Health staff export: Bangladesh looks to get a piece of the pie

In the first week of January this year, the Bangladesh Overseas Employment and Services Limited advertised jobs for nurses and medical technologists in oil-rich Kuwait, with close to Tk1 lakh monthly salaries, increments, accommodations and travel expenditures to be paid by the employers.

The ad belies the current state of the understaffed government hospitals struggling to tackle Covid patient rush and nearly half a dozen protests by medical technologists seeking job nationalisation in recently concluded 2021. 

In a major shift from unskilled manpower exporter to healthcare sourcing country, Bangladesh now plans to send health professionals to at least six countries – Kuwait, the Maldives, the United Arab Emirates, Qatar, Germany and Japan. According to the authorities, the countries have already shown interest to hire doctors, nurses, hygienists, caregivers and dental technicians thanks to Covid-led health worker shortage across the globe.  

"They have shown interest and we are very keen to capitalise on the newly emerged demand," Md Hamidul Hoque, joint secretary (Nursing & Midwifery) at the health ministry, told The Business Standard.  

According to the Bangladesh Overseas Employment and Services Limited, Kuwait will recruit 735 nurses and technicians in six categories for its different government hospitals in the first phase. Besides, the Maldives recently signed a memorandum of understanding with Bangladesh to recruit doctors and nurses.

Besides, the authorities say there are two other potential markets – the UK and Greece – for medical professional export. The manpower bureau and nursing directorate have joined hands to oversee the recruitments.  

Hamidul Hoque said some nurses, who got the jobs on their own, are already working abroad. But the government has undertaken the initiatives for the first time to export medical professionals.    

However, government officials could not elaborate how many health workers Bangladesh would send abroad, or when they would be sent.  

Md Shahidul Alam, director general of the manpower bureau, said the countries are yet to mention their demand and talks are going on in this regard.  

"Our target is to hit the ground running so that nursing students who would graduate this year qualify for the foreign jobs. We will enlist even the fourth-year nursing students who want to go abroad," he noted.

According to the Bangladesh Nursing and Midwifery Council, there are 271 BSc and 547 diploma nursing and midwifery colleges (public and private) in the country with more than 39,000 seats. Around 15,000 nurses enter the job market every year.

Until December last year, there were 80,739 nurses, while around 55,000 of them have been working at government health facilities. Others are employed at private hospitals and clinics.        

To tackle the Covid surge, the government last year recruited nearly 6,000 nurses. However, Shahidul Alam said there will be enough nurses graduating from the colleges in 2022 to meet the foreign demand.   

Besides, Nursing and Midwifery Council Registrar Shuriya Begum said the colleges will scale up their capacity, doubling the annual number of graduates to 30,000.

In 2020, the World Health Organization (WHO) stated the global nursing workforce was at 2.79 crore and estimated there was a global shortfall of 59 lakh nurses.

With the aging of the nursing workforce, 17% of nurses globally are expected to retire within the next ten years, and 47 lakh additional nurses will need to be educated and employed just to maintain current workforce numbers, let alone address the shortages.

In total, more than one crore additional nurses will be needed by 2030. According to a report, India and the Philippines are the major source countries for the high-income destinations. Some 2.4 lakh Filipinos and 90,000 Indians are now working in the countries. 

Quality matters   

Though the interest of the foreign recruiters is not fully matured yet to conclude whether the skills of Bangladeshi doctors and nurses are in line with the requirements, the authorities say the recruiters' willingness is evident enough that the potential workforce has required skills and standards.         

However, officials say there is no alternative to gaining skills further to unlock bigger markets such as the UK.    

Ahmed Munirus Saleheen, secretary at the Ministry of Expatriates' Welfare and Overseas Employment, said the UK needs a lot of nurses.

"Though the country did not indicate such, we want to catch the market. For that, we need to get ready by producing a quality workforce in line with the global standard," he told The Business Standard.                                                                                                                  

Md Zakir Hossain, first secretary at the Bangladesh Embassy in Tokyo, told TBS that they were working to send skilled Bangladeshi caregivers to Japan.

He said the island nation will recruit a total of 45,000-60,000 skilled workers from different countries, and will come to Bangladesh too to select the workers.

Md Sohel Parvez, first secretary at the Bangladesh Embassy in Male, told TBS that around 200 Bangladeshi doctors are currently working in the Maldives in both public and private hospitals. The Maldives is building three new hospitals that will need more health professionals.

"Under the MoU between Dhaka and Male, we will send more doctors to the Maldives – obviously with better salaries than home," he added.                                        

Expatriates' Welfare and Overseas Employment Minister Imran Ahmad told The Business Standard that their technical training centres currently do not have any arrangement for health workers. But major changes will be brought to the curricula soon to support export of medical staff.    

According to the manpower bureau, nearly 74% of exported Bangladeshi workers last year were unskilled.

The average monthly remittance sent by a Bangladeshi expat is around $203, while it is $564 for a Filipino worker, International Organization for Migration (IOM) data show. The monthly average income of a Pakistani expat is around $275, while it is $395 for an Indian and $532 for a Chinese citizen.

Authorities confident about export overlooking shortage at home

According to the guidelines of the World Health Organization (WHO), three nurses have to be recruited against one doctor.

According to the health directorate, there are 102,997 registered doctors in Bangladesh suggesting the number of nurses to be more than 3 lakh. That means the country has only 27% of the nurses it needs.

Nursing and Midwifery Council Registrar Shuriya Begum says, "If some of our graduates go abroad, it will not affect our local demand. If they get a better salary at foreign hospitals, then why would they not fly there?"

A nurse starts a career with Tk30,000 monthly salary at a government hospital, while Kuwait offers Tk73,000-Tk90,000 for nurses and technicians with three to four years of experience.  

Ismat Ara, president of the Bangladesh Nurses Association, said private hospitals do not have any specific salary for the nurses. The amount varies from Tk20,000 to Tk1 lakh depending on the medical facility.