Over 3 000 nurses ‘dumped’

Growing up  a few metres from Zingwangwa Health Centre in Blantyre, Tabia Mkorongo, 27, drew inspiration from an unknown nurse she kept seeing treating patients with utmost attention and love.

That was more than a decade ago when she was in senior primary education. She went on harbouring the desire to become like the unnamed Zingwangwa Health Centre nurse.

However, her urge faltered in 2017 after she graduated and later obtained a nursing licence from the Nurses and Midwives Council of Malawi (NMCM), the regulatory body of nursing and midwifery education and practice.

Mkorongo is among over 3 000 nurses and midwives across the country who graduated from the 16 different private and public nursing colleges and possess the requisite qualifications, but are jobless.

These, according to the Concerned Unemployed Nurses and Midwives (Cunm), graduated between 2015 and 2019 before obtaining their practising licences.

“Our current statistics show that there are 3 012 qualified and licensed nurses and midwives not yet employed,” Cunm chairperson Donald Zgambo said in an interview.

Zgambo said the numbers of unemployed nurses and midwives continue swelling as more students graduate.

Said Zgambo: “Instead, it   [government] is exploiting these people by placing them on internships as opposed to recruiting them permanently.

“This unemployment state is an absolute insult to the profession. It has also not only put the profession in disrepute, but has brought a great deal of exploitation,” 

The jobless young men and women are in different cadres—ranging from registered nurses and midwives, nurses and midwives technicians to community midwives assistants.

Mkorongo, a resident of Chimwankhunda Township in Blantyre, has now resorted to small-scale business as she has lost hope of effectively contributing to quality health care service.

“When I reflect over it, I hate myself. I no longer admire this profession, it is real exploitation not only because of government’s disregard, but the workload one takes part in while in wards,” she said.

Lilongwe-based Ruth Mapemba who graduated and qualified in August 2018 is another unemployed nurse with hard feelings about nursing, one of the oldest professions. 

After obtaining her nursing licence,   Mapemba, 25, was posted to Neno District Hospital as an intern for seven months.

“Life was just too hard to bear, looking at the workload, compared to my wage, so I decided to quit and just stay home with parents,” she said

The Malawi College of Health Sciences (MCHS) Zomba campus graduate recounted that as a relief nurse, she would work for the whole month only to receive K52 000 locum allowance.

The locum programme was introduced during the late president Bingu wa Mutharika’s administration as an incentive to health workers when the country faced a brain-drain crisis.

Said Mapemba: “Actually, it’s an abuse because nursing is not an ordinary job. Imagine, nursing the whole ward by yourself day and night and receiving K52 000 in turn. It is so unfair.

“As a young woman, I feel government is not considering us. Fellow girls cannot be inspired because it does not make sense to complete my college and then just be loafing at home.

“We can’t be role models to others so government must consider mass recruitment to avert the situation. Personally, I no longer have admiration for the profession. I am even dissuading my siblings from joining it.”

 After internship, during which these nurses and midwives receive upkeep allowances of K30 000 for diploma and K50 000 for degree holders, most of them work on a part-time basis and get paid K2 500 for day-work and K3 500 for night shift.

In March this year, some Cunm members demonstrated in the cities of Blantyre, Lilongwe and Mzuzu and delivered a petition to President Peter Mutharika, demanding full-time employment.

 As more and more qualified nurses and midwives remain unemployed, guardians at Chididi Health Centre in Nsanje  appear weary and frustrated due to long wait for a nurse to attend to their sick relations.

Such is the situation in the country’s public hospitals, where 62 percent of nursing and midwifery positions remain vacant. 

Statistics show that Malawi has one nurse per 3 000 people, against World Health Organisation (WHO) recommendation of one nurse per 1 000 people.  There is also one midwife per 5 000 people against WHO’s standard of one to 175 people.

Minister of Health and Population Jappie Mhango said government recruitment policy is based on job establishment, as such, it cannot go beyond the set up.

According to the Ministry of Health and Population’s 2017-2022 Health Sector Strategic Plan II titled ‘Towards Universal Health Coverage’, the total establishment for nurses and midwives stands at 11 901 out of which only 4 573 positions are filled.

This means government needs to employ the remaining 7 328 nurses and midwives, representing 62 percent of vacancy rate, for the total establishment.

This is in contrast to the Nursing and Midwifery Policy which the ministry launched three months ago aimed at improving provision of comprehensive and quality nursing and midwifery services.

Financial analysts, including the International Monetary Fund (IMF), have previously warned further recruitments of nurses and midwives would exert a further strain on government purse whose wage bill at 25 percent of national budget is said to be already on the higher side.

And Malawi is not among 11 African countries that have made significant steps towards achieving the Universal Health Coverage (UHC) which seeks to ensure communities access quality equitable essential health services without financial hardships.

Since 2013 when government stopped direct recruitment of nurses and midwives public hospitals have been using locum and students’ upkeep allowances to cover up the vacancy rate.

However, statistics show government spends almost K2 billion annually in such allowances, an amount economists have argued was enough to permanently employ 1 000 professionals.

Health rights activists George Jobe and Maziko Matemba said they were aware of the increasing numbers of unemployed nurses and urged government to urgently deal with the situation.

“Considering the profession’s sensitivity, government needs to review the job market and ensure the number of trained people match up with the human resource demand,” observed Matemba.