Africa's medical brain drainBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7519.780-c (Published 29 September 2005) Cite this as: BMJ 2005;331:780
All rapid responses
There has been a lot of interest generated recently by articles
highlighting and professing solutions aimed at addressing the problem of
medical brain drain in the BMJ; amongst several other publications.
As a doctor trained in Africa, i could not be in a better position to
give an opinion on this issue.
Firstly, medical brain drain is not new. During my undergraduate
medical education, most of our lecturers had at some stage trained abroad.
The impression we got was that standards were better in Europe and
America. Attached to this was a clear message that if you want to be the
best, experience abroad was vital.
Secondly, experience in Europe or America conferred a special status
on doctors as most government funded hospitals relied on such doctors to
draw on their new experiences to improve local standards.
Apart from the obvious training benefits, the opportunity to earn a
good income for a limited period was too good to pass for many.
To indicate that brain drain is purely for financial and economic
benefits is however to attempt to simplify a complex subject.
The key in my opinion is the inability to maintain what i will call-
'the migration equilibrium'.
In the past as doctors left Africa, some were returning proud of
their experience, newly found status, more fulfilled and keen to pass on
their knowledge. They were happy to work in less resourced but
nevertheless safe environments.
Years of under-investment in the health sector, poor management of
resources and government malaise has resulted in decay of previously high
standards in many institutions.
The returning doctor quickly finds that he cannot work in a safe
environment and the word spreads quickly.
Finally,the prospect of moving to a better environment and living a
more fulfilled life is one that transcends professions or origin.This
explains why a British man could take up a job in Spain in order to do
what he likes best. The key to retention in Africa is to make people feel
valued and create an environment where doctors can feel fulfilled in doing
what they do best- saving lives.
GO was trained in Africa and is currently working in the UK
Competing interests: No competing interests