Across the world, brain drain refers to the migration of skilled human resources from one country to another for trade, jobs, education among others. In recent years trained health professionals and intellectuals are needed in every part of the world. However, because of the availability of better standards of living and quality of life, higher salaries, access to advanced technology and more stable political conditions, the developed countries attract talents from Nigeria and other less developed countries. Therefore, majority of migration is from developing to developed countries. This is of growing concern worldwide because of its impact on the health systems in developing countries, particularly in Nigeria, a country with about 180 million in population but with inadequate health personnel to take care of the health needs of the people.
The World Health Organisation recommends one doctor for every 600 persons for a country to be regarded as having enough doctors. Nigeria has 35,000 doctors which translate to a frightening one doctor to every 5,143 persons. Experts indicate that Nigeria needs 303,333 medical doctors for high quality medical care for all Nigerians. Yet, there are well over 50,000 Nigerian medical doctors who are working in Europe and America. Nigeria has invested in the education and training of these health professionals. Their migration to the developed countries translates into a loss of considerable resources when they migrate, with the direct benefit accruing to the recipient developed countries in Europe and America who have not spent anything on the cost
of educating these health professionals. The intellectuals of any country are some of the brightest brains and most expensive resources because of their training in terms of material cost and time, and most importantly, because of lost opportunity.
Nigeria and some South Asian countries are now the main source of healthcare migration to the developed countries. This trend has led to concerns that the outflow of healthcare professionals is adversely affecting the healthcare system in developing countries and, hence, the health of the population. As a result, decision-makers in source countries are searching for policy options to slow down and even reverse the outflow of healthcare professionals. While it may not be possible to stop the migration of healthcare professionals to Europe and America, especially because of the current political and economic situations of the developing source countries and globalization. The increasing demand for health care in the higher income countries is fuelled to a large extent by demographic trends, particularly the ageing of the baby-boom generation.
Experts have argued that the opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from ‘human capital flight’ and ‘brain drain’ to ‘professional mobility’ or ‘brain circulation’. Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.
At current levels, wage differentials between the developing countries and the developed countries in Europe and America are so large that small increases in healthcare wages in Nigeria are unlikely to affect significantly the supply of healthcare migrants.
In the prevailing circumstances, Nigeria must understand and accept that health professionals’ mobility is part of life in the 21st century. Nigeria must also recognise that it is competing with the developed countries in the world for quality manpower. The federal and state governments in Nigeria must bury the archaic concept of brain drain and concentrate on improving the available healthcare systems and professionals as well as training new ones.
The Federal Government in particular must realise that the 21st century has not only brought technology and globalisation; it has also brought the modality by which scientists around the world can be connected in no time. In a globalized world the physical location of a person may or may not have any relation to the ability to make an impact on human health. Health professionals in the developed world may have most of their work portfolios in the developing world. Easy communication, quick travel, and greater collaborations between developed and developing countries are increasingly more common and Nigeria must develop ways and how their citizens abroad can contribute to their country of origin.
Remittances from expatriates living abroad constitute a significant proportion of foreign revenue for Nigeria and many developing countries. Nigerians abroad remit more than $10 billion home annually and this adds to the amount of foreign exchange generated by the country. If only a small percentage of this huge remittance home could be invested in research and development, it would spur some economic development. But, without resources and skills, this may not have a huge impact on health and disease prevention.
It has been estimated that foreign scientists from Nigeria and other developing countries who are involved in research and development produce 4.5 more publications and 10 times more patents than their counterparts at home. The vast difference in productive capacity is because the context and conditions in which science and technology are able to prosper require political decisions, funding, infrastructure, technical support, and a scientific community which are generally unavailable in Nigeria and other developing countries.
Also, the value and effectiveness of individuals depends on their connection to the people, institutions and organizations that enable knowledge creation, and together constitute a propitious environment. These expatriate scientists and healthcare professionals can contribute their knowledge, clinical and research skills to their native countries by developing collaborative training programmes, research projects and teaching their own countrymen.
Going forward, it must be noted that scientists who have emigrated from Nigeria to Europe and America for several reasons are recoverable assets who can play a part in developing opportunities at home. However, recovery requires the opening of diverse and creative conduits. The health services in Nigeria must be supported to maintain their skilled personnel. Only when health staff, whatever their cadre, have the tools they require to do their job, training opportunities, a network of supportive colleagues, and recognition for the difficult job they do, are they likely to feel motivated to stay put when opportunity beckons from elsewhere.
