THE BRAIN DRAIN IN AFRICA

PRESENTED TO AFRICAfest ’02  AT THE UNIVERSITY OF PENNSYLVANIA ON Tuesday, April 9^th 2002

BY JOHN KIWANUKA SSEMAKULA

The brain drain is an emotive subject and one which comes up all the time.I’ll talk about African professionals, and how they can contribute to Africa from the Diaspora.

I cannot promise any solutions or answers but I hope to stimulate debate and discussion on this subject, and perhaps prompt (instigate)or galvanize you to go out and find ways of addressing this issue.

It has been said when you are giving a speech or talk, talk about what you know so I’ll use Health as the backdrop of my discussion because what is taking place in the healthcare systems mirrors the situation in other fields such as engineering or teaching.

Africa

Africa is rich in diversity

• 52 countries
  
  
• 703 million people today to 1.2 billion by 2015.

Material Resources: Africa is a very rich continent and abounds in material wealth

• Agriculture, forestry, energy, oceans and rivers, and especially mines.
  
  
• Abundant reserves of coal, petroleum, and natural gas.
  
  
• Some of the richest deposits of gold, diamonds, copper, platinum and cobalt in the world.

Yet, the African economy enjoys barely 2% of world trade.

For lack of adequate infrastructures, Africa's GDP (gross domestic product) in no way matches its natural resources. The average annual income of Africans is about $530.00 (1992). 

HIV/AIDS is visible everywhere across Africa and is now considered the greatest threat to African development.

• 28 million people are living with HIV/AIDS in Africa, 70% of the worldwide population with the disease yet they are less than 1/6 of the world’s population.
  
  
• Southern Africa is the region hardest hit, with some countries having rates of over 30%
  
  
• Over one in six (17%) of persons infected with HIV in Africa is South African (4.7 million)

HIV/AIDS is also killing our people

• In some countries health care systems are losing a quarter of health care workers

• In Zambia, teacher deaths due to AIDS are equivalent to half the number of new teachers trained a year

• Malawi is losing 6-8% of its teachers annually, 7500 in 2001 alone

The figures of the brain drain in Africa

• Africa lost 60,000 professionals between 1985 and 1990 according to the UN

• Reported in the Zimbabwe Independent in Feb 2001, according to official figures, in 2000, over 20,000 nurses left Zimbabwe to go to the UK and other Commonwealth countries, 18,000 to the UK alone and as a result Zimbabwe is likely to suffer an acute shortage, especially of midwives and specialist nurses.

• 600 South African Doctors registered in New Zealand alone

• Kenya, 50% of graduates go to South Africa

• More Ugandan Doctors registered in South Africa than in Uganda

• Ghana 50% of nurses, 90% of Dr’s go abroad.

• 30,000 PHD’s live outside Africa according to UNESCO

• 21,000 Nigerian Doctors in USA

• There are more African Engineers and Scientists in USA than Africa itself

• A few years ago Zambia had 1,600 Doctors, but now there are only 400 registered in practice, the rest have migrated to neighbouring Botswana, Europe and USA

• South Africa – the African economic powerhouse seems to be suffering not just a brain drain but a brain haemorrhage, 41,000 South African Professional left between 1987 and 1997, and the loss of teachers is estimated at 8,000.

The Brain drain

The brain drain has been around probably for as long as man has existed and is a normal consequence of human migration.

People leave their countries for other shores for a variety of reasons.

• Economic reasons
  
  
• Political /Persecution
  
  
• Lack of career opportunities
  
  
• Poor facilities
  
  
• Personal reasons/ Adventure

Other contributing factors

Active Recruitment from abroad otherwise known as Poaching of professionals

• South Africa has accused countries in the Commonwealth of targeting their professionals for recruitment, particularly UK based recruitment agencies who are actively targeting teachers.
  
  
• Britain is actively targeting the Commonwealth countries for nursing staff; in 2001 alone they were seeking at least 21,000.
  
  
• Canada is actively recruiting Dr from S Africa. In the Canadian Medical Journal, it was reported that the South African High Commissioner had issued an unprecedented appeal to Canada’s health minister to stop recruiting S Africa’s Dr’s and health professionals
  
  
• In one issue of the South African Medical Journal of 23 employment ads, 11 were for jobs in New Zealand, Canada, The UK and Australia

The Internal Brain Drain

You often hear about the lack of professionals in the African health system. There is a also an internal brain drain, despite the fact that the vast majority of people depend on health delivered by public means.

• On average nearly 50% of Dr’s work outside the public health system.
  
  
• In Kenya of 5000 registered Doctors, only 600 work in Public Health

Average Publicly employed physicians compared to Privately employed physicians in Africa

This means as part of developing the health strategy in fighting diseases against HIV/AIDS, these doctors will not be available.

This goes for all other sectors, teachers who are outside the teaching field, engineers who are not doing engineering and so forth.

The Football Field analogy

The world cup is coming and I’m sure an African team is going to win. So football (or soccer) as it is called here I think will prove to be an apt analogy. I’ll also keep calling it football because it is played with the feet.

Imagine a professional football league and this is a one such team playing in the league. A football team for those  who don’t know  consists of eleven players and the aim in playing in the league is to win as many games and win the league.

A football team will consist of a squad of players with different skills who will be rotated and contribute to the team. The team is also supported by a staff, that includes coaches, managers, sports doctors etc

On order to win the team must have enough players of sufficient skills to defeat their opponents. But the team can lose because the lose players

• Transfer – players feel they are not being paid enough so they go where they will be paid better – Economic reasons
  
  
• The players argue or have differences with the coach who no longer fields them but keeps them on the bench, so they leave. Political problems / persecution
  
  
• Injury takes them out and they are no longer able to play – Professionals succumbing to HIV/AIDS.
  
  
• Players come to a natural end of their careers and retire – Retirement
  
  
• The players feel the team does not measure up to their talents – Career opportunities abroad
  
  
• The team does not have sufficient facilities to train their players so some leave,
  
  
• The team does not have the funds to pay their players and they go on strike

The squad  - In order for the team to perform in the league, they will need to have a large enough squad to draw upon with enough skills. A team cannot only consist of strikers (doctors), they need defenders (nurses), goalkeepers (pharmacists) to function.

Facilities and Equipment – they need equipment and facilities to train to make them competitive and they will have to invest in this to keep up in the league

New players - They will also need a source of new talent to replace those that they have lost – the youth team – i.e. the school system. The team will have to invest in their own youth team to ensure they have a pool of talent they can draw upon. This needs an effective education system to provide the new talent, teachers, infrastructure etc, but HIV/AIDS is already seriously affecting this stage, thus compounding the problems of lack of professional capacity in Africa

What are the effects of the brain drain – The Exodus of skills.

• It has been calculated that each skilled individual who leaves costs Africa $184,000
  
  
• Africa spends at least $4 billion dollars a year on 100,000 foreign experts.

Would They Have Made A Difference
As I mentioned earlier, the fact that there is a Nigerian Nuclear Physicist in USA does not mean if they were back in Nigeria they would have been any more effective. He or she may be one of only a handful working without facilities and equipment which render them useless.

African governments:

• Domestic policies
  
  
• Empowerment of professionals
  
  
• Stability
  
  
• Good governance
  
  
• Socio-economic conditions that allow for development
  
  
• Investment in Health and Education
  

NEPAD- New Partnership for African Development

African Professionals both within Africa and outside are going to be crucial to the success of the partnership. Mechanisms to enlist their full engagement will have to be put in place, but at the same time these professionals will need to be aware of what is going to be expected of them.

The International Community & Donors as partners

• Aid and help the economies grow
  
  
• Support fledgling democracies
  
  
• Conflict reduction and resolution
  
  
• Assist capacity building efforts
  
  
• Debt relief

The Need For a Critical Mass or Minimum To Set Off And Sustain Development - The Need For Investment in Education

Countries need a critical mass of trained personnel to develop. The numbers of African professionals leaving every year may sound a lot, but the problem is not just that they are leaving African nations are not producing enough professionals anyway.

Using the health system as an example, many nations still have the same number of Medical schools they had since the 1960’s. Up and till 1988, Uganda only had one medical school Makerere University, despite the fact the population had doubled in the meantime.

There are only about 100 in Medical schools in Africa for 700 million people compared to 141 in USA for 280 million people

This is a critical issue, not only are we losing professionals to HIV/AIDS and the brain drain, we do not even have the capacity to produce enough new professionals to keep pace with population growth that has taken place in the past 5 decades, even if the professionals hadn’t left!

Why is it an important subject - In Uganda for a long time, we only had one university and medical school, such that many people who qualified for University could not get in. This is a significant waste of a potentially valuable resource.

It is incumbent on African governments to invest more in education at all levels, if the issue of lack of capacity is to be addressed fully!

Nigeria in the late 1970’s and 1980’s flush with oil money decided to invest in their people and embarked on a bid to build more Universities. It has not entirely succeeded, but this is where their future lies

Uganda now spends 33% of its budget on education and health. There are now three medical schools in Uganda.

Creating networks – Mobilizing the Diaspora

In the past when someone went overseas, literally they were gone from sight and communication. The barriers were quite formidable, distance and cost to communicate. Physically, they were too far away. Telecommunications were unreliable and expensive, letters were slow and unreliable, travel was expensive.

With Information Communication Technology and better telecommunications it is now possible to be in touch with people regularly and easier to exchange information. This means that if you go abroad from Africa, one is no longer out of touch with your home country and this means that people who have left are no longer a lost intellectual resource. This has real and practical implications in terms of the contributions that could be made to Africa by these overseas professionals.

I recently came across the example of a Ugandan working in Scotland who is organizing the collection of obsolete computers from companies to send back to schools in Uganda. These are not machines that are junk, but are working machines that are considered useless!

The development of the simputer in India as a cheap internet capable computer is another example of ways that could be exploited to make sure Africans can keep up in the digital age.

Brain Drain to Brain Gain

In terms of research and science – for decades Africans have been doing research, much of which has not been shared due to the constraints of cost of publication, cost of traveling to conferences and symposia. This means their research and knowledge has been an unavailable resource.

But the ICT revolution means they can now stay in touch with each other, the rest of the world, keep up to date with the latest research.

Furthermore, a few scientists working in isolation on a problem scattered all over the continent may not be heard, but if you connect them up, you get a critical mass of people who will generate new knowledge, new ideas, new methods, techniques to solve Africa’s problems.

For example the 27,000 Nigerian scientists scattered over the USA can be swallowed up in the sheer size of the country, but connected up together they will form a formidable mass of people who can help Nigeria.

Africans need to develop networks and structures that enable and facilitate the exchange of information and ideas both within and without Africa. The tragedy of HIV/AIDS is a perfect illustration, a lot of countries are where Uganda was 15 years ago due tothis terrible disease. Yet if there had been better communication and exchange of information, this terrible situation should not have come about.

We must pull together to solve our problems. No man is an island.

THE AAI HIV/AIDS INITIATIVE

• To Train Health Systems Managers with the skills to improve healthcare delivery
  
  
• To substantially increase the number of health professionals in health management
  
  
• To equip university peer educators and volunteers to serve as HIV/AIDS awareness educators
  
  
• To intensify and expedite the training of professionals in other critical fields that have been hard hit by the disease for example teachers
  
  
• To vastly increase the number of qualified primary and secondary school teachers and to accelerate the rate at which they are able to enter the educational system;

Conclusion

Is there anything to celebrate? AfricaFest is about celebrating Africa’s achievements and what I have said may not sound as much to celebrate. However I believe there is much to celebrate.

True there is a brain drain, and it is not about to end, but the one fact that people often overlook is that despite the socio-economic and political problems, Africa is still able to produce and output of skilled professionals who are actively sought by countries from abroad, and they are able to go abroad and compete. This is a very positive thing because it means there is a foundation that can be built upon for the future.

It has been said that Africa’s greatest resource is her people the sons and daughters of the soil wherever they may be. The development in ICT and the increasing involvement of Africans in the digital revolution is creating more networks and opportunities for information exchange.

It is also allowing more Africans to take part in the global debate on development and means they are no longer remaining marginalized or isolated.

One voice cheering in the stadium cannot be heard, but many voices cheering together can be a powerful voice indeed

AFRICAFEST is a week long event celebrating Africa and its potential organised in conjunction with The Africa Studies Centre of the University of Pennsylvania

Thank you to the organizers of AfricaFest for inviting me here and giving me this opportunity to address you.

Thank you to the Africa America Institute for making my trip possible

John Kiwanuka Ssemakula is a Public Health Doctor from Uganda currently consulting with the Africa America Institute (AAI) in New York on their HIV/AIDS initiative. He is also the main editor at medilinkz.org

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