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Sunday, July 26, 2009

Brain Drain? Think Again

What’s the top exporter of nurses in the world? Just by looking at this chart, one can never tell. According to estimates, there are around 5000-8000 nurses that leave the Philippines every year – the most of any country in the world. If anything, we should expect to find the brain drain here. Data however shows even a hint of its presence is lacking.

In fact, the reverse might be occurring. The last few years have seen a spike in the number of nurses who went abroad to the US and UK. And yet, Filipinos, who would never have educated themselves if not for the option to migrate, are enrolling into nursing schools in huge numbers. As a result, we have almost twice as many nurses per capita as developed Greece, thrice as many as that of our neighbor Malaysia. We are producing the most number of nurses per capita among all other countries in our income group.

But still experts are quick to admonish the migration of nurses as a drain in the country’s human capital, which, they point out, have grave consequences. Former Secretary of the Department of Health, Dr. Jaime Galvez-Tan, declares it a “brain hemorrhage.” Lack of qualified healthcare workers due to the exodus, for example, is blamed for the failure to adequately service rural posts.

But even if there was a shortage of health care workers due to the migration of nurses, just because this occurs in tandem with a boy in rural Mindanao not getting proper healthcare does not necessarily mean it causes it. In the same way that rain occurring at the same time someone dies does not demonstrate a clear cause. All bright students of statistics would know that correlation is not causation. The poor healthcare system in urban and rural areas might actually be the one that is driving away the workforce. Or a third factor, such as poor pay incentives that nudge people to migrate and cause rural hospitals to be understaffed. Whatever it is, the relationship is ambiguous. And we should hesitate in calling out migration as the easy culprit.

Meanwhile, let me talk about what is crystal clear. A nurse who moves from Manila to the US earns thrice as much, immediately, even when adjusting for the cost of living. I am astonished how this tremendous gain to migration is often overlooked, or if not, is depicted as a saddening truth.

People are not lost in any sense when they move overseas. People cannot be "drained," like natural resources are. Migrants are human beings with hopes and desires. Their fulfillment in the US or elsewhere is a beautiful thing. Nurses freely choose to migrate and continue to do so in huge numbers. They have reason to value it. Now tell me, how is this not development?


Bobing said...

Actually Paolo brain drain is a 1960s theory when transport and communications infrastructure were such that a person who moves to another country completely loses touch with the country of origin. Nowadays with the internet and wireless communication allowing instant connections in real time, and with the air transport system able to bring people around quickly (like medical missions and the like) you wonder if partisans of the brain drain theory are stuck in a 1960s mindset.

Nicole Paterno said...

Gusto ko yung sinabi mo rito:

"People are not lost in any meaningful sense when they move overseas. They are not petroleum that can be drained. They are human beings with aspirations and dreams, whose fruition in the US or elsewhere is a beautiful thing. Nurses freely choose to migrate and continue to do so in huge numbers. They have reason to value it. Now tell me, how is this not development?"

[Re-]Post mo ito sa Brain Gain Network blogs. :-)

Paolo Abarcar said...
This comment has been removed by the author.
Paolo Abarcar said...

Bobing, I despise the term "brain drain." It's a non-neutral term that assumes that the effect of the movement of people are without question negative. There is not yet clear empirical evidence of this. I agree with you that the brain drain paradigm is an old view of the world. I think the term was coined by british journalists who wanted to sensationalize these things...

Nicole, I'll send you an email shortly.

Anonymous said...

Paolo, where are the nurses from Ireland, Netherlands, Canada, United States, and New Zealand going? Are industrialized countries' nurses moving to other industrialized countries? It is less likely that nurses from industrialized countries move to developing countries. Meanwhile, those from developing countries are moving to the industrialized countries and developing countries that are "richer" than the emigration developing countries.

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