Impoverished nurses barred from leaving Zimbabwe, despite shortages of health workers abroad

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By The Globe & Mail

With a salary worth the equivalent of less than $100 a month, Agnes Masarira can’t afford to buy lunch at the hospital in Zimbabwe where she works as a nurse. She dreams of a nursing job in Canada, but she cannot emigrate without key documents that the Zimbabwean authorities refuse to provide.

It’s a story happening all over Zimbabwe. Nurses know there are opportunities in countries like Canada and Britain that suffer from chronic shortages of health workers. Many are desperate to emigrate. Zimbabwe’s authoritarian government, however, makes it almost impossible for most to leave.

“It’s like I’m a slave,” said Ms. Masarira, 28, who works at a government hospital in Masvingo province. “I have no house, no car and not enough to eat, yet I’m considered employed. I live with my brother. I can only afford second-hand clothes. My child has to watch me struggling every day.”

Like other nurses in Zimbabwe, she cannot apply for international jobs without an official copy of her nursing diploma and a verification letter from the government – neither of which is available.

For years she has visited Health Ministry offices to request the documents. Each time she was told that the officials who must sign the documents were unavailable. One official asked for a bribe of US$200 to arrange her diploma, but she could not afford it. “Where do I get that amount when I earn less than that?” she asked.

Canada has been enduring a shortage of nurses for years. British Columbia alone was reported to have more than 5,300 unfilled positions in the nursing sector late last year. Governments have tried to recruit foreign-trained nurses to fill the gap, but countries such as Zimbabwe do not make it easy.

While the Zimbabwean government has never officially explained the restrictions on the documents that nurses need, it is believed to be an attempt to halt the exodus of health workers. More than 4,000 health workers, including about 2,600 nurses, left the country in 2021 and 2022.

Extreme poverty is stalking Zimbabwe, and nurses are seeking a better life

The exodus is a reflection of Zimbabwe’s collapsing economy, largely because of mismanagement by the authoritarian state. Despite government promises to raise the salaries of health workers, their wages remain at poverty level – and Zimbabwe has one of the world’s highest inflation rates.

Instead of boosting wages, the government is using repressive controls to prevent health workers from fighting back or leaving the country. After doctors and nurses went on a week-long strike to seek higher wages last year, the government introduced a law this month to prohibit any labour action of more than three days.

The government also exploits the desperation of the nurses by imposing higher fees for the documents they require. Last year it doubled the application fee for verification letters to US$300 from US$150. This has deterred nurses from emigrating – but in practice the letters have become almost impossible to obtain anyway, even when nurses are able to pay the fee.

“It’s a human-rights abuse against the suffering nurses,” said Setfree Mafukidze, a Zimbabwean nurse who emigrated to Britain in 2020 when the restrictions were not as onerous.

“People are being tied down by the government. It leads to corruption. Some officials are cashing in on bribes from desperate nurses. The danger is that we’re going to have a group of very disgruntled nurses in hospitals and clinics, which is very dangerous for patients.”

Mateline Dube, a 34-year-old nurse at a government hospital in Zimbabwe’s capital Harare, said she would like to work in Canada but cannot afford the US$300 fee for a verification letter. She doesn’t know how to get the other required document, her diploma certificate, from the Health Ministry, and she doesn’t have enough money to pay for a bribe.

With a salary of about $135 a month, she struggles to pay for food and rent. She had to take her child out of school because she could not afford the school fees. At work, unable to afford lunch, she sometimes has to get food from patients.

“I’m just living from hand to mouth,” she told The Globe and Mail.

“Often I have to walk to work, about four kilometres, because I don’t have money for transport. Sometimes, with my nursing uniform on, I have to beg for transport from motorists, but that’s dehumanizing and embarrassing for me. That’s why I want to leave this country.”

Nelisiwe Sibanda, a 36-year-old nurse in a government hospital in Harare, paid US$300 for a verification letter last year but never received the letter. One official told her that she would never get the documents. Her salary is only about $160 a month and she struggles to pay for food, rent and bus fare.

“I’ve become a burden to my friends and relatives, since I’m asking them for financial help every month,” she said.

“I’m tired of this now. I went into a shop to buy a packet of cereal porridge and it cost US$3. I can’t afford that. I’m very angry at the authorities for blocking my dream to leave this country.”