United States Leads in Stealing Africa's Doctors

Pediatric doctors at Donka Hospital in Conakry, Guinea

Pediatric doctors at Donka Hospital in Conakry, Guinea

The United States is stealing the world’s doctors — and from the very places that need doctors the most. Dubbed the “international brain drain,” the United States leads the way in attracting international doctors, especially those from Africa.

The United States, with its high salaries, attracts more international doctors every year than Britain, Canada and Australia combined. However, for every 1000 people, Africa has only 2.3 health care workers, while the United States has almost 25. Doctors emigrating in droves from developing countries for “greener pastures” are making an already critical health worker shortage ever more dire.

But this brain drain is not new. In countries like Ghana, some 61% of doctors produced in the country between 1986 and 1994 had already left the country by 1999. The financial loss from emigration like this has been extremely detrimental. The loss from this period of emigration in Ghana alone is estimated at over 5.9 million dollars.

Foreign MDs
Foreign MDs

Not surprising, foreign medical doctors make up a substantial proportion of the doctors workforce in some of the most affluent countries in the world. More than 34% of doctors practicing in New Zealand were from overseas in 2000.  And according to a 2010 report in the Economie Internationale other developed countries have extremely high proportions of foreign doctors, including the United-Kingdom with 31%, the United-States with 26%, and Australia and Canada with more than 20%.

This is in part the result of initiatives like the 1994 U.S. legislation proposed to allow foreign doctors on student visas access to stay in the U.S. if they agreed to work in some of the poorest places in the United States. Since then, over 8,500 African doctors have left Africa and gained jobs at American hospitals that were in short supply.

A sneaky initiative. It looks great from the outside from its ability to give African medical students the chance to work in the U.S. for higher wages but it does nothing but continue to keep those living in “periphery” countries ever more dependent on “core” countries.

This is described by most scholars as the dependency theory — an economic model that became popular in the 1960s as a critic of the way the United States, along with many western countries, exploits those in the “periphery” for their own gain.

Poor countries provide resources, in the form of raw materials, cheap labor, and a market to those countries in the core. While wealthy countries in the core perpetuate their dependence in every way possible — through control of the media, economic politics, banks and finance insinuations like the International Monetary Fund (IMF) and the World Bank, educational initiatives, cultural exploitation, and even sporting events like the World Cup.

Indeed, this exploitation is clearly exemplified by the emigration policies facilitating the exodus of medical doctors from Africa over the past decade. Of the 12 African countries producing the most medical graduates, 8 have seen a 50% increase from 2002 - 2011 in all graduates appearing in the U.S. physician workforce. Cameroon, Sudan, and Ethiopia each had over a 100% increase since 2002.

These policies in place, that are sucking up some of Africa’s greatest doctors, are just further methods of perpetuating the poorest country’s dependence on the wealthiest.

It becomes clear then that while the United States benefits, Africa only appears to benefit. The U.S. gains excess doctors, while Africa looses the few it barely has.

While the United Sates grows its ratio of 2.45 doctors for every 1000 people, countries like Mozambique see a decrease in the already alarming rate of .04 doctors for every 1000 people.

Health professionals around the world agree that human resources is the most key component to solving problems in global health. But it is often one of the most neglected components, with much more emphasis focused on managing disease outbreaks and not the people actually preventing diseases.

Oliver Bakewel, of the International Migration Institute, agrees with this logic in writing that “development practice has commonly seen a reduction in migration as either an (implicit or explicit) aim of intervention or an indicator of a programme’s success" in an 2007 report.

However some scholars at the World Bank disagree with the notion that migration is inversely proportional to success in African development. A 2014 article in The Atlantic headlined "Why the brain drain can actually benefit African countries," outlined their findings that suggest "one additional migrant creates about 2,100 dollars a year in additional exports for his/her country of origin.”

However, this argument does not look closely enough at the brain drain for specifically medical doctors.

The brain drain intersects more than just the medial field — it cross cuts every highly skilled profession. But the effects of the brain drain on the status of health care in Africa is much more harmful than that of the brain drain of — for example — African professors. The average increase of 2,100 dollars in exports will do nothing to solve the critical and immediate lack of medical doctors in almost every African country.

The time is here more than ever for the international community to play a more proactive role in addressing the international medical brain drain. Affluent countries like the United States should be held accountable for exploiting Africa for its doctors, while international policies should be put in place to help African governments increase wages for health workers and retain their much needed doctors.

Contributing Editor: @AustinBryan
LinkedIn: Austin Drake Bryan

Dubai: A Tale of Economic Upsurge

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Vinita Tiwari, Middle East CorrespondentLast Modified: 05:09 p.m. DST, 29 May 2014

"BURJ AL ARAB" Photo by: Nitin Badhwar

A recent survey done by one of the globally recognized auditors, Price Waterhouse Coopers (PwC) revealed that Dubai has been honorably named as the ‘City of Opportunity’. The emirate has left behind a lot of economically strong countries in the race; emerging as one of the flourishing employment producing cities.

Sweeping off the accolades and awards on a global platform was never easy for an Arab federation that was strangling in the ropes of tradition and orthodox perspectives; a couple of years ago. Let us explore and know the history and what led to the huge success of Dubai from different aspects.

History of Dubai: A Time-Line Reflecting the Rise & Fall of the City

Dubai dons the image of an economically powerful Arab federation and an employment powerhouse that encapsulates opportunities not only for nationals but for millions of expats as well. But the situation was never this favorable and Dubai has risen from the ashes, in a true sense. Let us analyze the Dubai’s history, year-wise:

  1. 1930-1940 (The ‘Dark’ Decade):

Long before, when the wealth-generating oil & gas fields were not explored; it was the Pearling industry that flourished in the corners of the UAE, especially Dubai. During this tenure itself, recession destroyed everything and the booming Pearl industry dipped in no time. The sudden fall created a lot of social pressures and there were scenarios of disputes amongst the royals.

  1. 1958-1968 (The ‘Bounce-Back’ Decade)

It was in the year 1958 that Sheikh Rashid officially became the ruler of Dubai and started building relations and directing initiatives towards revamping the economy of Dubai. The initiatives were for re-branding the image of the city and making it a major trading hub. After a couple of years, the city discovered its own oil field. This attracted a lot of traders and thereby after a long time, Dubai saw economic growth. As the decade ended, Dubai was already exporting crude oil and generating revenues.

  1. 1990-2006 (The ‘Fortunate’ Decade)

Dubai was now fast emerging as a wealth and job generating machine sort of country. By the end of 1990, there were political upturns as Sheik Maktoum, the new ruler of Dubai paved way for organizing Dubai shopping festival and the Dubai World Cup. Moreover, in this time period only, Burj Al Arab came into existence. By 2003, Dubai got recognition from the International Monetary Fund and the World Bank, as a financial hub. All these major political happenings led to the economic success of Dubai.

  1. 2006-Till Date (The Never-Ending Success)

Dubai has now become one of the top tourist destinations and placed itself ahead of all the powerful job markets and economies.

Other than economy and revenues, Dubai has come a long way in shedding its conservative image and rolling out as a country that welcomes people from different cultures and backgrounds. This is no less than a sign of a powerful country. Let us explore this aspect as well.

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Published: 29 May 2014 (Page 2 of 2)

History of Dubai: Ruling Out the Social & Cultural Barriers

Times have changed and so is the thought process. Owing to a strong economy and a high per capita income, Dubai manages to attract a good number of migrating job seekers every quarter. So, it can be clearly said that the flourishing city of the UAE has a mixed populace in terms of religion, caste and creed. The expats have reported a healthy lifestyle and this proves that the federation has left behind the age-old cultural stigmas that marred the success earlier.

The above discussion shares some of the facts that reveal the arduous journey that Dubai has covered from being a small city to what it is today. If people are regarding the city as fortunate, then there are reasons behind it. Let us unfold the current fiscal and job market scenarios of Dubai.

Dubai: A City of Booming Economy & a Ripple-Creating Job Market

Dubai has come a long way in creating the stature that it maintains today. The economic evolution and extermination of tightening cultural yardsticks has resulted into a city that is flourishing and raining jobs in almost all the sectors. There are certain government initiatives that have been taken to bring in revenues and make Dubai’s economy stronger. Here are some of them:

  • Government initiatives directed towards bringing in economic diversification
  • Foreign trade has proved to be a major contributor in boosting the economy
  • Initiatives to promote jobs in service industry-Finance & Trade sectors in the city of Dubai
  • There are initiatives strategized by government bodies in Dubai that aim to offer employees a better and secured workplace. This has actually attracted a lot of countries to partner with Dubai and create jobs for people.

All these factors and ventures have helped in developing Dubai in becoming one of the economically strong cities and a job market to ‘die-for’. Well, Dubai has acquired the status of being a land of opportunity, then there are ought to be some more reasons that supports the fact. Well, there are certain upcoming events that will even elevate the success rates. Here is a snapshot of the foreseen fortunate events:

Dubai: Upcoming Fiscal-Boosting Happenings

  1. World Expo Bid Win 2020

Dubai will be hosting the next World Expo Bid that will witness countries from different parts of the world participating and displaying job opportunities in different sectors. Some of the mobility and Oil & Gas related issues will also be addressed in the exposition. The event is expected to create millions of jobs across sectors. The economy is expected to be boosted by a whopping $24.2bn.

  1. Launch of World Free Zones Organization

Dated May 19, 2014, the World Free Zones Organization (World FZO) unveils in the city of Dubai. The organization is a non-profit entity that will operate for all free zones around the world and is set to transform the way in which world economy operates.

Not only fortunate for working lot, Dubai has also proved its worth for the business group as well. Dubai is a favorable place for all the working people owing to booming fiscal situation, high per capita income and a tax-free working zone.

A ‘City of Opportunity’ in True Sense

Dubai has come a long way to reach a place where it is now and has also shed its image of being a culturally narrow federation. The fierce combination of low corporate tax rates, affordable cost of living and quality of life are some of the defining factors of Dubai. The city is not only a favorable land for emiratis but also an excellent employment destination for expats as well. With all these factors combined together, Dubai has emerged as a winner in true sense.

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When Christine Lagarde Talks, Everyone Listens

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 01:14 AM EDT, 27 September 2012

Christine Lagarde Headshot, Photo by IMF

WASHINGTON, DC - Christine Lagarde, the International Monetary Fund, Managing Director is arguably the most powerful woman in global finance next to German Chancellor Angela Merkel.

Merkel is noted for her role in trying to resolve the Eurozone debt crisis, as leader of Europe's biggest and most robust economy. Merkel has also been named by Forbes magazine as the most powerful woman in the world.

Since the global economic slowdown, various countries have struggled to retire debt in the face of increased jobless rates, volatile financial markets, and decreased GDP.

Therefore, when Lagarde announced that the IMF is set to cut its forecast for global growth next month, the news was greeted with trepidation by the United States and other governments including China.

At issue is the growing lack of confidence in the ability of European policymakers to attack head on the crisis affecting the Euro Zone, as well as an increased unwillingness by countries with strong economic growth and low debt, like Germany, to support the bailout of countries that refuse to implement effective austerity measures.

In fact, the S&P 500 fell for a fifth straight trading day on Wednesday as protests in Spain and Greece over euro zone austerity measures raised fresh concerns over Europe's ability to get its debt crisis under control. The possibility of countries with stronger economies defecting from the euro zone in favor of a return to their national currency also contributes to continued market instability.

When Lagarde announced that the IMF is cutting its global growth projection for 2013 to 3.9 percent although it left its 2012 forecast at 3.5 percent in July 2012, it was widely viewed as a lack of confidence in Europe's ability to resolve the euro zone crisis.

In particular it was viewed as a tacit indictment of government officials inability to effectively address the economic downturn in their respective countries. The failure of these countries to implement austerity measures to reduce their debt has adversely affected the economies in the rest of the world.

In fact, Lagarde stated that she believes the euro zone crisis poses the greatest risk to the world economy followed by the looming U.S. fiscal cliff which she believes also presents a "serious threat."

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Published: 27 September 2012 (Page 2 of 2)

"We continue to project a gradual recovery, but global growth will likely be a bit weaker than we had anticipated even in July, and our forecast has trended downward over the last 12 months," Christine Lagarde said.

"Markets briefly rallied after the European Central Bank's decision to launch a conditional bond-buying program for troubled states. ECB President Mario Draghi introduced a program to buy European nations' debt on a potentially unlimited scale — with major conditions. The most important at the moment is that a country must formally request the assistance and agree to financial conditions from the international lenders." (Source: Seattle Times)

This model is similar to the U.S. Troubled Asset Relief Program which was enacted by President George W. Bush in 2008. The TARP program purchased assets and equity from financial institutions to strengthen the financial sector and stave off a severe financial downturn unseen since the Great Depression. However, it remains to be seen if the ECB’s approach will prevent the euro zone from slipping into deeper recession.

Lagarde said that the IMF supports Europe moving to a banking union which will prevent nations from being dragged down by sickly banks. The euro zone is currently weighed down by the faltering economies of Portugal, Greece, and Spain; and in the case of the latter, Lagarde believes that it appears headed toward a bailout like the one that Ireland received after rescuing its banks.

Despite this, Legarde does support the idea of giving Spain and Portugal more time to implement budget and other reforms. But she also expressed caution and was wary of Italy and France, two of Europe’s biggest economies, sincerity in charting a path to substantive economic and budget reforms.

Lagarde said structural reforms and fiscal adjustments are going to be unavoidable in crisis-hit euro zone countries, and that continued austerity measures must be more steadfastly enforced as a prerequisite for receiving future bailout funds.

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Jim Yong Kim, New World Bank President

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 00:16 AM EDT, 17 April 2012

Jim Yong Kim, President of World Bank, 2012WASHINGTON, DC – The World Bank announced today that they selected President Barack Obama’s nominee Jim Yong Kim to serve as its president. Mr. Kim has been selected to replace the out-going president Mr. Robert B. Zoellick.

Mr. Kim, a Korean-American doctor, will be the first leader of the institution who doesn’t come to the post with a financial pedigree. He successfully challenged the Nigerian nominee, Finance Minister Ngozi Okonjo-Iweala, and Colombia's former finance minister and development expert, Jose Antonio Ocampo.

“During the bank’s 68-year history, an American has always headed the institution, while the top job at its sister organization, the International Monetary Fund (IMF), traditionally goes to a European. But emerging economies have recently been contesting that informal arrangement at both the IMF and the World Bank and presenting their own candidates.” (Source: VOA)

Although, some of the Bank’s 187 members have expressed concern that Kim lacks the requisite financial acumen to head the institution, other view his tenure as the director of the World Health Organization and a co-founder of global non-profit Partners in Health as vital to his understanding of the needs of the countries to which the World Bank provides financial and technical assistance.

President Paul Kagame of Rwanda gave a ringing endorsement of Kim, as he reflected upon the dedicated support he provided in helping Rwanda to restore its health system. He went so far as to say, “Kim is a true friend of Africa and well known for his decade of work to support us in developing an efficient health system in Rwanda."

When Kim headed the World Health Organization he successfully implemented a program to increase access to affordable HIV drugs in the developing world.  He was tenacious in his efforts to extend treatment for HIV and AIDS to over 7 million people in developing nations.

Kim’s nomination has become controversial, with opponents angered by the upset of the pro forma appointment of wealthy nominees being selected to lead the institution, and in the process enrich themselves and their cronies; and proponents who believe that it is time for a new selection process and applaud the US' bold move in nominating an unlikely candidate.

It is fitting that President Obama would take the bold step of appointing an outsider to ‘change’ an entrenched culture and reform an organization which has lost sight of its mission to assist countries better support and improve the lives of their citizenry.

Kim will begin his five-year tenure in July 2012.

Legarde's IMF Jenga Gambit

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 00:49 AM EDT, 22 February 2012

FRANCE, Paris - In the latest Greek Tragedy, aka the 'Greek Deal,' the Troika seems determined to ignore the adage of “not pouring good money after bad.”

Greece, Ireland and Portugal are the first three countries in the euro zone to agree to ‘bailout’ plans with the so-called Troika consisting of the European commission, the European Central Bank (ECB) and the International Monetary Fund (IMF) which place them under the direct tutelage of their creditors.

Although exact figures haven’t been publicly disclosed, it is believed that after this second bailout Greece will owe a total of €50 billion to the IMF, and according to German Finance Minister Wolfgang Schaeuble, bailout No. 2 for Greece will be roughly €23 billion.

The IMF, ECB and European Commission have concluded that Greece's debt could hit 160% of GDP by 2020.  Even with recently implemented austerity measures which many claim are not substantive enough, Christine Legarde, the IMF’s managing director, seems poised to infuse additional capital into Greece’s foundering economy.

On Tuesday, Legarde issued the following statement, “The combination of ambitious and broad policy efforts by Greece, and substantial and long-term financial contributions by the official and private sectors, will create the space needed to secure improvements in debt sustainability and competitiveness.”

The obfuscated motivation behind the IMF’s desire to hurriedly conclude months of bailout negotiations despite Greece’s reticence and its likely inability to repay anything close to 100 cents on the drachma, has some questioning the deal.

According to financial news sources, this infusion has less to do with Greece and more to do with the rescue of the rest of Europe in an effort to prevent massive defaults and/or an exodus from the euro. Despite deep criticism, Legarde is faced with the same dilemma President Barak Obama wrestled with early in his presidency – capital infusion via bailouts or risk the total collapse of the economic system.

Legarde, as the IMF managing director is gambling that these measures will ensure the preservation of a 17-nation euro zone. Though many would argue that this is not central to the IMF's core mission, the global economies are so interdependent that like the game of Jenga, without careful positioning and risky calculations, it could all come tumbling down.

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Christine Lagarde, New IMF Director

28 June 2011 - French Finance Minister Christine Lagarde was named Tuesday as the new managing director of the International Monetary Fund (IMF). Her five-year appointment begins on July 5th, as such she is the first woman to lead the multilateral lender to nations. Lagarde succeeds countryman Dominique Strauss-Kahn, who resigned on May 18 after being arrested on charges of sexually assaulting and attempting to rape a hotel maid in New York. He is currently under arrest in New York while awaiting trial, Strauss-Kahn pleaded not guilty earlier this month.

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