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id21
viewpoints Skilled migration = brain drain is not a simple equation says Ronald Skeldon from the University of Sussex. Brain drains in context In order to 'make poverty history', it is often felt that Africa needs the skilled people it produces. Developed countries are seen as 'poaching' and 'hoovering up' skilled people from Africa and other developing regions to meet their own labour demands. This situation appears to be at its most acute in the health sector, where doctors and nurses from poor countries are recruited to fill significant numbers of vacancies in North America and Europe. Some governments in developed countries, including the United Kingdom, have responded with programmes of 'ethical recruitment' that limit or even prohibit recruiting health personnel from poor countries. Such policies may be extended to other sectors such as teaching. However, recent work by the Development Research Centre on Migration, Globalisation and Poverty at the University of Sussex in the UK shows that policies of ethical recruitment gloss over what is a very complex issue. Attempts to restrict the migration of skilled people may not achieve the desired objectives and may actually disadvantage those involved. Migration is an integral part of development and tends to increase as economic and social development takes place. Skilled migrants seldom come from the poorest countries in the world and rarely from the poorest parts of developing countries, the rural sector. There are also important internal brain drains as well as international movements of skilled workers that are rarely considered in the debate. Many skills that citizens of developing countries possess have been acquired in universities and training institutions in developed countries. Skilled workers also move from the developed world to poor parts of the developing world. Health personnel from Médecins Sans Frontières which is based in developed countries, are involved in more than 3,400 missions a year; developing countries themselves where surpluses of specific skills occur, supply many more. Not all skilled workers can necessarily be productively employed in their own countries. The Sussex research emphasises the nature of appropriate training programmes that might mean training for local rather than global markets but these will vary from country to country. Some countries actively promote the export of particular skills - the Philippines in the case of nurses and India for nurses and doctors, for example. The positive association of the health status of a particular country with the number of health workers is also too easy an assumption (that the more health workers there are the better the health status of a population). Agronomists seeking to improve food yields to raise nutrition levels, water engineers working towards providing clean and safe drinking water, and transport engineers constructing communication lines to bring food to places where it is most needed, may all be as instrumental in raising basic health standards as doctors or nurses. These professions need to be included alongside health professionals in the discussion of health crises in Africa. The migration of skilled workers to developed countries and their subsequent return to their own countries is important for the future development of these areas. The Sussex research is examining the conditions likely to induce return and that might lead to the outsourcing of health and education services to developing countries. In a globalising world, developing countries will have a growing role in servicing those living in developed countries world where health and education can be provided at lower cost and more efficiently than in developed countries. Outsourcing could include establishing health and to a lesser extent education centres in developing countries where health insurers or high profile schools and universities can outsource some of their services. Clearly, the issue
of the migration of the skilled is not one of simple developing-country
loss and developed-country gain. Policies that consider the real complexity
of the situation rather than a perceived simplicity are needed if a
more sustainable development is to be achieved.
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