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Q: How is nurse migration affecting nurses and the nursing shortage?


A: We have placed some of our analyses on the topic below.


Nurses on the Move: Migration and the Global Health Care Economy

2006 -- Mireille Kingma's important book, which earned her one of our Golden Lamp Awards, analyzes the causes and effects of the explosion in international nurse migration. It includes the personal stories of nurses who migrate from the developing to the developed world, and discusses the ethics of recruiting nurses from poor nations. Our full analysis is pending, but you can buy the book here.


Exodus

June 29, 2006 -- Many recent articles have addressed the flow of nurses from developing nations to the United States, in the context of the proposed easing of entry restrictions in the immigration bill that passed the Senate in May. On May 24, The New York Times ran Celia Dugger's "U.S. Plan to Lure Nurses May Hurt Poor Nations." This piece is a very strong, front-page examination of the state of nurse immigration to the United States, and the likely effects of eliminating the current restrictions. Dugger carefully presents different sides of the debate, citing the remittances the immigrating nurses send back home and the devastating blow to the home nations' health resources, including a weakened ability to fight diseases like AIDS. The Times followed up with a half-baked May 27 editorial, "For Want of a Nurse." For all its flaws--the most glaring being the suggestion that the generation of nurses now nearing retirement chose the profession solely because they did not want to teach--the editorial does urge the nation to start solving its nursing shortage "on its own," particularly by spending more on nursing education. Coverage of nurse emigration after the Senate bill's passage suggests that it would likely increase if the bill became law. Nida Mariam's June 18 piece in Daily News & Analysis (Mumbai, India), "City wakes up to nurse exodus," suggests that easing the U.S. restrictions would contribute to an already severe nursing shortage in India. There, many new nursing school graduates head abroad and hospitals suffer from extreme short staffing. Today the CNN site posted a fairly good unsigned Associated Press piece, "Nurses lead Kenyan brain drain." It highlights the immigration to the U.S. of Kenyan nurses who are desperate to support their families. And it suggests that easing the restrictions would have a real impact in Africa, not just in the Asian nations from which most nurse immigrants have traditionally come. more...


Importing health

March 4, 2006 -- Today the Taiwan News ran a short piece by Jenny W. Hsu headlined "Nurses groups warn of mass exodus to U.S." It says that the Taiwan National Nurses Association (NNA) is concerned that poor working conditions for local health workers and aggressive recruiting by the United States are driving a surge in nurse migration. This reportedly poses a grave threat to Taiwan's ability to care for its own rapidly aging population. more...


"Govt tames nurses"

January 2, 2006 -- Today the Daily Times (Malawi) posted a story by Anthony Kasunda reporting that there appeared to be some reduction in the number of nurses emigrating from the impoverished nation to the developed world, perhaps as a result of recent foreign aid-financed measures to improve pay and other aspects of local working conditions. Despite the unfortunate implications of the headline above, the short piece is a generally fair look at the problems faced by the "few remaining" nurses in Malawi, and what is being done to address those problems. more...


"The greatest crime against humanity of this century"

September 11, 2005 -- In a lengthy comment in today's Observer (U.K.), Jonathan Dimbleby urges world leaders not to squander the chance to "end poverty" by "bickering" during the United Nations summit this week in New York. Dimbleby is a major U.K. news media figure and president of the charity Voluntary Service Overseas (VSO). He illustrates his argument for releasing aid to Africa with a discussion of his recent visit to Malawi, whose 12 million impoverished people receive care from a grand total of 94 Malawian physicians and 300 Malawian nurses. By comparison Sweden, with a population of 9 million, has about 90,000 practicing nurses--that is, 400 times as many nurses per person for a far healthier population. more...


Could shortage-driven migration change nursing's gender gap?

August 23, 2005 -- Today the New Kerala web site posted an interesting unsigned piece about the apparent surge in interest in nursing among the men in the Indian state of Kerala. The story, "Kerala male nurses storm traditional female bastion," suggests that local males are being lured by the "[l]ucrative nursing options" overseas, with 20% of current Indian nursing school graduates going abroad. The piece is very positive about nursing, noting its intellectual components and at times sounding more like a recruitment ad in discussing how interesting and fulfilling the profession is. The piece does not explain exactly what nurses do to save lives and improve outcomes. And it seems oblivious of the larger context of the nursing shortage, and the effect this talent drain is having on health care in India. But the piece does--without seeming to realize it--raise the question of whether the huge pay differentials and transnational migration stemming from the shortage could alter the profession's gender makeup, potentially helping to empower the profession and ease the shortage. more...


The Paper Bag Princesses

June 24, 2005 -- Today the web site Hindu Business Line (Madras, India) ran a generally fair piece by Sreedevi Jacob about the recent trend of female nurses from the Indian state of Kerala migrating to the U.S. or the U.K., rather than the Gulf nations that were once their main destination for good jobs. Unfortunately, the Women's Feature Service piece reports, these nurses are finding a distinct "shortage of bridegrooms" among their male Kerala counterparts in the new nations. This is because those "highly skilled professionals" do not want wives with the traditional stigma of being nurses, who are felt to do "the dirty job of touching 'unknown' men." more...


Live 8, Nursing Division

May 25, 2005 -- Today Business Day (Johannesburg) ran a short piece by Razina Munshi about the recent call of South African Health Minister Manto Tshabalala-Msimang for local nurses to stop migrating to the developed world. The piece reports that the Health Minister stressed that such global migration undermines developing nations' investment in their health professionals, and threatens already weakened local health systems. more...


The changing face of Indian nursing

May 11, 2005 -- Lopamudra Maitra's piece posted on the expressindia web site today reports that, as nurses celebrate Florence Nightingale's birthday, Indian nursing schools are seeing more young women and more men taking an interest in the profession, as well as an increased demand for Indian nurses in English-speaking developed nations. The piece appears to be based mainly on conversations with local nursing school leaders and teachers, and it provides some interesting and important information about these trends. Unfortunately, it lacks any sense of the broader context of such migration, and it also presents some regressive stereotypes of nursing--the most egregious of which appear to come from a local dean of nursing. more...


"I should be thinking of the future of our kids"

February 3, 2005 -- Today National Public Radio's Morning Edition ran a very good report by Michael Sullivan, "Number of Philippine Nurses Emigrating Skyrockets." The balanced, comprehensive piece includes audio clips from a Manila hospital nursing executive, a senior nurse who is about to emigrate, the physician who directs the Philippines' National Institutes of Health, and government officials. The Philippines has long relied on remittances from workers abroad. But the fact that the nation is now exporting 15,000 nurses each year to developed nations like the United States, where they can make 20 times what they do in the Philippines, reportedly poses a serious long term threat to an already fragile and overburdened local health system. more...


Go west, young nurse?

January 19, 2005 -- Today the Times of India published a short unsigned piece, "Nurses go west," describing an "exodus" of Indian nurses to foreign nations, especially the United States. One nursing college principal is quoted as saying that 80%--yes, 80%--of her students apply to recruiters for foreign nations. The brief piece fails to address the likely effects of this trend on Indian health, instead comparing it to the superficially similar trend in the migration of IT professionals--a trend that we do not believe is the result of a life-threatening shortage in developed nations, nor a cause of such a shortage in the developing nations from which they recruit. more...


"Crisis as SA steadily loses qualified nursing"

January 14, 2005 -- Today South Africa's Star ran a good piece by Bruce Ventner describing the magnitude of that nation's "critical" nursing shortage. The piece reports that South Africa is "steadily losing" its best trained nurses, especially in rural areas, even as the growing population and expected increases in communicable diseases will mean a greater demand for skilled care. more...


The sting in the tail

August 27, 2004 -- Today the Guardian (U.K.) ran an analysis piece by its social affairs editor John Carvel about the ongoing debate over the issue of the U.K.'s "poaching" of nurses from developing world nations. Carvel's piece recounts some of the history of the issue there, as well as the current state of debate, but he closes by suggesting that the story's final "sting in the tail" may be that though Britain has been the most powerful player in "the poaching game" to date, the U.S. is poised to assume that role--not only as to "overseas" nurses, but "British" ones as well. more...


Unbearable

July 12, 2004 -- Today the New York Times ran Celia W. Dugger's "An Exodus of African Nurses Puts Infants and the Ill in Peril," an unusually powerful and comprehensive look at the catastrophic effects of the emigration of Malawian nurses to developing world nations with nursing shortages. Dugger outlines the staggering overall depletion of health resources in the AIDS-ravaged nation, where more registered nurses have left to work abroad in the last four years than remain in the public hospitals and clinics that serve most of the country, and where almost two thirds of the public health system's nursing jobs are vacant. But her special focus is the labor and delivery ward at the capital's Lilongwe Central Hospital, where 10 overwhelmed nurse midwives now attempt to deliver more than 10,000 babies a year--with the apparent result that many births are attended by no one. more...


"Recruiters Head South of the Border for Nurses"

June 27, 2004 -- A generally good AP story by Morgan Lee, which appeared today in the Los Angeles Times, reports that U.S. hospital recruiters are starting to seek nurses from Mexico. It explores many of the potential positive and negative aspects of the global migration of developing world nurses to wealthier nations with critical nursing shortages. Its use of quotes from a Mexican nurse, Mexican nursing professors, and representatives of the American Nurses Association and the International Council of Nurses is unusual and commendable. more...


The Times: "What am I bid for this nurse?"

May 4, 2004 -- Today the Times (U.K.) ran a very short, unsigned item about a proposal in a recent Department for International Development report on "international nurse recruitment" that the U.K. should "consider giving cash to developing countries to compensate for taking their nurses." The Times' headline (above) is catchy, if somewhat unfair to the developing nations--they haven't offered their nurses for sale, after all--and to nurses, who are economic actors, but not chattel. more...

last updated: April 15, 2007


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