As the clock struck midnight, 25-year-old Martha Kilegu found herself in a helpless situation. She was heavily pregnant, her belly protruding with the promise of a new life.
But Itale village in Tanzania’s Songwe region where Kilegu lives was miles away from the nearest hospital. As she struggled with labor pains, her husband, John, put her on the back of his squeaking bicycle and pedaled furiously to Itumba Hospital.
When they finally reached the hospital, Kilegu was rushed inside, but to her dismay, there was no midwife to help her.
As she was moved to the labor room, her cries and the frantic whispers of other patients echoed through the dimly-lit corridor.
When the pain became unbearable, Kilegu sat in a squatting position and pushed the baby out, leaving her husband visibly shocked.
Tragically, the infant died shortly after she was born.
The agony of losing her baby three years ago is still deeply etched in Kilegu’s mind.
“I still feel a lot of pain in my heart for losing my baby,” she said.
Kilegu’s story highlights the worsening plight of women in Tanzania’s rural areas, and how the quest for better opportunities abroad has led to an exodus of doctors and nurses, casting a dark shadow over a healthcare sector already afflicted by an infant and maternal mortality crisis.
Pregnancy and childbirth are the gravest risks to women in Tanzania despite some progress in healthcare service delivery, according to public health experts.
The East African country has one of the world’s highest maternal mortality rates, with 556 deaths for every 100,000 delivering mothers, according to the 2016 Tanzania Demographic and Health Survey.
Silent crisis
The problem has only been worsened by the large numbers of doctors, nurses and other highly trained medical professionals who are leaving for greener pastures in Europe, the US, UK, Canada and other Western countries.
At Itumba Hospital, Agnes Mwenda, a senior clinical officer, has always dreamt of advancing her career.
“I don’t have the money to pursue further studies. If I get the chance to study and work abroad, I will definitely seize the opportunity,” she told the Anadolu news agency.
The brain drain in Tanzania’s health sector, like other East African countries, is costing lives, according to Lukombodzo Lulandala, a chief medical officer at Songwe Regional Referral Hospital.
“This is a big challenge for our healthcare system as skilled health workers are leaving our hospitals,” he said.
Lulandala stressed the need for authorities to ensure better working environments for healthcare workers in order to retain them.
“We must recognize the value of our doctors and nurses and pay them well,” he said.
Sarah Michael, a midwife from Songwe who recently landed a nursing job in Sweden, had worked tirelessly to help women in rural areas through pregnancy and childbirth.
“I was not satisfied with the working conditions. That’s why I moved to Sweden,” she said in a phone call.
Her departure left her colleagues overwhelmed, struggling to maintain the same level of care she had provided.
The brain drain in Tanzania has seen healthcare professionals like Sarah lured away by higher wages, better working conditions and brighter career prospects abroad.
This exodus has left many hospitals struggling to meet the demands of a growing population.
Rural Tanzania, home to 9% of the country’s doctors and 28% of its health workforce, is in desperate need of healthcare professionals, data from the Ministry of Health shows.
In contrast, the commercial hub Dar es Salaam, with just 10% of the country's 65 million population, houses a staggering 45% of all doctors.
Doctor-patient ratio
The brain drain of doctors and nurses from Tanzania is part of a larger trend, where healthcare professionals across East Africa seek opportunities in Western countries, affecting healthcare systems in sub-Saharan Africa, where the doctor-patient ratio is already dismal.
Lilian Msele, chairperson of the Tanzania Nursing and Midwifery Council, said the brain drain has many driving factors and pointed out the cost to the national economy.
“It costs the nation about $100,000 to train just one doctor. So when these doctors leave, it is a big loss for the country,” she said.
She reiterated that nurses and midwives often face low salaries, inadequate resources and limited career advancement prospects, pushing them to move abroad.
Another issue is the gap between public and private healthcare sectors.
Many highly qualified medical professionals who stay in Tanzania find work in private healthcare sector according to Deus Kitapondya, an emergency medicine physician at Muhimbili National Hospital.
“Private healthcare is growing exponentially, creating a huge healthcare market. In contrast, the public healthcare sector is slow and bureaucratic,” he said.
“I have seen many of my colleagues work in the private sector. They don’t necessarily leave for abroad,” he offered
