Brain drain

The doctors, nurses and other healthworkers we have met so far have made a heartfelt plea to improve salaries and conditions to stem the brain drain from the health system. For instance, Dr Evaristo Kunka – one of three government-employed doctors in Siavonga district, home to 70,000 people – explained how most of his classmates now earn four times as much in Namibia or South Africa. But he also explained why he stays: ‘When you get in these rural areas, you see real poverty. We complain about our salaries, but there are people out there who really need our help.’

But at the Finance Ministry, the need to pay doctors more was just one item on a huge government wish-list. The government currently has a funding gap of over £370 million for its national development plan. Debt relief from the G8 deal is saving money: but only about £25 million this year. This is necessary – but not nearly enough. And there is still the concern that if the IMF imposes limits on what the government can spend, even having more resources is of little help. (The Finance Ministry also became last in a long line of places where we heard about the abuse of tax breaks in Zambia by transnational companies.)

Today, we also saw Mulima Akapelwa who spoke at the human chain around the G8 summit in Birmingham in 1998, and at the Make Poverty History G8 rally in Edinburgh in 2005. She argued that, ‘The people themselves should set their own conditions, with the government, not the IMF. The government should say: “These are the conditions the people want, in terms of transparency and accountability.”’ We spoke with Emily Sikazwe and some of the other staff at the immensely inspiring Women for Change organisation. They talked about their work with women and men in the most rural areas – and of the need to avoid a new debt crisis by dealing with Zambia’s poverty situation and IMF conditions: ‘If you cancel debt and still keep creating an environment where new debt is needed in future, then you still have a problem.’