re Rakesh & Michael's Health Workers Comments

[Hari Kumar <hari.kumar@xxxxxxxxxxxx>]

Both R & M recognise I am sure, that there are other issues, than simply the sheer availability of drs/nurses, in the matter of health professional emigrating to fill a 'need' in the metropolitan countries. Prehaps just a couple are worth mentioning:1)Training Requirements: The appropriateness of training for doctors/health professionals is geared to the metropolitan countries. i.e. Big High Tech medicine is sweeping across under-developed (ie.semi/neo-colonial type) countries. This makes the doctors that actually stay in that country, arguably less well trained for the health needs of the population at home as a whole.
Note that it is at the same time, certainly true that the traditional argument that only "prophylactic non-medical treatments" water, sewage, food) are needed in the neo-colonial countries, is OVER-PLAYED in Western discussions about these countries. This is the Luddite argument that high tech medicine is totally (or largely) inappropriate in the neo-colonial world - something in the medical world you hear a lot. There is a hidden racism in my view - of some of these expressison of prophylaxis.
2) Distribution not number Once the physicians are trained in the semi-colonies countries, their potential best renumerative market; and the type of life style they aspire to (amenities/culture etc) lie in the towns and cities. Not in the rural areas where still the large majority of the population lives - despite the increased industrialisation and the drift of peasantry into the cities and the shift of caste into class etc. Of course this applies to the metropolitan countries also. Programmes with native Americans going into medicine have been faced with the same reluctance of junior drs to go back to the areas from where they had been raised. Look at the mal-distribution of drs across Canadian cities versus rural areas. Same applies (I believe tho' I am less familiar with data)  in the USA.
3) Social Prestige vs money
Marx pointed out that all professions are subject to the onset of capitalist relations, and that the physician, poet etc etc  was not excluded from this. Objectively the physician is usually a worker. However subjectively till at least recently, the physician is encouraged by societal norms to believe that he/she (increasingly a gender equalisation) is part of the magic ruling circle. So Rakesh's point regarding work loads & remuneration of the drs in India vs those in USA is of course true. but it should be weighed against what many physicians do find - that the 'prestige' they enjoy in the neo-colonial countries is staggeringly high. Probably, more so than the average dr in the USA - who is not a heart surgeon, or a neurosurgeon etc. However, it is of course true that many drs end up... in the USA.
4) Country of Origin of drs/nurses.
As Rakesh pointed out, Emigrant Drs/nurses in the most Metropolitan countries, are not simply from the standard concept neo-colonial type countries. By no stretch of the imagination is Britain a neo-colony. Yet the NHS has been ravaged over the years by loss of nurses in particular to either Australia, or Canada, or USA (In the old days to South Africa). Similarly technicians/drs/nurses trained in China & the former USSR - are widely found in labs and hospitals around Canada. And someone pointed out the nurse recruitments in Canada for the USA.
5) Remittances to home
I am not citing any data, just a speculation - being in Mumbai airport & seeing manual workers from the Middle East arriving to go home to Kerala by plane, loaded down with various huge boxes of electronics and other things - I suspect that in terms of an on-going livlihood/monies for the family, a lot does go back. Does that include costs of education etc? - the families probably consider it to have been a good investment.
Of course the ensuing brain drain is a huge problem - but not one restricted to what is traditionally considered the neo-colonial world.
Conclusion? I doubt that any on this list would dispute therefore an understanding of this problem, like all those affecting the well being of the neo-colonial masses and peoples, only within the context of imperialism.
Hari Kumar
PS. Michael: Thanks for your sending on, of my comment regarding the opaqueness of some of the e-formatting of messages. The intellect of this news-list is far too difficult for me to grapple with anyway - without having also to guess at who says what to whom on what list about what and when etc!......... For maximum gain, perhaps style and content surely have to have a dialectical unity.