NIGERIA: Health worker Augustine Ukwa feels guilty about leaving Nigeria.
His mother toiled as a nurse for 32 years in Nigerian public hospitals but he couldn't last 12 months in the job.
"It's not just the wages, it's the quality of life. The biggest problem in my country is corruption," Ukwa says by way of explanation for his decision to migrate to South Africa.
After six years of domestic medical training, and a short stint in the hospital wards of his home country, he moved to Johannesburg where he now works as a full-time nurse. One of his sisters, another healthcare professional, followed him out of Nigeria to work in London.
"It's a very sad situation when you see the youth of the country leaving. I feel bad about it, but you have to do what you can to survive," says Ukwa.
His case forms part of a growing international problem highlighted by the World Health Organisation (WHO) in its annual report, published in Zambia yesterday.
The 2006 World Health Report identifies a "serious shortage" of health workers in 57 countries, 36 of them in sub-Saharan Africa.
The world's poorest continent was said to be losing up to 20,000 qualified nurses and doctors each year, with rural areas feeling the exodus most.
Life-saving interventions, like childhood immunisation, safe pregnancy and delivery services for mothers, and access to treatment for HIV/Aids, malaria and tuberculosis have all been badly hit, according to WHO assistant director-general Dr Timothy Evans.
"Not enough health workers are being trained or recruited where they are most needed," he says. "Increasing numbers are joining a brain drain of qualified professionals migrating to better paid jobs in richer countries."
The report calls for improved healthcare training in developing countries, and also says developed countries should address their manpower needs without poaching staff from overseas.
The destabilising effects of such migration can be seen in South Africa where - despite its relative affluence to other African states - up to a third of public health sector posts are vacant.
Liana Grobler of local nursing union Denosa said up to 200 domestically-trained nurses are leaving South Africa each month for jobs mainly in the US, Europe and Saudi Arabia. She added the number of nurses migrating to South Africa was "very small" by comparison.
Dr Evans warns that developed countries "are likely to attract even more foreign staff because of their ageing populations, who will need more long-term, chronic care."
The report points out that sub-Saharan Africa has 24 per cent of the global burden of disease, but only 3 per cent of the world's health workers.
It also suggests political factors have contributed to a decline in healthcare standards in certain countries, with life expectancy for women in Zimbabwe just 34 years - by far the lowest in the world.