India is the top country of origin of migrant doctors in Organisation for European Economic Co-operation (OECD) countries with more than 56,000 Indian doctors in these countries, which include the UK, the US, , and Australia. In the Caribbean, Guyana is among the leading countries for nurses’ migration to those territories, according to recently released World Migration Report 2010.
India also figures at sixth place in the expatriation of nurses to OECD countries (about 23,000). In terms of percentages, however, these figures constitute just eight per cent and three per cent respectively of the doctor and nurse population in India, comfortingly low compared to some of the smaller countries severely affected by emigration of doctors such as Mozambique (75 per cent) and Angola (70 per cent).
These numbers, revealed by the report, however, do not include the large number of Indian doctors and nurses working in the Gulf.
“It is estimated that at any given time there are over 100,000 Indian nurses in the GCC (Gulf Coordination Council) countries. The poor working conditions in India coupled with low salary and the lack of respect at the work place are the top reasons for nurses migrating abroad,” said Sreelekha Nair, of the Centre for Women’s Development Studies at a recently organised seminar on Indian Nursing in the New Era of Healthcare.
The World Migration Report talks about the problem of “medical brain drain”, especially in African countries. According to the World Health Organisation (WHO), the number of physicians per 100,000 population for India is 70, which is at par with low-income countries, and for the public sector, the figure is a paltry 20.
In the European Union, the figure is 310 physicians per 100,000 population and in the US, 240 physicians per 100,000. Similarly, the number of nurses per 100,000 population in India is 80, while it is 330 for the world and 160 for low-income countries.
The WHO threshold for a ‘health workforce crisis’ is 230 health workers per 100,000 population. For example, India, an origin country, with only 190 health workers per 100,000 persons, is in a crisis state.
As destination countries, the United Kingdom and the United States have ratios of 750 and 1,250 health workers per 100,000 persons respectively, which are far above the benchmark. However, there is still a demand for doctors and nurses in these countries. This was pointed out in a background paper, “The Future of Health Worker Migration”, by Professor Binod Khadria of the Zakir Hussain Centre for Educational Studies in JNU.
In OECD countries, there is an increasing demand for health workers because of rising incomes, new technology, and an aging population.
In terms of nurses, the Philippines is the main country of origin for nurses, with over 110,000 Filipino nurses working in OECD countries, followed by the United Kingdom (just under 46,000), Germany (under 32,000).
According to the OECD data of 2007, the top five countries in terms of emigration rates of nurses are all from the Caribbean — Haiti leads with an expatriation rate of 94 per cent, followed by Jamaica (87.7 per cent), Grenada (87.6 per cent), St Vincent and the Grenadines (81.6 per cent) and Guyana (81.1 per cent).
“A lot of the data on migrating health workers could be outdated and also fluctuates a lot depending on the demand around the world. But it is a given that there is no stopping the migration of health workers. Migration for employment abroad is the basic human right of every health worker – or any skilled worker,” said Professor Khadria.
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