|Migration Resources: Brain Drain Resources|
The "brain drain" issue is a recurrent theme in the Southern African media, with much heat, very little light and a great deal of scaremongering. The brain drain is increasingly cited as the cause of a growing skills crisis in individual countries and the region as a whole. In South Africa, the idea of a brain drain-induced "skills crisis" was the single most significant reason for the recent rethink of government policy towards skills immigration.
A SAMP survey of 200 South African public and private sector enterprises in 1999 asked them to assess the impact of the brain drain on their operations. One third rated the outflow and impact of post-apartheid migration as "significant." On the other hand, 41 % said that the brain drain was of "no importance" to their operations with another 26% saying the impact was negligible. What this suggests is that at present there is no crippling shortage of skills across the board. Responses were sharply differentiated by sector. This suggests that brain drain impacts are likely to be sector and even firm-specific. A recent study of South Africa's R & D sector also found little concrete evidence of a "brain drain crisis" in the private sector. The actual labour market impacts of the brain drain have yet to be satisfactorily understood in any SADC country.
The brain drain has undoubtedly accelerated in the last decade but some care is required in interpreting data and making policy recommendations for the following reasons:
Despite the extraordinarily poor quality of the data, there can be little doubt that the "brain drain" has accelerated from the SADC region since 1990, particularly from South Africa and Zimbabwe. Domestically, economic and political circumstances have conspired to create a large pool of potential emigrants. New global job opportunities in many sectors have turned latency into action.
Attempts to document the dimensions and causes of the contemporary brain drain have been most extensive in South Africa and Zimbabwe, perhaps the two countries hardest hit. In the case of South Africa, there is evidence that official statistics undercount the numbers by as much as two-thirds. Official emigration statistics show that 82,811 people emigrated from South Africa between 1989 and 1997. Official statistics from the "big five" destination countries (Australia, Canada, New Zealand, UK, USA) show that 233,609 South Africans landed as immigrants over the same time period. For professionals, the comparable figures are 7,534 individuals (South Africa) and 19,890 (overseas). Studies of other countries in the region show statistics that are either non-existent or very badly outdated. In the vacuum, highly-inflated guesstimates are extremely common in the media. Clearly, all governments would benefit from an improved baseline capacity to document and monitor the extent of skills emigration.
In the case of Zimbabwe, one recent study notes the difficulty of obtaining brain drain statistics that are "accurate, reliable, comparable and detailed." At the same time, a seemingly precise figure of 479,348 Zimbabweans is advanced as the total number of Zimbabweans outside the country, including 176,400 in the UK, 165,375 in Botswana, 33,075 in the USA and 22,050 in South Africa. The source of these figures is unclear, as are the findings reported from a survey of diasporic Zimbabweans. Certainly the Botswana figure seems high and the South African very low. Similar problems of measurement have been observed in the Malawian case. A systematic data base of the numbers and skills profile of diasporic Southern Africans worldwide using host country census, immigration and survey data would be an extremely useful exercise.
In the absence of reliable statistics, prediction of future trends is also a hazardous exercise. SAMP developed a methodology in the late 1990s to assess the real emigration potential of the skilled population. At one end of the spectrum was Botswana with low rates of emigration and low emigration potential. At the other are South Africa and Zimbabwe. In the case of South Africa, an Emigration Potential Index was developed which showed 2% of the skilled population with very high emigration potential (32,000 individuals), a further 10% (192,000) with high potential, and 25% with moderate potential. In the case of Zimbabwe, no EPI was calculated but the data suggests that the brain drain is likely to accelerate in the foreseeable future. There, 27% of skilled respondents were committed to emigrating within 6 months, 55% within 2 years and 67% within 5 years. SAMP has also initiated a 6-country study of skills-in-training—the PSBS or Potential Skills Base Survey — to assess the emigration intentions and potential of tomorrow's labour force. The results are not yet available.
These studies also provide insights into the reasons for the brain drain by asking respondents about factors that would promote or stop emigration. In general, push factors are much more important than pull factors in pre-disposing people to leave. Crime, personal safety and poor working conditions rank very highly in South Africa. In Zimbabwe, more conventional economic factors are important: taxes, cost of living and public services. Political conditions are not, per se, a concern even if people feel alienated from national politics, as do whites in South Africa and the vast majority of skilled Zimbabweans. Another finding in both countries is that state efforts to restrict the brain drain through bonding or compulsory national service are likely to precipitate rather than slow emigration. Research on South Africa's compulsory community service program for new health sector professionals shows widespread satisfaction with the system and a high propensity to emigrate (20-40%) once the service is over. Recent legislative moves to reform public health sector in South Africa have received a less-than-enthusiastic response from doctors who recently took to the streets of Cape Town.
The brain drain in the health sector is clearly the most problematical for countries within the region. Aggressive recruiting of health professionals by Europe and North America is denuding the region of scarce skills, at a time when they can ill afford to lose them. Working conditions emerge as the single most important pre-disposing factor for health professional emigration. As Loewenson and Thompson (2003) argue "personnel scarcities have become a critical limiting factor in health interventions" for the public health sector and the poorest populations. Health systems in Southern Africa face a variety pf problems, including "an overall lack of personnel in key areas of the health sector; an inequitable distribution of those health personnel who are available (public v private, urban v rural); and a significant attrition of trained personnel from the health sector and from the region." The capacity of the public health sector to deliver services is being compromised by the brain drain at precisely the time at which the HIV/AIDS epidemic is seriously increasing the burden on the system.
There are no adequate statistics to measure the existing stock of health professionals and the extent and trends in health personnel flows from and within the region or individual countries. The general South African data problem was alluded to above. In the case of the health sector, two additional factors complicate any attempt to assess the stock of health professionals from local health council data. First, many who leave maintain local registration with the councils. Second, some who register no longer practice or practice on a part-time basis. In the South African case, destination country statistics show 23,400 health workers from South Africa in the "big five," The OECD notes that this is equivalent to 10% of all health professionals registered in the country, "suggesting that emigration rates are significantly higher for health workers that skilled workers in general." Of these, 8921 are practitioners, 6,844 nurses, and 7,642 other health professions. Some 3,146 South African nurses registered with the UK CC between 1998 and 2001. In the United Kingdom, the OECD also estimates that six percent of the total health workforce is South African. The net training loss to South Africa is estimated at US$1 billion. In the case of Zimbabwe, the Ministry of Health does not have precise figures because departing health professionals are "not willing to announce their destinations" and many who leave choose to keep their registration active." Statistics are anecdotal at best: for example, that of 1,200 physicians trained in Zimbabwe in the 1990s, only 360 were left in 2001. Or that Zambia has retained only 50 of more than 600 doctors trained since independence. Clearly a far more detailed inventory is needed than currently exists.
Another issue which affects the impact of the brain drain is the permanence of health professional emigration. Many South African-trained doctors came initially to Saskatchewan, Canada, to do locums. Once in the country they begin the immigration process in order to stay. In the case of the nursing profession, professionals from South Africa, Zambia, Malawi and Zimbabwe who leave tend to accept fixed-term contracts with the intention and likelihood of return. Again, whether actual return behaviour correlates with intended behaviour has not been established.
In general, state responses to the brain drain have been control-oriented in character and not informed by research on the actual perceptions and intentions of the skilled. South Africa's Health Professionals Recruitment and Retention Strategy is a notable exception, attempting to develop a broad-based and multi-faceted set of interventions which includes addressing social and economic push factors. Ironically, this strategy cannot address a major cause of emigration (crime and personal insecurity). And it makes no comment on the desirability of developing a strategy for replacement immigration. Restrictions on outward movement are not generally feasible in states that guarantee freedom of movement to citizens. Instead, Southern African states have also sought to exercise leverage over the pull factors by (ineffectual) appeals to the morality of industrial countries or entering into bilateral or multi-lateral agreements with western governments to control recruiting or hiring of professionals on a sectoral basis. The effectiveness of such agreements has yet to be properly tested.
In the last year, the South African media has been profiling what it calls the "brain gain" of returning South Africans. There is little concrete evidence, however, that this return is either large or sustainable. The only attempt to tap the diaspora to date is the SANSA project, set up by the University of Cape Town and taken over by the National Research Foundation. SANSA was designed to match diasporic South Africans with local employers for short-term assignments and employment. The intention was never to encourage permanent return. The success of this initiative is unknown. In Zimbabwe, a new initiative by the IOM to resettle and reintegrate diasporic Zimbabweans is under way. However, without a significant change in the circumstances that are forcing Zimbabweans to leave it is hard to see such an initiative having much short-term success, much less compensate for the ongoing brain drain.
Other initiatives have sought to encourage the return of diasporic citizens by offering incentives and job-matching programs. The IOM's Return and Reintegration of Qualified African Nationals (ROAN) Program (which included Angola, Mozambique and Zimbabwe within SADC) assisted the return of a miserly total of 2,009 professionals to Africa as a whole over a 17 year period. On the evidence of ROAN, these kinds of programs are likely to be rather ineffectual at best. Recently, the IOM has initiated a more flexible skills transfer program called MIDA (Migration for Development in Africa) with the IOM acting as a kind of "go-between." While this program seems, in principle, to have a higher likelihood of success, its effectiveness has yet to be tested. In general, it seems likely that formalized skills return or linkage schemes coordinated by international organizations are not going to have a major impact in reversing or ameliorating the effects of the brain drain.
Replacement recruitment is one strategy that South Africa might pursue. However, South Africa is in something of a bind. In order to mount a case against other countries recruiting its health professionals, it needs not to be seen as a "poacher" in other fields. Hence, in late 2001, South Africa undertook not to recruit any physicians or nurses, except under specific agreements with countries of origin. At the same time the country has concluded agreement with Cuba and Germany for the temporary import of doctors. There are now close to 500 Cuban doctors practising in rural areas and townships. The country is also seeking to negotiate bilateral and multilateral agreements with destination countries to stop recruiting of health professionals in South Africa.
Although increasing attention has been given to the brain drain in Southern Africa, the field is notable for the lack of sound information on which to base policies that might impact positively on the poor. A more systematic and comprehensive effort needs to be made to (a) document the extent of the brain drain by examining data in the region and in major host countries; (b) inventory the overseas skills base and, through survey work, determine the potential for return and the nature of backward linkages (financial and social); (c) a systematic assessment of the economic impact and resource implications of the brain drain by sector (with particular emphasis on health implications for the poor); and (d) working with government and private industry to develop retention, replacement, brain train and attraction strategies to mitigate the impact of skills loss on development prospects.
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Crush, Jonathan (ed). 2000. Losing Our Minds: Skills Migration and the South African Brain Drain. SAMP Migration Policy Series No 18.
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Dodson, Belinda. 2002. Gender and the Brain Drain from South Africa. SAMP Migration Policy Series No. 23.
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McDonald, David and Jonathan Crush. 2002. Thinking About the Brain Drain in Southern Africa. SAMP Migration Policy Briefs No. 8.
Myburgh, Andrew. 2002. "Globalisation, Labour Mobility and the Economics of Migration: The Case of South Africa" Paper presented at TIPS Annual Forum, Muldersdrift.
Oderth, Reidar. 2002. Migration and Brain Drain: The Case of Malawi (New York: Writers Club Press).
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Oucho, John. 2000. "Skilled Migration in Botswana: A Stable but Temporary Workforce" in John Oucho, Eugene Campbell and Elizabeth Mukamaambo. Botswana: Migration Perspectives and Prospects. SAMP Migration Policy Series No. 19.
Padarath, Ashnie, Charlotte Chamberlain, David McCoy, Antoinette Ntuli, Mike Rowson and Rene Loewenson.2003. Health Personnel in Southern Africa: Confronting Maldistribution and Brain Drain. Equinet Discussion Paper No. 3.
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Xaba, Jantjie and Gary Phillips. 2001. Understanding Nurse Emigration: Final Report (Pretoria: Democratic Nursing Organisation of South Africa (DENOSA)).
Zimbabwe Media Coverage of Brain Drain, 2001-2004.