We know it won’t hap­pen overnight, but we have to do some­thing about the sit­u­a­tion. We have a re­spon­si­bil­ity to en­sure that we have nurses in Ja­maica.”

Ad­di­tion­ally, she said, the au­thor­i­ties have to ad­dress work­ing con­di­tions to en­hance job sat­is­fac­tion.

Some may cast it as the op­ti­mism of a youth, the can-do, pa­tri­otic spirit that hasn’t yet been jaded by the re­al­i­ties of life as Dixon, the fi­nal-year med­i­cal stu­dent, sees him­self as part of the so­lu­tion.

“The com­pen­sa­tion may not be great, but I’m ready and will­ing to work in the pub­lic sys­tem to help my peo­ple as best as I can,” he said.

“I don’t see run­ning from the prob­lem as the so­lu­tion. I pre­fer to take up the man­tle and ad­vo­cate for a bet­ter sys­tem. I see my­self as some­one who wants to work to im­prove the sys­tem.”

This doesn’t mean that he be­lieves there is no obli­ga­tion on the part of the Gov­ern­ment to do more. He wants them to in­crease the health-care bud­get, but how, in the face of com­pet­ing de­mands, he did not say.


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