22
Feb
08

Should luring developing world doctors be a crime?

A group of international medical experts has said that so many African health professionals are being recruited by Western countries that the practice should be viewed as a crime.

They say, for instance, that more than 13,000 doctors trained in sub-Saharan Africa are now practicing in Britain, the United States, Canada and Australia, and that they’re leaving behind are healthcare systems that can’t cope.

If you live in the West, do you feel guilty about the doctors and nurses from the developing world who work in your hospitals?

If you live in the developing world, do you resent those doctors and nurses who leave?

And should the practice of actively recruiting these doctors be made illegal?

Meanwhile, a report out today (by the Organisation for Economic Co-operation and Development) says that there’s little evidence that there is a brain drain from the developing to the developed world. They say it affects all countries. In which case…

Should graduates be obliged to stay for a period of time in the country which has educated them?

Or should we live in a free world with a free global economy, where we can work without restriction?

OTHER MATTERS…

1. IS FAIR TRADE FAIR?

2. CONTRIBUTORS’ CHARTER. I’ve updated this and you might want to have a look. It runs through what you can expect if you contribute to WHYS online or on the radio. To those of you who are trying to post very very long comments on the blog, it also explains why we’re not going to publish them.

3. TRIPLETS AT 16 – AGAIN

No chance of this making the show, but this is an unbelievable story from Argentina. Six? I can only just cope with one.

4. LUBNA’S NEW BLOG

With some help from WHYS regular Ian in Phoenix, Lubna in Baghdad has started blogging.

5. FAREWELL LEONARDO, BEN AND MARTIN

There have been a few too many leaving parties for my liking recently and we’ve another this evening. Leo has already left and Martin and Ben are on their in the next week or two. All three have been brilliant producers for us, and it’s a real shame that we’re going to be without them.

That’s it for this week. Have a good weekend.


102 Responses to “Should luring developing world doctors be a crime?”


  1. 1 Rashid Patch
    February 22, 2008 at 13:48

    I live in the U.S.A., and I don’t have medical insurance, so I don’t have to feel personally guilty about being treated by doctors recruited from the developing world, since I don’t get treated by doctors anyway.

    That said, I think that there is something clearly and gravely wrong with the way that the developing world, after being blatantly exploited by colonialism for it’s material resources, is now being strip-mined for it’s human resources. Currently the rich ores of laborers being extracted are in medicine and IT. Other fields may be mined in the future.

    If the ‘free market’ was in fact a system that produced the best results for the most people, the flow of medical help would be the other way. Why is it that a poor country like Cuba can afford to send thousands of it’s doctors to other countries, while the U.S. or E.U. are taking doctors from elsewhere?

    Peace,

    Rashid Patch
    Oakland, California, U.S.A.

  2. 2 John in Salem
    February 22, 2008 at 13:49

    For the same price they could build a better carrot than a stick. Give them a reason to stay.
    Or better yet, how about making becoming a doctor just for the money a crime.

  3. 3 Janai Calluy
    February 22, 2008 at 13:56

    It sure is.
    I think this practice is referred to as ‘brain drain’.
    Some time ago I heard there are more doctors from Malawi working in the Manchester hospitals then there are doctors in Malawi itself…
    This is a great obstruction to the development of third wirld countries.

  4. February 22, 2008 at 14:05

    Hi WHYS, its really unacceptable. I live in Uganda and the Health services here are appling.Imagine in the main national referral Hospital of Mulago, one nurse has to attend to over six women who are in labour at ago.No womder the martenal deaths are high in Uganda and we are doing led to badly on the MDG’s.
    This is to be blamed on the Government which has failed to concentrate on key issues like health and has resorted and diverted resources to other non-issues such as political funding. This leads to individuals streaming out to look for “greener pastures” elsewhere.
    I think the best option will be to improve the motivation of these health workers and there will be no “brain drain”. I thus do not resent the doctors who leave but rather urge them to become more patient because many poor people are dying daily because of lack of services.

  5. 5 Dee in Chicago
    February 22, 2008 at 14:08

    Perhaps they can develop a system whereby their education is paid by the government and in return they would provide the same number of years service to that country.

  6. 6 Arnaud ntirenganya Emmanuel
    February 22, 2008 at 14:30

    I tried once and failed and if situation doesn’t change I will try again….
    In order to stop this flow of Africans to Europe many thinds need to be done, African governments should satisfy their citizens by providing better education, health facilities, transportation means, housing, and more important employment to all, because we leave just because we need all these. Also the western countries should be reminded to exploit Africa’s intelectuals because some west countries have skills shortages the reason that Africans are lured. Let also the west be reminded to take the young ones to train them than luring the mature brains that causes poverty and all sorts of problems in Africa.

  7. February 22, 2008 at 14:36

    hi everyone. its a great topic, i am a Ugandan though now in Egypt but i have observed that Ugandan educated population including medical workers always flee the country to work outside. this is because there is lack of nationalism for the Africans and all they look at is money and forget about the countries that have educated them. in Uganda the government educates around 250 doctors per year but like only 50 work in the country. ists not only with the medical sector but also students who go abroad on national scholarships abroad on different courses never come back to work for the country.

  8. 8 Ros Atkins
    February 22, 2008 at 14:42

    Hi Ros,

    Is there an Open Season? Can I put his head on my wall?

    No seriously, why on earth should it be a crime if the doctors want to go elsewhere, and their own countries are incapable of keeping them in the manner to which they would like to become accustomed, mostly because of bad governance, and spending everything on ministers’ cars/houses/trips or whatever.

    How can it be a crime for someone to want to better himself, if he has the legal means?

    Cheers,
    Chris in Namibia.

  9. 9 Ros Atkins
    February 22, 2008 at 14:43

    Hi Precious Aras ! Thanks a million for mentioning my blog in the WHYS daily email. Since 2003 1000 Iraqi doctors in different specialties have fled Iraq. Also since 2003 222 Iraqi doctors in different specialties have been murdered. No country in the developing world is suffering from the consquences of BRAIN DRAIN like Iraq is. There’re organised gangs in Iraq specialised in assassinating Iraqi doctors. And here’s how it goes : The Iraqi doctor receives a threat and fleds Iraq, but if he refuses to leave then either he gets kidnapped or the worst happens, he gets killed. Now Iraqi patients with critical illnesses (like CA, or heart diseases ) are suffering a great deal because of the absence of specialised experienced doctors while Jordan, Syria and the UAE enjoy the experience of our best doctors who had to make a choice between their lives and staying in their country. My heart blames our Iraqi doctors who have left their country and their patients behind, but my mind sa!
    ys that they’re right to leave. With my love. Yours forever, Lubna.

  10. 10 Elias Ratteng
    February 22, 2008 at 14:48

    Dear Ros,

    This is utter rubbish. Nobody toils studying to give charitable services. Who doesn’t want a world class pay? If one has got good terms in the west, so be it. If the governments in sub-saharan countries want to retain the medics, they should compete in the offers. Legislating and criminalizing this would not be a panacea either. Kenya is a victim of this, but who wont want to run away from a burning country, complete with a dictatorial regime. Given an opportunity, i would quickly flee as well.

  11. 11 VictorK
    February 22, 2008 at 14:49

    Re recruitment of doctors abroad: it’s pretty absurd to be talking about criminalising this.

    Firstly, in most developing countries education is not free but something you pay for. If you took nothing from the state then you owe nothing to the state and should be free to practice your profession wherever you please. In those cases – if any actually exist – where the state has contributed to the training of a doctor then the cost of training should obviously be re-imbursed.

    Next, most African countries – no, make that all – are failed states. There is no mystery as to why a doctor would want to work in a civilised and ordered society in which he will be paid on time and in which such luxuries as clean water and electricity will be available. Mogadishu General or St Barts, London: there isn’t really a contest. If Africa wants to retain its talent let Africa reform its now habitual incompetence, corruption and all round inefficiency.

    Thirdly, freedom of movement is a fundamental liberty. To lack it is to be a slave. I’m amazed at the racist logic that argues the case for Westerners keeping from Africans the freedoms that we in the Western world take for granted.

    Fourthly, African professionals working in the West do not represent a pure loss to Africa. The remittances that they send back to their families represent a significant benefit to an impoverished continent. It wouldn’t surprise me if the monetary value of what the typical expatriate African doctor sent back over several years actually exceeded the cost of originally training him (and that assumes that his family didn’t bear the cost of his education in the first place).

    Of course, the real animus behind all of this is the usual one of hatred of the West in certain quarters. It is the notion that Westerners are benefiting in some way that is the real cause of offence, not the loss to Africa. There is also the vanity involved in thinking that the West is in some way dependent on Africa, as well as the exaggerated sense of victim-hood that this feeds into amongst some Africans who take a masochist’s delight in imagining that Africa is suffering yet another terrible injustice at the hands of the West (“It’s a modern day slave trade!!!!’ etc, etc…).

    Well the simple fact of the matter is that the West does not need anything from Africa but its mineral resources, which are paid for fair and square. If Africa’s dictatorial leaders and governments were to treat their people as slaves and forbid them to hire themselves out freely and according to their own wishes, then very well. Western countries would simply train up more doctors locally and/or find willing recruits from other countries (and there is a vast reservoir of talent in the countries of Eastern Europe). It will come as a blow to the self-importance of many Africans, but their continent counts for very little in the world and has next to no influence. What this pseudo-debate is leading to is a demand from African governments for the West to pay ‘medical reparations’ for this brain drain. As yesterday’s discussion on President Bush revealed, many Africans are hardcore welfarists who have convinced themselves that they are entitled to regular injections of cash from the West. This is an opportunity to dress up that begging bowl mentality in self-righteous moral outrage and to argue that charitable donations from Western governments really ought to be transformed into institutionalised transfers of wealth to recompense an imaginary injury to Africa.

    It’s not going to happen.

    Africans need to get over their welfarist outlook, their culture of dependency, their view that government and government action is the solution to all their problems, their sense of grievance and victimhood, and their envy and resentment of the West. They need to grow up and take responsibility for their own affairs instead of always wailing that somebody else is to blame for their failures and shortcomings.

  12. 12 steve
    February 22, 2008 at 14:58

    This is such a stupid topic. Should luring doctors away from third world be a crime? Should cheating on a significant other be a crime? Should being rude to other drivers be a crime? Should passing gas in public be a crime? Should being ugly be a crime? Come on BBC, you are too respectable of an institution to have silly topics like this or things about Britney Spears.

  13. 13 Ros Atkins
    February 22, 2008 at 15:13

    Hi Ros,
    [Or should we live in a free world with a free global economy, where we can work without restriction?] If Health Ministers in Uganda worked with restriction,then doctors/nurses would not go to other countries. The siphoning by one Cabinet Minister is enough to raise the full salary and fringes of very many doctors.
    Go doctors go!!!
    Togo Kasoro
    Kampala

  14. February 22, 2008 at 15:23

    Health care in developing countries leaves much to be desired. Hospitals are short of modern equipments. Medicines are expensive. Poor patients resort to traditional medicine as it is cheaper.

    In Morocco, the ratio of doctors is one to every 10,000 people. There are areas short of well-equipped hospital for childbirth and surgical operations. Patients have, sometimes, to travel hundreds of kilometres, to get medical check-up and diagnosis. Ironically, there are many people trained in nursing who are still unemployed. Those with training have to undergo a test for the selection of just a few of them. Some cases were registered in which there were some hospital with medical staff and no equipments as there were hospitals with medical equipments and no medical staff!

    In poor countries, there can be many reasons for doctors to migrate. There are the conditions in which they work. The hospitals where they work are ill-equipped. The salary is small and the load of work is heavy. Some are sent to work in impoverished areas in their countries. There is a sense of frustration because there is little they can do to help the patients as they have no equipments to work with or hospitals are understaffed so the work is painfully carried out.

    The West provides a full contrast where ambitious doctors can have the opportunity to evolve professionally and to have high living standards.

    As doctors have an oath to save human lives, theoretically they should stay in their own countries to save the lives of their fellow citizens and not to migrate to the West to save the lives of those who can pay a much higher price. These doctors must have cost their country a fortune to educate them and finally they are offered to the West on a silver plate.

    So what’s the compromise? As qualified doctors can’t be persuaded to stay in their poor countries while the West offers them the best opportunities, the West should work to train more doctors in poor countries and to build more hospitals. As there will a surplus of doctors in them, their recruitment won’t create a shortage in their countries. Governments should create incentives for doctors to stay at home by investing in medical projects.

    Many people in poor countries die from preventable diseases. Others die from illnesses that can need simple operations. The medical staff needed is in the West enjoying prosperity. Health care is fundamental for prosperity. “Stealing” doctors from countries that badly need them is like transplanting healthy organs of a poor person in the body of a rich one to make it possible for them to survive.

    There should international regulations to govern such recruitments to preserve the rights of all parties. Making health services a part of international free trade will just deepen the gap between the healthy North and the aching South.

  15. 15 Andrew Stamford
    February 22, 2008 at 15:23

    OK, who should be feeling guilty? The locals in country X where the foreign doctors are heading to? No of course not. Does the doctor from that country not also share the culpibility for this state of affairs? After all they grow up in that country, see for themselves the state of the health system, use the resources to study medicine and once graduated leave that country for greener pastures, leaving their nation all the poorer. OK if they wish to make more money overseas, that is their prerogative, but they should also bear the consequences of leaving their health system in the state it was rather than having some loyalty or sympathy for their own people and help them, help the nation, rather than just take a mercernary attitude and look out for themselves.

    It is ironic that we hear about medical tourists who travel to a country like India to recieve medical treatments when many Indian doctors are leaving to practice in the countries of those who travel to India. But this level of health care is geenrally not available to Indians as they cannot afford it themselves and many clinics are set up for wealthy medical tourists.

    I speak for the Australian example now where you find that universities are not churning out the doctors as they should be, locally trained, locally experienced and locally sensitive students to serve as doctors. Instead we hear about growing hospital waiting lists and an over strectched system groaning under the strain. The solution has been of late not to increase the availability of university places for those wishing to study medicine, or to reduce the immense cost to students wishing to practice medicine in the future, but to recruit doctors from overseas (particularly India at this point in time). Time after time we hear about imported doctors with skill levels far below what is expected, though not all I would add. Many do well, but there are very often basic problems such as language skills lacking. Foreign doctors with faked, limited or non-existent qualifications scam the public. If a supposedly rich nation like Australia cannot train its own to serve in medecine then this situation will continue as the lure of money and significantly better working conditions will always be more attractive than to work in their own nations. It seems at times that governments are banking on filling shortfalls of doctors the easiest way they can which is simply to harvest them from overseas as if this is a long-term solution and a satisfactory one. I cannot say all foreign doctors are inept, but it is a situation that many times causes death, unnecesary deaths.

    It is simply a point of money, it comes down to money and as such I place the blame firmly on the shoulders of those who leave under developed nations to seek the big dollars. I wonder about the consciences of doctors from third world countries who live and practice in the west.

  16. February 22, 2008 at 15:24

    I my self live in adeveloping country [Uganda],it’s very suprising,According to the International Organization for Migration (IOM), Africa has already lost one third of its human capital and is continuing to lose its skilled personnel at an increasing rate, with an estimated 20,000 doctors,leaving the continent annually since 2000.Ironicaly Africa spends US$4 billion per year (representing 35% of total official
    development aid to the continent) to employ
    some 100,000 Western experts performing functions generically described as technical assistance including health workers.Kenya loses on average 20 medical doctors each month.The loss of nurses, in particular, is a growing
    phenomenon, fueled principally by the
    shortages in developed countries. The United States has 126,000 fewer nurses than it needs and
    government figures show that the country could face a shortage of 800,000 registered nurses by 2020.
    The move by African countries to consider it a crime to employ any medical worker from developing country is much more justified than one may imagine.

    Regards
    stodart Musika
    Kampala Uganda.

  17. 17 Ros Atkins
    February 22, 2008 at 15:25

    Steve, you may not think this worthy of discussion but plenty of people do, inclduing a great deal of experts on the world’s healthcare systems. Is the quality of healthcare that people receive really of no importance or interest to you? Because there’s no shortage of people arguing that allowing developing world doctors to be recruited is having a real effect on the treatment that millions receive. Just look at some of the comments already.

    And while I’m here, WHYS is about news stories and issues that people are talking about, so next time Britney Spears is the most read story in the world, you can expect to hear us talking about her again. You may pass judgements on what’s important and what isn’t, but that’s not our game.

  18. 18 Ros Atkins
    February 22, 2008 at 15:26

    Hi Ros,
    Don’t forgot the 16 year old from Argentina had a son when she was 14 before her first set of triplets, so now she has lucky number 7!

    Melissa
    (Ghanaian living in Boston).

  19. 19 Ros Atkins
    February 22, 2008 at 15:27

    OK, who should be feeling guilty? The locals in country X where the foreign doctors are heading to? No of course not. Does the doctor from that country not also share the culpibility for this state of affairs? After all they grow up in that country, see for themselves the state of the health system, use the resources to study medicine and once graduated leave that country for greener pastures, leaving their nation all the poorer. OK if they wish to make more money overseas, that is their prerogative, but they should also bear the consequences of leaving their health system in the state it was rather than having some loyalty or sympathy for their own people and help them, help the nation, rather than just take a mercernary attitude and look out for themselves.

    It is ironic that we hear about medical tourists who travel to a country like India to recieve medical treatments when many Indian doctors are leaving to practice in the countries of those who travel to India. But this level of health care is geenrally not available to Indians as they cannot afford it themselves and many clinics are set up for wealthy medical tourists.

    I speak for the Australian example now where you find that universities are not churning out the doctors as they should be, locally trained, locally experienced and locally sensitive students to serve as doctors. Instead we hear about growing hospital waiting lists and an over strectched system groaning under the strain. The solution has been of late not to increase the availability of university places for those wishing to study medicine, or to reduce the immense cost to students wishing to practice medicine in the future, but to recruit doctors from overseas (particularly India at this point in time). Time after time we hear about imported doctors with skill levels far below what is expected, though not all I would add. Many do well, but there are very often basic problems such as language skills lacking. Foreign doctors with faked, limited or non-existent qualifications scam the public. If a supposedly rich nation like Australia cannot train its own to serve in medecine then this situation will continue as the lure of money and significantly better working conditions will always be more attractive than to work in their own nations. It seems at times that governments are banking on filling shortfalls of doctors the easiest way they can which is simply to harvest them from overseas as if this is a long-term solution and a satisfactory one. I cannot say all foreign doctors are inept, but it is a situation that many times causes death, unnecesary deaths.

    It is simply a point of money, it comes down to money and as such I place the blame firmly on the shoulders of those who leave under developed nations to seek the big dollars. I wonder about the consciences of doctors from third world countries who live and practice in the west.

    Andrew Stamford

    Australia

  20. February 22, 2008 at 15:29

    How can we live in a free world with a free global economy -when the so-called “free global” (or free-market) economy isn’t “free” (in any sense) at all?

    Do you honestly believe that a small company really has an equal chance against the giant global corporations?

    If that was true -then why are these giants continually merging “in order to survive” in the global economy that is supposed to be fair and equal for all?

    How can there be “fair trade- when there isn’t even a fair market?

    How can anyone still believe in these silly and dangerous myths?

    …and the problem isn’t even an “African” one -here in the Philippines the medical profession is being stripped bare too.

    By “work without restriction” -do you mean “work until one drops dead from exhaustion”? Even in the mid 1800’s it was understood that restrictions were essential to prevent excessive abuse of workers by employers….. Bring back Dickensian conditions:Is that what you are asking for? Is it the “freedom” to continue to abuse people that you mean by a “free global economy”?

  21. 21 steve
    February 22, 2008 at 15:30

    The topic was “should it be illegal” which is a childish suggestion. That’s like saying “should being mean be illegal”? should it be discouraged perhaps? Just the topic is childish in nature. Fact is, these doctors want to come to the west. So are you suggesting that these doctors be forbidden from travelling? Because if they travel, they probably won’t come back because THEY WANT TO WORK IN THE WEST!

    something tells me that at no point was Britney the most read story in the world. Something tells me the hundreds of millions of poor people in China and India don’t give a damn about her or the attention you give her.

  22. 22 Alison, Idaho
    February 22, 2008 at 15:33

    I don’t know how it is in Africa, but in the US it takes a decade of study and tens of thousands of dollars to become a doctor. Anyone who puts in that kind of time and money and effort should be allowed to practice wherever they want. And a hospital should be allowed to recruit the best doctors in the world however they want.

  23. 23 Ros Atkins
    February 22, 2008 at 15:51

    Unless you want to turn the doctors of the world into slaves with no right of free movement, you will accept that they will practice medicine wherever in the world they wish. It will balance out eventually. Nor do I feel guilty about the two African doctors practicing in my community. It’s virtually impossible to get Canadian-trained doctors to move north.
    Viola in the States

  24. 24 John in Salem
    February 22, 2008 at 16:09

    The reason the healthcare system in the U.S. is screwed up is obvious when you consider we now refer to it as the healthcare INDUSTRY. Our medical colleges have way too many people who don’t really give a damn about the patients they’re going to be treating – they are there for the money, the lifestyle and the prestige. It’s like watching pedophiles go though seminary because of the payoff when they graduate. These so-called “doctors” are bleeding us dry and giving all the real ones a bad name.

  25. 25 viola anderson
    February 22, 2008 at 16:26

    Hey, I’m not in the states; I’m in Canada, although I did immigrate to Canada from the states a long time ago.

  26. 26 steve
    February 22, 2008 at 16:28

    John in Salem, are you suggesting that only doctors are self absorbed? Sorry, but just about everyone is a borderline sociopath these days because people only care about themselves, and when they show “concern” for others, they want something in return. It will only get worse with more people in the ME ME ME! Generation entering the work force.

  27. 27 Ros Atkins
    February 22, 2008 at 17:04

    From Melissa in Boston (and from Ghana)
    I really believe it is the responsibility of governments in developing countries to do everything possible to keep their medical professionals in their home countries, especially if they were trained there. The cost of going to medical school in a country like Ghana is almost nothing compared to what you would have to pay here in the States and the quality of the education is comparable in the two places which is why Ghanaian doctors are able to assimilate quite easily into the American healthcare system. When a person trains in Ghana and pays a pitiful amount of fees to do so, and comes here to America to work, they are doing nothing less than robbing the country. I definitely think it should be a requirement for doctors trained in Ghana to remain there for at least 10 years before being allowed to leave to work in the West. Each year, we are losing our best talent to western countries. In fact, there are more Ghanaian doctors in New York city alone than they are in the whole of Ghana – that is completely unacceptable. That being said, the governments really need to show more appreciation for the doctors that do remain in their home country by paying them decent salaries.

  28. 28 Ros Atkins
    February 22, 2008 at 17:13

    I dont blame the west for recruiting our willing health practitioners.
    These people have no sense of patriotism and are only interested in enriching themselves and not contributing as they should to their country’s devt, when so much of the taxpayers money went into their education. Developing countries must put legislation in place to force the health workers to work in their countries for a period before they can practice outside the country. This period should be long enough to ensure that their service has repayed the taxpayers money spent on them.
    The developed world must help by ensuring the people they recruit have served the required service period before hiring their services if they are really interested in africa’s devt.
    KWABENA OWUSU-AMPRATWUM.
    Accra Ghana.

  29. 29 steve
    February 22, 2008 at 17:13

    I’m really shocked at the suggestions here! What you are suggesting is nothing less than slaver and forbidding travel! This isn’t the iron curtain with a Berlin wall preventing people from leaving! Can you imagine if you were in that situation and someone even suggesting you shouldn’t be allowed to leave your country and go some other place? Are you suggesting these doctors should be any less than full human beings, or are they slaves in your eyes?

  30. February 22, 2008 at 17:21

    If doctors or better still well trained Africans don’t leave Africa to go and make big money in the Western world where they are valued, the future of Africa will be very very bleak. Ask me why. I’ll give you just one label.
    * Check out clearly, visit any international money transfer agencies during School reopening periods, during christmas and new year; or when a family is in difficulties and you will understand what I mean.

    From the very long cue found at these money transfer agencies, during school return periods or end of year feasts; one doesn’t need a degree to conclude that many children here in Africa go to school because they have relatives abroad, that many Africans get money to threat themselves at the hospitals because they have relatives abroad, that many African children are happy during Xmas and New Year because they have relatives abroad, that… that… and the list is just too long.

    Yes, I agree it may have a more negative impact in about 30; 50 or even a 100 years to come but what do you expect people to do? So if it is a crime, then to stop that crime will be to create jobs, not only jobs but well paid jobs in Africa; and that is only possible when we will have a better, fair and transparent elections. If elections keep on failing, then everything else will be bound to fail and there will continue to be more brain drains.

    So I say, to a fair election will only exist when during elections, poorer people get a weighted vote and wealthier people lighter votes. That is, “the wealthier you are, the less your vote counts and conversely, the poorer you are the more your vote counts”. That is what I call Vote Sizing.

  31. 31 ki
    February 22, 2008 at 17:23

    I can understand why anyone who has trained so long to do something they love would want to go somewhere, where they may be compensated more.
    Perhaps some of the money donated as aid could go into providing health professionsals with better wages and opportunities for professional development in their own countries, so that they would feel less compelled to leave? I’m sure it’s not a decision people would make lightly.

  32. 32 John in Salem
    February 22, 2008 at 17:24

    No, Steve, I’m not. There’s plenty of it to go around.
    It’s just that I work in the “industry” myself and what I’ve seen in my 37 years in it is disgusting. I’m a dental technician and I’ve always believed that integrity is essential in this business, but I’ve seen too many cases of doctors putting a bunch of implants and bridgework into the mouths of 96-year-old people with Alzheimers.
    And I’m afraid that a lot of what is luring people in third world countries to pursue a career in medicine and come to the U.S. to practice is the worst side of it.

  33. 33 KWABENA, Accra, Ghana, by email
    February 22, 2008 at 17:56

    I dont blame the west for recruiting our willing health practitioners. These people have no sense of patriotism and are only interested in enriching themselves and not contributing as they should to their country’s devt, when so much of the taxpayers money went into their education. Developing countries must put legislation in place to force the health workers to work in their countries for a period before they can practice outside the country. This period should be long enough to ensure that their service has repayed the taxpayers money spent on them.
    The developed world must help by ensuring the people they recruit have served the required service period before hiring their services if they are really interested in africa’s devt.

  34. 34 Rob, Texas by email
    February 22, 2008 at 17:58

    Those who come to the west for education usually stay in the west because we need them and life is nicer than in their homeland. So that the losing nation is not forgotten they should be required to send one half of their western salary home to pay for and attract professionals there for 20 years or else go home for 10 years.

  35. 35 Ros Atkins
    February 22, 2008 at 18:01

    Scott in Las Vegas

    I think that the key to this issue can be found in the sentence in the Reuters article that says the following, “While many doctors and nurses were leaving freely, Mills and colleagues say they were also being actively recruited.” It’s kind of an odd sentence and seems to be implying something sinister either about free will or the people who are making job offers. Should doctors and nurses be doomed to work for crappy wages and hideous conditions simply because they were born in a particular place on the planet? Should doctors and nurses who are born in Britain, the U.S., Canada and Australia be forced to move to Third World countries to improve doctor to patient ratios?

  36. 36 Brett
    February 22, 2008 at 18:06

    Actively recruiting foreign doctors especially from third world countries can be seen as a moral or ethical dillema, but ultimately it is the decision of the individuals to make.

    I’m all for creating incentives for them to stay in their home country. But you cannot create a cage to keep them in.

    You could even provide education incentives such as reduced price for education in order to have an agreement that they will spend X amount of years in that country or that facility after their studies. This would assist in retaining the doctors and others and also allow them time to become settled and start a life in the host country which would reduce further their chance of leaving once the ‘contract’ is fufilled and their required time of service is up.

    Brett ~ Richmond, Va.

  37. 37 Raouf
    February 22, 2008 at 18:12

    Why not the developed world encourage doctors to go back to their countries for 3 month a year and carry on paying their salaries – it is pay back and I am sure the doctors would love to do that.

  38. 38 Joey
    February 22, 2008 at 18:14

    Apparently the health care industry is going to be shaken up with the election of a democratic president. Both possible candidates said last night at public debate, they want to CHANGE.
    Who knows if they will, Clinton has had like 20 years to change.
    How closely is the US industry, linked to the world? That’s my perspective, and you see a lot of doctors coming here from Asia.
    Just like everything else, economically, I think this is linked to the US system, and I hope it changes with a new president.
    Thank you.
    Joe
    Colorado, USA

  39. February 22, 2008 at 18:15

    Vertel from Kingston Jamaica. (email)

    I think it is a crime to take from people who is not in a position to give. In any event only the type of labour that is needed in the west have an opportunity to go there. Those who have nothing to offer will not be welcome.

  40. February 22, 2008 at 18:16

    The doctors are going where the money is; it’s that simple…Unfortunately

  41. February 22, 2008 at 18:17

    Steve, usa (email)

    I think the only doctors that should be forbidden by law from leaving their countries to work elsewhere are doctors that try to blow up airports with flaming cars. Other than that, so long as they follow proper immigration rules, people should be free to work where they want.
    It’s outrageous to suggest these people should be forced to stay in some place. Would any listener to WHYS now stand for it if your profession were told you could not leave your country to work elsewhere? You would cease to be a full human being. You would be a slave. And I certainly would, if considering entering that field, would not enter it. Any such law would only discourage people from joining that profession!

  42. February 22, 2008 at 18:17

    Daniel, China (email)

    Nigerian doctors are about to start nationwide strike due to bad treatment,

    if one of this doctors get chance in the west, won’t he leave for better life?

    When the Senators and the governor are eating fat, the doctors are suffering.

    West is not to blame, all the blame is hanging in the neck of the governments in
    the less developed nations.

  43. February 22, 2008 at 18:26

    Franklin, Ugandan in the Caribbean (email)

    I’m a medical student in the Caribean and
    i left because i was not given the chance to do medicine the university and now i left i have invested alot of dollars that if i go back i cannot raise and replace that money, if i was on a schoolarship i would go back. but i know that uganda needs more help that US where am going and in uganda a doctor get a salary of what i pay for my rate here.

  44. 44 Chernor Jalloh
    February 22, 2008 at 18:26

    Victor:I must say, j’ai déjà vu.This is what every body is saying about your pyramids of unfair comments about Africa and Islam.No-one hates the West,but as I always say you look different when you post your points on the blog.Both of us can argure bitterly over a variety of issues on Africa and the West,but our leaders will continue doing business together.Here in Spain,the Spanish government has donated 150million Euro to Guinea for agricultural purpose and they are going to install for the first time their new Ambassador.Isnot that a good sep forward, Victor?There are no mineral resources here in Spain;it is only gold and agriculture and with the help of Immigrants from Africa,Latin America and other countries coming in,the Spanish’s economy is growing.

    Victor,no man is an Island and nobody stands alone.Africans have got a lot of things and the problems are of bad governance.Also,the unfair trade that exists between the continenets that is why many are leaving their countries.

  45. February 22, 2008 at 18:27

    M. Jackson, Portland, Oregon (by email)

    Ive spent time in hospitals lately…. 90% of the doctors I see arent Americans. This is the other side of the globalization coin.

  46. February 22, 2008 at 18:28

    Michael, Seattle, USA (by email)

    No one has the right to demand that another person self sacrifice their life to serve the health needs of others. Doctors are people first. People want the best for their wife, children, and grand children. The question is not that doctors are leaving third world countries for developed countries. The question is How can third world countries seduce doctors to practice in their country ? There must be any number of ways to meet the major medical needs of developing countries with the requirement that doctors must sacrifice themselves and their families. Perhaps a rotation system that allows young unmarried doctors to practice for a specified period of time and then have the option to rotate to a developed country.

    I am not a doctor and I do not play one on television.

  47. 47 Elias Lostrom
    February 22, 2008 at 18:28

    Why is the presenter saying that the developed world is seeking doctors from under-developed countries. The truth is we have a surplus of doctors here, These foreigners are the ones seeking to stay here for obvious economic advantages… Just because the lifestyle here is better than in, say, Malawi doesn’t make us the bad guys…

  48. February 22, 2008 at 18:30

    Henricus, Utrecht , The Netherlands (by email)

    One should not forget that 99 percent of the doctors who leave the country have been following a university education for free or a very very low price. The real cost have been paid by the state, i.e. the population of the country. Then to leave the country for greener pastures elsewhere is theft. Double theft: first for not having had soneone else paid for their education, secondly to have occupied one of the few places for pure personal interest.
    FYI, I have worked as a medical doctor in 6 developing countries.

  49. February 22, 2008 at 18:32

    Ivan from Lund, Sweden (by email)

    Does he believe he would have stayed in Malawi if he had studied there instead? My country, Sweden, has doctors leaving for higher paying jobs abroad. This is despite having good medical schools in Sweden.
    Perhaps we should require a certain amount of service hours for receiving a training. Like a scholarship that requires a certain period of employment upon completion.

  50. 50 Elizabeth
    February 22, 2008 at 18:33

    I think that for every doctor working in the first world, the first world governments should be required to send an aid worker to the doctor’s country of origin.

  51. 51 Mark
    February 22, 2008 at 18:37

    As an ex-physician, now in finance, the solution is simple, and is the same solution for the brain drain out of medicine in the UK. Changing the rules whereby medical students / dentists / nurses pay off the cost of their medical training back to the state through a certain number of years service. It works in the armed forces, it would work for healthcare. Simple and only likely to be resisted by medical unions / special interest groups.

    So – stop harping on about ‘freedoms’ and use the financial motivations which are at the root of the migrations to provide the solution.

  52. February 22, 2008 at 18:41

    Izza, Australia (by email)

    I have no problem receiving health care from foreign doctors. I also applaud any doctor from a third world country that leave a country that obviously does not care about the welfare of their own citizens. These doctors are trying to make a better lives for themselves and their families and have every right to do so in todays free society without being judged.

  53. February 22, 2008 at 18:42

    John, Portland, Oregon, US (by email)

    Our family doctor for some years was a man of Nigerian extraction who was perhaps the most outstanding general practitioner I have ever encountered, and my wife was treated and delivered by a young OBGYN from Vietnam while pregnant with our third son. As far as I am concerned, a doctor who is skilled could come from the moon if he provides excellent care, as these men did.

    As an interesting side note, the general practitioner I mentioned above returned to Nigeria about three years ago to pursue his practice in his home town, though I am sure he took a significant cut in pay for doing so. I was very sorry to see him go, but at the same time I admired him greatly for choosing to go where he could do the most good. I mention this to illustrate that the moral decision for where to practice resides with the doctor himself, regardless of the financial and professional lures that we in the West may dangle in front of them.

  54. February 22, 2008 at 18:43

    Marc, Austin, US (by email)

    Doctors in developing countries have the same obligation to stay in their home countries as doctors in developed countries have to relocate to the poor world. It is unjust and discriminatory to condemn some people for working in the developed world, while lauding others for doing the same thing simply on the basis of the country where they were born.

  55. February 22, 2008 at 18:44

    Rob, San Francisco, USA (by email)

    I think that if a person’s education in the US or Europe is paid for by the Government of their home country then they are OBLIGATED to work least part of their career in their home country. This applies not just to the medical profession but to all technical professionals.

    Beyond that a person does have right to pursue the best career they can achieve, though it is a shame if a doctor has no sense of service and duty to their home country, and is only interested in themselves, and I’d feel that they are of questionable ethics in the broadest sense.

  56. February 22, 2008 at 18:45

    Nduta, (by email)

    i agree that the third world countres are suffering from brain drain;but these countries should make moves to motivate their health peersonnel to stay. im a nursing student in the US. will i go back and work in Kenya my beloved country? probably not!the pay would not be near anywhere i get here and the whole health system does not support the healthcare workers, be it technologcally or safety wise or financially.whys shold expatriates be paid better than local drs and nurses? thats why they leave- here, they are the expatriates.

  57. February 22, 2008 at 18:47

    Ibrahim.

    Somehow the whole discussion on economic migration has been focused on Africans going to the “developed world”. From the viewpoint of history, the migration of African professionals (including doctors) simply follows earlier waves of migration from Europe to other parts of the world. That is how Afrikaners reached South Africa, how the British came to settle in Zimbabwe, and how America, Australia and New Zealand were re-populated.

    If current African development trends continue over the next decade, many African professionals abroad (including doctors) will return to their countries.

  58. February 22, 2008 at 18:48

    Keith, by email

    The developed world needs more doctors to CURE people because its health services are focused on ILLNESS. It does far too little work on disease prevention.

    Doctors in developing countries, at least those in rural areas, find themselves actively involved in public HEALTH matters, disease prevention etc.

    If the developed countries were more actively involved in public health measures there would be fewer patients and less need to attract doctors from developing counties in the first place.

  59. February 22, 2008 at 18:49

    Njenga, Kenya (by email)

    I am from Kenya; In the recent years, the cost of proccuring health care from private practitoners/ doctors has been prohibitive due to the monopoly established by the few specilaist doctors left behind by their collegeues leaving for greener pastures abroad.

    Clearly the inadequate medical and health care service experienced in develping countries in the wake of medical brain drain should be a strong fact enough for our “doctors” abroad to come back.

  60. February 22, 2008 at 18:50

    Chimwemwe, Malawi (by email)

    My view is that those that have decided not come back should consider running clinics on probornal basis like the lawyers do. This means they would mobilize each other and agree on a period to visit back home to give a hand to the communities. The key is to work on retaining those that are still in the country or being trained – give them good salaries.

  61. February 22, 2008 at 18:50

    Jermaine, Atlanta, GA, USA (by email)

    As long as they are qualified, I don’t care where my doctor originates. But on the other hand, if docotrs are being recruited from countries with little to no medical professionals to care for their population, then there should be programs implemented to maintain quotas where there is always a sufficient number of physicians available for the local communities. Their lives are just as precious ours.

  62. 62 tom farney
    February 22, 2008 at 18:51

    I am a physician practicing in Oregon, USA.
    We do get foreign medical graduates and in general it is hard to criticize their medicine. Their accents can and do cause sigificant confusion resulting in a series of insider jokes.
    I think, because of predicted shortages of US trained physicians, more of this will occur.
    The choke seems to be the realization that US expectations of their medical world surpasses both the ability to provide, and the willingness to pay. The life is truly a calling, not just a job.

  63. 63 Chernor Jalloh
    February 22, 2008 at 19:06

    Should graduates be obliged to stay for a period of time in the country which has educated them?

    Absolutely yes,and I suggest they stay for much longer as they can,if their salary that they earn is far better better than the one at home it will be better to stay.

    Or should we live in a free world with a free global economy, where we can work without restriction?

    The answer is simple,it will be very much unfair to restrict any qualified individuals to remain in Kenya,Zimbabwe at this present moment and other countries wherein there is no peace and security and inspite of all these the salaries they earn per month will not be sufficient to take care of themselves and their families.Seeking a better future is everybody’s dream.

  64. February 22, 2008 at 19:12

    Stephen, From Canada (by email)

    We have the exact same issue that these African countries have in Canada. A large number of our doctors are displaced by higher paying jobs in the United States. The only way we have had any luck alleviating this is through government programs to assist with education of new doctors and contracts requiring their retention. We have found that doctors staying in Canada tend to settle here after their first few years and remain.

    This has worked well for Canada and should be considered by developing nations.

  65. February 22, 2008 at 19:13

    Nicholas, Egypt (by email)

    Am really disappointed with those drs in the studio, thats why our africa has low development. Thy care about themselves and money not their countries. Africa needs more Drs today yet its children dont care about it. please try to be nationalistic and bring back the african brains home.

  66. February 22, 2008 at 19:14

    Christopher, Los Angeles (by email)

    As a gay male, I would most likely feel less comfortable if my primary Physician was not American or at least Western, because I would be concerned that the lack of shared culture might make the Physician more judgemental towards me being a gay man.

  67. February 22, 2008 at 19:14

    Serina Singapore (by email)

    A question that has to be asked is WHY exactly are western countries recruiting doctors from developing nations? Are there no available local medicos to fill the need in these countries? I am sure that overseas doctors would not be underpaid and on equal terms with local doctors so that cannot be a reason surely?

  68. February 22, 2008 at 19:15

    Jamie, San Francisco, (by email)

    I do feel badly about the medical drain on third world resources. That said, I would not avoid going to a doctor that i perceived to be from there.

    I live in San Francisco, but i grew up in Appalachia in Kentucky. There, a foreign doctor commanded a great deal of respect from my community as American doctors had no interest in coming to our rural area.

  69. February 22, 2008 at 19:16

    Andre, USA (by email)

    Since arriving in the US in 1999, I have had Pakistani, Nigerian, Lebanese and American doctors. Once they know what they are doing – I don’t mind where they come from.

  70. 70 Chernor Jalloh
    February 22, 2008 at 19:17

    Ros Atkins:Ireally want to know why LEONARDO, BEN AND MARTIN are leaving us at this point in time?Will they return back and share their intelligency with us again or not?I wish them a very happy time wherever they are.Believe me,Ros I too will be missing them dearly.Many thanks.

  71. February 22, 2008 at 19:17

    Peter, Lagos, Nigeria (by email)

    It is too simplistic to say its criminal for developed world to poach doctors from developing world.

    Why are doctors leaving their countries in the developing world?

    How much are they paid in there countries? How much are their friends who entered politics get?

    A friend of mine left medical school after 3yrs and went into economics, and today, he is so happy he took that decision.

    The simple truth is that, globally there is dearth of qualified medical professionals.

    If you want to keep your good doctors, improve your health system

    How many times do doctors go on strike in Nigeria because of salary issues?

    After all, is it not natural that a doctor who stayed 5yrs in the University and deals on a daily basis with human lives

    Should look for where he will get the best possible income for his profession?

    Let us call a spade a spade.

    Lets stop blaming the west for the woes of Africa when the richest heads of states are from Africa.

  72. February 22, 2008 at 19:20

    John — Las Vegas, NV (by email)

    Addressing your question whether Americans have a strong preference for US-born doctors, I can only speak for myself, but — no: I don’t even consider that an issue. I have a doctor from Egypt and one who’s originally Filipino, and they’re both great!

    In fact, I think they sometimes bring a different perspective that can be refreshing. I’ve certainly been quite pleased with their care.

    Based on my own experience, I wouldn’t consider think of my doctors’
    country of origin as a factor as long as they’re well trained and genuinely care about their patients. In fact, I believe it can even be a positive attribute.

  73. February 22, 2008 at 19:21

    Peter, France (by email)

    I have just been listening to World Have Your Say on the African brain drain and I was outraged but the lack of insistance that rich countries should not be training less than enough experts in all subjects and rely on taking qualified staff from poorer countries. I live in France and here it is considered normal to take staff trained in Africa whilst keeping out the poor. This shocks me. I think that we should be exporting our qualified staff to poorer countries to help them.

  74. February 22, 2008 at 19:22

    Cindy, California, by email

    I’m writing from California, USA, after listening to you in the car–now I’m at my desk. You asked people in the developed world to respond re: how they feel about having a doctor from another country.

    I live in Oakland, California, one of the most diverse cities in the US. It would seem very strange to me if I were to enter my doctor’s office and see only American-born doctors. I am a retired registered nurse, and likewise in my work life it would have been highly unusual not to have doctors and nurses who came here from other countries. It doesn’t matter to me where a competent professional is from, except that it is often interesting to talk to people who came from where I haven’t been.

  75. February 22, 2008 at 19:23

    Eric, by email

    I do not know if it is moral or not and I do not see it like that from Europe. The responsibility of the government is to insure enough resources everywhere. The alternative to import doctors and nurses is to make kids! If Europe starts to do so, then it shall have enough doctors. Unfortunately, there is competition on all kind of human resources. Therefore, should also Europe and others to avoid attracting IT, science, and so specialists?

    I am getting old and I hope there will be a doctor born wherever to help me.

  76. February 22, 2008 at 19:24

    Franz from Los Angeles, by email

    1. There should be these contracts to make the doctors stay AND sabbatical programs for these good doctors to work where there is need (EU, Africa, South America).

    2. Provide greater and lower cost medical education – global recognized standards examinations.

  77. February 22, 2008 at 19:25

    Theodore, by email

    I have taught medical students in the United States for over 40 years. I can fully understand the many reasons young physicians and nurses have for leaving, many of which have been mentioned on your program. One thing that has not been touched upon is the Cuban Medical Training Program. I know a fair amount about this, and indeed will be traveling to Cuba in April for further observations. The medical schools there are training physicians in large numbers, many of whom travel to underdeveloped countries to assist in their medical care problems. In addition, they are sending trained medical personell to countries such as Uruguay and others to assist in building medical schools and hospitals there, so that they may begin training more doctors and nurses who are strongly encouraged to remain there to practice. The basic philosophy behind the Cuban program is one which strongly encourages students to practice medicine where they are most needed. Salaries are, of course, a consideration, but not the primary one. The cost of medical education, unlike the situation in developed countries, is within easy reach of all qualified students. Most students I have known graduate with minimal debts of $40-60,000. This is simply not the case in Cuba. There is an excellent film, “Salud!”, which is available on DVD, which describes this program extremely well.

  78. February 22, 2008 at 19:25

    Thomas, Zambia. (by email)

    In a nutshell: The working conditions here are appalling, the government spends large sums of money on educating medics and there are greater opportunities in the west. In light of this I do not support controlling migration but will simply say it is an personal
    choice: the nurses and doctors should consider why they chose to become medics. I am an aspiring Doctor out of high school and I am committed to working for my people, contract or not.

  79. February 22, 2008 at 19:26

    Bakarr, Sierra Leone (by email)

    First i will like to thank you for highlighten short an important issue which almost plung Africa to arnachy.
    The brain drain of finest young and energentic graduate Dr. to Europe for greener pastures is mainly influence by our corrupt leaders, who always nor sooner they grab power instead of creating the nessaray and conducive enviroment for the vast unemployed graduate, they just enback on enriching themselves.God save Africa.

  80. February 22, 2008 at 19:27

    Keith, Canberra, Australia (by email)

    The developed world needs more doctors to CURE people because its health services are focused on ILLNESS. It does far too little work on disease prevention.

    Doctors in developing countries, at least those in rural areas, find themselves actively involved in public HEALTH matters, disease prevention etc.

    If the developed countries were more actively involved in public health measures there would be fewer patients and less need to attract doctors from developing counties in the first place.

  81. February 22, 2008 at 19:28

    Nshom, Cameroon (by email)

    Of what use is to stay when our corrupt politicians will perpetuate their bad leadership and the ensuing chaos like is happening in Kenya will not spare even the lives of the medics?
    as long as we do not seem to know our prioritiies i will dare say that brain drain has come to stay with us for a very very long time.

  82. 82 kpellyhezekiah
    February 22, 2008 at 20:17

    When 1 nurse is helping 8 women in the delivery ward in Uganda, 1 doctor is caring for 800 to 1000 patients in northen Ghana, 1 doctor to 500 patients on the average in Malawi,1doctor to 700 patients in Liberia the world must consider the medical staffs of developing countries especially those in Africa as endengered spieces and we must collectively put in place measures to retain and preserve them on the continent. If we are able to do same for mamals such as whales, gorillas, bears etc then I don’t see the reason why we cannot do same for our endengered medical staffs. For instance, instead of paying expatriate doctors $40,000 to go too Malawi or Uganda to work that money should be used by the UNDP to supplement the incomes of the African doctors there as a means of motivation so that they would stay in their countries and work. After all this is what we do to motivate skill labour everywhere. Why do we give winning bonuses to footballers although they are paid quite well to play as professionals? This is a moral issue and if there are honest men of integrity in the western developed countries I’m urging them to begin to take steps to address this problem. Medical doctors are in short supply in the world in general but should the developed world be poaching Africa’s doctors with their mouth-watering contract sums of employment when they could simply invest in their own human resourses to bring out more doctors? Do they know how much africa’s poor economies invest in their medical doctors? A simple advice to the west as a step in solving this problem. Please, send your potential medical doctors to africa and pay for their training so that they’ll come back to you after their training. Then you’ll be helping the poor african countries to have funds to expand their hospital facilities and you’ll not be carrying this guilt of poaching the poor continents medical doctors and nurses not to talk about other staffs like phamacists etc. but will be having your own people. Then there will be the natural reduction in the demand for Africa’s medical staffs.
    God bless Africa.

  83. February 22, 2008 at 20:27

    A mechanism should be put in place by a not yet established international ombudsman(seperate from UN). This IO(International Ombudsman) could regulate professionals that immigrate from developing countries to developed countries. The basic framework could be that any professional educated in a developing country is leased by the country in question where by the lease payment is paid seperate from the wages paid to the professional for the tenure of their time in that country. This seperate lease payment would compensate the developed nation for their investment in the professional and for the loss of their services not rendered in the home country.

    Tak – Canada

  84. 84 George USA
    February 23, 2008 at 03:20

    The proposal has nothing to do with protecting third world nations.

    In 1982 the oil crash affected doctors incomes in Texas, which has the oversight organization Boards of Medical Examiners.

    They conducted a witch- hunt to “close the door to foreign medical graduates” by false witness in the Claud Pepper Ad Hoc Committee on Aging.

    The false witness was used to fabricate a witch hunt to intentionally destroy the lives of Doctor, legitimate physicians, who graduated in the Dominican Republic.

    This was done for economic protection, and retaliations were hired through federal agencies and politicians to cover up the unethical witch-hunt motivated by greed.

    What is being proposed is exactly on the wave of recession that appears to be coming at us today.

    Do not kid yourselves: since the Pepper Witch-hunt, there has been no ethical licensing in the USA.

    Corruption and greed run US medicine. They want to close the door universally via a hired “law”.

  85. 85 Rory
    February 23, 2008 at 04:30

    RORY

    Try living in Zimbabwe where most of our talent in the medical profession has left. Now I cannot decry anyone for seeking greener pastures- I have had to- I work in Dubai- but I do not need specialist equiopment to support my expertise…. doctors and medical people do and while i would give my eye teeth to go back home – the awful thing is that medical personnel will not (or rarely) return- our salaries will never match international rates- freedom of expression is limited(and once you taste that it is hard to take restrictions again). Equipment is below par.
    I do not think it should become criminal – I think that is worse than curbing freedom of expression. But I do feel that something should be done in governments to allow their own people in emerging countries to have medical attention. Maybe that is where more Aid should be aimed – if you can avoid the local corruption of course..

  86. February 23, 2008 at 07:25

    “While many doctors and nurses were leaving freely, Mills and colleagues say they were also being actively recruited.”

    Well, actually, the whole thing is a scam. As we read above, governments such as the Australian (American/British) connive to get cheap staff without having to train them. The “donor” governments can then charge all sorts of fees as part of their “export” of human labour. Indeed, large sums of money are often sent home -which keep families at home alive -so local governments don’t have to bother with their responsibilities any more. This leaves them free to make even more money (personally) by scamming and pork barreling off all the foreign being forced investment schemes being pushed through in their countries.

    Like all good scams -it is wonderful for those who benifit. The health INDUSTRY -that gets cheap labour, with low investment costs. The inhabitants of the rich counties that are so smug about how they get cheap services and how they are “helping” people from poor countries…. The families who profit by exporting their relatives. The “donor” governments who sell their people and so don’t need to develop their own local economies (which is virtually impossible anyhow under the current unfair system of trade). The transport companies profit; the bankers profit (as the exchange rates go up because of the remitances -so the more people send the less actually arrives); the telecom companies profit from the extra communication needs of lonely people, etc., etc…

    But what about the effect on the people who exploit the system and the people who are left? Bankrupt and corrupt countries with no basic facilities and where people are forced to emmigrate (if they can). Fortress America and Europe -building fences (like Israel) to keep out the unwanted -so they can get the pick of the best….. On the other side, smug, rich people who have no idea how they profit from the destruction of human societies around the world. …. and in the middle -legalised people traffickers and orgaganised prostitution of human intelligence and labour…. a rising flood of international corruption that is increasingly seen as normal…..

    Perhaps worst of all is the obscenity of those who defend legal people traficking as “freedom of movement”….. When a bullet is fired from a gun -does it trully have “freedom of movement” -or is its trajectory determined by those who pull the trigger? Indeed, we now live in a trully Orwellian world -where commercialism has become the new dictatorship, where “Big Brother” has become entertainment -and where being forced to sell your child or your soul is all part of the new global “freedom”.

    Incidentally, this isn’t just about medical staff -similar things apply to teachers, researchers, call center workers, etc…

  87. 87 Jon
    February 23, 2008 at 07:45

    The only individuals who should feel guilt about well educated people leaving the societies they received training from are the corrupt political elite whose populism and pandering destroys any incentive for hardworking people to stay. To suggest that the developed world should be ashamed of the fact that it knows how to appreciate real talent and has the capacity to appreciate professionalism is shameful. The inferences made by the question itself are nothing more than crimson-red, communist propaganda repackaged to be sold to those who believe that self-deprecation is the only measure of virtue. The question is one of personal choice and should never digress into a discussion about how a government can best coerce its high-functioning citizens into achieving its own, limited ends.

  88. 88 John in Germany
    February 23, 2008 at 08:33

    Hi Ros.

    Brain poaching has been going on since the world began, incentives were used to keep the best in the tribe.

    A very simple method to keep qualified persons is to make a contract. We train you to qualification including hospital experience, we want you, for this input, to contract to us for x amount of years.

    Globalisation has bought the normal Tom-Dick-and Harry nothing, it all goes back to the same thing. We are bombarded with propaganda about how good it is-REALITY it is only good for those that have.

    No it is not a crime, Professionals of all types are poached, the prisons would not hold all of the agents, talent scouts, Ect ,that would be guilty of the crime.

    Have a nice weekend
    John in Germany

  89. 89 Shakhoor Rehman
    February 23, 2008 at 12:15

    Doctors should work where they want to work with no reprisals. Africa is not producing enough doctors anyway ,even if nobody left their continent or country, to meet the needs of her people. As in all things the only serious practical solution is global. It is possible to put together a task force when it comes to war so it is practical to do so for peaceful purposes. What is required is the will. That will does not exist because beggar my neighbour is the rule which means that everyone ends up beggars to varying degrees. In the case of doctors going from Africa to the UK to help the NHS to show one example which reflects many others in the so-called “First World”, they have not led to improvements and the service is vastly underfunded like its private sidekicks so that according to a EU Survey of 2006 the health services is in the UK are 15th out of 27. I always remember the famous song “Money Is The Root Of All Evil”. It is an American song and in this case its application means that there is not enough of it being spent globally on health care and looking for scapegoats is the road to despair and continueing failure.

  90. 90 George USA
    February 23, 2008 at 12:49

    It is all about economic protection of those proposing closing the door to foreign trained doctors.

    This has absolutely nothing to do with brain drain.

    Medicine in the USA hires laws past, regulations changed, federal agencies retaliations, and abuse of power to cover up their activities.

    This is just economic protection of income on the winds of recession, self interest, with hired economic protection by law.

  91. 91 George USA
    February 23, 2008 at 14:16

    I am a Medical Doctor, US citizen but graduated from medical school abroad.

    My first hand experience with organized medicine uses of the media, ECFMG, Boards of Medical Examiners, Congress, Federal Regulations, and Federal Agencies to impose economic protection is valid and truthful observation.

    The reluctance of WHYS to publish first hand, valid, experience of abuses of the federal government for the ends of economic protection and more importantly “economic enhancement” is the exact reason this activity goes on- unreported and unspoken, abuses are not addressed.

    Organized Medicine in the USA has not and will not do one single thing to have any law enacted that is not specifically and solely for it’s own economic interests, and those interests do not lay within legal or ethical bounds today.

    “Closing the Door to Foreign Medical Graduates” was the specific reason for witch hunts in the past, and the economic protection this has been used for is the specific reason for this sudden interest in “brain drain” as a motivation to pass a law to “close the door to FMG’s” for economic protection.

    Money is the sole issue here.

    To pose the question of “brain drain” without addressing the actual motivation behind it gives far too much use of the media to people who do not have the publics interest in any part of what they do, much less third world nations.

  92. 92 George USA
    February 23, 2008 at 14:46

    Lubna’s new blog is good.

    It reminds me that no matter how bad things are in US medicine, there is a real brain drain in Iraq.

    That brain drain is through the murder of doctors.

    Lubna calls it targeting Brains.

    Good Luck Lubna.

  93. 93 kubi alex
    February 23, 2008 at 15:19

    We should look at the nationalist point of view, I think we should at it on the social economic angle! are my children happy at home?are they going to the school I want them to learn from? are they eating two meals a day? are they healthy?

    If I could be able to make this happen, I think there should no one to answer to? If you want me to answer to the nation, let the country invest in me and thereafter follow-up on returns despite, despite of where I work!

  94. 94 Vernon
    February 23, 2008 at 16:49

    Why aren’t there enough doctors recruited from the British population for the needs of the British people or other 1st world nations? Is it because most want to work in private practice for more money and there is a shortage in government institutions? So in the end then the desire for more results in suffering for the poor in 3rd world nations.

  95. 96 Xie_Ming
    February 24, 2008 at 09:07

    The USA talks of a “free market”, but tightly controls the number of medical schools and graduates allowed.

    This monopoly seems to be fostered by the union (the American Medical Association).

    Health insurers (in Canada, for example) have also discovered that having fewer doctors means having fewer people having medical expenses.

    Answer: break the monoply and allow the education of all students who can pass the exams!!!

  96. February 25, 2008 at 08:52

    Xie_Ming February 24, 2008 at 9:07 am

    “The USA talks of a “free market”, but tightly controls the number of medical schools and graduates allowed.”

    Yes -it is so easy for people to talk of “individual freedom” and “individual responsibily” when living in comfort behind protective barriers which separate one entirely from the realities of life.

    Only a trully indoctrinated people could believe in their own freedom while subjected to a daily bombardment of propaganda from governments and the multi-billion advertising industry. An industry dedicated to persuading them to buy things they do need so that people they do not know can live in comfort beyond anybody’s dreams -while others suffer the hidden costs..

    There is no “freedom of choice” for people living in poverty -caused by corruption, aided and abbetted by governments; trapped by biased laws, armed police and a well fed army; surrounded by smug people who have no understanding of the situation who still claim that they know best. Under these conditions there is no “freedom” -only the choice between the contiuing fight for survival against all odds -or death…..Sometimes even this is no choice -and the game is lost.

    But what’s the use of trying to explain anything to people who are so biased and convinced of their own superiority……

    Haven’t the problems in Iraq taught us to question our own certainties? Wasn’t that supposed to be a “walk in the park” -and wern’t the Iraqi’s going to welcome the invasion with flowers and cheers? So what happened?

    If people were so wrong on one issue -perhaps they are similarly mislead on a whole range of issues…..Ultimately, the true situation in the world will manisfest iteself -whatever one has been told to believe about it…..

    So sleep on, sweet dreams -but perhaps one day the sleepers will awake to yet another nightmare….

    In the meantime -we should all try looking at the whole picture, and not just the little bit that supports our own wishes.

  97. 98 shirley
    February 25, 2008 at 17:59

    I don’t mind where my physician comes from, as long as she respects me and my values as they apply to my health care. And I think it only proper that if someone has decided to work here in the West – regardless of what field – he or she should receive the very same kinds of rights in the workplace as anyone who was born in that same place. However, I see the importation of doctors from developing countries into the West as a kind of imperialist theft. We in the West should be careful about leaving others around the world in short supply.

  98. 99 Dedi Ramba
    March 7, 2008 at 01:04

    It’s not fair to make the practice of luring developing world doctors to the west a crime. I think world leaders have to agree on a global mechanism to regulate it. Looks like the doctors in the west are asking for too much than the system can afford. The result is that they refuse to serve their communities creating a high demand for them; an example is the case of the Polish doctor who commuted between countries in Europe to practice medicine in UK.

    Until then, nothing can be done to stop doctors leaving the developing world to the west since there’s no legislation to prevent them from doing that.

    Dedi Ramba

  99. 100 theophilus
    March 11, 2008 at 14:23

    pls, i want to know the current trend of the movement of ghanaian doctors to developed countries for better COS.

  100. March 27, 2008 at 12:44

    For those that may be interested to continue this debate, the issue of the migration of health workers will be discussed in a global virtual dialogue via a community of practice hosted by the World Health Organization, Realizing Rights and the Global Health Workforce Alliance. The global dialogue will run for three weeks from the 31st of March and will be launched in a videoconference at 1500 GMT.

    This dialogue is open to all for participation and forms part of the consultation process in developing a framework for a code of practice on the ethical recruitment of health workers.

    From the website http://my.ibpinitiative.org/public/HWMigration/ you can sign up, see the discussion, participate and access information. I am a Project Coordinator for the International Pharmaceutical Federation (a professional body for pharmacists) and a member of the technical working group that is helping to organise this programme. It would be great to get your views, inputs, experiences in this dialogue.

    There is a need to see migration in its complexity, context and various forms. There is no single solution to the human resource for health crisis and migration is but one strand of focus in efforts to build the health workforce. Retention strategies, career development pathways, appropriate remuneration packages, safe and supportive working environments are all critical. Human rights must not be infringed in this process and all individuals have the right to emigrate. One key consideration is what contributes to the attrition or exit of health professionals out of the workforce, be it out of the profession, sector or country. Tackling these issues will go a long way towards sustainable development of the workforce and it is likely that relying on migrant workforce to meet health workforce shortages in any country will not lend to such a pathway.

  101. 102 Dennis Young, Jr.
    May 9, 2008 at 01:59

    luring doctors to the west from developing countries should
    be done in very EXTREME cases.

    other words, they should be providing medical
    care to there countries….

    Dennis
    Madrid, United States of America :)


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


Follow

Get every new post delivered to your Inbox.

Join 251 other followers

%d bloggers like this: