LETTER: Urgent Concerns Regarding the Treatment of Nurses and Midwives in Antigua and Barbuda

Open Letter: To the Honorable Minister of Health, Wellness and the Environment, The Executive of the Antigua and Barbuda Nurses Association, And the Concerned Public,

I write this letter not merely as a nurse, but as a heartbroken citizen, a weary professional, and a voice for countless colleagues who feel silenced. It is with profound disappointment, simmering anger, and utter disbelief that I express our collective anguish over the continued degradation of the nursing and midwifery profession in Antigua and Barbuda.

The recent arrival of nurses from Ghana, under the newly passed act, has served as the final insult—a glaring symbol of a government and a system that refuses to see, hear, or value its own. While international collaboration is not inherently wrong, the manner in which this was executed is disgraceful. To our utter dismay, the Antigua and Barbuda Nurses Association (ABNA), the legitimate representative body of the very professionals at the core of this crisis, appears to have been sidelined and not genuinely consulted. This is not inclusion; this is imposition.

This policy is a mere Band-Aid on a gangrenous wound. You seek to import hands to fill vacancies while actively ignoring why those vacancies exist in the first place. Our locally trained, highly skilled nurses and midwives are fleeing. They are not leaving for wanderlust; they are escaping:

*   Poverty wages that do not reflect our critical role, our expertise, or the cost of living.

*   Debilitating working conditions: chronic understaffing that burns out even the most dedicated.

*   A blatant lack of respect and professional victimization when we dare to advocate for our patients or ourselves, only to be labeled “political.”

*   Stagnant careers with little to no upward mobility or access to specialized educational opportunities.

*   A systemic environment that is fundamentally abusive, where our dedication is exploited as a perpetual given.

And what do we see? Nurses brought from abroad are, in some cases, offered better packages—housing, transportation, incentives that local nurses can only dream of. Yet, when their contracts end, they too often leave. We are left to train them, to guide them, to share our limited resources and institutional knowledge, without additional compensation or recognition, only to be left behind once more. We feel used and abused by a system that sees us as disposable, and by a cycle that perpetuates our misery.

The crisis is not merely a “staffing” issue. It is an issue of fundamental dignity and infrastructure. Our healthcare system is crumbling physically. Many clinics are housed in dilapidated, outdated buildings. We work in environments without reliable running water, without consistent air conditioning in this brutal heat, without backup generators—conditions that would be deemed unacceptable for any other essential service. How can we provide quality care in such decay? The solution is not just more bodies in a broken building; it is to fix the building.

The most recent, and perhaps most personally painful, slap in the face was the grand banquet to welcome the new arrivals. The symbolism is crushing. During Nurses Week, our sacrifice is met with silence. At Christmas, our year-round vigilance earns no gesture of thanks. We cannot get a simple plate of food or a genuine “thank you” for holding this system together with our bare hands and fraying nerves. Yet, for newcomers, there is a public celebration. This is not hospitality; this is a stark demonstration of where your priorities lie. It screams that you will invest in everyone and everything except the professionals who have given their lives to this country’s health.

We are not asking for banquets. We are demanding:

1.  Meaningful consultation and recognition of the ABNA in all matters affecting nursing and midwifery.

2.  Immediate, serious, and good-faith negotiations for a living wage and competitive compensation that reflects our value and stops the exodus.

3.  A comprehensive plan to overhaul our working environments, including urgent refurbishment of clinics and provision of essential resources (water, power, air conditioning).

4.  Clear, accessible pathways for career advancement and continuing education.

5.  An end to the victimization and political labeling of nurses who speak out for better patient care and professional standards.

We are the backbone of healthcare in Antigua and Barbuda. We are the hands that catch your newborns, the calm in your emergencies, the comfort in your pain, and the vigil at your final hour. We are tired of being treated as the problem, when we are, and have always been, the solution.

The band-aid must come off. It is time to address the festering wound with surgery, honesty, and respect. Stop importing solutions and start valuing the ones you already have.

Sincerely,  

A Deeply Concerned and Heartbroken Registered Nurse