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In Zambia, at the Lusaka College of Nursing and Midwifery, college head Dr Priscar Sakala-Mukonka is training the next generation of nurses in their new Critical Care department. Once qualified, her students will join a health care system that is critically short-supplied and short-staffed - not due not to a lack of new nurses, but due to a shortage of paid positions. Despite decades of investment, there is still only 13 nurses per 10,000 people in Zambia, compared to 175 in Switzerland. Many qualified nurses are officially unemployed, and those with jobs do the work of many.

Dr Priscar Sakala-Mukonka trained as a nurse herself in the 1980s in Zambia. Considering her work a vocation as much as a profession, she watched as many of her fellow graduates left the country, feeling demoralized and undervalued, to pursue nursing careers overseas. Since then, admissions to nursing schools have mushroomed, and new schools have opened to meet demand – but without further investment, a perpetual cycle of loss of talent and recourses seems possible.

Now, as European and North American countries once again ramp up their efforts to recruit Zambian nurses to fill Covid-19 related shortages, we ask what training and approach will keep this new generation of trained nurses in the country, and what motivates nurses to keep going, despite the unpredictable pay and difficult working conditions.

(Photo: Nurse training at St. Luke's Mission Hospital in Mpanshya, Zambia. Credit: Gareth Bentley/SolidarMed)