“Stronger together”

We recently held our regular M&M meeting; always a good platform to generate robust discussion around how we can improve our clinical practice and bolster our overall service delivery. At the end of the meeting, one of the senior nursing personnel came up to our HOD, Rob Snyders to discuss the tireless waves of frustration directed at upstream stakeholders who have not procured more staff and required equipment etc. At this point the nursing manager declared that he was fed up and was seriously considering moving abroad. I smiled to myself hearing our HOD exuberantly declare to the senior nursing manager: “Don’t leave, let’s all be fed up together!”.

Many of us know of colleagues leaving the country, a nurse going to Canada, a surgeon off to Australia etc etc. Every so often, we have become accustomed to hosting farewell parties as yet more friends, family and good colleagues leave and, in their midst, sometimes leave us with thoughts, on whether we too should consider new expansive territories of growth. For several multifactorial reasons we elect to stay and plod through. ?When Mr Snyders exuberantly made the remark referred to earlier, I saw in him the ever-optimistic leader, always resonating with hope and courage; finding solutions to oft what seems like impermeable challenges. During that particular M&M our HOD Rob Snyders a white Afrikaner male donned his rugby meeting along with a traditional zulu amqhele (a traditional headband made of fur). His attire represented a celebration of the fusion of national cultural identity and a deep sense of belonging to the soil of this land. His heartful plea to the senior nursing personnel not to leave and consider that collectively we can all lament or celebrate together planted some seeds of reflection in me. Here before me, stood a public healthcare service delivery leader who at any time could leave the flawed public healthcare service realm for the private domain, yet chooses to stay and daily exerts himself in generating positive outcomes despite all the perceived setbacks.

Whilst I respect the many reasons why so many colleagues end up leaving, the brain drain phenomenon affecting South Africa continues to be a subject of concern for several years, as the country witnesses a significant exodus of skilled professionals and experts seeking better opportunities abroad. This ongoing trend has had profound implications for the nation's economy, healthcare system, educational sector, and overall development.

One of the most noticeable consequences of the brain drain is the loss of highly trained and experienced professionals in key fields such as medicine, engineering, information technology, and education. South Africa has produced a substantial number of talented individuals who, due to a variety of factors, have chosen to leave their homeland in pursuit of better lifestyle prospects elsewhere. One major factor driving this phenomenon is economic opportunity. Many South African professionals feel compelled to seek better-paying jobs and career advancement in countries with stronger economies, such as the United States, Canada, the United Kingdom, and Australia. The allure of higher salaries, improved working conditions, and access to state-of-the-art research and technology infrastructure often proves irresistible. Another factor contributing to the brain drain is political instability and concerns about safety and security. South Africa has grappled with issues such as corruption and incremental crime rates which have prompted some professionals to seek stability and security in foreign nations. The consequences of the brain drain are multifaceted:

Skills Shortages: The departure of skilled professionals has led to a paucity in critical sectors of the economy and public services. This has hampered the country's ability to deliver essential services, such as healthcare and education, effectively.

Reduced Innovation: The loss of innovative and creative minds can stifle technological advancements and economic growth. South Africa's ability to compete globally and innovate within various industries is compromised.

Healthcare Crisis: The healthcare sector has been particularly hard-hit. The departure of doctors, nurses, and healthcare specialists has strained an already overburdened healthcare system, affecting the quality and accessibility of healthcare services for the local population.

Education Challenges: The educational sector has suffered from a shortage of qualified teachers and academics. This impacts the quality of education and hampers efforts to address educational inequalities in the country.

Economic Impact: The loss of skilled professionals contributes to a decreased tax base, which can hinder government revenue generation. Additionally, it reduces the potential for job creation and economic growth.

Addressing the brain drain in South Africa is a complex challenge that requires a multi-levelled non-linear approach. These few words of reflection do not quite capture the myriad different perspectives which can be unpacked and analysed. However, a few suggestions include creating a more conducive environment for professionals to remain in the country, offering competitive salaries and benefits, improving the overall safety and security situation, and implementing policies to retain and attract skilled individuals. Furthermore, efforts should be made to tap into the South African diaspora and encourage skilled professionals living abroad to contribute to the development of their home country. In doing so, South Africa can begin to reverse the brain drain and harness the potential of its talented workforce for the betterment of its society and economy. At the end of the day, it is a complex decision mired with many variables and remains a personal choice. In the meantime, here we are collectively as a country rooting for the Amabokoboko, “Stronger Together” this weekend. “We have a lot of problems in our country, but when our team comes together, it shows we can pull together to achieve something” -Siya Kolisi.

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