I am writing my student fellowship paper under the broad topic of health worker “brain drain,” so I have been keeping an eye out for related news stories. Two stories that caught my eye in the past few weeks were about the health worker migration from civil war torn Syria and economic-crisis ridden Sudan. In Syria for example, half the doctors in Homs and all of the country’s nine psychiatrists have recently migrated. In Sudan, 1620 doctors left the country last year compared to 338 in 2008. In countries like these, especially Syria where medical personnel have been targets of violence, solutions to stem the migration or replenish the ranks seem particularly futile. Additionally, these countries’ self-inflicted wounds, including civil wars and poor administration, complicate matters. Not only do these internal struggles diminish the probable efficacy of potential solutions to the brain drain, but they also negate the perceived responsibility of the countries receiving these migrants, diminishing their will to help counteract the deleterious effects of the brain drain.
Civil war stricken countries like Syria present especially difficult cases for developed nation responsibility and intervention. But these news stories led me to think about brain drain and responsibility that results from war, specifically wars waged by developed nations in developing ones. A prime example is the recent war in Iraq. The Brookings Institute estimates that 20,000 of the 34,000 Iraqi doctors in the country in 2003 have migrated, and only 1525 had returned as of 2009. They also cite that 2000 Iraqi physicians have been murdered and 250 have been kidnapped over the same period. 50% of surveyed Iraqi doctors living both in Iraq and abroad said they had been threatened. A recent article in Lancet describes that before 2003 the major problems facing the Iraqi healthcare system stemmed from drug shortages and poverty. These problems have been superseded by violence and failing infrastructure in the intervening years. The brain drain has likely been exacerbated by these new threats.