Medical exodus: Morocco's healthcare system bleeds medical professionals

Not a day goes by in Morocco without medical professionals leaving for Europe or North America, in a wave of mass migration of doctors and nurses leaving behind a significant gap in the country's healthcare sector. This exodus comes at a time when the kingdom is striving to implement a universal healthcare coverage project, which requires a larger healthcare workforce.

Healthcare facilities and hospitals across Morocco are grappling with a substantial loss of doctors, nurses, and health technicians due to this ongoing migration trend. Countries like Germany, the United States, and Canada are drawing these professionals with attractive wages and incentives, exacerbating the shortage back home.

The health workers that Raseef22 spoke with in the healthcare sector unanimously attribute the continuous migration of doctors to a mix of internal and external factors. These include "unfavorable working conditions in exchange for low wages and inadequate compensation, alongside a lack of financial incentives."

A better opportunity in Germany

Before the onset of the COVID-19 pandemic and the subsequent travel restrictions, Dr. Morad Abarkani managed to move to Germany to further his professional journey. The Moroccan doctor left behind the clinic where he had been practicing in the city of Beni Ansar, situated in the Nador Province of northeastern Morocco.

Dr. Abarkani, who currently resides in Germany, underscores the driving force behind doctors leaving their home country. He believes that "the allure of better job opportunities and higher salaries abroad, particularly in nations that have advanced medical infrastructure like Germany with its sophisticated and sustainable healthcare system, plays a pivotal role."

Healthcare facilities and hospitals across Morocco are grappling with a substantial loss of doctors, nurses, and health technicians who are opting to emigrate to the West

Beyond economic factors, living conditions also contribute to this migration trend. Dr. Abarkani emphasizes to Raseef22 that "seeking enhanced personal and economic prospects, coupled with the pursuit of professional growth, draws doctors towards countries that provide ample educational and training opportunities. These factors create an attractive environment for doctors looking to refine their medical skills and specialization."

The same speaker anticipates that "the migration of doctors from Morocco and other developing nations to countries offering improved professional and living conditions will continue." He points out that the migration rates of healthcare professionals "may be influenced by a range of factors, including political and economic developments in Morocco, as well as shifts in immigration policies in recipient countries.

Migration of both doctors and nurses

In its ongoing efforts to monitor the hurdles hindering Moroccans from fully accessing healthcare services, the National Human Rights Council (CNDH) – an authoritative body safeguarding human rights in Morocco – has directed its focus towards the critical issue of medical professional migration. Their report, titled "Effectiveness of the Right to Health in Morocco... Challenges and Ways to its Strengthening", was released in April 2022.

This report underscores the concerning trend of "doctor drain", revealing that despite a sizable contingent of approximately "23,000 Moroccan doctors practicing within the nation, a substantial number – ranging between 10,000 to 14,000 – are choosing to practice their trade abroad, notably in European countries, which makes one in every three Moroccan doctors pursuing their careers overseas, even as the domestic demand for their expertise remains pressing and the need for more professionals becomes ever clearer."

In every conversation I have with a colleague who has emigrated to work abroad, I often pose the question of whether they regret their decision to leave. Their usual response is that they regret all the years they worked with the Ministry of Health

The CNDH report emphasizes the disconcerting reality that "Morocco currently employs 23,000 doctors, yet necessitates an additional 32,000 doctors based on the fundamental benchmarks set forth by the World Health Organization. Moreover, the country requires over 65,000 healthcare professionals." Anticipating an acceleration of these human resource requirements, the report underscores the inevitable expansion of healthcare coverage in the near future.

A study to sound the alarm

In response to the burgeoning emigration of Moroccan medical professionals, a study conducted by the "Foundation of Medical Professors in the Free Sector" – a non-governmental entity – raises a red flag. The study asserts that "Morocco experiences an annual loss of 600 to 700 doctors, accounting for nearly 30% of the current pool of trained medical personnel." Significantly, this migratory phenomenon and "mass exodus encompasses all cadres, spanning from medical students to specialized practitioners and educators alike, further exacerbating the prevailing shortage."

The General Secretary of the Independent Syndicate of Public Sector Doctors (SIMSP), al-Muntathar Alawi, shared with Raseef22 that "in the absence of official government statistics, it's imperative to take the numbers from this study seriously to sound the alarm and a call for action. The government should be urged to take action, while also emphasizing the necessity of conducting a scientific study and gathering official statistics on this matter. This would provide credibility to discussions surrounding the emigration of doctors."

Between 10,000 and 14,000 Moroccan doctors are currently practicing medicine in foreign countries, particularly in European nations.

However, Alawi adds, "It's an undeniable fact that the mass emigration of doctors is taking place, and even the Ministry of Health acknowledges this reality. The trend of migration will undoubtedly continue, especially since individuals have the freedom to move and seek opportunities that align with their aspirations and personal convictions."

The physician and union activist underscored that "the significant deficit in the medical sector, particularly in terms of human resources, isn't solely impacted by international migration. There's also an internal migration of doctors from remote and mountainous regions to urban centers, especially major cities and coastal areas. Additionally, there's a shift from the public sector to private clinics and hospitals."

A troubling situation and critical shortages

The situation is equally challenging for nurses and health technicians who opt to move and work abroad, leading to a severe shortage of these professionals within Moroccan hospitals and healthcare centers, according to concerns expressed by nurses' unions over this issue.

Zakaria al-Taabani, the regional representative of the National Health Union, highlighted, "While official statistics are lacking, based on our experience as nursing practitioners in Morocco and our strong union and association connections, we can categorize the situation as deeply concerning for those currently employed in the sector."

Al-Taabani told Raseef22, "To illustrate, Bouafi Hospital in Casablanca (west) lost more than 14 nurses over the past year due to their decision to emigrate to Canada. Rhe Bernoussi district in Casablanca alone lost 7 nurses and health technicians, seeking opportunities in Germany, Canada, and Britain."

In light of this situation, "dozens of young nurses have chosen to leave the country on a national scale. Moreover, there are those who are merely awaiting the right opportunities or the acceptance of their applications," emphasized the nurse and dedicated union advocate.

Lack of motivation amid persistent polarization

The Independent Nurses Union (a non-governmental organization) seized the opportunity to compile a report titled "Migration of Nurses and Health Technicians in Morocco: Reality, Reasons, and Solutions." This comprehensive report was initially presented in October 2022 during a session before the Economic, Social, and Environmental Council (a constitutional advisory institution).

Over the span of a decade, a staggering 10,000 Moroccan nurses have emigrated abroad, at an annual average of 1,000 nurses.

The union's report, a copy of which has been made available to Raseef22, unveiled that "Over the span of a decade, 10,000 nurses have emigrated, at an annual rate of 1,000 nurses." The report further sheds light on the ongoing trend of "recruitment of nursing talent abroad, which persists due to the lack of any positive incentives or motivating measures from the Moroccan government and the Ministry of Health. Instead, the tendency to marginalize this professional group has persisted over the years, emerging as a pivotal factor fueling the escalation of the nursing exodus. This dynamic has enabled certain nations to capitalize on the opportunity to attract these skilled professionals."

The same source clarified that "the number of nurses and health technicians in Morocco does not exceed 34,000, with 29,000 male and female nurses in the public sector. This places Morocco among the countries with the lowest professional density." It was further highlighted that "the kingdom necessitates 65,000 nurses and health technicians to meet the minimum international standards", nearly double the current amount.