But Mr. Catton, of the international nurses organization, said that was not the current pattern. â€œFor nurses who are recruited, there is no intention for them to go back, often quite the opposite: They want to establish themselves in another country and bring their families to join them,â€ he said.
Zambia has an excess of nurses, on paper â€” thousands of graduates of nursing schools are unemployed, although a new government has pledged to hire 11,200 health workers this year. But it is veteran nurses such as Lillian Mwape, the director of nursing at the hospital where Mr. Mulumba works, who are most sought by recruiters.
â€œPeople are leaving constantly,â€ said Ms. Mwape, whose inbox is flooded with emails from recruiters letting her know how quickly she can get a visa to the United States.
The net effect, she said, â€œis that we are handicapped.â€
â€œIt is the most-skilled nurses that we lose and you canâ€™t replace them,â€ Ms. Mwape said. â€œNow in the I.C.U. we might have four or five trained critical-care nurses, where we should have 20. The rest are general nurses, and they canâ€™t handle the burden of Covid.â€
Dr. Brian Sampa, a general practitioner in Lusaka, recently began the language testing that is the first step to emigrate to the United Kingdom. He is the head of a doctorâ€™s union and vividly aware of how valuable physicians are in Zambia. There are fewer than 2,000 doctors working in the public sector â€” on which the vast majority of people are reliant â€” and 5,000 doctors in the entire country, he said. That works out to one doctor per 12,000 people; the W.H.O. recommends a minimum of one per 1,000.
Twenty Zambian doctors have died of Covid. In Dr. Sampaâ€™s last job, he was the sole doctor in a district with 80,000 people, and he often spent close to 24 hours at a time in the operating theater doing emergency surgeries, he said.
The pandemic has left him dispirited about Zambiaâ€™s health system. He described days treating critically ill Covid patients when he searched a whole hospital to find only a single C-clamp needed to run oxygenation equipment. He earns slightly less than $1000 a month.