'Doctor drain' leaves Third World ailing

The cost to South Africa of losing 600 medical graduates to New Zealand is more than $50 million, the British medical journal Lancet has revealed.

The situation was part of a "medical carousel" where doctors and nurses moved to richer countries - a major cause of the decrepit health infrastructure in poor nations, said the journal.

"Doctors and nurses are linchpins of any healthcare system.

"In countries already severely deprived of professionals, the loss of each one has serious implications for the health of citizens."

In Asia, the big losers in the migration were Nepal, Bhutan, Papua New Guinea, Afghanistan, Cambodia and Indonesia.

But the problem was acute across most of sub-Saharan Africa, where 24 out of the 28 countries had just one medical school, said the Lancet.

"Each migrating African professional represents a loss of US$184,000 ($262,750), and the financial cost to South Africa, 600 of whose graduates are in New Zealand, is estimated at US$37 million.

"Yet Africa spends US$4 billion a year on the salaries of foreign experts."

The report said Britain was especially to blame for the brain drain.

A third of practising doctors and 13 per cent of nurses in Britain were born outside of the country.

By comparison, the figure for France and Germany was only about 5 per cent, said the journal.

New Zealand Medical Association spokesman Dr Don Simmers said 40 per cent of doctors working here were foreign-born.

"It's a world-wide problem. The World Medical Association wants countries to do more to retain doctors," he said.

"New Zealand uses more than its fair share of foreign doctors."

Many New Zealand graduates left the country, said Dr Simmers. Kiwis liked to travel after they graduated, and working overseas helped to pay back student loans.

"Not enough is also being done to attract doctors to community-based healthcare," he said.

"It's really hard for developing countries, creating a medical workforce, only to have them poached."

The Lancet said "poaching" was a form of migration in which medical personnel headed towards a progressively richer country, and that the United States was the only overall winner.

Research had shown that few of the migrants returned home, and any money they repatriated went into the country's general economy, not specifically into its health budget.

"The medical carousel does not turn full circle, so the poorest nations experience all drain but no gain."

The Lancet called for:

* More medical training in rich countries.

* Restrictions on the duration of visas granted to doctors and nurses who go to rich countries for training, in order to encourage them to return home.

* Incentives for health professionals in poor countries to stay after graduation or at least to work there for a number of years before heading abroad.

- NZPA