Health worker salaries in Zambia are low by any standard. In recent times there have been real reductions in the salaries of health workers. This has resulted in significant attrition in the public sector as health workers are attracted to the private sector or leave Zambia entirely, leaving a large deficit in public sector health workers. In this study we examine the relationship between health worker incomes and their satisfaction and motivation. Cross-sectional data collection was undertaken using both quantitative and qualitative methods. A refined survey instrument was used for the quantitative data method. Document review (past and current records) was employed for the qualitative method. Data was collected in three regions that represent extremes in overall remuneration and benefits. Lusaka represented the favourable area while Monze and Nyimba represented less favourable areas for study in Zambia. There are hefty disparities between different health workers. There are also enormous salary differentials for the same workers between the public and private sectors. These salary differentials explain the experience of public to private “traffic” of health workers as well as casual private sector work by public sector health workers. In addition, there are negligible efforts by government to reduce the benefits gaps among key public health cadres. The low incomes received by public health workers in Zambia have many negative implications: it begets absenteeism, results in low output, poor quality health care, and the departure of health workers to the private sector and overseas.