Abstract
Background: The loss of healthcare professionals because of migration remains a challenge
for low- and middle-income countries. South African Emergency Care Practitioners (ECPs)
are no exception with many choosing to leave South Africa (SA) to work in the Middle
East (ME).
Aim: To investigate and describe the push and pull factors that are influencing ECPs to leave
SA and work in the ME.
Setting: The study took place in the ME in an online setting.
Methods: A prospective mixed-method sequential design was adopted that made use of a
purposively designed, pre-piloted, online questionnaire followed by a number of one-on-one
interviews with a purposefully selected sample of participants to explore push and pull factors
that influenced their decision to leave SA to work in the ME.
Results: The increased cost of living, low salaries, poor and unsafe working environments,
and being undervalued by management in SA were the main push factors that emerged. Better
pay, improved safety and security and a better quality of life in the ME were identified as core
pull factors that are drawing South African ECPs to the ME.
Conclusion: To stem the ongoing exodus of ECPs, significant work has to be done to improve
local salaries, working conditions and the overall job satisfaction experienced by operational
ECPs in SA.
Contribution: Understanding why ECPs are leaving the country, and in particular why they
choose the ME as their employment destination can assist Emergency Medical Services (EMS)
managers to implement measures that aid in the retention of these highly skilled healthcare
professionals.