They work in silence, their triumphs often unnoticed, their struggles rarely acknowledged.
Across Africa, nurses are the backbone of healthcare, delivering care where resources are scarce, facilities are overstretched, and life-and-death decisions are made under impossible constraints.
A new World Health Organisation (WHO) report illustrates the disparities between responsibility and incentive – African nurses provide 43% more patient care hours than the global average, yet operate with 62% fewer resources.
While nearly two million nurses worldwide joined the profession since 2018, Africa remains critically underserved. The continent is home to 17% of the world’s population but makes do with just 3% of its nurses.
The consequences are severe.
South Sudan has only three nurses for every 10,000 people, far below the global average. A staggering 76% of nurses on the continent report that they regularly work without essential medicines, while up to 58% are forced to reuse single-use equipment due to shortages.
This isn’t just a crisis of numbers; it’s a crisis of survival.
Almost 5,000 doctors moved to Britain between 2015 and 2021, according to a Nigerian non-profit.
In a rural Kenyan hospital, nurse Sanaiyan Torome faces this reality daily. During one gruelling 17-hour shift, she assisted a mom carrying twins through a complicated pregnancy, helped deliver two more babies, treated malaria cases, and stabilised a motorcycle accident victim.
Sanaiyan had just another nursing colleague to help her see the night through without a significant hitch.
Just before her marathon shift was to end, another challenge cropped up. “There was this woman in obstructed labour who arrived in the wee hours. I knew the generator could fail any moment," she tells TRT Afrika.
"I had to make a difficult choice. Do I prioritise the oxygen machine or the operating theatre lights? In that moment, you realise no nurse should have to make that decision alone."
Heartbeat of healthcare
These are the untold stories of African nurses working miracles in the shadows of staggering challenges.
"We are not just understaffed; we are under-equipped," says nurse Mahamadou Cissé from a clinic in Mali, holding up a blood pressure cuff whose torn edges are taped together.
"Whether it’s about patients sharing a bed, us reusing gloves, or having to choose who gets oxygen –this is not the nursing I was taught,” says Mahamadou.
This community health nurse has made it his life's work to reduce mortality among expectant mothers and newborns in Ghana's hinterland, often travelling solo to villages with an ultrasound machine to help those who can't afford preventive scans.
The State of the World’s Nursing report for 2025 highlights the irony of 23% of nurses in high-income countries being foreign-trained, many from Africa.
"Every time another colleague leaves for Europe, part of me understands," says Lagos-based nurse Chioma Okeke. "But then I look at my paediatric ward and wonder who will care for these children if we all go?"
International Nurses Day, commemorated on May 12 every year, is a tribute to weary frontline healthcare warriors like Chioma.
In rural Malawi, community healthcare nurse James Kalonga walks 12 kilometres daily between villages.
"My 'clinic' is whatever shade tree we find," he chuckles, patting the medical bag containing his entire inventory.
James has immunised over 1,200 children this year alone.
Nursing old grievances
Ghana’s recent healthcare policy shift, including salary improvements, enhanced working conditions, and career growth initiatives, aims to slow nurse emigration.
Still, with 47% of Africa’s population lacking essential health services, the nursing sector requires urgent reinforcement.
Globally, nearly 33% of nurses are under 35, but in Africa, many battle burnout due to understaffing and a general lack of support.
"I have seen nurses break down after shifts," says Zuena Mugisha, a midwife in Uganda. "There’s no time to rest, no counselling. We keep going."
Only 42% of countries worldwide provide mental health support to nurses, which is seen as a glaring omission, especially after the trauma induced by the pandemic.
WHO Africa launched a campaign this International Nurses Day with three key objectives: tripling nurse recruitment in underserved areas, establishing minimum safety standards across healthcare facilities, and securing emergency supply chains to ensure nurses have the tools they need to provide quality care.
“Although this report contains encouraging news for nurses, the backbone of healthcare, we cannot ignore the persisting inequalities in the global nursing landscape,” WHO’s director general, Dr Tedros Adhanom Ghebreyesus, said ahead of its launch.
“I urge countries and partners to use this report as a signpost, showing us where we have come from, where we are now, and where we need to go – swiftly."
For thousands of nurses across Africa, these challenges are more than statistics; they are lived experiences.
It’s another day at the rural Kenyan hospital where Sanaiyan works. At the first light of dawn, she checks the generator, hoping there is enough fuel to power the operating room for the busy C-section ahead.
"We don’t just need more nurses; we need systems that value and support us in keeping our patients healthy," she tells TRT Afrika. "We are often called heroes. But heroes need help too."
