By Thalif Deen
UNITED NATIONS, Sep 6 2006 (IPS)

The continuous flow of skilled workers and talented professionals from developing to developed nations was once described by a U.N. official as the “Robin Hood syndrome in reverse” – the rich robbing the poor.

“The massive outflow of nurses, midwives and doctors from poorer to wealthier countries is one of the most difficult challenges posed by international migration,” the U.N. Population Fund’s (UNFPA) latest annual report said Wednesday.

On the one hand, said UNFPA, skilled women and men are increasingly turning to migration as a means of improving their lives and that of their families. On the other, their countries are facing a health-care crisis “unprecedented in the modern world.”

In its 2006 “State of World Population” report, UNFPA said nowhere is the effect of the “brain drain” more acutely felt than in the already fragile health systems of developing nations.

“The problem with the brain drain is that health systems are already collapsing in poor countries that face massive health care needs. The outflow of doctors and nurses aggravates this situation,” Maria Jose Alcala, the report’s principal author, told IPS..

She pointed out that nursing is one of the few occupations that offer migrant women decent work with decent pay, since most migrant women work in low-skilled, low-paid jobs.

A recent survey in Africa revealed that the “intention to migrate is especially high among health workers living in regions hit hardest with HIV/AIDS.” In Zimbabwe, about 68 percent of those surveyed expressed a desire to migrate. In Uganda, it was about 28 percent.

The Global Commission on International Migration says more Malawian doctors are practicing in the northern English city of Manchester than in the whole of Malawi. And only 50 of the 600 doctors trained since independence are still practicing in Zambia.

According to the World Health Organisation (WHO) in Geneva, there has to be a minimum ratio of 100 nurses for every 100,000 people. But many poorer countries are far below this target.

In Central African Republic, Liberia and Uganda, the ratio is less than 10 nurses per 100,000 people, compared with more than 2,000 per 100,000 in countries such as Finland and Norway.

Jose Alcala said addressing the brain drain requires global cooperation among wealthier and developing countries.

First, there should be measures to improve health systems in poor countries – including by improving health staff job satisfaction and retention.

Second, richer countries should invest more in training sufficient nurses to meet their own needs. It also implies that donor countries fulfill their commitment to invest in the health care systems of impoverished countries, she added.

The UNFPA study, which focuses on women and migration, was released Wednesday in advance of an upcoming high-level U.N. meeting on international migration and development scheduled to take place Sep. 14-15.

In 2005, international migrants numbered about 191 million. Of this, 95 million were women. The thrust of the report is that although women constitute half of all international migrants, their rights and concerns are largely ignored.

Lawrence Smith, Jr., president of the Washington-based Population Institute, told IPS the mass movement of people across borders and even across oceans is a demographic phenomenon of vast magnitude with varying consequences – both beneficial and detrimental.

Though there does not appear to be a uniform, comprehensive solution to the problems associated with migration, the most vulnerable migrants are and will continue to be women and children.

He said that estimates of the number of persons trafficked across international borders each year run as high as 800,000, of which 80 percent are women and girls who are forced into sex work, domestic jobs or sweatshop labour.

According to the UNFPA report, Smith said, human trafficking is the third most lucrative illicit trade, behind only drugs and arms smuggling, and nets from 7 billion to 12 billion dollars annually.

“The severity of this travesty cries out for strong and resolute international action to curtail this horrific flesh trade,” he added.

Moreover, restrictions on immigration are destined to continue to be issues involving innumerable complexities, ranging from the value of remittances to the sending countries to xenophobic discrimination and violence within receiving countries.

“International standards, however, can and must be established and enforced for guaranteeing the human rights of migrants most particularly the rights of women and children,” he added.

The UNFPA study argues that “migration can be a win-win situation only if women’s rights, health and needs are addressed.”

The positive side of migration is that every year millions of women working overseas remit hundreds of millions of dollars for sustenance of their families in home countries.

These funds, according to UNFPA, go to feed and educate children, provide health care, build homes, foster small businesses and generally improve living standards for loved ones left behind.

In 2005, migrant remittances amounted to an estimated 232 billion dollars. With 167 billion dollars going primarily to developing nations, remittances are now considerably larger than official development assistance (ODA) from the rich to the poor.

Of the more than one billion dollars in migrant funds sent back to Sri Lanka in 1999, women contributed over 62 percent of the total. And of the six billion dollars remitted annually to the Philippines in the late 1990s, about one-third were transferred by women workers overseas.

Still, several human rights organisations, including Amnesty International and Human Rights Watch, have documented the increasing ill-treatment of women and the harsh working conditions, particularly in Middle Eastern countries.

Asked what the United Nations and its member states could do to rectify these grievances, Jose Alcala told IPS that many migrant women are excluded from national labour laws and protections.

For example, domestic work – a major driver of women’s migration today – remains largely outside the purview of public policies and laws. “In many countries, their visas are often tied to one employer,” she said. “When migrant domestic workers are exploited, they remain quite literally confined and hidden in homes.”

In many countries, she said, they are usually barred from switching employers, even in cases of abuse, or they lose their visa status. This “dependency trap” is what keeps too many of them enduring violence and exploitation.

She said there are many ways to prevent and stop these human and labour rights violations against migrant women.

Among them: reviewing immigration policies and visa policies; ensuring labour laws afford migrant women workers the same protections as any other worker; regulating agencies that recruit migrant women; prosecuting unscrupulous employers; and providing migrant women with access to information about their rights, including where to report abuse or seek support services or legal counseling, as well as supporting migrant women’s organisations.

“Their work deserves recognition, and their rights protection,” she added.

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