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Poor countries need to tackle the brain drain

BMJ 2004; 329 doi: (Published 01 September 2004) Cite this as: BMJ 2004;329:0409312b
  1. Roger Dobson1
  1. 1Abergavenny

With the United Kingdom needing 10 000 more doctors, and with more than 7000 nurses from the Philippines alone currently registered in the United Kingdom, compared with just 52 in 1999, a new report says that the countries providing the workers, as well as those that hire them, need to look for solutions.

“Source countries must work on improving staff attraction and retention. Recipient countries should also try to get their own houses in order so they are not a permanent drain on health professionals from the South,” says a study in Health Policy (2004;70:1-10).

In research funded by the UK's Department for International Development, the authors looked at Ghana, a net exporter of health workers; South Africa, an importer and exporter; and England, a net importer.

The authors, Peter Bundred from the department of primary care, Liverpool University, Tim Martineau from the Liverpool School of Tropical Medicine, and Karola Decker from the University of Hamburg, say that the effects on source countries of losing health workers can be serious.

“The Centre for Spinal Injuries in Boxburg, near Johannesburg, South Africa was the referral centre for the whole region. On the same day in 2000 the two anaesthetists were recruited by a Canadian institution opening a new Spinal Injuries Unit. A consequence of the loss of these two key staff was the temporary closure of the centre,” says the report.

The authors report that India has lost up to $5bn (£2.7bn; a4.1bn) in investment in training of doctors since 1951 and that Ghana has lost around $60m.

The authors say a “carousel” movement of doctors exists. The Canadian provinces of Alberta and Saskatchewan, for example, have been recruiting actively in South Africa for GPs to work in remote rural areas. At the …

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