Africa: Wellness Centre for healthcare workers stops drain

[Guest guest]

A Swazi success story by Belinda Beresford 04 May 2008 06:00

For a country like Swaziland, retaining staff is a major problem.

However, the Swaziland Wellness Centre, where healthcare workers can

receive medical attention, seems to be working.

When a class of 40 newly graduated Swazi nurses left the country en

masse a few years ago, the government decided it had to find an

effective way to stem the loss of this precious human resource.

The solution was to create the Swaziland Wellness Centre, a place

where healthcare workers receive medical attention themselves,

participate in continuing education programmes and get counselling to

help manage work-related stress. The centre is open to their immediate

family members.

With the help of international partners, the wellness centre model has

been replicated across the region. Lesotho opened a similar centre

late last year and Zambia and Malawi are about to follow suit. Apart

from national governments, funders include the International Council

of Nurses, the Danish Nurses' Organsation and the

Foundation.

With 26% of its population HIV-positive, Swaziland has the world's

highest levels of HIV infection. Healthcare workers are doubly

affected, both because of the increased workload that HIV/Aids causes

and because they and their relatives are directly and indirectly

affected by the epidemic.

For Swaziland -- and other countries in the region -- retaining staff

is a major problem. Masitesela Mhlanga, former president of the

Swaziland Nurses' Association, said that from his class of 33 nurses

who graduated 14 years ago, only six are still in the country. About

96% of Swazi nurses go to the United Kingdom, but Australia is gaining

in popularity. In total Swaziland has about 8 000 healthcare workers

-- of which 3 054 are nurses -- serving a population of about one million.

According to the World Health Organisation (WHO), sub-Saharan Africa

carries 25% of the global burden of disease, comprises 11% of the

world's population, but has only 3% of the world's healthcare workers.

Surveys of Swazi nurses who had left the country were conducted in

2003 and 2004 and found that money was not the main issue. Rather,

nurses said they were not appreciated by patients or managers. Nurses

also felt their authority was undermined because when they themselves

were sick, they had to queue alongside their patients for treatment

and medicine.

Healthcare workers are at greater risk of infections, which they can

catch if they are exposed to the bodily fluids of their patients, for

example, through needlesticks. Mhlanga said the counselling service is

particularly helpful because it allows healthcare workers to develop

trust in the counsellor. " When they come, they are offered VCT

[voluntary counselling and testing]. Because of the stigma they have

never been able to open up and felt the stigma from the population

they serve. Now they can confidentially discuss other cultural and

personal issues. "

A donation from pharmaceutical company Merck Sharpe and Dohme and from

the United States's medical technology company BD means that through

the two existing wellness centres all healthcare workers in Swaziland

and Lesotho will be offered the hepatitis B vaccine. Hepatitis B is a

viral infection that can lead to liver damage and cancer. The WHO

estimates that about 40% of hepatitis B and C infections among

healthcare workers worldwide are because of exposure at work. The BD

donation is for disposable syringes, part of a campaign to prevent the

re-use of needles to curb the spread of infection.

As well as providing testing, counselling and antiretroviral drugs,

the Swaziland Wellness Centre collects data to get an accurate

estimate of the levels of HIV infection among healthcare workers.

However, Mhlanga said he has noticed that the impact of HIV/Aids seems

to be abating among his colleagues, mostly because of better access to

treatment. In 2004 every weekend there was a funeral for a healthcare

worker; now there seem to be fewer deaths. " Maybe we will have a

sustained, healthy workforce, " he said.

So far about 5 200 healthcare workers and their immediate families

have used the centre. Mhlanga said an important facility is the grief

healing garden: a private place where people can mourn their own

losses and cope with the pain they see daily at work.

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