Developed nations draining poor countries of doctors

While many foreign doctors are drawn to the United States to treat underserved poor and rural areas, some experts and health officials say the physicians are needed more at home.

The call by developing nations to stop the practice of recruiting foreign doctors _ the so-called "brain drain" _ has been getting louder in recent years.

Dr. Fitzhugh Mullan of George Washington University said the U.S. must stop looking elsewhere to fix its problems. He compared the practice to "poaching" and said it amounts to poor citizenship in the world community.

At least 20 countries export more than 10 percent of their physician work forces to richer nations, Mullan said.

Every doctor that leaves a poor nation leaves a hole that likely won't be filled, he said.

"That creates enormous problems for the (source) country and for the educational and health leaders in the country who are attempting to provide healers," Mullan said.

His research shows that sub-Saharan Africa has lost 13.9 percent of its doctors to the U.S., Britain, Australia and Canada. The Indian subcontinent lost 10.7 percent and the Caribbean 8.4 percent.

There is little reciprocation. The U.S. exports less than one-tenth of 1 percent of its doctors.

While many American doctors don't want to work in poor rural and inner-city areas shunned, the U.S. still has 280 physicians per 100,000 people. But doctor-poor Ghana has two per 100,000, while Zimbabwe, where junior doctors make about $45 a week, is down to one.

Dr. Kgosi Letlape, president of the South African Medical Association, said doctor migration creates a trickle-up effect, of sorts.

"What goes around comes around," he said. "We are in a continuum. What South Africa loses to the developed world, to the United States say, we gain from Uganda."

___

Michelle Faul in Johannesburg, South Africa, contributed to this report.