Silent Heroes, Loud Cries: 10 Real Challenges Nurses in Africa Face And How to Fix Them

By Ojebode Dorcas Ifeoluwa (TheNurse_Writer) For Fellow Nurses Africa

They say nursing is a calling. But what happens when the call becomes a cry for help?

Across African countries, Registered Nurses remain the heartbeat of health systems, often sacrificing their own comfort, health, and dignity to serve others. Yet, behind every life-saving act lies a reality many refuse to talk about — the daily struggles, broken systems, and unspoken sacrifices nurses endure just to keep hope alive.

This report highlights 10 common challenges faced by African nurses, woven with real-life stories and practical, hopeful solutions.

If you’re a nurse, this is your voice. If you’re a policymaker, this is your call to act.

1. Understaffing and Overwork

In a packed general hospital in Lagos, Nurse Grace handled an entire night shift—alone—with 30+ patients. No assistant. No rest. Just duty.

The reality? Thousands of qualified nurses remain unemployed—not for lack of need, but because of unattractive pay and poor work conditions. Many opt out, creating a vicious cycle of shortage.

Solution:

• Prioritize mass recruitment and proper placement.
• Implement task-shifting policies.
• Offer fair wages to attract and retain nursing talent.

2. Poor Pay and Irregular Salaries

Chinedu, a devoted nurse in Eastern Nigeria, worked tirelessly for months—without pay. He began side hustles after hours just to survive.

Solution:

• Timely salary payments and salary scale reviews.
• Offer bonuses and hazard allowances.
• Nurses can explore side income streams like wellness coaching, antenatal classes, or health content creation.

3. Lack of Equipment and Facilities

During a rural outreach, Mariam stitched a wound using a phone torch. The health post had no light. One pair of gloves served multiple patients.

Solution:

• Ministries must fund infrastructure and supply chains.
• Nurses should log shortages and seek support from NGOs and private donors.

4. Burnout and Emotional Fatigue

Ade, a trauma nurse, broke down after losing a child in her care. Between endless emergencies and zero psychological support, her strength began to wear thin.

Solution:

• Create safe spaces for nurses to debrief.
• Offer mental health support and peer counseling groups.
• Encourage work-life balance and structured time off.

5. Limited Access to Continuing Education

Ngozi graduated 12 years ago. She still depends on faded notes from school. She dreams of learning new techniques, but time and money are scarce.

Solution:

• Governments and associations should provide CPD scholarships.
• Nurses can access free/low-cost online courses (Coursera, WHO, FutureLearn).
• Employers should allow study leave or flexible learning hours.

6. Lack of Public Respect and Recognition

When Ruth asked a patient’s family to wait for an IV, they said, “Na only nurse? Call doctor abeg.”

Solution:

• Celebrate nurses in the media and on hospital boards.
• Conduct public health campaigns to show what nurses actually do.
• Healthcare leaders must advocate for nurse representation at all levels.

7. Unsafe Working Conditions

During the COVID-19 peak, Musa reused the same face shield for a week. He later got infected and received no compensation.

Solution:

• Provide consistent PPE and ensure safety protocols are enforced.
• Establish a secure and anonymous reporting system for unsafe practices.
• Nurses should be insured against occupational hazards.

8. No Clear Career Growth Path

Despite multiple certifications, Sarah has been stuck on the same grade level for over 15 years. No promotion. No recognition.

Solution:

• Define clear promotion pathways based on skills, not just years.
• Create opportunities for specialization and leadership roles.
• Encourage nurses to document professional achievements regularly.

9. Gender Bias and Workplace Harassment

Emmanuel, a male nurse, is often asked, “Why nursing?” His female colleagues face inappropriate jokes—even during rounds.

Solution:

• Implement zero-tolerance policies against harassment.
• Train staff on gender sensitivity and workplace respect.
• Set up safe, confidential reporting systems in every facility.

10. Brain Drain and Migration

Last year, five of Ife’s nursing friends left for the UK and Canada. She stayed—but with more patients, fewer hands, and little hope.

Solution:

• Offer better local incentives—housing, safety, CPD access.
• Set up return programs and professional exchange opportunities.
• Build pride in home-based nursing through mentorship and national recognition.

Final Thoughts: Nurses Deserve More Than Praise

Being a nurse in Africa today is not just about compassion — it’s about resilience in the face of hardship, silence in the face of injustice, and loyalty to a system that often forgets them.

But this silence must end.

We must do better. Recruit fairly. Pay promptly. Equip thoroughly. Respect loudly. Support emotionally. Promote justly. And protect always.

“When nurses are empowered, entire communities are healed.”

Let’s not just applaud nurses on May 12. Let’s build systems that protect them all year round.

Are you a nurse with a story or solution? Write to us at Fellow Nurses Africa — your voice matters.

Fellow Nurses Africa is the independent voice of African nursing. We educate, inform, and support the nursing profession