Dec 18 2011
|Dr. Isaac Odame|
In fact, Canada is prominent among poachers of medical talent from other countries, especially from developing nations where this talent is desperately needed and in lamentably short supply. Other major offenders include the United States, Australia, the United Kingdom and Saudi Arabia.
Exactly how much they gain, and what poor countries forfeit, is impossible to tally. But a new Canadian study manages to put a dollar figure on at least a portion of our windfall and the developing world’s loss. It’s a sobering result, one that cries out for more ways to repair the damage that we cause.
Researchers studied nine sub-Saharan nations and found they spent almost $2.2 billion training doctors who subsequently left for Canada, Australia, the U.S. or Britain. All nine, including Uganda, Zimbabwe and Ethiopia, are struggling to cope with AIDS and a host of other ills that together kill millions of Africans every year.
Meanwhile, the four rich countries eagerly attracting the brightest and the best have saved $4.5 billion by training fewer of their own doctors and taking physicians from these sub-Saharan nations.
“It’s a great way to build your health-care system,” Ed Mills says with a grim laugh. The University of Ottawa professor headed the study published in the British Medical Journal last month. He warned that health and stability in African countries is being undermined.
That’s bad enough. But what Mills discovered is just a fraction of the brain drain benefiting Canada. He didn’t count the many doctors who have come here but failed to find work in their field. He examined the loss from only nine countries — not all of Africa or all the Third World nations from which Canada draws medical expertise. And he didn’t consider gaps left by departing nurses, pharmacists and other professionals.
As Canadians, we like to think of ourselves as a caring and generous people. And we are. But the ugly fact is we’ve been stripping life-saving medical talent from the very places that can least afford to have these skilled professionals slip away. That carries a human toll.
“Sometimes I struggle with why I left Ghana,” says Dr. Isaac Odame, at Toronto’s Hospital for Sick Children. “You sit here. You’re consulted. You’re a leader of some repute. You’re helping children. And you know that, back home, children are dying needlessly.”
As he speaks his hands cradle a small globe — a clear glass sphere the size of an orange engraved with the world’s continents. He says it reminds him of the global nature of health care and the need to give something back to the poorest on the planet.
To that end, Odame has been instrumental in creating a program training nurses in his homeland. With an infant mortality rate 10 times higher than Canada’s, Ghana had no certified pediatric nurses to care for its 8 million children. Not one.
To change that, Sick Kids and the Canadian International Development Agency are investing $3.5 million to train 140 nurses specializing in caring for children. Selected for their leadership skills, they are to train others. The goal is to create up to 1,500 pediatric nurses in Ghana over the next 10 to 15 years, certainly saving lives.
“This needs to happen through all sub-Saharan Africa,” says Odame. And he’s right. A few other Canadian centres have launched similar efforts, but these are rare and often of limited duration. CIDA has spent an average of about $38 million annually since 2006 on projects boosting access to trained and equipped health workers. It’s better than nothing, to be sure. But to put that in perspective, Mills showed that Canada gains almost $400 million just by attracting doctors from nine African nations.
Aggressive steps should be undertaken to share more of our health-care expertise with countries in dire need. It’s only fair since we take much of it from them. The Hospital for Sick Children has found a way to send help back, and other hospitals and regional health authorities should do likewise. There’s no lack of expertise. According to new figures from the Canadian Institute for Health Information, 16,700 of this country’s doctors — 24 per cent — were trained abroad. That’s a huge pool of talent with international experience.
And there’s no shortage of good intentions. Dr. Habtu Demsas, a family physician in Selkirk, Man., has gone back to his Eritrean homeland three times at his own expense to voluntarily deliver care. He has gradually become discouraged by lack of outside support and a grasping local bureaucracy. “My intention was to open a clinic and serve,” he says. “But it’s not happening.”
Federal authorities could help by creating an agency specifically to act as a clearing house for health-care professionals, like Demsas, eager to share their skills abroad. It would link them to areas most in need, help with paperwork and logistics, and provide some funding. There have been calls for such an agency in the United States and it’s an area where Canada could take the lead.
We would all be better for it. Hard-pressed developing nations would receive life-giving aid, and Canada’s health professionals would return with new perspectives and better diagnostic and treatment skills, honed under extreme conditions.
“It’s never one-way. It’s always of mutual benefit,” says Odame of Sick Kids. He leans forward and peers over the top of his glasses, giving his words special intensity. “It changes you. People come back and say this has been the most transformational experience that they’ve had.”
That’s worth pursuing by Canada as a whole. With a bit of effort we can transform from a society largely absorbing others’ medical expertise to one that also gives much back. In doing so we’d be keeping faith with our own best aspirations.