Ethiopian Healthcare -- Brain Drain

By: Susan

Ethiopia has been plagued with one of the world's poorest health care systems due to a variety of problems. One significant cause of the complete lack of health care in the country is the brain drain- a loss of trained professionals to another country. Brain drain is not only unique to Ethiopia as it has had some past or present affect on almost every country in the world, but Ethiopia has been one of the most greatly affected countries.
Brain drain was not always a problem that plagued Ethiopia. Prior to the 1974 revolution, almost all Ethiopians who obtained higher education in the country remained in the country at the completion of their education. Also, a large percentage of those who attended universities overseas returned to Ethiopia. However, the negative environment created as a result of political persecution and the Red Terror during the Derg government, which was a communist military dictatorship, caused a significant emigration of highly trained professional Ethiopians to other countries, and this emigration still exists to this day.

Statistical information on the brain drain is confusing and conflicting as there are no long-term, reliable macro statistics for the documentation of the problem. However, the information since the revolution has been consistently depressing, most prominently in the science, engineering, and medicine areas. Based on studies, Dr. Dejene Aredo reports that 35% of Ethiopian students officially sent abroad for study between 1968 and 1996 failed to return. The least likely to return were those trained in medicine and the higher the level of education, the more likely they would remain in their adopted country. Dr. Yoseph Hassan Mengesha reported that 50% of Ethiopians who went abroad to complete their studies have not returned home in the past 10-15 years. Dr. Yohannes Kebede explained that Ethiopia trained 2,491 general practitioners between 1988 and 2001. Of those, one-third have left the country seeking better employment opportunities, which leaves 1,366 physicians working throughout Ethiopia in 2001. This means there is only one physician for every 47,000 people in Ethiopia. Another mind-blowing statistic is that there are more Ethiopian-trained doctors practicing in Chicago than there are in Ethiopia alone.

There are many "push" and "pull" factors behind the brain drain. Looking first at the push factors, one of the significant causes, as mentioned before, is political persecution. The political environment consists of poor human rights practices, a backlogged court system, intolerance of political dissent, lack of academic freedom, civil conflict and war, illegal regime change, and favoritism based on ethnic affiliation. Ultimately, all of these are the political push factors, or reasons for the brain drain. There are also a number of economic reasons such as difficult living conditions, a weak economy, high unemployment, low wages, and considerable poverty. Ethiopia's poor economy combined with political instability are the two principle causes of the brain drain.
There are also many pull factors that are literally pulling the educated out of the country, and these are even harder to overcome because they are completely out of Ethiopia's control.
The high wages and strong economies of countries in North America and Europe are very enticing. There is also a more peaceful political environment and a high standard of living in these so called adopted countries. Trained professionals chose to come to these countries because they get the opportunity to fully exercise their training, and there is predictable career advancement and job mobility. Work institutions have up-to-date equipment and provide benefit packages for health care, insurance, and retirement. Visa policies in certain countries also often promote brain drain. In addition, once immigrants are already in the country, its easier for them to obtain permanent residence. As a result of these desirable factors, in addition to the push factors from before, brain drain is amplified.

Although certain factors push trained professionals from Ethiopia and pull them towards more desirable countries, there are other personal factors that ultimately keep these professionals from going back. Most of these professionals are married, have families, have children, and have become accustomed to life in their adopted country. One of these professionals, Philip Emeagwali, stated that “an African professional will not resign from his $50,000 a year job to accept a $500 a year job in Africa.”

The brain drain has ultimately caused a vicious cycle. Emeagwali states that brain drain has hindered the creation of a Middle Class in Ethiopia and thus there are those who are extremely poor and those few who are rich who go on to corrupt military and government officials Originally, as a result of political instability, professionals leave the country searching for better opportunities. As a result of a decrease in professionals, the economy and the health care of the country as a whole decreases. This in turn dissuades professionals from returning, hence causing an even further decline. This is extremely significant in Ethiopia, which was lacking in health care from the start. Now, as a result of this brain drain, the country is having an extremely difficult time caring for the people of the country, and one of the most notorious problems is dealing with AIDS and other diseases. If solutions for this brain drain, which has robbed Ethiopia of its talent, are not found, it can ultimately mean a slow death for Ethiopia.

Many are looking for ways to reverse the brain drain. One of these proposals is reducing the outflow of professionals by strengthening their economy, improving governance, and increasing political freedom. One of the first steps for Ethiopia would be to create an accurate and continuing database of the impact of the brain drain. This will hopefully show the hindering effects on Ethiopia's development. Another step would be to reward, develop, and challenge trained Ethiopians who stay in the country. Loans and assistance should be provided and more funds should be made available for research. Efforts need to be taken the improve technology up-to-date. There should also be a focus on education and building health-related infrastructure as opposed to the focus of sending Ethiopians out to get a good education elsewhere.

However, there is only so much the country itself can do. This is where the global word and religion come into play. Through globalization and realization of the worlds problems, other more-developed countries should understand the importance of education and should try to help lesser-developed countries get on their feet to climb the ladder of development. Anything from big grants and funds to small food supplies from other countries can help Ethiopia. Religion can also play a role. Missionaries from outside the country could come to Ethiopia and help. Internal religions can also be of assistance. There are a variety of religions existing peacefully in Ethiopia, however, they seem to be taking a bystander's position. If they cooperated to form some kind of system that educated the people of the political, economic, and social problems, many changes could come about. The first step to anything is to be aware, and if religions simply made the people aware of problems such as the brain drain, it could be a major turning point for the brain drain, the problems, and Ethiopia as a whole.