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

Muslims & Jews Unite Against German Circumcision Ban

israeli-doctors-perform-adult-male-brit-milah-photo-by-israel-21c-internal.jpg

Ayanna Nahmias, Editor-in-ChiefLast Modified: 22:58 PM EDT, 13 July 2012

Circumcision Day For Muslim Boy, Istanbul, Turkey, Photo by Patrino IoCOLOGNE, Germany - On 29 June 2012 a doctor in Cologne circumcised a 4-year old Muslim boy at the behest of his parents. His family is part of a community of 120,000 Muslims who inhabit the region and practice Khitan, the Islamic rite of circumcision.

A few days later the boy was taken to the hospital because he was still bleeding which resulted in the doctor who performed the procedure being charged with causing the boy grievous bodily harm.

Male circumcision is a 3,800-year old practice that is the bedrock of Judaism and Islam, and within these two faiths it is a physical demonstration of an individual's covenant with God.

Jewish boys must be circumcised on the eighth day following their births, and many Muslims boys must also be circumcised though the age at which the procedure occurs varies according to family, country and branch of Islam.

The Cologne Regional Court’s ruling prohibiting non-medical circumcision has subsequently raised a furor among German Jews, Muslims, and some Christians. Leaders of all three faiths are outraged by the government’s interference in religious practices, and it is seen by many as the first step in the erosion of the separation between church and state.

Many believe that these challenges to religious and cultural practices are being instigated by anti-immigrant sympathizers. In April 2011 France banned the Muslim practice of full-face covering headscarves, and on 6 July 2012 the French MP urged the government to ban Muslim headscarves for female soccer players despite the fact that the International Football Association Board (IFAB) ruled that hijabs could be worn.

While many may disagree with the practice, if circumcision is outlawed, it will not eradicate the practice and most likely will increase the number of injuries suffered by young boys because the procedures would then be performed in secret by unskilled practitioners in unsanitary conditions.

The Cologne court’s ruling is reminiscent of the criminalization of abortion in the United States. Prior to 1973 many women died because it was illegal in most states for them to receive an abortion in clean and sterile environments by trained medical personnel. This didn’t change until 1973 when the U.S. Supreme Court ruled that abortion is legal because it falls under the right to privacy.

According to Reuters, a spokeswoman for Chancellor Angela Merkel stated that “Everyone in the government is absolutely clear that we want to have Jewish and Muslim religious life in Germany. If circumcision is carried out in a responsible manner it must be allowed in this country without punishment."

In an era where there is increasing hostility between Muslims and Jews, this ruling has resulted in European rabbis and Muslim clerics banding together to vociferously denounce this decision. Europe is increasingly secular and these continued assaults on religious freedoms have become the catalysts for unlikely alliances as former adversaries adopt the stance of ‘the enemy of my enemy is my friend.’

[youtube=http://www.youtube.com/watch?v=W7btIrMVWPk]

Al Khalifa's Vendetta Against Bahraini Medics

bahraini-medical-workers-help-injured-protester-photo-by-bahrainiac.jpg

Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:14 PM EDT, 21 March 2012

A Wounded Shiite Bahraini DemonstratorBAHRAIN – On Tuesday, 20 March 2012, the Bahraini attorney general concluded his summation in the government’s case against the medics who defied an injunction against treating wounded Arab Spring protesters last year.

Although, the prosecutor initially suggested that the charges against the 20 medics would be drop, they changed course last week with an announcement that the government decided to pursue charges against 5 of the healthcare workers. The remaining 15 cases would be transferred from a military to an as yet unspecified professional tribunal.

Sheikh Khalid bin Ali Al Khalifa, the justice minister, directed the public prosecutor to release a statement clarifying the government’s intent to prosecute the defendants for violating an injunction against treating wounded protesters. The majority of the wounded were Shi'a, which leads some observers to believe that these trials may be motivated by sectarian agendas.

The predominantly Sunni government did not provide an explanation for the choice to pursue the indictments and trials against the medical workers, despite initial claims that they would bring no charges against the doctors. It is also unclear what methodology drove the decision to try five medics while referring the remaining cases to a tribunal.

The Bahraini government’s decision to prosecute these doctors drew international condemnation, and human rights groups were vociferous in their assertion that the medical workers were being punished simply because they helped civilians during the bloody crackdown by state security forces during the anti-government demonstrations.

Last September, the military court sentenced each of the doctors to 15-year jail terms for the crimes of sedition, incitement to overthrow the government, stockpiling weapons, and taking hostages. These charges arose out of an incident when 20 doctors and other medical staff refused to stop treating the injured protesters and subsequently barricaded themselves in Salmaniya hospital.

After the militia agreed to let them leave, the medics disbanded peacefully and were of the understanding that the matter was concluded. However, they were subsequently charged and their cases referred to a military court. In the face of worldwide criticism, their cases were moved to a civil court  where the charges were dismissed. The presiding judge in the current case provided no explanation for why the initial charges were never dropped, nor why the defendants had not been informed of their continued indictments.

Bahrain is a pivotal ally to the United States, hosting the US Navy’s 5th Fleet, providing an observation point for America in the Middle East, and aiding its efforts to monitor Iran and its nuclear program. Michael Posner, the US assistant secretary of state, said last month that Bahrain should seek "alternatives to criminal prosecution" in the case.