The economic migration of Nurses from developing countries

Training African nurses in Africa, which is what Do Good Charity supports financially, is generally viewed positively here. It’s deemed a worthwhile cause because we’re investing in poor people’s education and training. This is something that will benefit them for life and is never a waste: education for education’s sake.
In addition to the individuals we are supporting financially through their nurse training, families and local communities will benefit. And in a world keen on evidence-based outcomes, we can point to X numbers sponsored, Y numbers trained and an estimated Z number of patients seen, babies delivered, children vaccinated and so on.

However, this positive outlook is frequently met with: ‘But how do you prevent them, once qualified, from leaving to work elsewhere?’ Sierra Leone and Malawi, the countries where the nurses we support are trained, are poor and under-developed, and their need for more trained nurses and other healthcare professionals is great. These countries are even included in a list where no active recruitment of healthcare professionals is recommended.  

But putting restrictions on trainees in regard to where they will work is not something the charity agrees with. It’s true that some are ‘bonded’ to work in specific hospitals or health centres for a year or two after qualifying, but they are then free to work where they choose. If this means seeking work overseas, that’s their prerogative.

Then I’m asked: ‘But how will these countries’ desperate need for more healthcare workers be met if qualified people leave? Don’t they have a duty to stay and help their fellow citizens? Doesn’t their leaving further contribute to their countries’ brain drain?’

Yet would we apply these same criteria to newly qualified nurses here whose training has been paid for by the state? Would we expect them to stay and work for the greater good? There would be outrage if it were suggested. So why do we hold different views when it comes to nurses wanting to migrate from the developing world?

I believe that by putting restrictions on these nurses’ freedom of movement, we are saying that they should be held responsible for their countries’ lack of development. And that they have a duty to stay there to plug away at the problems this presents. Isn’t that putting too heavy a burden on the shoulders of people who might want to seek a better life elsewhere? Why would we want to deny them the rights that the rest of us enjoy predominantly because of an accident of birthplace? Isn’t it reasonable for them to want higher wages, more learning and professional development, and better working conditions? Any developed country offers these, along with higher standards of living than are available to them at home.

Much needs doing to make the most of workers’ expertise in the health arena in both developed and under-developed countries, but I believe the broader problems of development need to be tackled in the political arena.

First published here 5.12.13