The moral implications of recruiting doctors from poor countries

A group of international medical experts has said that so many African health professionals are being recruited by Western countries that the practice should be viewed as a crime.

They say, for instance, that more than 13,000 doctors trained in sub-Saharan Africa are now practicing in Britain, the United States, Canada and Australia, and that they’re leaving behind are healthcare systems that can’t cope.

Health care in developing countries leaves much to be desired. Hospitals are short of modern equipments. Medicines are expensive. Poor patients resort to traditional medicine as it is cheaper.

In Morocco, the ratio of doctors is one to every 10,000 people. There are areas short of well-equipped hospitals for childbirth and surgical operations. Patients have, sometimes, to travel hundreds of kilometres, to get medical check-up and diagnosis. Ironically, there are many people trained in nursing who are still unemployed. Those with training have to undergo a test for the selection of just a few of them. Some cases were registered in which there were some hospitals with doctors and no equipments as there were hospitals with medical equipments and no doctors!

In poor countries, there can be many reasons for doctors to migrate. There are the conditions in which they work. The hospitals where they work are ill-equipped. The salary is small and the load of work is heavy. Some are sent to work in impoverished areas in their countries. There is a sense of frustration because there is little they can do to help the patients as they have no equipments to work with or hospitals are understaffed so the work is painfully carried out.

The West provides a full contrast where ambitious doctors can have the opportunity to evolve professionally and to have high living standards.

As doctors have an oath to save human lives, theoretically they should stay in their own countries to save the lives of their fellow citizens and not to migrate to the West to save the lives of those who can pay a much higher price. These doctors must have cost their country a fortune to educate them and finally they are offered to the West on a silver plate.

So what’s the compromise? As qualified doctors can’t be persuaded to stay in their poor countries while the West offers them the best opportunities, the West should work to train more doctors in poor countries and to build more hospitals. As there will a surplus of doctors in them, their recruitment won’t create a shortage in their countries. Governments should create incentives for doctors to stay at home by investing in medical projects.

Many people in poor countries die from preventable diseases. Others die from illnesses that can need simple operations. The medical staff needed is in the West enjoying prosperity. Health care is fundamental for prosperity. “Stealing” doctors from countries that badly need them is like transplanting healthy organs of a poor person in the body of a rich one to make it possible for them to survive.

There should be international regulations to govern such recruitments to preserve the rights of all parties. Making health services a part of international free trade, in this age of globalisation, will just deepen the gap between the healthy North and the aching South.


  1. Looney said,

    February 24, 2008 at 4:36 am

    It is nice to hear your voice on this issue. The West doesn’t produce nearly enough doctors which is one of the reasons for skyrocketing costs.

    What makes things worse is that most of the health care is going to people who are extremely old and frequently dying. One of my friends had a $250,000 operation performed on his 85 year old mother which had a 50/50 chance of keeping her alive 6 months longer. That was 15 years ago, so such an operation would cost more than US$500,000 today. Meanwhile, diseases run unchecked in other countries.

  2. Abdelilah Boukili said,

    February 24, 2008 at 11:24 am

    You are right Looney. In Morocco, a large number of people can’t afford to pay even for a medical operation costing $1,000. On many occasions, there are notices on local newspapers in which needy sick people ask for financial assistance for operations ranging from $1,000 to $20,000. However not all medical operations are possible to carry out in Morocco because of the lack of qualified doctors or equipments.

  3. Anonymous said,

    February 24, 2008 at 9:26 pm

    The situation here in Marrakesh has improved a lot since I came over fifteen years ago. There are more varieties of specialties available in Marrakesh, and many more GOOD doctors than were available before.

    Madame Monet
    Writing, Painting, Music, and Wine

  4. Abdelilah Boukili said,

    February 25, 2008 at 10:20 pm

    You are right Madame Monet. In Marrakesh and other big Moroccan cities, there are hospitals and clinics with modern equipments and well-qualified doctors. But still health services aren’t easily available for everyone. Poor people have to be on the waiting list for a long time to get free operations in public hospitals. Only those with money or health insurance can easily benefit from adequate medical care.

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