Poaching local health workers: the case of Haiti
By Fiorenzo Conte
In writing of the challenges faced by the global health community, professor Garret denounced the risk of creating alternative health services that compete with rather than complement the national public health system. If this tendency can be explained in view of the need of NGOs to hire local employees to run their programs it presents challenges in the long term. More particularly, the author condemns the practice of international NGOs and organizations to outcompete the national health system when it comes to hiring local staff. In her words :
“Pepfar-funded programs, un agencies, other rich-country government agencies, and ngos routinely augment the base salaries of local staff with benefits such as housing and education subsidies, frequently bringing their employees’ effective wages to a hundred times what they could earn at government-run clinics.”
In the aftermath of the earthquake in Haiti the local newspaper Le Nouvelliste denounces that a similar problem is emerging on the island. As the island is turning in a “republic of NGOs”, the international NGOs offered free health care services and hired local staff that was previously employed in the Haitian health system. On the other hand, the Haitian hospitals damaged by the quake were excluded by the big part of the international donations. In the short term the gains are evident: professionals are able to actually treat and cure patients, which would have been impossible in the current dismayed Haitian hospitals. And people can receive treatment for free. But what about the long term outlook? NGOs operate without any coordination on the behalf of the government and therefore there is no long term planning for reconstruction. Furthermore, recent years have shown how the presence of NGOs on the island is volatile given its reliance on donors funding (see here). This situation, according to the newspaper, bears the question: what will it happen when NGOs pull out as another emergency will call them? A question that need to be asked and answered by the key players if to the emergency response is to follow a long-term reconstruction.