South African Doctors Earn 3 Times More Than Those In Nigeria & Kenya (pics)
Unemployed doctors aren’t the health department’s only vice; those who do work in state clinics and hospitals are heavily underpaid, says the South African Medical Association (SAMA).
Yet, South African government doctors earn up to three times more in a month than what some make in a year in other middle-income countries in Africa, such as Kenya and Nigeria.
But while the government is scrambling to get enough money to ensure that all 694 unemployed doctors, as well as recently graduated healthcare professionals, are employed, SAMA says the country’s public-sector doctors aren’t paid enough.
At a media briefing ahead of SAMA’s annual conference in mid-February, Mzulungile Nodikida, CEO of the association, said that a study commissioned by them shows that those doctors who are already employed by provincial health departments “are earning 2015 salaries”.
The study found doctors are experiencing “cost-of-living pressures”, but also concedes that their salaries are “above what other similar income-level countries pay their doctors”.
SA VS KENYA AND NIGERIA
For example, in Kenya, medical interns were paid around Ksh122 000 and Ksh145 000 per month (including risk and housing allowances) according to the 2013 Commission’s allowances for government employees. This works out to around R16 000 to R19 000 a month, compared to the almost R28 000 a medical intern earns monthly in South Africa that year.
Similarly, an entry-level medical officer (which, in South Africa, means you have completed two years’ internship and a year of community service) was paid Ksh250 000 (about R32 500) a month in Kenya from 2013, whereas their South African counterparts earned almost R62 000 per month.
Salaries for doctors in Nigeria — which is experiencing a large-scale exodus of doctors — are even lower.
Data from the National Salary, Income and Wages Commission in Nigeria shows that an entry-level doctor currently earns roughly NN1.8 million (about R22 000) per year, compared with someone in a similar post in South Africa getting more than three times that per month. In other words, South African medical officers earn 40.9 times more than Nigerian entry-level doctors (R900 000 vs R22 000 per year).
The health department says it has not yet looked at why SAMA claims doctors should earn more. But, says Foster Mohale, spokesperson for the department, they have “had meetings [with SAMA] and we are planning to review our salary scales”.
SA DOCTORS’ SALARY SCALES
Each post in which doctors work has different levels, with a specific basic salary linked to it. For example, an entry-level medical officer would be on a Grade 1 salary, which sits at just over 900 000 rands a year (75 million naira). A medical officer is a doctor who has completed their mandatory two-year internship and a year of community service and works at a public sector hospital.
After five years’ experience in the position and depending on their performance, they can move on to a Grade 2 salary in that post, and earn a basic starting salary of just over R1 million (N83 million). Grade 3 medical officers earn between R1.2 million (N100 million) and R1.5 million (N125 million) a year.
CHALLENGES FACING SA DOCTORS
The SAMA-commissioned study suggests that money is a big issue. Like all other public servants, doctors get a salary increase every year, yet the study notes that doctors have felt “a significant erosion in income levels” over the past few years because of small increases, particularly, they say, considering “inflation as well as cost-of-living pressures”.
Between 2013 and 2019, yearly increases were above inflation, but in 2020 the government implemented a salary freeze to keep its wage bill in check.
However, money isn’t the only issue that stops doctors from working for the state. Long working hours because of too few personnel and safety concerns, both at urban and at rural facilities, were also mentioned as deterrents.
More than 70% of South Africans use government facilities, yet there’s only about three doctors for every 10 000 patients in the public system. This means that the doctors who work in state hospitals have a heavy workload. A 2021 study showed that working almost 60 hours a week was common, contributing to more than 80% of these workers experiencing burnout. Burnout is job-related stress which can cause exhaustion and negative reactions to patients.
“Doctors in South Africa frequently contend with heavy workloads and long working hours … making maintaining a healthy work-life balance challenging,” said Mzukwa.
Safety at state facilities is also a problem. Between 2017 and 2022, around 200 violent incidents at public hospitals were reported across four provinces — and that’s only security issues that were big enough to get noticed.
In response to this week’s budget announcements, SAMA says they hope enough funds will be put towards dealing with “the shortage of doctors in hospitals and the plight faced by medical practitioners where salaries have been eroded by inflation over the years”.