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To coincide with the 60th anniversary of Britain's National Health Service, the BBC looks at healthcare around the world. The BBC's Will Ross reports from Ghana where the "brain drain" has left hospitals struggling.
A nurse providing help to a patient at Ndola hospital in Zambia
The exodus of health professionals has affected many African countries
If you want to train in Ghana as a nurse and then disappear in search of greener pastures abroad, you better have deep pockets.
That is the message from the government as it attempts to stem the so called "brain drain" of health workers.
Nurses face a fine if they want to work abroad before serving in a Ghanaian hospital for five years.
"We have looked at the cost of training a nurse and if you default for the whole five years then you will be paying around 12,000 Ghanaian cedis, ($11,000, £5,500)," says James Antwi, the Health Ministry's deputy director of human resources.
In theory a nurse wishing to work abroad would have to produce a certificate as proof of qualification and so until any fine has been paid, the Health Ministry can withhold the certificate.
The Ghanaian government says the threat of a fine has helped although the accountants have not exactly been inundated. Since the scheme was implemented three years ago just four people have paid fines of between $2,000 (£1,000) and $6,000 (£3,000).
I can see why nobody wants to stay here
Nurse Joanna Poku
In 2004, 700 nurses notified the ministry before going to work in Britain. But that has dropped massively to just six nurses leaving to work in the UK last year, according to the government.
This is, however, partly due to the fact that nowadays doctors and nurses from other parts of the European Union would be in front of Ghanaians in the queue for jobs in the British health system. It is also not clear how many have slipped under the government's radar.
There is no practical way of preventing a nurse from quitting the profession altogether and with low morale amongst health workers, retaining staff is a major challenge for the government. 