Critical South African nursing officials discuss impact of health care shortage on continent’s AIDS crisis

Photo by Caroline Sheen

South African nursing officials discuss the AIDS epidemic and shortage of nurses in their country with students and faculty at a School of Nursing brown bag luncheon Feb. 27.

By Katherine Thompson Jackson

Leaning forward, the leader of a South African delegation visiting U.Va. whispered to student Meriwether Anderson.

“Do you want to come to South Africa?”

“Yes, I lived there three months, and I want to return to pursue a career in international health care,” said the fourth-year student.

Anderson is just what the nurses ordered.

Six South African officials visited U.Va.’s School of Nursing last month to observe and exchange ideas about management techniques, including how to effectively recruit nurses to help deal with the AIDS crisis.

Arriving to see their first snowstorm, the one-man, five-women nursing team from the sweltering province of Limpopo discussed the challenges facing their country’s health-care system at a brown bag lunch hosted by the nursing school.

Anderson, along with other students and nursing faculty, heard disturbing descriptions of the impact of South Africa’s nursing shortage. The visitors described the extreme shortage of health-care workers and supplies and how that impacts caring for people with AIDS and other patients. A majority of the 25.3 million Africans infected with AIDS won’t get the best available treatment, and as a result many will die, they said.

Bennette Mabuda, manager of nursing services at Tshiwozini Hospital, detailed the urgent need for implementing retention efforts. “We are experiencing a ‘brain drain.’ South African doctors and nurses are leaving in large numbers to practice in richer countries. Professionals are leaving because of working conditions and low pay.”

One South African official reported losing almost half the nurses in her hospital because of financial problems. The exodus of experienced nurses has made an already desperate situation more difficult. Because doctors are scarce, nurses have become more experienced at treating and diagnosing patients, and a residual benefit has been highly experienced nurses. This high level of training is why South African nurses are in great demand, and the cream of the crop are first to go, the team reported.

“These nurses are familiar with critical issues such as providing medical care that is outside the scope of nursing and dealing with the ethical dilemmas that exist if they withheld those treatments,” said Dr. Tina Brashers, associate professor of nursing at U.Va. Brashers helped coordinate the team’s visit.

Through connections with U.Va.’s Southern Africa/Virginia Networks and Associations (SAVANA) consortium and Center for Regional Environmental Studies, the team was eager to exchange ideas with Virginia professionals. As part of the continuing development of the consortium, the visit was a positive exchange of experiences and expertise in nursing education, training, management and retention issues, said Bob Swap, a U.Va. environmental scientist involved in the SAVANA project.

“Southern Africa is an extremely important region for collaborations,” said Jeffrey Plank, assistant vice president for research. “We want to establish infrastructures that will help southern Africa build its fate through good decisions and policy making.”