Recruitment of foreign nurses does not promote nurses anywhere, as  excerpts [found in this page] of several countries studies and commentaries reveal. Efforts to increase the importation of foreign nurses have occurred in each acute phase of the longstanding nursing shortage, including the 1970s, 80s, and this most recent crisis shortage now exerting effect.  In the past, recruitment of foreign nurses was able to offer some buffer.  But in the 21st century, a world wide shortage of nurses exists, and all nations compete for other nation's nurses; NO nation is able to meet its own need.  No one really disputes that foreign recruitment is a woeful band-aid , neither that it causes hardship to  impoverished countries. Opinions vary as to the ethics involved, but the  facts are easy to see: There is a global nursing shortage, and the  third world countries are most susceptible to the drain and most in need of their nurses while the wealthier countries all compete for, and entice them. Still, as a result of pressure to address the nursing shortage so affecting America, and in August of 2002 the National Council of State Nurse Examiners voted to begin overseas testing of nurses to encourage their practice in the US. [See detail and excerpt herein] . Each country targeted has its own nursing shortage, and each competes with the US globally in recruitment efforts to entice foreign nurses to practice within those nations.  Page Table of Contents:  Introduction and Review of Topic  Excerpts from literature describing specific countries' Shortages , their attempts to alleviate  See Also associated page: RN Earnings Worldwide

Just as in any era of nursing shortage, rich countries continue to look to the poorer countries for a nursing labor pool, and the US itself approved an increased number of foreign nurse visas. Hospitals, hoping to ease immigration restrictions, are lobbying Congress to increase the number of health-care professionals that can be recruited into the United States each year. Foreign recruitment efforts escalate in each period of crisis nursing shortage, and they are inevitably accompanied by American legislative mandate to make nurse education cheap,  but no crisis shortage has provided the necessary creative insight assuring  the viability and retention of American nurses once OUT of school and credentialed to provide care.  Now that all nations throughout the world, even those traditionally responding to the American recruitment efforts (including , Canada , Ireland [describing desperate shortages] and the Philippines ), are describing crisis shortages, this former bandaid offers little protection from the inevitable catastrophe of an ever burgeoning American crisis shortage if the alpha factors fueling it  are not realistically, creatively , and meaningfully addressed.
Similar, previous recruitment attempts in periods of crisis shortage never diminished the strength of the subsequent crisis shortages inevitably following the quick fix band-aid. Each bedside nurse is always happy to see a new nurse on her floor, regardless of her country of origin, but , in fact, since in the past increased importation temporarily lessened the effect of the native nurse shortage, that importation suppressed the needed market adjustment to assure the viability and retention of the American trained RN and so allow this country to tend to its own ill and frail.  Worse, this pirating of the poor nations' needed resource contributes to a shortage of nurses in the poorer countries that far eclipses the ill-effects  Americans experience in their own cyclical nursing shortages.  We are well  aware of America's shortage, but the English are no different, neither Germany, nor France, nor any country in Europe, nor Asia, the Mid-east,  South America..the list of countries experiencing a nursing shortage includes ALL nations, in fact,  throughout the world. In Australia alone, 40% of new nurses quit within one year {see citation excerpt} .  The global shortage is now in crisis phase, and no country has exhibited immunity.

The drain of nurses from the poorer countries  to the wealthier ones is so severe that the President of South Africa made a national appeal [see excerpt below through link] to the country's nurses to stay, Filippino nursing leaders are addressing the loss of their nursing educators to competitor nations [loss of the educators diminished the ability of the Philippines to remain the only country, until this decade, able to meet its own nurse needs AND produce nurses for the export market] , and England has made it illegal to import nurses from countries themselves in shortage as a result of the appeal of those nations heads of states directly to the British government citing an erosion of diplomacy in its absence. But it isn't just the rich countries pirating the poor, its the wealthy ones competing amongst themselves as well.  America is recruiting the Irish; The Irish are fighting to keep their nurses. America is recruiting the Canadians, the Canadians have started job fairs in the US to entice their nurses back. America is busy harvesting in Latin America, itself in obvious dire need, while Japan recruits Filipino educators, thus diminishing the ability of this one factory nation to meet the entire world's supply needs.  Everyone worldwide recruits Filippino nurses, who, because of post American occupation education supports, turned the Philippines into a nursing factory of great importance to the gross national product of that nation [Filipino foreign workers send MUCH of their wages back to family in that country]  until this decade in which that country itself acknowledged feeling the drain and an erosion of health care in their country.  There appears to be no concern for the finite supply as all countries seek to harvest this one nurse , fragile , nurse factory nation itself describing an emerging , and catastrophic for the entire world, crisis shortage.

Excerpts from the literature supporting the above follow.

Canada, Poland, Chile:
"Several other countries report problems similar to the United States. The Toronto Star reported in June 2001 that Ontario, Canada, expects to lose 14,000 of its 81,000 nurses due to retirement by 2004. Almost a third of Canada's nurses are over age 50, and only 10 percent are under 30. In December 2000, the World Health Organization reported that 10 years ago Poland was graduating more than 10,000 new nurses annually. That figure has fallen to 3,000. And in Chile, out of 18,000 nurses in the country, only 8,000 are working in the field. "
Facts About the Nursing Shortage HONOR SOCIETY OF NURSING, SIGMA THETA TAU INTERNATIONAL. JULY 2001

Canada:
"Canadians may go into nursing because they want to help others. But nurses across the country are making it clear that they are not prepared to help others if it's at their own expense.
The era of the long-suffering Florence Nightingale figure is over.
If nurses and their unions have become more combative, it's because they have to meet rents and mortgages, put food on the table, and send their kids to university, just like everyone else.
The slogan most favoured by politicians over the past decade is that we all must compete. Nurses are now in a position to tell the politicians that they, too, had better start to compete. "
Florence Nightingale flexes her muscle. The Toronto Star. June 21, 2001

Canada, Switzerland, France: Canada seeks to regain its nurses.
"Last year, Canada had 228,450 registered nurses. That is 6,000 less than we had in 1994, and approximately 20,000 less than the health-care system requires in order to meet current needs. And, as newspaper reports point out, this serious shortage occurs at a time when an estimated 20,000 Canadian nurses are working in the United States¬many of them lured away by what they say are better work opportunities and conditions, including higher salaries, better scheduling, paid education and more career options.
'Three years ago, we would have gone to three recruitment events per year,'  says Jasmine Boyer. 'Since April 2000, we have been involved in 29 different job fairs at universities throughout Canada, in Texas and in France, and open houses at the Vic, the General, the Children's and the Neuro.' In addition, the MUHC participated in a recruitment trip to Switzerland last month to target some of the 400 Quebec nurses working there, as well as Swiss nationals. This month, Boyer returns to France for a three-day job fair. '  The Nursing Shortage. May 2001 . McGill University Ensemble.
The Filippines:
"That Filipino overseas workers or immigrants are appreciated in the more than 100 countries where they work is a refrain often heard in the Philippines, a country of 80 million people said to be the  world's largest organised exporter of human labour.
But the irony is particularly painful in the case of Filipino nurses - of which nearly 14,000, or some say much more -- leave each year for better pay and opportunities.
The costs of this migration are being felt in this poor country that needs its best health professionals but spends thousands of dollars training each nurse - only to have them serve the needs of countries like Britain, the United States, Saudi Arabia and Ireland.
'Sadly, this is no longer brain drain, but more appropriately, brain haemorrhage of our nurses,' said Dr. Jaime Galvez Tan, vice chancellor for research at the University of the Philippines in Manila, and  executive director of the National Institutes of Health Philippines. 'Very soon, the Philippines will be bled dry of nurses.' " Manila, May 15, 2003: LABOUR-PHILIPPINES: Nurses' Exodus Making Health System Sick  by Patricia Adversario . Interpress Service News Agency

The Filippines:
"Considering that this phenomenon will go on for the next 10 years or so Ö this is a 'wake up call' to administrators in the nursing-practice, education & research. Now is the time to collaborate intensively and ensure that despite the ìbrain drainî the Philippines will not be lacking in dedicated and competent professional nurses.
The attractive benefits offered by job placements in foreign countries have again positioned nursing as the top profession among our young people. Enrollment in Nursing schools have increased and our students donít hide the fact that their main reason for taking up nursing is ì to go abroad and earn moreî"
Nursing Workforce Global Trends and Future Directions
SR. FRANCESCA SAN DIEGO, MAN,RN,SPC . Director of Total Quality Management of the De La Salle University Medical Center (DLSUMC) in Dasmariñas, Cavite.[Philippines] She specializes in Nursing Service/Quality management.

UK, Ireland, Finland, Switzerland, Singapore, Japan, The Filippines:
Officials in the United Kingdom have recruited 13,750 Filipino nurses in the past year. They also have attracted thousands of nurses from Nigeria and South Africa, according to a report from the United Kingdom Central Council for Nursing, Midwifery and Health Visiting.
Ireland, which sent more than 700 nurses to the United States in the 1990s, has started to tap the Philippines pipeline.Ý Marie Keane, nursing director at Dublin's Beaumont Hospital, made her first recruiting trip to Manila last September. She hired 87 nurses and plans to return in the next year.
Another country that needs Filipino nurses is the Philippines itself. The country faces a growing nursing shortage in impoverished rural regions, said Dr. Cecilia Laurente, dean of the University of the Philippines College of Nursing in Manila.
She said she was having difficulty retaining nursing teachers who are moving to hospitals in the United Kingdom, Ireland, Finland, Switzerland, Singapore and Japan.
'I just wish our graduates would stay and serve the Filipino people,' said Laurente, who worked as a nurse in Detroit in the 1970s. 'But I think this is going to be a problem for us over the next 10 or 20 years.' "
Shortage has hospitals in U.S. scouting foreign lands for nurses,
Glenn Thrush, BLOOMBERG NEWS, 6/3/01
 

Ireland:
"Fifteen years ago, Ireland was inviting U.S. hospitals over, setting up job fairs for their abundant pool of nurses, said Lorna Martin, vice president of nursing for Piedmont Hospital. Now they are competing for business. "
Hospitals go overseas for nurses.Julie Bryant Ý Staff Writer. Atlandta Business Chronicle. May 4, 2001

Ireland and England
"Other countries, such as England and Ireland, are jumping on the bandwagon with their own new efforts to shore up nursing shortages, shelling out better pay and providing more educational opportunities for nurses they hope will stay. "
Hospitals go overseas for nurses.Julie Bryant Ý Staff Writer. Atlanta Business Chronicle. May 4, 2001

Ireland:
"ICS chief executive, Barry Dempsey, said people were pleading for help in caring for relatives who want to spend their last days with their families in the comfort of their own homes. But he said many have been refused overnight support because of the nursing shortage which is also hitting the countryís hospitals and hospices. The shortage is most acute in Dublin and the east, where demand from some of the bigger hospitals is highest, he said....But he says more and more Irish nurses are on the move, many taking up jobs abroad. 'And because the demand for them is very high, nurses are in a position to be more selective in the work they take,'  he said."Shortage of nurses for cancer care programme IrishExaminer.com by Linda McGrory

Northern Ireland; May 14, 2003
"Ulster loses 2,000 nurses in two years . Health Minister told to move urgently over staff crisis. ...
NEARLY 2,000 nurses have left the profession in Northern Ireland over the last two years, the Belfast Telegraph can reveal today.The shock exodus during the past three years highlights a new low in an NHS that is starved of staff in virtually every area. .... the figures have caused concern among nursing leaders here as well as politicians." [ By Nigel Gould....From Belfast Telegraph > News Publication Date: Wednesday, May 14, 2003 ]

Ireland and South Africa:
"Statewide, 70 percent of hospitals report they are recruiting nurses from other states and 26 percent are recruiting nurses from other countries, including Ireland and South Africa" CBC, health agencies remedying nursing shortage   7/8/02  By Annette Cary,  Herald staff writer. tricityherald.com

Canada, England, USA , Philippines, Northern Ireland
"Faced with a crippling nursing shortage, U.S. hospitals are increasingly recruiting nurses from Canada and England and as far away as the Philippines. By the end of the year, Tenet Healthcare Corp. [ed note, see dedicated page on this corporation] hopes to recruit at least 100 registered nurses from Northern Ireland to hospitals in the Southeast through a special visa program passed last year by Congress.
But foreign countries such as Ireland and Canada are dealing with their own spiraling health-care labor shortages. Global talent pools that were once plentiful are now drying up, strained by high demand, immigration issues and spreading competition.
Some health-care officials, meanwhile, say foreign recruiting is a deceptive quick fix and could actually detract from solving the real problem..."
Hospitals go overseas for nurses.Julie Bryant Ý Staff Writer. Atlandta Business Chronicle. May 4, 2001

Canada, France, Switzerland [Canada seeks to regain its nurses] :
"Last year, Canada had 228,450 registered nurses. That is 6,000 less than we had in 1994, and approximately 20,000 less than the health-care system requires in order to meet current needs. And, as newspaper reports point out, this serious shortage occurs at a time when an estimated 20,000 Canadian nurses are working in the United States¬many of them lured away by what they say are better work opportunities and conditions, including higher salaries, better scheduling, paid education and more career options.
'Three years ago, we would have gone to three recruitment events per year,'  says Jasmine Boyer. 'Since April 2000, we have been involved in 29 different job fairs at universities throughout Canada, in Texas and in France, and open houses at the Vic, the General, the Children's and the Neuro.' In addition, the MUHC participated in a recruitment trip to Switzerland last month to target some of the 400 Quebec nurses working there, as well as Swiss nationals. This month, Boyer returns to France for a three-day job fair. '  The Nursing Shortage. May 2001 . McGill University Ensemble.

Northern Ireland:
"There is a shortage of both beds and nurses. The report shows that there is at least a 10% nurse vacancy in Northern Ireland and in a lot of these A&E departments there are also a high level of agencies nurses and bank nurses. ...The report on the survey said 88% of nurse managers believed patients were put at risk due to short staffing at least occasionally. A third said it happened regularly or often.....He accepted that there were shortages of nurses in some areas of the NHS but said efforts were being made to improve the situation, though this would take time. "
Patients 'at risk' in casualty . BBC News. Friday, 25 February, 2000

Results of study of Global Nursing Shortage in 69 nations reports The outflow worse for Oceania, Africa, Central America and the Caribbean:
ì (University Park, PA) ó In the first systematic study of the problems facing nurses globally, Penn State researchers have found that the nursing shortage is a worldwide phenomenon that is jeopardizing health care and creates stressful working conditions for nurses.
' Ninety of the 105 nursesí unions and organizations in our surveyórepresenting 69 nations and every geographic regionóreported their countries were experiencing a nursing shortage,î' says Dr.  Paul F. Clark, Penn State professor of labor studies and industrial relations. ' This is bound to have a negative impact on the quality of patient care.'' ... 'Also, 44 nursesí associations and unions in 33 countriesóprimarily in Oceania, Africa, Central America and the Caribbeanóreported that the outflow of nurses to more affluent countries was a serious to extremely serious problem,' Darlene Clark says. ' This exacerbates the shortage that already exists in poorer countries and further weakens their healthcare systems.'
'Overall, nursesí associations and unions rank better salaries and benefits and improved patient care as their membersí two highest priorities. The second is all the more significant since registered  nurses have traditionally seen themselves as the patient's advocate,'  Paul Clark notes. 'Other  priorities are professional development, greater voice in the workplace and improved safety and health concerns.' Worldwide Nursing Shortage Has Reached Crisis Proportions/ June 28, 2002 . The College of Heath and Human Development

England:
"RCN General Secretary Christine Hancock said: 'With a current shortage of 15,000 nurses, employers can no longer afford to ignore the needs of nurses if they are to retain a committed, experienced, workforce.'"
 NHS still losing nurses . BBC News. Wednesday, October 6, 1999.

England and the Philippines
 " The Radcliffe was one of 12, out of 190 NHS trusts, to get nul points. It was too dirty. In some respects it was too dangerous: too many people were checking into the heart centre, and not checking out again. And above all it failed the test of  'patient access', which is the bureaucrats' way of saying that you turned up in a hell of a state, spent a night on a trolley, and were then told to get your coat on and come again some other time.
The reason they 'fail'  is because patients can't gain admission. Patients can't gain admission because there aren't any 'beds' , which is a ridiculous locution. There are plenty of beds, with pillows, sheets, etc. There just aren't enough nurses to make those beds and keep those wards open. The trouble with such hospitals, say the managers, is 'nurses, nurses, nurses' .
The Radcliffe has a new contingent of Filipinos on the way, another 200 or so; and yet it is still 280 nurses short. At any given time, it is about 10 per cent down on its requisite complement of 3,000, because it is so difficult to recruit nurses in Oxfordshire, and so difficult to retain them."
Stuff socialism, nurses need a market wage .By Boris Johnson 06/12/2001 [Boris Johnson is editor of The Spectator and MP for Henley]. Presented in  opinion.telegraph.co.UK

Scotland:
"Between October 2001 and March this year, the rate of nursing and midwifery vacancies rose by 0.4% to 3.6%.  The Scottish National Party (SNP) described the figures as ' shocking' and claimed that there had been a 46% rise in vacancies since 1999. ' Rise in nursing shortage. Tuesday, 20 August, 2002, BBC NEWS

United Kingdom, Phillippines, India, Nigeria, South Africa
"A huge influx of foreign nurses is about to rescue the NHS from staff shortages that were threatening to undermine the government's plans to expand hospitals.
Figures released yesterday by the UK Central Council for Nursing, Midwifery and Health Visiting showed a 71.1% increase in overseas-trained nurses applying to get on the UK register during the 12 months to the end of March.
They included 13,750 from the Philippines, 2,459 from India, 2,065 from Nigeria,and 2,056 from South Africa - where health authorities have expressed concern about a drain of scarce skilled staff being tempted into Britain. "
Influx of foreign nurses helps NHS  by John Carvel  Friday May 4, 2001 From SocietyGuardian.co.UK

South Africa: President Mbeki's plea to nurses planning to leave SA [South Africa]
"President Thabo Mbeki has called on South African nurses to consider loyalty to their country when they feel tempted to work abroad. This did not mean the government was seeking to limit their rights to market their skills freely, he told a nursing award ceremony in Pretoria.
'But I certainly do appeal to your sense of loyalty to this country,' Mbeki said. 'I believe that there is unlikely to be a point in our nation's development when your contribution will have greater meaning."'...
Wage agreements in 1996 were what he described as a critical intervention - ' but there is still a lot to be done to improve working conditions'.
A revival of a sense of vocation among nurses was also required. Mbeki said the public health system was straining under a complex and heavy disease burden. ' We are stretched to extremes across three fronts - dealing simultaneously with growing rates of, communicable diseases, non-communicable diseases and trauma.'
Mbeki's plea to nurses planning to leave SA. sabcnews.com April 05, 2002

Japan:
"According to reviews of Japanese nursing and medical history, modern nursing in Japan was established in 1885 when a physician who was influenced by Nightingaleís concept of nursing started the first training school for nurses (Doona, 1996; Hisama, 1996; Kodama, 1984, 1994; Kusakari, 1989; Long, 1984; Nakahara, 1997; Tierney & Tierney, 1994). Although the ideal of nursing as both an art and science was introduced early on, public perception of nurses has not reflected nurses as independent practitioners with unique skills. Nurses have been perceived as being educated and caring, but also subservient to physicians. Furthermore, nursing work has been described using negative terminology such as 'hard, dirty, dangerous, low salary, few holidays, minimal chance of marriage and family, and poor image" (Katsuragi, 1997; Tierney & Tierney, 1994).' "
NURSING AROUND THE WORLD: JAPAN - PREPARING FOR THE CENTURY OF THE ELDERLY. Janet Primomo PhD, RN. Presented at NursingWorld.org

Australia:
"Senate committee finds national nursing staff crisis
A Senate Committee has recommended a Commonwealth Officer be appointed to oversee Australia's ailing nursing sector.
The report into the nursing workforce was tabled in the Senate late this afternoon.
The committee has found the shortage in nursing staff has reached crisis point and the aged care sector is the worst affected, with under-qualified nursing staff being left to administer medication.
The report says there is a severe lack of undergraduate nursing places at universities across the nation and the workforce is ageing, with 40 per cent of new graduates leaving the profession within the first year of work. "
ABC News ONline  Wed, Jun 26 2002. Presented at allnurses.com

IAustralia:
" Auckland's Starship children's hospital has  announced that it is to resume some non-urgent surgery from next week. Last week, the hospital announced that because of a shortage of nurses it was suspending elective surgery for three weeks, affecting the operations of about 300 children.
The hospital's manager of surgical services, Trisha Ross, says Starship will resume day surgery next week. She says while there is still a shortage of nurses,  staff can be freed up to deal with day surgery patients because there are no major elective operations being performed. "
"Starship to resume surgery Aug 14, 2001. NZoom.com. the homepage for new zealanders.

Australia:
"AUSTRALIA would face a massive nursing shortage in the next five years unless measures were taken to keep nurses from leaving the profession, a new report has found.
The report, A National Review of Nursing Education, made 36 recommendations to improve the image of nursing and make it a respected profession.
The report said more than 22,000 nurses would leave the workforce over the next five years, making up the bulk of the 31,000 vacancies expected by 2006.
Patricia Heath, who chaired the review of nursing education, said Australia faced a serious shortage of qualified nurses. ' We've got a very big problem, as every country in the world has,' Mrs Heath told reporters.
'At the moment, pretty well every country in the world is poaching nurses from every other country.'
Mrs Heath said while nurses were not highly paid, pay was not the most important factor in keeping them in the workforce.
'Nurses want to be recognised for their professionalism, for the role that they play and they want to be recognised as a major contributor,' she said."Nurse shortage looming: report from news.com. au

Australia:
"Nursing shortages are also having a serious impact on patient care. In a recent report, Professor Mike Stacey, a vascular surgeon from Fremantle Hospital, stated that 25 percent of patients in public teaching hospitals had pressure ulcers, more than double the prediction rate.Pressure ulcers, or bedsores, are caused by excessive or prolonged pressure on the skin. They can be superficial or very deep, extending to the bone.  Stacey blamed shortages of staff, which resulted in patients not being adequately attended to. 'Most hospitals are having difficulty getting nurses,' he explained. 'When you have a staff shortage it means you have less time to do things like this and they are the easiest things that  get dropped off.' " s Funding crisis forces hospital emergency closures in Western Australia. World Socialist Web Site. By Joe Lopez  14 December 2000

The Carribean and Africa [Ghana, South Africa, Trinidad and Tobogo, and Jamaica]:
"As global labor markets become more integrated, the health care systems in developing countries face a new crisis: a shortage in the supply of supply of nurses. Some countries particularly hard hit include Ghana, South Africa, Trinidad and Tobogo, and Jamaica. Given the high incidence of HIV in some of these countries, health care professionals are an asset they can scarcely afford to lose.
The problem comes not from a lack of nurses being trained in these countries but rather the high numbers of nurses leaving their homes for jobs in more developed countries which can afford higher salaries. As stated in the article, 'The global flow of nurses, from poor to rich lands, reflects the way talent goes to the highest bidder, regardless of national borders. 'Thus, an original shortage of available nurses in the US, Britain, Canada, and Holland has now caused a shortage in developing countries. For example, nurses from Canada come to the US seeking higher wages, which causes Canada to recruit nurses from Britain which in turn recruits nurses from Ghana.
In addition to higher wages, nurses who go to developed countries often face better working conditions abroad than at home & conditions which are worsening daily as fewer and fewer nurses remain in country. The quality of the health care provided in these developing countries, despite the increased availability of advanced equipment, has also deteriorated.
It is not clear how and even whether the developing countries can stop these outflows. South Africa complained to Britain about the situation so Britain stopped recruiting in South Africa. This only meant that South African nurses were recruited by other countries, including the US. Some developing countries have proposed plans whereby they would receive some compensation for nurses recruited abroad. (This seems especially fair when the governments themselves have invested in the training.) In the near future, the situation can only worsen as there are predictions that nursing shortages in the US could turn into a "severe crisis" causing further pressure on the global market."
Labor Movement: Shortage of Nurses Hits Hardest Where They Are Needed the Most
LEAD STORY-DATELINE: The Wall Street Journal, January 24, 2001.
 

Ghana
"Ghana exemplifies the lower rungs of a global shortage, with   nurses hopping from country to country for better pay and better conditions. Although training for nurses in Ghana is different than in Western countries, 500 Ghanaian nurses went abroad last yearómore than double the number of nurses who graduated, according to a January report in the Wall Street Journal . But the country also exhibits the sort of pluck that prospers in hard times.
'With what they have to work with there, it was a remarkable job they did,' said Ann Rood, RN, a retired nurse from Chico, Calif., who volunteered in Prampram, a small coastal village in Ghana.
Chickens and goats roam freely about the clinic, where women give birth in rooms separated only by cloth curtains.
'[Itís] because thatís the way it is.' The clinic faces obstacles. 'They have terrible conditions to deal with, with the male dominance,' said Rood, whose three-week post was organized through Global Volunteers. Workers go from village to village, dispensing care, making do. 'The clinics were held under a tree or on a porch.' "
Trickle-down effect . Global nursing shortage provokes competition and cooperation between countries desperate for RNs  By Karen J. Coates June 11, 2001 nurseweek.com
Jamaica
"Jamaica Nurses Flock to UK Jobs
To relieve Jamaica's acute nursing shortage, nurses have been imported all the way from Ghana (as reported in the last issue of Hot Calaloo). But, now Jamaica's nurses might be bolting for greener pastures in the UK! A British employment agency visited Jamaica to advertise for nurses. There was an overwhelming response as over 500 nurses swarmed for interviews at the Pegasus Hotel in New Kingston. Jamaican nurses, obviously highly regarded in England are sought by the UK which itself has a shortage estimated at over 8,000. The agency was in search of 50 to 75 Jamaican nurses now, with more expected early next year. They are being offered a 1-year contract with a salary of between US$19,800 to US$33,000 per year, depending on experience and qualifications.
This really dramatises how poorly nurses in Jamaica must be paid. In comparison, nurses in Maryland, USA can receive a starting salary of as high as US$35,000.
Nursing shortage in Jamaica goes back as far as I can remember. If only there were some way that Jamaica could become a nurse factory, producing certain employment, and nurses not just to satisfy its own needs but to supply the world. (from Hot Calaloo, V 7#4, Dect 1998) "
Hotcalaloo. Caribbean News, Views and Culture

Jamaica
"Nursing shortage hits Jamaica
The Ministry of Health has said that the sector has been operating at 75 per cent for several years. Government's recognition of the nursing shortage has resulted in the recruitment of nurses from Cuba and Nigeria to complement those graduating from the Kingston School of Nursing and the University School of Nursing. A health official said three times the number of current graduates of approximately 120 per year, are needed to bring the sector up to its full capacity.
At the same time the recruitment of experienced nurses continues, and more than 600 nurses have left the island in the last five years."
Hotcalaloo Caribbean News, Views and Culture September 2001 Presented on Companion Website

Botswana:
"Health posts at Disana, Shashe, Somelo and Bodibeng in the North West District remain closed because of shortage of nurses.
Oganeditse Lefatshe, a senior matron with the North West District Council, said at Councillor Omponye Botumile's kgotla meeting at Disana last week that some newly completed health facilities in other parts of the country also remained closed because of shortage of nurses.
Lefatshe said the resignation of nurses for greener pastures outside Botswana has worsened the situation; eleven have since resigned while others were transferred to other parts of the country. She said some nurses refused to be transferred to the North West District and this put the residents in a desperate situation. She pleaded with communities that have newly built but not operational health posts to be patient while the government tries to solve the problem. "
Shortage of nurses affects health posts. 27 June, 2001.  Republic of Botswana Daily News

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