For the past four years, Setfree Mafukidze has been working as a nurse in Northern Ireland.

Originally from Zimbabwe, he is part of a growing wave of health professionals leaving the African country in search of better career opportunities, safer working conditions and better pay.

"I loved my job back home, but the conditions made it impossible to keep going," Mafukidze told DW. "You reach a point where you feel you're giving everything and getting nothing back."

Low salaries and poor working conditions appear to be the main drivers of this exodus. Zimbabwean nurses earn around $250 (€216) per month, with doctors averaging about twice that at best. Strikes and protests in the past have done little to improve the overall situation.

By contrast, nurses in the UK can earn up to 3,150 pounds (€3,590, $4,150) monthly, according to the National Health Service (NHS). That enables them not only to maintain a higher standard of living in their new home countries but also to send money back home to support their families.

Thousands of skilled nurses face burnout

Before relocating, Mafukidze served as head nurse at a rural clinic in Chivhu, located about 140 kilometers (87 miles) south of the capital, Harare.

The facility, which serves an area of around 10,000 people, had only two nurses, a situation increasingly common across Zimbabwe's public health system.

The dwindling number of nurses who still remain in Zimbabwe's understaffed hospitals and clinics has to make up for this shortfall.

"There is a lot of burnout. Some clinics have one or two nurses serving a catchment area of 8,000," says Enock Dongo, president of the Zimbabwe Nurses Association. He highlighted that while "the nurse-patient ratio should be one to five or seven, it has risen to one to 20."

According to the country's Health Ministry, Zimbabwe is facing a shortfall of at least 14,000 health care workers, which officials warn is crippling basic service delivery and pushing the sector to the brink, especially as communicable diseases like cholera and measles continue to be rife across much of the region.

More Zimbabwean nurses now abroad than in the country

All these factors combined mean that more and more trained health care professionals are heading to countries like the UK, Australia, Ireland and New Zealand. Others move within the region, heading to Botswana, Namibia and South Africa, though rising xenophobia means that they might not always be welcomed with open arms.

There are currently an estimated 16,000 Zimbabwean nurses abroad, with the highest numbers in Australia and in the UK.

Following Brexit , which led to a significant drop in EU national healthcare workers, and the effects of the COVID-19 pandemic, the UK eased specific recruitment rules for foreign health and social care workers, creating new entry pathways to relieveits staffing shortfall.

In 2019, the NHS said it had employed over 4,000 Zimbabwean health professionals, an increase of 169% compared to previous years.

WHO red list not enough in the long term

As a result of these developments, Zimbabwe was placed on the World Health Organisation's (WHO) Health Workforce Support and Safeguards List in 2023. This list, known as the red list, includes 55 countries facing significant challenges in their health workforce.

Some countries, such as the UK, have, in response, stopped actively recruiting health care workers from Zimbabwe, although this measure has so far had limited impact on the ground.

"Putting Zimbabwe on the WHO red list is not working. Nurses are finding other avenues," Dongo told DW. "Some go [abroad] as nurse assistants and still earn more than a qualified nurse here."

Zimbabwe now effectively banning young nurses from leaving

In an attempt to stop public sector healthcare professionals from leaving, Zimbabwe has resorted to withholding the issuance of verification letters, which are required by thousands of nurses and doctors to secure jobs abroad, despite applicants paying about $300 in fees to obtain them.

Warren George, a 31-year-old nurse, has been trying to emigrate along with his wife since 2023, but their paperwork has been withheld.

"We have almost given up because of the verification issue," George told DW. "Given the chance, I would leave. Talking to colleagues abroad who found decent opportunities motivates you, but I can't go without papers."

The government has now taken a step further: Under new regulations, Zimbabwean nurses must be bonded for 20 years to the health care system before they can be released for work abroad, a move that unions have heavily criticized.

'We want to bring our skills back home'

Despite the exodus, many Zimbabwean professionals abroad like Mafukidze also say they would be willing to return home if the conditions were to improve.

"The idea isn't to stay permanently abroad," he explained. "The idea is to learn, grow and take it back home."

Health Minister Douglas Mombeshora, meanwhile, claims the government is working to rebuild the sector.

"We will build a resilient, equitable and high-performing health system where quality care is a right, not a privilege," he said, adding that domestic funding must also increase.

To this end, a National Health Insurance Bill is being prepared in Zimbabwe to expand equitable access for all and improve financing for health care. It is accompanied by a divisive government PR campaign that aims to counter the public's criticisms of the state of Zimbabwe's hospitals and clinics.

But for the time being, the few nurses that remain in the country will have to continue to bear the burden of the healthcare system's struggles.

Edited by: Sertan Sanderson