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

LGBT Progress Overshadowed by Abuses

United Nations general assembly hall

United Nations general assembly hall

NEW YORK - The second report ever released by the United Nations on protecting LGBT rights was published today by the U.N. Office of the High Commissioner for Human Rights (OHCHR). The report outlines steps for governments to take in stopping LGBT discrimination.

There are 80 countries in the world today that criminalize consensual same-sex relations. The punishments vary, including prison sentences, torture, and the death penalty.

The report represents the gradual progress being made by governments in protecting LGBT people around the world. Since the first report released in 2011, 14 countries have adopted or strengthened laws that protect LGBT rights. These changes often extended protection of sexual orientation, gender identity and introduced legal protections for intersex persons.

But it is clear that the progress is overshadowed by abuse. The report states that “since 2011, hundreds of people have been killed and thousands more injured in brutal, violent attacks” because of their LGBT identity.

This violence is in part fueled by anti-LGBT rhetoric issued by regional, national, and international leaders.

In May the president of Gambia, Yahya Jammeh at a rally said that he would “slit the throats of gay men” in the West African nation. In 2014, the president of Uganda, Yoweri Museveni, said that gay people were “disgusting” after being asked if he personally disliked homosexuals in a BBC interview.

Even in 2012, the Nobel peace prize winner and president of Liberia, Ellen Johnson Sirleaf, defended the current law that criminalizes homosexual acts by saying, “We like ourselves just the way we are.”

Although these leaders have not changed their opinion on supporting legislation that criminalizes LGBT persons, the UN report published today is meant to outline international obligations that leaders like these have in protecting their LGBT citizens.

The report outlined five standards and obligations that every state has in protecting the human rights of LGBT persons.

The report calls on countries to protect LGBT individuals from violence, torture and ill-treatment. This includes condemning “conversion” therapy for LGBT persons, forced and otherwise involuntary sterilization and treatment performed on intersex children.

The report also demands states to “decriminalize homosexuality and to repeal other laws used to punish individuals on the basis of sexual orientation and gender identity.”

States also have the “obligation to address discrimination against children and young persons who identify or are perceived as LGBT or intersex.” This means that states are obligated to protect children in schools from harassment, bullying, and in addition to protecting all LGBT people from lack of access to health information and services.

The report also outlined the obligation that countries have to “protect the rights to freedom of expression, association and assembly and to take part in the conduct of public affairs.” This means that states must protect the rights of LGBT persons and LGBT allies to assemble and advocate for their rights.

In much of the world these standards and obligations are not followed and support for LGBT rights is often cited as a western construct meant to destroy autonomy and “traditional cultural values” that exist in sovereign nations.

However the United Nations has made it clear once again that this view is not acceptable.

The report states that “All human beings, irrespective of their sexual orientation and gender identity, are entitled to enjoy the protection of international human rights law.”

Contributing Editor: @AustinBryan
LinkedIn: Austin Drake Bryan

Al-Shabaab Prosecutor Murdered in Kampala

high court of uganda, kampala, photo by tom/Flickr

high court of uganda, kampala, photo by tom/Flickr

KAMPALA, Uganda - It's been almost five years since the perilous al-Shabaab bombings in Kampala, Uganda that left 79 dead during the World Cup Final. But the death toll from this terrorist group rose again after they followed and murdered Ms. Joan Kagezi, the country's chief prosecutor in this case, while she was in the car with her children. She was the head of Uganda's Public Prosecutions's Anti-Terrorism and War Crimes Division, and has been the lead on prosecuting the suspects in these bombings.

Prior to Joan Kagezi's murder, the U.S. Embassy in Kampala issued a warning of possible terrorist threats, and urged Westerners to stay away from spots that typically are known as Westerner epicenters. Depending on what intelligence they received to issue this warning, it is yet to be determined whether al-Shabaab was planning to solely seek out Ms. Joan Kagezi, or if they have other attacks planned that could also target Americans. Security forces in Kampala have now amped up measures in response.

The U.S. Embassy in Kampala issued a Facebook message stating, "[Joan] will be remembered as a brave and tireless promoter of justice, dedicated to ensuring peace and stability in her country...The United States reiterates its support for the Ugandan government’s efforts to combat international terrorism, in which Joan Kagezi played a leading role. We deplore this senseless act of violence and cowardice and join Ugandans in mourning the loss of this heroine in the forefront of the fight against crime and terrorism."

The loss of this just and influential leader through a profoundly immoral act of violence is entirely unacceptable, and Uganda, along with its international allies with relevant intelligence, must work together to bring those responsible to justice. Beyond that, it must be ensured that these acts will not be tolerated ever again.

Africa Correspondent: @JessamyNichols
LinkedIn: Jessamy Nichols

Ugandans Leverage Viral Activism

former-child-abductee-with-lra-photo-by-sean-sprague.jpg

Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:54 PM EDT,  23 April 2012

Evelyn, she was one of LRA leader Joseph Kony's child brides, Photo by Sean SpragueKAMPALA, Uganda - The Joseph Kony video that revealed gross human rights abuses in Uganda, particularly with regard to the kidnapping of children who were subsequently pressed into war as child soldiers, is not without its critics. Many Ugandans feel that their involvement in fighting against the ills that plague their war-torn country were portrayed peripherally if at all.

In the video below, the Ugandan people want the world to remember that they are like other people living in conflict areas around the world - they are inherently resilient, dedicated to conflict resolution, and involved in creating solutions to the problems which afflict their country and society.

This does not mean that The Kony 2012 video which went viral was not positive, only that it didn't go as far as it could from the perspective of the Ugandan people. There are many Ugandan activists on the ground making a difference, in fact, we recently featured a post on 'Victoria Seeds | Josephine Okot,' who is working to reeducate and train women to become successful farmers and businesswomen.

Africans are no different from most people engaged in life or death struggles. They are people of great courage fighting for the right of self-determination like groups in countries across the Middle East, fighting for the right to live in a conflict free society as are people in other countries across Africa, and for economic or religious equality as do people in Asia, Europe and the United States.

The difference usually lies in how the media portrays Africans versus these other cultures. Unfortunately, Africans are often portrayed as victims instead of victorious survivors, capable of effecting positive, lasting change in their societies and communities without external intervention. Though the Kony 2012 video is not guilty of this bias, many Africans through force of habit and historical experiences, reacted to the video with lukewarm response.

Thus, the first video features Ugandans telling their stories in their voices about their lives and the many challenges they face in their country including Kony. They share with us how this conflict has affected them, but also how they are persevering, thriving, and succeeding.

The second video is a response by the producers of the Kony 2012 video to its many critics, and documents the genesis of the project, the original objectives, and the utter surprise that this video project would garner so much attention and support.

Whatever side of the discussion you find yourself on, this video has done more than most in bringing the genocide that is occurring across the Continent front and center to the global consciousness. It is both inspirational and instructive because it demonstrates that each one of us is capable of making a profoundly positive difference, and if we just have the courage of conviction to follow-through on our dreams, we may be surprised at the global impact our vision coupled with action can have.

[youtube=http://www.youtube.com/watch?v=AvcWdNUujmg&feature=player_embedded#!]
[youtube=http://www.youtube.com/watch?feature=player_embedded&v=c_Ue6REkeTA#!]

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Victoria Seeds | Josephine Okot

mother-farming-with-children-photo-by-gates-foundation.jpg

Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:23 PM EDT, 13 March 2012

Baskets of Beans in Market, Photo by One.org

Baskets of Beans in Market, Photo by One.org

KAMPALA, Uganda - With the recent fervor over the viral Joseph Kony video, Uganda has shot to the forefront of many American’s consciousness. There are many tragedies occurring across the Continent, and we have focused most recently on the genocide that is occurring in the Democratic Republic of Congo.

In keeping with our mission, we strive for balanced reporting and to present positive stories of Africans making a difference in their lives and the lives of their communities.

Josephine Okot is the type of person of whom we are speaking. She is a Ugandan entrepreneur who invested a lot of sweat equity into building a company that promotes sustainable agriculture through seed delivery. She founded Victoria Seeds Ltd in 2004, and has grown the company from a struggling start-up which could not get bank financing to become Uganda’s leading seed house marketing over 90 seed varieties of cereal, legume, horticultural, oil and forage crops in the domestic and regional market.

Although, Ms. Okot’s business model is based upon helping farmers grow bot staple and cash crops, her company is essentially modeled after agro-dealers in other emerging markets who seek to increase market share and profits by educating their consumers. Victoria Seeds provides management skills and farming techniques to help them increase their yields and bring their product to market more profitably.

In 2006, according to their website they “opened a Sales Outlet in 2006 at Nakivubo place to facilitate seed delivery to agro-dealers. They also established a research facility thereafter at Kawanda in 2007 to research and develop new varieties adapted to our environment. The company commissioned a seed processing and research facility in Gulu in 2008 to improve seed availability to communities resettling in Northern Uganda and started engaging largely women in the regional seed industry supply chain.”

In an interview, Ms. Okot said that one of her beliefs is that business can only survive when society thrives. She is also passionate about women’s empowerment. In a small town bordering Sudan, her company is helping women who were previously living in refugee camps surviving off the UN’s World Food Aid program, can now farm and provide for their food as well as monetary needs.

These women, during the height of the conflict in Northern Uganda, were no longer able to care for themselves or their children. Like the DRC, weaponized rape was used to control and subdue the populace, and when women left the camps in search of firewood or water, they were at great risk of being raped and violently killed.

Victoria’s Seeds also provides training because these women are not professional farmers, and many employ the practice of broadcast planting which is very ineffective. They are instructed in the proper planting of crops in rows that are well spaced. They are also being trained to plant single crops per field to increase yield and quality.

According to the company, ‘in 2011 they opened a third Processing and marketing facility in Masindi Town to expand its processing capacity and meet the increasing country demand for improved seed.” We have featured Ms. Okot and Victoria’s Seeds because of her company’s core mission of empowering rural women.

Visit Victoria’s Seeds official website here.

[youtube=http://www.youtube.com/watch?v=5-_X62b-gLk]

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First War, Now Elephantiasis

elephantiasis.jpg

Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:55 PM EDT, 30 January 2012

UGANDA - When I was a child I first encountered a person afflicted with Elephantiasis when we moved to Nigeria. I wrote about this encounter in my post The Road to Naijiriya which details my arrival in Lagos as we embarked on our new life in Ile Ife.

Now, this disease is once again in the media as health services in Southern Africa have alerted the region to the need for increased preventative measures and prophylactic treatment options.

The 20-year civil war in Uganda has left severe scars on the economy, infrastructure, health and human services, and most of all on a populace that no longer has access to basic necessities such as potable water, food and medical treatment.

Lymphatic filariasis, commonly known as Elephantiasis, "afflicts over 25 million men with genital disease and over 15 million people with lymphoedema. Currently, more than 1.3 billion people in 72 countries are at risk. Approximately 65% of those infected live in the WHO South-East Asia Region, 30% in the African Region, and the remainder in other tropical areas." (Source: World Health Organization)

With proper medical treatment, the condition, which is caused by a parasite that is part of the roundworms family, can be cured. The parasite is usually transmitted to its human host through a mosquito bite. It subsequently invades and proliferates throughout the lymphatic system where it blocks and disrupts the immune system. "The adult parasites live for 6-8 years and, during their life time, produce millions of microfilariae (small larvae) that circulate in the blood." (Source: WHO)

Although, quite disturbing, this condition is easily treatable for patients with access to proper health care. However, in countries like Uganda, which has a long history of civil unrest and unstable governments; this disease remains unchecked in its transmission and infection. In addition to the excruciating physical pain caused by the disease, there is the accompanying psychological and sociological impact.

People afflicted by this disease remain ostracized by society and their communities much like lepers in previous centuries. They are also unable to earn a living because of the crippling disfigurement caused by the symptoms of this disease. The adult worms can be successfully killed usually with one treatment, however, the disfigurement suffered by the individual remains unless they can arrange to have surgery to remove the tumors.

It is sad that the Ugandan people who have been victimized by a series wars instigated by despotic rulers, the most egregious being Idi Amin, must now face a new marauder in the form of this parasite.

To learn more about the disease watch the Voice of America video below.

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