Cameroon or Canada? Poorly Paid Doctors and Nurses are Choosing to Leave. That’s Common in Africa

BY MARK BANCHEREAU

12:02 AM EDT, June 11, 2024

DAKAR, Senegal (AP) — After training as a nurse, Nevielle Leinyuy spent almost a decade in Cameroon working as a front desk receptionist because he was unable to find a decent paying job in the medical field. Last year, he gave up looking. He applied for a nursing program in Canada, where he now lives with his wife and children.

“They are stealing us from Cameroon,” the 39-year-old Leinyuy said. “We want to work in Cameroon but there is no pay, so we have to look for other options.”

Cameroon has one of the world’s lowest ratios of health workers per capita. About a third of trained doctors who graduated from medical school last year left the country, the minister of higher education, Jacques Fame Ndongo, has said.

Many doctors and nurses are leaving the West African nation for more lucrative jobs in Europe and North America. Canada, like Cameroon, has official languages of English and French.

Leinyuy said he would have earned 60,000 CFA francs, or less than $100 a month, working as a nurse in Cameroon.

“Just imagine what a family of a father with three kids and a wife would do with that,” he said. “The rent of my house alone was 40,000 francs ($66).”

Cameroon is not the only sub-Saharan African country where low salaries are driving health workers to leave.

While the number of health workers increased after the COVID pandemic in several countries, almost 75% of African nations still experience medical staff shortages and high rates of healthcare professionals leaving to work abroad, according to a 2023 report from the World Health Organization.

The lack of health workers makes it increasingly difficult to tackle infant mortality and infectious diseases and provide essential services like vaccinations, the WHO regional director for Africa, Matshidiso Moeti, has said.

Cameroon has fewer than seven nurses per 10,000 inhabitants, according to the latest WHO data. Neighboring Nigeria has more than double that ratio, and Canada has more than 14-fold.

Marie-Pier Burelle, a spokesperson for Health Canada, told The Associated Press that Canada is facing its own health workforce shortages. Over 30,000 nursing positions in the country are vacant, according to Statistics Canada.

Burelle said Canada follows the WHO’s code of practice to ensure that its recruitment of workers internationally is ethical. Ethical recruitment includes strengthening the health systems of developing countries dealing with medical personnel shortages, according to the WHO’s code of practice.

Late last year, the Canadian government donated around $2.2 million to Cameroon’s health ministry and delivered medical and monitoring equipment as part of Canada’s Global Initiative for Vaccine Equity.

But such investment falls far short of needs.

Cameroon’s government employs around 100 doctors each year, for a population of around 28 million people, said Dr. Peter Louis Ndifor, the vice president of the Cameroon Medical Council, a doctors association. He said the numbers are even lower in the private sector.

By comparison, the Canadian province of Nova Scotia, with a population of under a million people, recruited around 155 doctors last year, according to provincial health authorities.

As the director of a private medical clinic, Ndifor said he experienced the problem of health workers leaving Cameroon firsthand.

“Personally, I will not hold back any young person who thinks that their future is traveling abroad,” Ndifor said. “But when a young doctor that you’ve supervised for three to five years and given responsibility to leaves, it becomes a major setback.”

The shortage of health workers is just part of Cameroon’s current health crisis.

More than 210 health facilities are no longer functional because of destruction or abandonment by health personnel during a separatist conflict in the country’s west, according to the United Nations. The conflict has killed thousands of people over the past several years.

Cameroon’s health ministry did not respond to questions about the high number of health workers leaving the country.

Tumenta Kennedy, a Cameroon-based migration consultant, said Canada has become an attractive destination because Canadian agencies specifically target local doctors and nurses. Family ties overseas also play a role.

Canadian government immigration programs like the Federal Skilled Worker Program or Express Entry are increasingly active. Cameroonians are among the top nationalities applying for Express Entry, according to the program’s latest report.

Overall in 2022, more than 1,800 new permanent residents came to Canada to work as registered nurses from other nations.

Inès Kingue, 30, a medical lab technician from Douala, is hoping to join them. Despite holding two masters degrees in virology and microbiology, she has been working as an intern without a contract for the past four years, earning less than $200 a month. She heard about training opportunities in Canada from a colleague.

“When Canada opened its doors, I put all my focus into trying to go there,” Kingue said.