For Paulvie, a western educated doctor, moving back to the Democratic Republic of the Congo (DRC) was one of the best decision she ever made. While studying in the U.S., she missed her friends and family. A few months back home, she remains excited but slowly senses the pessimism growing each day.

Paulvie drafted a detailed business plan for a high-class hospital in Kinshasa. She calculated the number of medical devices required and verified their availability in the country. She trekked back to the DRC several times over the past year to specifically ensure that the right cement would be used for the building. But she forgot to verify one key thing: the number of available nurses in the country.

Brain drain is hardly new to the medical field in the DRC. However the lack of nurses is less brain drain and more lack of available quality schooling. Experts estimate that eight to ten nursing schools are currently active in the DRC. The shortage of nursing schools and teachers translates to less than one nurse per 10,000 persons in the DRC.

But Africa’s fourth most populous country is not alone. Ethiopia – Africa’s second most populous country – has about two to three nurses per 10,000 persons. In the United Kingdom, there are approximately 100 nurses per 10,000 persons.

Dr. Tony Magana, a Harvard educated doctor who came to the Ethiopia to help build a specialist practice, says that most hospitals lack the nurses needed to support Ethiopia’s growing medical needs. Tasked with teaching other doctors from several neighboring countries, he wonders aloud about the potential success of these doctors in applying their new knowledge back in their home countries absent the necessary nurse support.

Neighboring Tanzania – Africa’s sixth most populous country – has two nurses per 10,000 persons. World Health Organization (WHO) experts argue that Tanzania’s inability to quickly and procedurally accredit different nursing schools speaks to the core of the nursing deficit in the country.

One expert argues that schools pop up but must wait years for the government to consider their accreditation. Accordingly, the growth in the number of schools has slowed in Tanzania despite millions of Tanzanians being interested in the potential of such jobs.

Many Africans travel to Asia and Europe for basic diagnoses and checkups. Their medical tourism amounts to a more than $1 billion industry. Abebe, a local Ethiopian, made yearly trips to Thailand to have all check-ups conducted in what he calls a more “reliable market.”

Recently, Messai decided to move to the U.S. to be near his adult kids because, despite U.S. increasing medical costs, his medical expenses have decreased absent the flight to Thailand and payments to doctors to do “what nurses should be able to do at any local hospital regardless of country.” Rumours of a potential chain of nursing schools coming online in Ethiopia in the future excites Messai. Still, he is keen to remind me that rumours are just rumors until he sees the actual progress

“Training nurses in internationally accredited schools will not solely boost the DRC’s supply, but will boost Africa’s supply,” says one private equity investor looking at this education space in the DRC. “International standards are better than most local standards in African countries easing our ability to replicate the idea and teaching materials across the DRC and into other markets.”

The investor, with laptop and kindle by his side, represents how technology will change Africa. In the same way mobile phones has transformed mobile banking and influenced the classroom, the investor believes that kindles and iPads have the potential to provide medical education absent the physical books and journals available in Western countries.

The investor planned a week trip to look at the DRC nursing market. After one day, he had accumulated all the needed information: “It will take one week to get a waiting list of 1,000 students in one neighborhood of Kinshasa….the rest of my research requires finding a good facility, good staff, and good management.” Those tasks will surely take time in the DRC market. This imaginary waiting list can only double day by day when accounting for neighborhoods across the DRC, Ethiopia and Tanzania.

“Excitement is excitement” says Paulvie, “despite the need, do not expect the processes for building training facilities to move at a faster speed.”

Paulvie hopes she is wrong again.


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