“The fundamental flaws and root causes are there.” These were the words of Kunj Desai, a Zambian U.S. based Immigrant Doctor and the last line of an article in the New York Times titled America is Stealing the World’s Doctors. I must say that while I appreciate the light the article drew to the issue of the “brain drain,” I do not agree with the word “steal;” it is quiet misleading. I do not think Uncle Sam is a thief; I think he is just a good businessman. I do not mean he is virtuous (though he likes to think of himself this way), I mean he has mastered the art of business. He is only offering doctors and other experts what their home countries fail to offer them. It is not his fault that Doctors and other highly skilled workers emigrate from their home countries. Ultimately, the fundamental flaws and faults lie with the home countries.
Zambia has a Bursaries Committee — a federal loans program — that funds tertiary education. No doubt the program has helped many since its initiation in 1973. So far I have not heard of anyone on the program dropping out of school because the committee was unable to meet its commitment. It is faithfully serving its purpose. Yet the problem begins after the students are fully qualified doctors, engineers and scientists. Zambia, like most developing nations, does not offer high pay for these experts unlike the developed world. It is not enough to groom these “brains” and expect them to stay. Why would a doctor want to stay and earn $24,000 a year when they have the chance of earning $216,000 a year? I understand that there are differences in GDP, but the 9 years that a Zambian doctor has to work to earn as much as a U.S. doctor earns in a year is too long of a time. Reducing this gap should be among the government’s top goals because it is a much better approach in the long term to fulfilling the Millennium Development Goals of reducing child mortality, improving maternal health and combating HIV/AIDS, Malaria and other diseases as there will be more doctors available than the current free medical care approach.
But even huge paychecks will not be enough incentive to keep the country’s skilled labor. The lack of proper infrastructure is a big disincentive. Just like Desai, no doctor wants to use a Bosch power drill in operations. More government investment in building key infrastructure is needed. Even more needful is consistency in investments towards building the infrastructure. Ad hoc election-time solutions like mobile clinics divert resources and in the long run bring no real development to the country. And compounding the problem of infrastructure, the existing infrastructure suffers from poor maintenance. This flaw has worsened to the point where a neonatal-intensive-care unit can go without ventilation for two to three years.
Though the Bursaries Committee has been effective in providing financial aid to those who need it most, there is a major flaw when it comes to collecting loan repayments. It is easy for the Bursaries Committee to collect loans from those graduates who stay, but I doubt if there is any mechanism for loan repayments from graduates who decide to leave the country. So the government spends taxpayers’ money educating and training people who will eventually emigrate to serve other countries. There isn’t any sense in that. Making these highly skilled workers sign time commitments of service to their home countries would help retain them. Better still, immigration permits conditional on loan repayment for those who are educated on taxpayers’ money.
These fundamental faults and a host of other flaws such as the high emigration rate of nurses continue to beleaguer Zambia and other developing nations suffering from brain drain. The U.S. remains a top destination for highly skilled immigrants. Aside from high pay, better infrastructure and greater civil liberty as incentives, the U.S. has legislative incentives like waivers for foreign doctors on J-1 student visas and longer Optional Practical Training for science majors.
While pondering this issue, I wanted to know the thoughts and attitudes of international students at Amherst concerning the longer OPT for science majors. I created a three question survey. The aim of the survey was not to find anything ground breaking but merely to know the thoughts of students. [The survey did not take into account biases. There was a 28 percent response from what was supposed to be the entire international student population]. The questions and results are as following:
1. Do you plan on going back home (your country of origin) after completion of studies (graduate or undergraduate)? Opinions were divided with 38.6 percent answering “yes,” 31.6 percent answering “no” and 33.3 percent answering “maybe.”
2. If given American citizenship on a silver plate with one condition only — that you use your expertise (major) here instead of your home country — would you take it? 33.3 percent answered “yes,” 28.1 percent answered “no” and 40.4 percent answered “depends.”
3. Are you a science major? If yes, has your choice of a major been influenced by the longer Optional Practical Training for science majors? There was some unanimity on this one as 70.2 percent answered “no” while 31.6 percent answered “yes.”
For those students who answered “maybe” on the first question and/or “depends” on the second; economic conditions back home was given as a key determinant for whether they would decide to return or not when the time came. As mentioned previously, better job prospects and higher pay should be top aims of home countries, especially developing nations if they are to retain these [international student] “brains” and reduce the brain drain. For some international students, the longer OPT definitely swayed their decisions, but for the majority, it did not influence their choices.