Voting with Their Feet: Migrant Zimbabwean Nurses and Doctors in the Era of Structural Adjustment

Most attempts at studying the effects of economic crisis and structural adjustment on the health sector in Africa have concentrated on the impact of cuts in the public health budget and the introduction of user charges/cost recovery measures on the capacity of the populace, especially the working poor, to maintain or improve access to modern medical services. Very useful insights have certainly been gained from those studies, especially with regard to the documentary evidence that has been marshaled to capture the declines in the health and nutritional status of the majority of the consumers of health services. However, there remains a major gap in the literature on the consequences of structural adjustment for the African health sector and this has to do with the fact that the experiences of the medical professionals who work in the sector have remained unstudied. Yet, there is no doubt that the sharp cutbacks in the health sector with which these professionals have had to cope also affect their working and living conditions during the adjustment years, has compelled many of them to re-think their livelihood strategies. The ways in which these professional have sought to respond the changing environment of work and livelihood in Zimbabwe since the country adopted an IMF/World Bank structural adjustment programme constitute the essence of this research report. Of particular interest are those doctors and nurses who took a decision to migrate from Zimbabwe to Botswana and South Africa in search of "greener" pastures.