Bring Africans to the US and the EU as Healthcare Workers!

Many policy ideas on immigration in the US and Europe deal with containing and controlling immigration. One extreme example is the recent talk in the US about building a wall on the border with Mexico, a suggestion that has provoked fierce debate and deep anger.

But immigration, legal and clandestine, is not going away. Rather than hide behind walls and nationalism, Europe and America should transform immigration: by making it even more beneficial for our societies than it already is, and by using the flow of ideas and skills that is promoted by immigration to address global issues such as healthcare.

The proposal outlined below attempts to address three major problems - immigration, African poverty and underdevelopment, and a global shortage of healthcare workers - by treating them as inter-related. But first, let's briefly review some facts and trends.

THE FACTS: IMMIGRATION, AFRICAN POVERTY, AND THE GLOBAL HEALTHCARE WORKERS SHORTAGE

The problems posed by immigration in both the United States and the European Union are well-known. To cite just a few examples, France has deep rooted tensions between sections of the white, "native French" community and immigrants from North and sub-Saharan Africa; such tensions were visible as recently as the current presidential campaigns. Immigration into Britain hit an all-time high last year, provoking serious debates about how to handle illegal immigrants and integrate newcomers, especially in a context where the fear of terrorism runs high. Meanwhile, many young African men are so determined to reach European shores that they set off for Spain's Canary Islands by boat. Such desperation has sparked concern among European leaders, who in 2005 pledged to greatly increase their aid to Africa.

Africa's economic and social crises are equally well-known. Three decades of instability, economic decline, and stagnation has led some pessimists to begin laying the blame for Africa's problems at Africa's feet. While blaming Africa goes too far, many experts and much of the Western public would agree that foreign aid money has achieved mixed results in Africa. America and Europe face the tough challenge of how to use aid money not as a band-aid, but as a serious investment in long-term development.

Meanwhile, according to the World Health Organization, humanity faces a global shortage of healthcare workers. The consequences of this shortage will be severe:

Fifty-seven countries, most of them in Africa and Asia, face a severe health workforce crisis. WHO estimates that at least 2 360 000 health service providers and 1 890 000 management support workers, or a total of 4 250 000 health workers, are needed to fill the gap. Without prompt action, the shortage will worsen.

Health workers are inequitably distributed throughout the world, with severe imbalances between developed and developing countries. This global workforce shortage is made even worse by imbalances within countries. In general, there is a lack of adequate staff in rural areas compared to cities.

Sub-Saharan Africa faces the greatest challenges. While it has 11 percent of the world's population and 24 percent of the global burden of disease, it has only 3 percent of the world's health workers.

There is a direct relationship between the ratio of health workers to population and survival of women during childbirth and children in early infancy. As the number of health workers declines, survival declines proportionately.

The WHO lists a number of strategies for solving the crisis. Tellingly, the first is "more direct investment in the training and support of health workers."

A separate WHO report addresses the widespread phenomenon of healthcare workers from developing countries who migrate to developed nations in search of better economic opportunities and working conditions. This trend brings some benefits to the home countries, mainly in the form of income workers send back to family and friends from abroad. But in the long run, each doctor or nurse who leaves represents a financial loss as the investment a country has made in a professional's education is lost to another country. Even more serious is the impact on the healthcare industry as a whole in developing countries:

When a country has a fragile health system, the loss of its workforce can bring the whole system close to collapse, with the consequences measured in lives lost.

The proposal does not necessarily aim to halt the migration of health workers. Rather, it aims to control and promote it, turning a loss into a gain by giving experienced professionals incentives to use their skills in their home countries.

The United States has not been untouched by the global shortage of nurses, doctors, technicians, and other specialists. By 2002, "inadequate nurse staffing has been a factor in 24 percent of the 1,609 cases involving patient death, injury or permanent loss of function reported since 1997″ and "90 percent of long-term care facilities don't have enough nurses to provide even the most basic care." According to numbers given by the American Association of Colleges of Nursing, the current shortage may grow to 340,000 unfilled positions by 2020. Reports in the last few years suggest that Canada faces similar problems. The shortage is not as acute in Europe. But if low European birth rates continue, Europe will likely face a healthcare crisis of its own.

While the problems outlined here are grave, they also represent an opportunity. Each side has needs, and each side has assets. The proposal that follows attempts to show how African immigration into the West, if properly transformed and guided, could bring massive benefits to America, Europe, and Africa.

THE PROPOSAL

I propose that the European Union and the United States begin training young Africans to work on a temporary basis as healthcare workers in the EU and the US.

Such a program would entail recruiting promising young Africans from universities all across the continent, paying for two years of intensive training to become nurses, x-ray technicians, or one of any of a number of other specialties. Additional training would be given, if necessary, in a European language selected by the participant, thereby completing their preparation to work in a hospital or other healthcare facility in the developed world.

After a stay of at minimum 5 and at maximum 10 years, graduates of the program would be sent back to Africa with the intent that, once back in their home countries, they would contribute their skills and experience to the development of the healthcare sector there. Graduates could also act as mentors for future generations of African healthcare professionals. A strong alumni network and outreach effort would keep graduates connected with each other and with peers in Europe and America.

After fine-tuning the specifics of such a policy by experimenting with several pilot programs, a broad-based effort to recruit Africans for work in the healthcare sector could be put in place.

RECAP

The program would help solve the following problems:

1. An increasingly problematic shortage of nurses and healthcare technicians in Europe and America.

Highly trained healthcare workers from Africa could provide a much needed influx of skilled workers in a vital economic and social sector.

2. Economic and social repercussions as the baby boomer generation in America begins to approach retirement age and birthrates in Europe decline.

In societies where demographic trends threaten to skew the age balance of developed nations, opening the doors to a large number of skilled immigrants who will be able to help care for the elderly in these countries would help to maintain economic vigor and demographic balance.

3. The need for a more organized and productive framework for absorbing Africans who wish to immigrate to the Europe and the US. As an increasing number of Africans hope and attempt to leave Africa in search of better economic opportunities abroad, the consequences of illegal immigration have negative effects on race relations in developed nations and strain the capacities of governments and law enforcement units.

Providing a program that paves the path toward immigration in a constructive manner, and allows African immigrants to enter America and European nations at higher levels of income-earning potential and social status will help to reduce the burdens caused by illegal immigration.

4. Problems of under-development and public health in African nations threaten to become more, not less, severe in coming years and decades.

Creating a sizable pool of skilled workers who can send money home while abroad on temporary work programs, and then return home with vital professional skills that they can apply toward the development of their home countries, will help to attack the problems of under-development from two critical angles.

CONCLUSION

If people abroad are willing to do almost anything to work in America and Europe, why refuse them? Rather, let's train them and put them to work where we need them most. And then let's send them back, armed with the experience, the tools, and the money they need to address the root cause of immigration - poverty and low standards of living - and continue to build our global community in a spirit of cooperation and good will.

WHAT'S NEXT?

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