African nurses face discrimination

African nurses working in Britain, majority of them from Southern Africa are facing discrimination at their places of work. They were recruited as a result of the long-standing shortages in the health sector. But their presence has sparked off a huge concern, which seems to be fueling a new action from the British government.

It all started off sometime last year when the British media reported a finding made by the Wolverhampton Health Authority (WHA) in Central England. The WHA had then detected that some of the nurses it had recruited from southern Africa as part of a drive to cope with the nursing staff shortage, were HIV positive.

What followed thereafter was very frightening. The media yelled, the authorities quivered and the public seemed confused as a barrage of media stories sought to portray a bleak picture of UK’s health delivery with the advent of the African nurses.

The mass-selling tabloid “The Sun”, which first reported the case, was very poignant with its remarks: “The trainees are from a part of Africa where HIV infection and AIDS are rampant . . . All are from a region in which one in four of the adult population has been infected with HIV,” it said.

Health chiefs apparently detected the nurses’ HIV status through checks carried out on their arrival in Britain to take up places at the city’s hospitals and the Wolverhampton University School of Nursing and Midwifery. WHA at that time confirmed that 10 nurses were HIV positive.

The authorities were, however, quick to reassure the public that the said nurses would not be allowed to carry out “high-risk procedures” such as operations. They also assured the public that the nurses did not pose any risk to patients.

Although the nurses were allowed to stay on, the ramifications have been very debilitating. It has also showed how ambivalent AIDS education is in Britain especially among media personnel.

Chief Executive of Britain’s National Aids Trust, Derek Bodell, was even surprised about the level of argument that the media engaged themselves in. “I am sad that the papers are writing scary stories about HIV. We should know by now how HIV is transmitted, and we should know that we have got good, clear procedures. I am afraid some papers just see HIV as something to sell papers,” he said.

Although the authorities refused to disclose the affected nurses’ home countries, “The Sun” and other newspapers went ahead to name Zimbabwe and Zambia as the countries where most of the HIV positive nurses were from. Following the discovery, British health authorities came under fire for allowing the HIV-positive African nurses to work in the country.

The backlash was expected because prejudice and ignorance have dogged AIDS in the UK. Over 30,000 people are reported to be living with AIDS in Britain. Of this number, an estimated one third is said to be unaware of their infection.

The barrage of media articles on the African nurses has now compelled the government to consider reviewing testing procedures on nurses from overseas. It is contemplating testing foreign nurses for HIV/AIDS before allowing them to work in the UK.

What has accentuated the problem are British media reports that nearly 700 infected nurses were last year recruited from Africa. But Bodell has described the reports as “unrealistic and a complete fantasy meant to scare the public.”

Bodell said although there are a few infected nurses recruited by the National Health Service (NHS), “we haven't got a blanket invasion of people who have been recruited abroad who are HIV positive.”

The media apparently have painted Africa as the source of the pandemic, and have gone further to impute that African nurses are a potential threat, a situation that has created difficulties for African nurses.

Since the issue of the HIV positive nurses came to the fore, the British government has doggedly sought to introduce compulsory HIV tests for all new health staff working in the country. The plans, according to insiders, have been prompted by fears emanating from what has been termed as the ‘African experience’ a reference to reports on the HIV positive African nurses.

But the plans have been strongly opposed by the Nursing and Midwifery Council (NMC) and organisations working with HIV infected people. The council says the move has provoked a great deal of surprise and anger within the medical profession. “It came as a bolt out of the blue to us when it was announced,” Stuart Skyte, Head of NMC’s Communications, said recently.

The Royal College of Nursing (RCN) has already sounded a note of caution to the government saying, “it (government) was treading on difficult ground as it was illegal in Britain to test for HIV unless an individual consented.”

A RCN spokeswoman said: “Foreign trainee nurses receive the same occupational health testing as UK trainees and we would like to see that continued. If admission procedures for foreign trainees are reviewed, we would want to know why one set of standards is being set for foreign trainees and another for British.”

If approved, the tests would be a condition for employment. Already the nursing council ensures that nurses are in good health before being allowed to work. It is, however, unclear when the government intends to introduce the policy, and whether a positive test would disqualify a nurse or a doctor from working in the British National Health Service (NHS).

The government has so far not defined what good health means. The argument is that one can be HIV positive and be in good health. In a situation like that, it will be difficult to tell what the government’s position will be.

At present, HIV tests are voluntary and health workers do not have to undergo screening before working in the UK. Those found to be infected are restricted in the type of work they can do.

An official from the African HIV policy Network, Joshua Odongo, believes the government's plan would only heighten the stigma and discrimination against African nurses working in the UK.

Various arguments have been made in the UK over the recruitment of nurses from overseas. Although some may sound legitimate and be well grounded, others have mainly been counterproductive.

There have, however, been calls to discourage the recruitment of foreign nurses because of fears that the UK may be draining much needed talent from the developing countries. The NHS has been accused of stunting already fragile healthcare systems by taking nurses from less-developed countries. At the moment, Ghana is in a fight to save the few nurses she has. She has formally complained to Britain about the massive recruitment of her nurses to that country.

Recently, NHS bosses ordered hospitals not to recruit from countries known to have own nurse shortages unless an approved exchange programme is in place. It is however, difficult to tell whether this is a genuine concern or a way of avoiding areas considered as HIV infested.

A Department of Health spokeswoman said recruitment from abroad “should only be considered by the NHS when there is a clear nursing surplus in the countries where they are being recruited from. The objective is to safeguard the interests of nursing in those countries,” she added.

Nursing staff shortage has occurred in British because of lack of job satisfaction. Morale among nurses has come to an all time low, whilst the low pay levels have discouraged potential British nurses from embarking on the profession hence the recruitment of foreign nurses.

Nine African countries are currently among the top 20 countries supplying nurses to the UK. South Africa, which is the second largest contributor apart from the Philippines (7235), has the largest contribution among the African countries - 2114 nurses as at May, this year. Zimbabwe follows with 473 nurses. Nigeria, Ghana, Zambia and Kenya have 432, 195 and 183 nurses respectively. Botswana, Malawi and Mauritius have also provided 100, 79 and 62 nurses.

African nurses have vowed to soldier on despite the prejudice. A Zambian nurse, Gloria Phiri retorts: “We have been strong in our conviction that we have a job to do, we want to gain the necessary recognition as we pursue our job diligently. We know our work rate is high and we’ll keep on pushing that far.” This seems reassuring despite the taint and humiliation they suffer as a result of being branded as HIV carriers.