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Is health worker migration a disease or a symptom?
August 17, 2006
The World Health Organization has launched a new report, Taking Stock: Health worker shortages and the response to AIDS (.pdf), which states that the “reasons for the health workforce shortage include poor pay and conditions, lack of training and migration.” Among other things the report praises “ethical recruitment” — a euphemism for “rich countries should not tell African women about the lucrative nursing jobs available to them overseas, nor explain to them how to get those jobs.”
Note that the report says the problem is “poor pay and conditions” and “migration,” as if these were separate. But they are not. Migration is a result — a symptom. It is not a cause of the problem. African health workers migrate precisely because conditions are so difficult for them there. Would we prefer that African nurses (mostly low-income women) could not get better jobs to escape those awful conditions? If not, then migration per se is not bad; it is not a “problem” in and of itself.
Is it “ethical” to give African women no alternative to facing their fate simply because they didn’t happen do be born in a country with good working conditions for health professionals? Defining migration as part of “the problem” is like saying that the cause of a police officer shortage in the US is 1) low wages and dangerous working conditions and 2) the fact that young working-class men can get safer, higher-paying jobs outside of law enforcement. Who would want to reverse the latter? We need to stop discussing “migration” as a problem that must somehow be handled. Solving the real problem would vastly reduce or eliminate migration.
Those interested in health worker migration will want to have a look at a new CGD database that systematically measures the emigration of African-born doctors and nurses for the first time. Data like these, far better than what has heretofore been available, will allow us to make progress on clear and objective assessment of the causes and consequences of health worker migration.
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2 Responses to “Is health worker migration a disease or a symptom?”
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August 21st, 2006 at 11:47 am
I am an african-born nurse, presently working in public health in the united states,I would like very much to go back home to work in improving health conditions back home if opportunity presents itself.I have made trips home in an attempt to reseach immunization needs in my country,but lack of good record keeping made it difficult.I would like to know what program is available through WHO or GAVI board or Vaccine alliance that individuals who are willing to return home and utilize that which they have acquired in developed countries,not necesarily monetary, but knowledge to serve and provide needed care.
August 23rd, 2006 at 11:11 am
I am doctor, with specialty training in the US, plus an MPH and a PhD from Johns Hopkins. I tried to go back to my country, and had a very difficult experience there for 2 years, until I said enough of nonsense and accepted a job offer in the US (I had gotten 3 job offers from US Medical Schools). People should think about the implications of this; I agree with Dr. Clemens, the problem is no simply that greedy doctors are leaving behing poor hamlets in developing countries. Sometimes these poor hamlets do not want the experts, specially the doctors that hold the power there. They can make your life a nightmare.