A poor nation’s costliest export

Uganda 2008

By Donald MacGillis

June 10, 2009

Published in The Boston Globe

KAMPALA, UGANDA - LAST MONTH, medical students at Makerere University here organized a series of workshops on the brain drain of Uganda's professionals to the West. The focus was on finding ways to slow this hemorrhaging, but it quickly became evident to me that for many of the aspiring physicians, nurses, and medical technicians crowding the lecture hall, the brain drain looked more like an opportunity than a problem.

Two students slipped notes to me asking if I could help them find positions in particular specialties in the West. When a workshop organizer invited audience comments, one student praised the remittance money that professionals abroad send back to Uganda, which amounts to almost 9 percent of its gross domestic product.

Uganda exports coffee, tea, and cotton, but its highest-value exports are its professionals, and their migration comes at a price. Uganda is beset by diseases like malaria, HIV/AIDS, and tuberculosis that have left the country with a life expectancy of 45.3 years. Eighty percent of women with breast cancer get no medical attention until their disease is in an advanced stage.

One problem is that the country simply cannot offer enough jobs to all its graduates. The physicians it does hire earn less than $400 a month. President Yoweri Museveni, during a press conference with visiting journalists brought to Uganda by the International Reporting Project, said his first priority was not stanching the brain drain but building Uganda's industrial base and collecting the taxes this would generate. "There is really no shortcut, you can't solve all these problems at the same time," he said.

If Uganda now lacks the resources to hold onto its highly trained, English-speaking professionals, the West can take steps to address the problem. The United States already funds high-tech research facilities in Uganda that provide its doctors with the chance to work with state-of-the art equipment. Bills reauthorizing President Bush's global AIDS program include provisions for improving conditions of health workers in developing countries. At the workshop, a student proposed getting the Western employers of Ugandan health workers to repay Uganda for the investment their home country made in their training.

No one is talking about limiting the professional freedom of Ugandans. But the West has a responsibility to ensure that its need for Uganda's doctors and nurses does not place an unconscionable burden on the Ugandans left behind.