This resource uses a map and newspaper articles to provide a broad overview of the contemporary 'brain drain' of healthcare workers. Its goal is to further understanding of the general dynamics of contemporary migrations of healthcare workers and to stimulate thinking about the implications of this movement for sending and destination countries, as well as for the migrants themselves.
A typical stereotype, that migrants are unskilled and poorly trained, is defied by the significance of the global migration of highly skilled workers, such as doctors and nurses. This is part of a phenomenon popularly called the 'brain drain,' which is a term used to designate the emigration of highly skilled individuals, often from a developing to a developed country. Globally, the continued migration of healthcare workers from places where there are critical shortages exacerbates already existing inequalities between world regions and nation-states. For sending states, this migration not only results in the loss of skilled workers, but it is also a lost financial investment. The training of healthcare workers is expensive, and when healthcare workers leave their home country, their training leaves with them. However, like other migrants, many healthcare workers still maintain ties with their home countries by sending financial remittances. Some countries, such as the Philippines, even encourage the migration of healthcare workers, because their remittances are important for the national economy. Another potential, but currently rare, benefit for sending countries results when migrants return with more education and work experience. In the receiving countries, the critical need for healthcare workers does not necessarily mean that these migrants receive superior treatment. Indeed, quite the opposite may be true: studies undertaken in a wide variety of receiving states attest to the racial discrimination experienced by migrant healthcare workers, despite their social location in the labor market. Moreover, migrant healthcare workers have also been subject to different degrees of deskilling (when their skills are not acknowledged and they are given jobs for which they are over-qualified) because educational credentials may not be recognized in receiving states.
The following sources provide a perspective on the global dimensions of the migration of healthcare workers, as well as more specific stories about its impacts on sending and receiving states. The first source is a map, produced by the World Health Organization, which shows countries with and without critical shortages of health service providers. The second source, a story broadcast by National Public Radio, includes pictures and links to an audio clip which describe the impact of critical shortages of healthcare workers in Kenya. Finally, the third source, an article from the BBC, details the experiences of racism faced by migrant nurses in the United Kingdom.
World Health Organization. 2006. Countries with a critical shortage of health service providers (doctors, nurses and midwives).
Wilson, Brenda. 2005. Developing Countries See Health Care 'Brain Drain'. Morning Edition, National Public Radio.
BBC NEWS. 2003. UK 'racist' to overseas nurses.
(1) The map reveals that Africa suffers the most from critical shortages of health service providers. How is Kenya trying to combat the impacts of 'brain drain'? What are the implications of this strategy? What are other possible reasons, besides migration, that may account for the shortage of healthcare workers?
(2) The map is based on data collected at the scale of the nation-state. What are the implications of focusing on the nation-state as the primary unit of analysis? What does this focus obscure (for example, differences between rural and urban areas as highlighted in the NPR article)?
(3) Consider the voices of the health service workers and how they are represented in the two articles. While nurses may be legally recruited from abroad, they still face exploitation, discrimination, and deskilling. What are the challenges faced by migrating health service workers? Consider racial and gender-related dimensions.
Coombes, Rebecca. 2005. Developed world is robbing African countries of health staff. BMJ: British Medical Journal 330, no. 7497:923-923.
Hugo, Graeme. 2007. Population geography. Progress in Human Geography 31, no. 1:77-88.
Pond, Bob, and Barbara McPake. 2006. The health migration crisis: the role of four Organisation for Economic Cooperation and Development countries. Lancet 367, no. 9520:1448-1455.
Ray, Kristin M., B. L. Lowell, and Sarah Spencer. 2006. International Health Worker Mobility: Causes, Consequences, and Best Practices. International Migration 44, no. 2:181-203.