Training overseas-bound graduates ‘net earner’ for poor countries

Rich countries are doing nothing wrong when they poach vital workers educated at poor countries’ expense, a Bangkok conference has heard.

Medical scientist and entrepreneur Joseph Mocanu said the money sent home by graduates working abroad often exceeded the cost of their training.  

“A great deal of the Philippines’ [gross domestic product] comes from remittances from foreign workers,” he told Times Higher Education’s Global Sustainable Development Congress. “If you’re having huge demand for Filipino nurses all around the world…the logical conclusion [would] be [that the Philippines] should build more nursing schools.

“The remittances greatly outweigh the cost of training, and the taxes on those remittances probably provide the ability to train more.”

Dr Mocanu is co-founder of investment company Verge HealthTech Fund and a former cancer researcher. He said offshore recruitment of medical professionals from the developing world ultimately led to improvements in the donor countries’ health systems.

“Those nurses don’t stay there forever. Sometimes they come back home and…start a nursing school or [become] senior nurses at the top hospitals in the country, and bring in better standards of care. Having a bunch of people outside, seeing what good looks like and then eventually coming home, [helps] improve the governance and systems.”

Dr Mocanu said that when graduates moved to richer countries, the imperative to send money home was strong. “You don’t send remittances back to your family because they’re well off. You go abroad so you are able to bring your entire family to a higher economic status. If you have a little brother and he’s starving, are you going to let him die?”

Describing his own family as economic refugees from their native Romania, Dr Mocanu said his parents had sent money to relatives from their adoptive Canada. “When we couldn’t send currency, because it was a communist country, we sent materials. We sent food; we sent vitamins; we sent medicines. You do that because it’s your family.”

Divya Sripada, an organisational psychologist at Vellore Institute of Technology in Chennai, said it was unfair to expect graduates to stay home out of loyalty to the countries that had educated them.

“We’re talking about individual players at the grassroot level,” she said. “They are getting a better life and they’re able to sponsor their families back home.” Their host countries were providing “a beautiful work-life balance” for healthcare workers, she said. “And the same cannot be said for their home countries.”

Dr Sripada works with Indian health organisations to improve their employment conditions. She said developing countries needed to take responsibility for the exodus of their health workforce. “[They] should…have better policies…on how they incentivise healthcare organisations to promote better living conditions for workers.”

Dr Mocanu said health system shortcomings and health worker shortages often had the same “root cause”. He said some countries “just didn’t care enough about health”.

“When you have an abundant resource, you use it. And a lot of emerging economies have way too many people. If you have so many people, the value of an individual person is low, so why should you pay for their healthcare? They die, you just have someone else replace them.”

He cited an “old joke” about former US president Richard Nixon complaining to Chinese leader Mao Zedong about worker shortages in America. “Mao [said], ‘How many would you like? Fifty million? A hundred million?’”

john.ross@timeshighereducation.com