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

Immigration Policies: Two Countries Address the Global Expat Dilemma

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Vinita Tiwari, Middle East CorrespondentLast Modified: 02:23 a.m. DST, 25 July 2014

Dubai - UAE, Visa, Medical, Registration, Photo by Emon Dinglasan

“Remember, remember always, that all of us, and you and I especially, are descended from immigrants and revolutionists”. ~ Franklin D. Roosevelt

This phrase by one of the most iconic figures in the history of the American presidency affirms the fact that the process of immigration which has been a part of the human experience since time immemorial, and which continues today, is a crucial part of nation building.

Yet, even with the historical proof that immigration is valuable and necessary, the process of moving to another country to achieve upward mobility is more challenging than it has ever been.  This post does not seek to address the issue of 'legal' versus 'illegal' immigration, but the simple fact that in all of the contention people have forgotten their own origins as they lay claim to lands in which they were once strangers.

Society, economies, and global relations are an integral component of a robust immigrant population, and for the world to continue walking on the right path or precisely on a path of continued success owing in large part to the efforts of immigrants and their descendants; countries need to refocus their immigration policies to streamline and provide greater avenues for legalizing migrants, versus an approach that borders on xenophobia.

Some of the most vociferous complaints lodge against immigrants is that they will become a drain on society because they are poorly educated and lack skills required in this technological era. What has been forgotten is that the lack of education or skill does not constitute a high-probability of failure.  Many titans of industry arrived on foreign shores with little more than the clothes on their backs, and a primary school education to boot.

These migrants who shuffled from place-to-place in the earlier centuries were not afraid to wager on the future with their hard work, dreams, and determination to rise above their humble origins, thus laying a strong foundation for future generations to build upon.  This is not to say that there aren't many people who seek to gain illegal entry to a country for nefarious intent, but the majority of immigrant expats are law abiding citizens.

Immigration: Historical Significance

If one were to turn the pages of history, it can be seen that immigration activity started in the United States during the colonial era, and for the first part of the 19th century the country experienced unprecedented rates of immigration during the period between the 1880s to the 1920s.  According to the History Channel in an article about U.S. Immigration Before 1965, immigrants were divided into two lots on the basis of their motive behind their desire to immigrate; the first group entered America to look for better economic opportunities, while the other group which mainly constituted pilgrims, moved to America in search of religious freedom.

Only in 1965 did America formulate immigration laws which subsequently paved the way for Asia and Latin American laborers to immigrate.  Prior to the codification of immigration legislation a Quota System was used, but it clearly favored laborers of European descent.  This inherent inequity in the system has led to persistent accusations of racism, while the other side claims justification for this imbalance with specious diatribe and fear mongering.

Immigration: Different Nation, Different Facets

Since time immemorial, the activity of moving from one place to another for work, money or religious purposes has been prevalent. These globe trotters have been called many names in different nations; ‘Nomads’, ‘Wetbacks’, ‘Banjaras, Pikey, or Gypsies, but these derogatory labels sought to diminish migrants as human beings and malign their true intent, which has always been to search for better life in a better place. Soon, social concerns, religious constraints, and a clash of cultures served to ignite anti-migration activity.

In response to the demands made by the citizens already inhabiting various countries legally or by birth, their elected representatives institute tougher immigration laws to level the playing field, and reduce the appearance of bias and negativity.  But, how many succeeded and how many failed?  What were the hurdles?

The Current Story of ‘Sweet & Sour’ Experiences

Migration activity has become a trend nowadays as individuals are feeling the need to work and settle down in countries with good economic conditions and standard of living. There are favorable nations for them and then on the other side there are nations that have risen from the ashes and have achieved an enviable stature, yet reject immigrants because they do not want the country to experience a reduction in standards of living because too many migrants "may" require social services support at the tax payers' expense.

The positive gains made in immigration policy by many nations, has suffered blows in recent years.  In 2012, the Global Post published an article that listed the top 5 nations (Latvia, Japan, Thailand, UAE, and Australia) with the world's worst immigration policies.  Additional research and rankings of countries with similar labor abuses was done by the Human Rights Watch and Foreign Policy groups, and these studies confirmed and expounded upon the dangers faced by migrants seeking a better life in other countries.

Several of these countries on the lists are faring well both economically and socially, and their resistance to immigration supports the assertion that they view immigrants as a nuisance and a drain.  The report also revealed that each of these countries had severe shortcomings in their employment laws, practiced unfair and punitive behavior toward immigrants, especially in preventing immigrants from joining or forming labor unions which may have providing them with basic workers' rights and additional protections.

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Published: 25 July 2014 (Page 2 of 2)

‘The Wounds Washed & Bandaged’

The fact cannot be ignored that there are several nations, predominantly Asia and Arab, that are thriving because of the high rate of immigration, lax or none -existent worker's rights, and the subsequent benefit derived from these laborers that encourages foreign investments due to low wages.

Though this is still the prevailing model, many countries with stable economies that are flourishing, have begun to roll-out initiatives that seek to align the disparity between the benefits realized from these migrant workers versus their treatment and status..

Though identified in the Global Post, these 5 countries are definitely guilty of harsh anti-immigration policies, but there are many more socially restrictive nations that refuse to even let expatriates reach their shores, as has been reported these past few weeks in several tragedies where immigrants were wounded, drowned, or killed in open waters.

One incident occurred off of the coast of Italy where 60 people were killed trying to escape suffocation in a poorly ventilated and over crowded below deck area of the ship. Another ongoing concern is how Australia is currently handling immigrants seeking asylum.  Instead of allowing them to plead their case on shore, immigrants are stopped at sea and sent back without any regard to potential persecution they may face as a result.  Amongst the 5 countries listed above, one Asian and one Middle East country have begun to re-addressed their immigration laws to make them more equitable and as a result have begun to frame new laws and regulations.

United Arab Emirates (UAE)

Recently, UAE has emerged as one of the favorite destinations for immigrants. Expatriates from different nations who are seeking to expand their professional horizons are seeking career opportunities in the UAE.  Job seekers with technical skills can anticipate high per capita income, easy home loans and a vibrant lifestyle.  But, this is a relatively new but positive turn of events, especially since the UAE made the 2012 list of countries with the worst immigration policies.

Now, 2-years later, many Emirate-level governments have taken steps to strengthen the rights and protection of migrant workers.  With new strategic direction the federation has begun to focus on labor issues and legislating governmental bodies to arbitrate between the workers and employers, a mutually beneficial resolution of any immigration issues.  The country has reviewed and revised some laws, as well as its bilateral agreements with the countries from which many of the migrant laborers have originated for the past several years.

One such noteworthy amendment legislating greater protection in the interests of workers who were not covered under Wage Protection System (WPS). For this, the UAE government did following:

  • In 2012, the UAE Federal National Council called for legislation for addressing the protection of domestic workers' rights.
  • Later in 2013, the UAE government revised a federal law to safeguard victims of human trafficking.
  • There were initiatives and training programs developed to help custom and immigration officers to identify and targeted those who may be guilty of tafficking.

This may not seem like much, but these changes are substantial when one considers that the UAE based upon the 2012 report, gave the appearance of such a lack of interests in the rights of migrant workers, that laws and regulations did not even exists.

Japan

It is said that Tokyo’s government intended to pay the immigrants to leave the country as soon as possible. Sounds weird and disheartening, but it’s true.  Similar anti-immigrant action is being taken in both the United States and Australia where  asylum seekers and immigrants are being treated inhumanely and with little compassion or any consideration of extenuating circumstances.

However, as with UAE, Japan has realized some positive reversals in its heretofore inhospitable immigration policies.

  • The Japanese government has introduced a point system that makes migration protocols easier for workers conducting one of three activities: academic research, specialized technical work or business management.
  • New Preferential Treatment System that allows a foreign professional to work in a number of fields as long as they possess the requisite education or business acumen and/or capital.  Similar to the US H1B visa which is a non-immigrant visa that allows US companies to employ foreign workers in specialty occupations that require theoretical or technical expertise in specialized fields such as in architecture, engineering, mathematics, science, and medicine.
  • Clauses that will allow families of professionals to enjoy many of the same benefits of citizens.

Similar amendments are in progress in the 3 remaining countries on the list, but immigration reform in these countries has not progressed enough to demonstrate outward manifestation, nor is the process transparent enough for us to gain additional insight.

The Final Verdict

The countries that have been facing issues pertaining to harsh anti-immigration laws now recognize that their heinous treatment of foreign workers will no longer go unnoticed and in fact is being classified as a human rights violation.  It is easy to malign countries with record of various human rights abuses; however, it is more reprehensible for countries with robust economies and strong human rights protections to deny the benefits that have been received from immigraant or 'undocumented' laborers. To adopt such a hypocritical and uncompromising stance on immigration will only hurt the economic ecosystem in the long-term.

One could be kind and say that the stance they have adopted is because they haven't realized the true worth of these migrants and the advantages they bring.  But, more likely the exact opposite and that these governments are keenly aware of the benefits derived, but because this population of migrant workers is vulnerable and have the most to lose, many laborers find themselves in the untenable position of being regularly abused and taken advantaged.

This is a highly charged issue clearly demands greater awareness and compassion, as well as a desire to accept people from different backgrounds and religious beliefs into their midst. Once this has been accomplished, immigration laws will hopefully become merely written words on a piece of paper, because policy will then be driven less by the letter of the law, but the fulfillment of the original framework that provided avenues for people to improve their lot in life while bring great benefit to their adopted country.

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Follow Vinita on Twitter Twitter: @nahmias_report Middle East Correspondent: @vinita1204

Sub-Saharan Immigrants Suffer in Libya

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 21:25 PM EDT, 28 March 2012

Libyan Rebel SoldierTRIPOLI, Libya - Illegal immigration is a problem in emerging economies where many migrants seek to make the dangerous journey to Europe in hope of a better life. Libya, as a gateway to Europe, finds itself in a politically sensitive position with regard to immigrants.

Specifically, native-born Libyans now seem to have a serious problem with 'black' Africans. Sub-Saharan Africans are now viewed with suspicion and are often discriminated against through racial profiling. Because of their skin color they are easily identifiable and singled out.

Muammar Gaddafi, the former Libyan leader recruited thousands of mercenaries – nearly 30,000 according to the nonprofit group Human Rights Solidarity – largely from Sub-Saharan countries. The men were reportedly hired to take care of the dirty work of repression, and many were ruthless in their violence.

Shortly after the overthrow and death of Gaddafi, rebels hunted down mercenaries from Nigeria, Ghana, Chad, and Mauritania, including some black Libyans who were subsequently detained, beaten and extra-judicially killed. Even immigrants who have legally entered the country suffer immense discrimination.

Because most Libyans view Sub-Saharan Africans with suspicion, illegal immigrants fare much worse, especially those caught at the borders. Just outside of Tripoli there is a camp that houses about 600 detainees who have been caught trying to cross the border illegally.

Most have used all their money and resources to get to Libya which is a gateway to Europe. They don't want to stay in the North African country, but are simply seeking passage to countries where they can work in anonymity.

Once detained men and women are housed separately and subjected to harsh conditions. They are housed in corrugated steel buildings with concrete floors and no heating.  Many of the men complain that they haven't had access to telephones and are therefore unable to contact their families to let them know what has happened. According to a BBC report, they also state that many are sick and lack access to healthcare, and are hungry.

There are just a few wardens to guard over 600 prisoners and they recognize that this is a potential human rights violation, but are powerless to do anything about it.  They are doing their jobs though some sympathize with these immigrants who are just trying to make a better life for themselves and their families.

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