This is the VOA Special English Development Report.

The health care industry needs more nurses. All areas of the world face a nursing shortage. But the shortage is most severe in developing countries. Many of their nurses leave. They move to more developed nations for better pay, better working conditions and better chances for career development.

A World Bank report earlier this year called attention to the problem. For example, nearly two thousand nurses left the Caribbean between two thousand two and two thousand six.

Caribbean nations currently have about one nurse for every one thousand people. The ratio of nurses to population is about ten times higher in the United States and countries in the European Union.

Currently, more than twenty-one thousand nurses who trained in the Caribbean are working in the United States, Canada and Britain.

Gaetan Lafortune is with the Organization for Economic Cooperation and Development in Paris. He says the nursing shortage also affects industrialized countries.

GAETAN LAFORTUNE: "There are concerns in most O.E.C.D. countries that the number of nurses is too small to respond to the demand.  And what is more worrying is that their concerns are sort of growing."

Mr. Lafortune says a large number of nurses are expected to retire within the next ten years. At the same time, the health care needs of aging populations are expected to grow, intensifying the shortage of nurses.

GAETAN LAFORTUNE: "In the U.S., for instance, some researchers have projected that there may be a shortage of close to a million nurses by two thousand twenty."

The United States is one of thirty-one countries in the O.E.C.D. Gaetan Lafortune says in recent years many of the countries increased their efforts to hire foreign nurses.

GAETAN LAFORTUNE: "But this has raised concern that O.E.C.D. countries were mainly exporting their shortage problem to countries that may have an even greater need for these nurses."