Global Development: Views from the Center

There can be medical brain drain even when medical professionals stay in their home country. There have been horrible 'brain drain' effects brought on by Aid Donor Organizations offering substantial wage increases to medical professionals to stop their regular general practitioner duties and instead administer antiretroviral therapy to aids patients. "[t]he Gates Foundation effort, with its tight focus on the epidemic, may have contributed to the broader health crisis by drawing the nation's top clinicians away from primary care and child health." You can read more about this on my website, http://www.WhatNewsShouldBe.org at this subpage
http://mysite.verizon.net/vze25x9n/wnsb/id19.html

Angie
http://www.WhatNewsShouldBe.Org

In countries like Philipines, the prospect of migration induces many more women to pursue nursing than they otherwise would. Does the subsequent migration of such nurses count as "brain drain"?

There is an interesting recent International Crisis Group report on the distortive effects of NGO and UNMIL involvement in the medial profession in Liberia, "emergency salaries" that are totally unsustainable are being institutionalized as a result of labor-market and organized labor pressures. Forget about those distortive effects, a lawyer can make more money in Afghanistan as a translator for SFOR than he or she can as a lawyer for the Afghan government!

Brain drain, though, also pumps money back into these economies through remittances and sometimes results in skills acquisition. Has there been any research into doctors going overseas and then returning?

You make an interesting set of counter points here. Aside from sending remittances, as Charles mentions above and which in India is over $20 billion a year, a remote work force can be tapped to lead a diaspora-powered movement for development. The People to People organization places Ethiopian doctors overseas within in-country assignments and also run a virtual clinic for those without access to foriegn-educated providers. The virtual network also provides a strong community outlet.

it is better to have brain drain, then all the brains going down the drain.

The wide coverage the British media gave to medical brain from Africa is a clever cover up of a well designed effort by Britain to keep medical jobs for her citizens. Crocodile tears. It is common knowledge that whilst there is abundance of foreign born, British trained, surgeons in Britain, the British National Health Service (NHS) raised alarm about the dearth of surgeons in Britain, two years ago. The NHS even planned to train senior nurses to carry out surgeries in order to reduce long waiting lists of patients. Whilst the NHS plans to turn nurses to ‘surgeons’, thousands of third world specialist doctors – surgeons, gynaecologists etc, have to make do with being general practitioners, a better trade off to going back to their mismanaged home countries. I have practiced medicine in Nigeria for close to thirty years now. There is underutilization of available medical manpower and poor governance. The poor health status of Nigeria, as in other African countries, is mostly due to failed governance and little to do with medical brain drain. British citizens, like their footballers, should learn to compete in an open market, which should be the true message of globalization and fair trade. If Britain wants to sell its finished goods to developing countries, it must not prevent developing countries from earning income (from advanced countries) through the sale of professional expertise. That is the true meaning of free trade and the opening of markets. Nigeria earned more money from home remittances than from developmental aid in 2007. Currently, credible information is available to the global community in all spheres of human activities. In view of that, I suggest that the media in all countries should eschew hypocritical campaigns because their genuineness can easily be tested. All media should encourage fair trade policies because that is the only way world peace and progress would be facilitated.

Health workers are not "human resources" - whilst you cannot deny that the individuals motivations are economically rationale this does not mean they are best for society (both developed and developing). Health care workers are being attracted to developed countries by market forces. Due to the huge differential in purchasing power parity between developed and developing countries the intrinsic value (rather than purely monetary) an individual in a developed country associates with health care provision is not necessarly equivalent to someone in a developing country. In essence this argument claims that the pull of market forces allows individuals to pursue dreams - a hotly debated issue and worthy of a thesis in its own right. Perhaps the western dream of individualism and consumption but this isn't necessarly a happy formula.

"prevent Ghanians from leaving" - again this relates to the first point. It is not a question of preventing them from leaving but giving them a reason to stay!

The migration of health professionals from Africa gravely impacts health service delivery; thus reflecting in the serious health indicators of maternal mortality, infant mortality,contraceptive rates, etc. These in trun impact on the general development/welfare of the societies. Skilled workers have a direct role in improving the health status of the people.

I believe Michael showed facts about the migration status. I would want to make a contribution on the retention aspects. PERFORMANCE BASED INCENTIVES/FINANCING have a vital role in motivating and retaining the skilled professionals. Motivation is a fundamental issue for any person at the work place. Preaching patriotism may be a good thing, it is better to address the substance of the matter: basic requirements for a descent living.

Health authorities/governments in Africa should focus on increasing health care budgets as percentage of the national budgets and understand that motivation of health professionals is key to better service delivery.

I am sure if a Malawian doctor or nurse can be given compelling reasons to stay, I dont see them leaving. Otherwise their extended families back home and indeed their country's current account balances tend to benefit more from such movements than if they were to stay in their countries.

I hope that Michale can still understand that can engineers, entreprenuers, politicians or technocrats save lives in Africa? Africa needs more doctors and nurses, but i think there is massive need to have Health sector reforms which would trigger doctors and nurses scope and renumeration. Pakistan have done quite a good work in rural areas where doctors and para medical staff hestitate to stay, but incentives in terms of promotion and salary have siginificant impact. The development of Africa is the solution, but still the brain drain is big problem facing by continent.

I must repeat this again and over again.

For a nation, when push comes to shove, it is not the possible brain drain that matters; it is the heart drain that could occur if those health workers forget their homeland that is of real importance. Let them go out in the world…but do not forget them or let them forget you.

This whole issue about brain drain, remittances, dismal health situations in the Third World and the covert move by Britain and the rest of the developed World to prevent the migration of qualified professionals from the Third World are all part of the grand design to sustain the underdevelopment of the Third World. Who established the foundation of contemporary socio-economic and political problems in the Third World? Who benefits from the economic insolvency of the Third World?
If the Third World was developed, well able to cater for the needs of its citizens, very many professionals will rather remain at home than suffer degradation and abuse overseas, where they are underemployed and largely unappreciated.
The issue ought not be preveting them from leaving, but keeping them at home. Before the 1980s, the lure of the 'pull' of migration was not strong enough to propel massive movement of people out of the Third World as prevailing situations at home were favourable. The challenge before the developed World should be: how do we re-create the pre 1980 economic conditions in the Third World? However, this would not be possible as the 'North' is the beneficiary of the present situation, which it would rather seek to perpetuate.