In Nairobi, Kenya, a very small, very basic house costs 3,500 shillings a month (?25) - almost three-quarters of a nurses salary and beyond the means of nurses with families to feed. But many complain not about the poor standard of housing, but about the fact that around a quarter of qualified Kenyan nurses have no permanent nursing jobs in a country with a health system in crisis.



Those that have found work are often overworked and staff are leaving in droves, tempted by better conditions abroad, and they are not being replaced. There is a large reservoir of unemployed nurses throughout most African countries but many governments claims that are forced to introduce recruitment freezes due to the conditions of the IMF/World Bank aid packages designed to force African countries to slim their bloated civil services.

Many health professionals have scrimped to find the money to qualify but then struggle to find work once qualifying. Now, like thousands of others, they are saving to leave for the UK and USA. The African government often promises that they will increase spending on healthcare but many never do.

The migration of doctors and nurses from Africa to rich countries has raised fears of an African medical brain drain as disgruntled doctors and nurses scatter all over the world in search of better-paid and secure jobs. According to health ministry statistics in Zimbabwe, fewer than one in four posts for doctors is filled. Four out of five of the district hospitals that serve rural areas have no doctors. But empirical research on the issue has been hampered by lack of data. How many doctors and nurses have left Africa? Which countries did they leave? Where have they settled?

Not only are African governments, the IMF and World Bank making it difficult for them to find jobs but recently new rules designed to safeguard jobs for British trainee nurses have been introduced which could mean that thousands of foreign nurses already employed in the UK are forced out of work.

Recent studies in the UK say that as many as 80 per cent of nursing graduates are unable to find work in the UK, the Government has removed nursing from its list of professions that bypass immigration rules in August 2006.

This means that overseas nurses will be given a job only if no suitable applicants come forward from Britain or Europe. But the change also applies to existing nurses from overseas once they reach the end of their contracts.

Overseas nurses have become the backbone of the health services in recent years, with 45 per cent of new nurses registered in Britain coming from abroad.