Burundian doctors : bonuses to stay… or a band-aid on a deep wound?

SOS Médias Burundi

Bujumbura, May 13, 2025 – The small east African nation is facing an alarming outflow of healthcare professionals. In response, the government has decided to increase the salaries of doctors assigned to the provinces. This initiative was welcomed, but deemed late and partial by those most affected.

Brain drain, deserted hospitals, abandoned patients : Burundi is losing doctors day after day. In response to this silent hemorrhage, the authorities have finally acted. As of Monday, May 12, an ordinance signed in February 2025 comes into effect, establishing bonuses and relocation fees for doctors practicing outside Bujumbura – the commercial city where United Nations agencies and the central administration are concentrated.

In concrete terms, a general practitioner, previously paid 500,000 Burundi francs (approximately USD 170), will see their income quadrupled. For specialists, their salary will be multiplied by five if they are assigned far from the capital.

A breath of fresh air for some, who see it as long-awaited recognition. But on the ground, enthusiasm is tempered. While money is an important factor, it doesn’t solve everything.

“It’s not just low salaries that push doctors to leave. It’s also the lack of equipment, isolation, and lack of prospects,” explains a doctor based in the north of the country. Hospitals in the interior, often underequipped and neglected, struggle to provide decent working conditions.

The reality of the medical exodus is hard to ignore. According to the Burundian Medical Association, more than 300 doctors have left the country in the last five years. The most common destinations are Rwanda, Kenya, and Europe. In some provinces, a single doctor sometimes covers more than 100,000 inhabitants, jeopardizing access to basic healthcare.

“I almost left for Rwanda last year. I was exhausted. We’re alone, overwhelmed, and sometimes we work without even an IV drip available. These bonuses are welcome, but they won’t keep us here long-term,” confided a general practitioner from Karusi province in east-central Burundi.

Another source of frustration : only tenured doctors are affected by these increases. Nurses, nursing assistants, and contract workers—who provide the bulk of daily care—remain excluded from the reform. This imbalance is denounced by several sector stakeholders.

For many, this salary reform is only a first step. The real challenge remains : reforming a healthcare system that is exhausted. This requires better governance, investment in equipment, quality continuing education, and clear prospects for young doctors.

Bonuses may retain some. But only a profound transformation will convince healthcare workers to stay and build Burundi’s future… where they are needed most.

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A health worker collecting blood for health facilities in Burundi during a blood donation campaign (SOS Médias Burundi)