The Cook Islands Ministry of Health has resorted to employing nurses from the region after no response was received to locally published advertisements.
Health secretary Vaine Teokotai says that three nurses from Vanuatu and one from Fiji have been recruited on a two-year contract specifically to fill the gap until the first year nursing students graduate.
The decision by the three Vanuatu nurses to shift their expertise to the Cook Islands has raised concerns with their government and the media in Vanuatu.
A senior Vanuatu health official Thomas Isom was quoted by the Daily Post as saying that the resignations have shocked the ministry.
However he admits that nurses heading for greener pastures has now become a trend.
A Vanuatu spokesperson for nurses, Cecil Ala, says that the brain drain reflects a health system that has limited financial resources due to budget cuts.
The Cook Islands currently has about 60 registered nurses and there are 18 first year students at the school of nursing.