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

Looking Forward: Prosperity in Growing African Economies

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Jessamy Nichols, Africa CorrespondentLast Modified: 16:08 p.m. DST, 29 January 2014

China President Xi Jinping Delivers Speech in Dar es Salaam, Tanzania - March 2013

AFRICA - There’s no doubt that the continent of Africa is plagued by the common misperception and overarching reputation of being poor, downtrodden, corrupt, unsafe, unstable, and a list of other discouraging adjectives.

However, the world is not far away from having to look at Africa in a totally different light, where African countries are equal business partners overflowing with lucrative business opportunities.

A large portion of the world’s emerging economies hail from Africa, including South Africa, Nigeria, Morocco, Zambia, Namibia, Botswana, Tanzania, Uganda, as well as others. (Source: Center for Global Development)

As economic expansion tends to do, this has also led to internal reforms that are beneficial for the overall population beyond just GDP. For example, earlier this month, Nigeria rolled out their new mortgage refinancing program, similar to the American Fannie Mae reform, to make housing more accessible for citizens. For the first time, Nigerian citizens will be able to utilize mortgages and quality housing through an affordable and reasonable system.  Not only will this greatly improve the standard of living, but it puts more money into the economy and is also estimated to add over 300,00 jobs to the economy.

Coinciding with these economic improvements, the Nigerian power sector reforms have led to indications of incoming and ongoing investments. According to the Oxford Business Group (Daily Trust), the power sector will garner major investment, even compared to Nigeria’s vast oil and gas, banking and manufacturing sectors.

Other examples of expansive and impressive economic accomplishments include Ethiopia’s vast enhancement of its industrial zone, the Eastern Industry Zone, on the outskirts of Addis Ababa. Through these improvements, over 20 foreign companies have already secured factories at the site, including big businesses from China, Taiwan, South Korea, Pakistan and India. To expand the success even further, the World Bank is believed to be working to help Ethiopia gain more funds for the influx of foreign direct investment. (The Reporter)

Moving farther south in Africa, Tanzania is also following the economic growth train. South Africa’s robust business community has shown much interest in expanding into Tanzania, particularly in the infrastructure, mining and agricultural sectors. In order to facilitate these opportunities, the Tanzanian government is encouraging local businesses to create and build relationships with their South African counterparts, while providing an ever more conducive environment for business expansion. (Tanzania Daily News)

Outside of meaningful economic reforms and advancements, there are also other vital changes and partnerships being created to support a continent that is more stable, prosperous and successful than ever before. For example, at last week’s World Economic Forum meetings in Davos, HarvestPlus and World Vision signed a partnership to tackle hunger and help improve nutrition for hundreds of millions of people. (International Food Policy Research Institute ) Partnerships such as these will be key to supplementing economic growth, because without food security, solid education, stable political situations and adequate healthcare, the economies will be stunted.

As the world searches for the next big economic opportunity, there is no doubt that Africa should top their priority list. The continent is no longer stagnant and economically stunted, and increased foreign direct investment and business partnerships will only enhance the improving image as well as drastically boost the quality of life for many African nations.

Follow Jessamy on Twitter Twitter: @nahmias_report Africa Correspondent: @JessamyNichols

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.

Haiti Rocked by Political Earthquake

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:01 PM EDT, 24 February 2012

PORT-AU-PRINCE, Haiti — Haitian Prime Minister Garry Conille abruptly resigned Friday after less than five months. He didn’t provide an explanation for his departure when he submitted his letter of resignation to President Michel Martelly.

According to the Associated Press, “Conille, a physician who previously served as an aide to Bill Clinton in the former U.S. president's role as U.N. envoy to Haiti, was ratified by the opposition-dominated Parliament in October after Martelly's two previous picks for prime minister failed to win support from lawmakers, delaying the formation of a government by about five months.”

In a statement Conille said, "I feel obliged to present to you my resignation as Prime Minister of the Government of the Republic of Haiti. Please accept, Mr. President of the Republic, the assurance of my patriotic sentiments."

Some people suspect that Conille's resignation may be the result of escalating disagreements with Martelly and his inner circle as well as other Parliamentary officials. Conille’s resignation is another blow to a nation still recovering from devastating earthquakes that rocked the country in January of 2010. The catastrophic effects of the quake exacerbated the preexisting and endemic problems of poverty and instability.

This latest crisis, which is viewed by many Haitian experts as another case of self-sabotage, will cripple the ability of the Haitian government to overcome the enormous challenges it faces in trying to rebuild the infrastructure of the country.

After the 2010 earthquake, people from around the world pledged in excess of $4.5 billion in aid but only half of this amount has been released. Because the new Haitian government has been preoccupied with one crisis after another, it hasn’t had the opportunity to focus on the management of reconstruction efforts.

With the departure of the prime minister and the uncertainty of when President Martelly will appoint a new official or how long it will take the person to be confirmed; existing donors may be reticent to honor their pledges, which would further hamper reconstruction efforts.

One of the donors, the World Bank-run Haiti Reconstruction Fund, has more than $100 million on hold pending the government's approval of projects to be carried out in a transparent and coordinated manner.

Many, including the head of the United Nations peacekeeping mission in Haiti, Mariano Fernandez, said in a statement issued on Friday that Conille’s departure signifies to the world that a rift has occurred in Haiti government that is to the detriment of the country.

After years of brutal dictatorships and political instability, it was hoped that the democratically elected Martelly would be able to lead Haiti into a new era of economic growth, self-sufficiency, and political stability.

Unless this situation is resolved quickly, it will affect legislative and local elections which fall under the purview of the Prime Minister who is responsible for scheduling these elections. The terms of 10 senators, or one of third of the Upper Body, are slated to expire this year.

Nollywood | Bollywood

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Ayanna Nahmias, Editor-in-ChiefLast Modified: 14:14 PM EDT, 25 January 2012

NIGERIA - Lagos is one of the most populace cities in Africa. It is also the seat of the Nigerian film industry which began in 1992 and is known as Nollywood. It is the third largest film industry in the world after India's Bollywood and Hollywood in the U.S. Nollywood produces 2,500 films a year most for under $15,000.

The Indian movie industry caters to a population of over 1.2 billion citizens, and Nigeria, roughly 158 million. These numbers are the reason Nigeria is the largest and most dominant film industry on the Continent. (Source: World Bank, World Development Population Indicators)

In 2011, Bollywood and Nollywood concluded plans to host a joint film festival for both movie industries to commemorate the 60th and 50th independence anniversaries of both countries respectively. As former British Colonies, this festival would have provided a venue and opportunity to strengthen the cultural and economic ties that have existed between India and Nigeria. Unfortunately, due to safety concerns the 8th ION International Film Festival was moved from Port Harcourt, Nigeria to Phnom Penh, Cambodia.

The first Nollywood movie, Living in Bondage, was incredibly successful and is credited with launching the booming film industry in Nigeria. The films produced in Nigeria are financed and sold by electronics merchants and sold all over Nigeria in open air markets. Prior to 1992 most of the movies sold in Nigeria were imported from America or China or other markets. Since the advent of Nollywood, Nigerians claim that they only watch Nigerian made movies because they get to watch themselves and enjoy their unique culture, jokes, and the hope for a better life these films inspire.

Nigerian producers assert that Nollywood has become the voice of Africa. Because it is such a robust market it has become the benchmark for African film industry. In the West, Bollywood films have come to define the success of a film industry in an emerging market. Even though the highly acclaimed "Slumdog Millionaire" is not a Bollywood film, many Americans with only a cursory knowledge of the industry may concur with one of the movie's stars, Anil Kapoor that the movie is reminiscent of the genre.

Indian movie stars are well compensated through lucrative movie contracts, commercial and video appearances and product licensing. By contrast, many Nigerian actors work for little or no money because many believe that investing sweat equity into Nollywood's film industry is an important contribution. These actors feel that they are part of an important social and economic movement that helps ordinary Nigerians to dream of achieving a better life.

Nigerians believe that Lagos like New York, is a place that will make you or break you. If you can make it in Lagos you can make it anywhere in the world because life there is so grueling. I remember even as a child the sprawling ghettos, the crumbling infrastructure, and how crime was a dominant feature of Lagos. It has not changed much in the intervening years despite the incredible wealth generated by the oil industry.

In the early 1970's the Nigerian citizenry were increasingly subject to wanton violence as soldiers returned home from the Biafra wars with no opportunities and weapons. These men subsequently turned to crime as a means of support and began to terrorize the population. The danger posed by these marauders crippled downtown Lagos which resulted in the closure of restaurants, movie theaters and other entertainment venues. Going to watch a movie in a theater could result in the loss of life or property.

This socio-economic reality contributed to the underground development of the film industry because it was no longer safe to go out to the theaters to watch movies. In fact, there are only three functioning movie theaters in Lagos and none of them show Nollywood films. Most of the Nigerian made films are sold directly to the consumer who then view them at home or in communal settings.

These films speak directly to this population of poor people who have come to Lagos in search of a dream. When Nigerians watch these films they not only see themselves in the characters to whom they can aspire, and it provides them with the strength to continue to strive and not to loose hope. The film "Living in Bondage," is similar to a Medieval "English Morality Play," because during the lead character's struggles to make it he is repeatedly tempted to rely on the old tradition of Juju and witchcraft. Ultimately, this path provides him with worldly riches he desires at the cost of his soul. After experiencing other challenges, the character is finally redeemed through his conversion to Evangelical Christianity.

In a nation that is 52% Muslim and 47% Christian, Nollywood producers have adjusted their product to suit consumer demand. As more and more people struggle to survive in the economic downturn that followed the devaluation of the Naira, they need more than escape, and religion has begun to fill this void.  One of the largest film makers in Nollywood is Helen Ukpabio who is the head of Liberty Gospel Church which has over 50,000 members and 78 churches. Throughout many of her films, she blames witchcraft as the source of suffering for most Nigerians and the reason why many of their souls will be damned to hell.

Her films have captured a large segment of the 80 million viewers of Nollywood by presenting stories which preach the doctrine of achieving peace, prosperity and salvation by overcoming obstacles with the help of the church and a hefty donation. Though it may not have been her intention, Ms. Ukpabio and other Nollywood directors and producers recognized an opportunity to leverage the industry by moving from pure escapism to marketing religion as the new panacea. Right or wrong, the direction in which Nollywood is moving can be viewed cynically as a ploy to fleece the downtrodden, or beneficently as a tool to bolster faith.  Only time will judge, but for now Nollywood remains a powerful symbol of Africa's ascendancy.

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