Brain Drain

The U.S. congress has set aside 50,000 special immigration visas for nurses willing to work in U.S. hospitals and all caps on the immigration of nurses were removed, while American nursing schools reject more than 150,000 applicants per year due to poor qualification (“The Challenge of Global Health,” 2009).  This creates a brain drain in developing counties that are desperate to build infrastructure that support a healthy population. The developed world then launches a campaign where for-profit, not-for-profit and NGO etc begin to collect and donate money to the developing countries from people who are giving out of a sense of moral obligation, emotional response or because they are aware that microbes have not borders, yet virtually no provisions exist to allow the world’s poor to decide which project serve their needs or adopt local innovations (“The Challenge of Global Health,” 2009). The influence of intergovernmental agencies is being crowded out by donor-driven funding patterns that may not be fully responding to country needs (The Lancet, 2009).

Let’s first address the fact that instead of fixing the unfunded and desperate education system in the US we are willing to forgo investment in our nation education for the resources that other countries possess. When we take the best and the brightest from other countries we are not only bankrupting these countries economically but also in health care systems and infrastructure.  This begins a vicious cycle where we then throw money at the problems that arise due to the lack of that same infrastructure which we destroyed. We don't really address the problem and we need to address it. I am not saying that giving money for these cause is wrong, what I am saying is that let’s tackle the problems from both sides.  The US is in need of well-trained doctors and nurses, and other countries have them, but those counties are in need of infrastructure, and instead of one country benefiting and the other not, there should be some type of reciprocation.  Like the US send doctors and nurses (who may be from developing countries themselves) to train people in developing counties it seems that the best of the developing countries should train people in the US on how to be better educators for their population. This could start a global collaboration effort, where developing counties are seen as equal and due the same respect as the US and other developed countries. This would also ensure that developing countries get a say in what their needs are and what issues they would like to tackle first because quite frankly you can’t treat TB without addressing Malaria and you definitely can’t treat HIV/AIDS without addressing the systems that drive it such as access to birth control, or adequate health care.  What should global health include then, Szlezak et.al, says that: “Global health needs to include disease prevention, quality care, equitable access and the provision of health security for all people.  The global health system is the constellation  of actors (individuals and/or organizations) whose primary purpose is to promote, restore or maintain health and the persistent and connected sets of rules (formal or informal) that prescribe behavioral roles, constrain activity, and shape expectation among them. Such actors may operate at the community, national or global levels and may include governmental, intergovernmental, private for-profit and/or not-for-profit entities.” I think this takes into account all the actors that play a role in global health and creates a collaboration rather than a savior relationship.