In some Gulf states, more than 50% of health workers are migrants. 75% of Mozambican doctors and 56,000 indians physicians work abroad. The situation can get to the absurd point of having more Ethiopian doctors in Chicago than in Ethiopia itself!
These few figures were carefully quoted as the more extreme examples of health workers migration consequences, but even when it comes down to more ponderated observation, there is no way to deny that health workers migration is a real issue (as shown in this infographic).
The globalization of the work force market (supply and demand) logically leads to these migration movements.
Besides the obvious financial reasons, health workers are looking for better job and career opportunities, and greater professional satisfaction (be it linked to material or to managerial conditions). As other types of migrants, they are also moving away from difficult national context (political instability, war, violence, etc.).
But the roots of the phenomenon also lies in the destination countries needing these professionals to take care of their aging population, to face the rise of chronic illnesses like diabetes and heart disease (especially in rural areas); but also to compensate the decrease of their health work force (aging and insufficient).
The causes are various, and so are the consequences. They can be positive, as it allows migrants to get better job conditions and destination countries to face some tricky health and populational issues. Because some of the migrant professionals return to their countries, it also helps to bring back there skills and expertise. And, as it is the case for every kind of migration, the remittances can be a financial support for the source country population.
But, on the other hand, it means significant losses in investments in health worker education, shortage of health professionals, and even the collapse of health system for the source country.
On a more personal level, it is also important to remember that leaving your own country and adapting yourself to an other culture, language and professional context is not always an easy process. Especially when it comes down to getting equivalence for the skills acquired or facing the lack of full recognition of education and work experience.
Because of the globality of the problematic, politics about health care workers in one country have direct effects on others. It means the issue needs to be addressed on a trans-national level, through a global strategy and international cooperation. That is, for example, the objective of the WHO Global Code of Practice on the International Recruitment of Health Personnel. It was conceived to achieve an equitable balance of the interests of health workers, for source and destination countries, and to propose recommendations: better workforce retention, treatment and training conditions (and policies facilitating the return of the migrants) for the source countries; efforts towards reducing the dependency on foreign workers, improvement of the recruitment policies and treatments of the migrants for the destination countries.
However, as global initiatives can not cover the more specific aspects of the phenomenon, national strategies are also developed. Some destination countries, like Canada, develop their own policy to optimize these migration movements (better access to health sector, profession-specific language training, proposition to address financial difficulties, counseling, information, etc.). And some source country adapt their health system to face the most urgent problems (as does the Pakistan through the hiring and training of the Lady Health Workers, for example).
Concluding on such a topic would be presumptuous, as it is (and will be) an on-going dynamic process linked to a multiplicity of factors. Information and initiatives about the issue are many (the MoHProf – Mobility of Health Professionals; the AHRNI – Applied Health Research Networks Initiative (AHRNI); etc.). But this information often focus on a general point of view (statistics, policies, etc.). Health workers migrations, like all migrations, are not only made of numbers and proposals. They are made of individuals, histories, specific places and moments.
That is why we would be interested to hear about your testimonies, thoughts, experiences, about the way you lived (or are still living) the causes and consequences of this global issue, be it from the source or from the destination country point of view.
Feel free to tell and share!