Charity Begins at Home: Stemming the Brain Drain.

Brain Drain from Ghana has received an extensive coverage from the media and has been the subject of many discussions in various forums in Ghana. Both the Vice President and the Minister for Health have appealed to the World Health Organisation (WHO) to help solve Africa’s brain drain of health professionals (Ghanaweb 21 November and 3 December), the Minister for Defence has also referred to this issue. In the State of the Nation address in 2002, the President announced that stemming the “brain drain” was one of the challenges that confront his government. He singled out doctors and other health and allied health professionals for particular mention. A year down the track and the issue is still being discussed. It is therefore time to reexamine the causes of the problem and adopt strategies that would help stem the tide. Causes of “Brain Drain” Brain drain is caused by both external and internal factors. We do also have internal “brain drain” when people are not employed in their field of expertise eg an Agricultural Science graduate from KNUST working as a factory hand in Ghana. My main concern is with the internal factors because if we are unable to deal with the local conditions that cause the “brain drain”, there is no way we can cope with the external “pull factors” for the global forces will always be with us. As the old adage goes: “take care of the pence and the pounds will take care of themselves.” What we need to find out is why almost every Ghanaian, even the less skilled, wants to leave the country. Why are some of the skilled people not coming back especially when they only have menial jobs in the overseas countries (eg qualified doctors cleaning offices) because their qualifications are not recognised or they do not have the correct papers. International migration of professionals from Ghana is not new. What is new is the extent to which it is affecting the country. The other new aspect is the numbers of Ghanaians sent overseas for training who do not return. Many years ago most people sent to study abroad were eager to return home for “home sweet home.” On the contrary many people will use any means to stay outside the country including entering into false marriages. The problem is those leaving are the very people the country needs to develop. These people are also taking their skills with them so they are unable to pass them on to the next generation. Many of the developed countries are facing acute skilled shortages especially in the health and allied health professions because of the ageing population. These countries are therefore putting in place policies to attract professionals. Immigration laws are been changed to help with the migration of skilled professionals. The US is offering huge packages to doctors and IT professionals. Many other countries have changed immigration laws to attract skilled overseas students. Germany, which considers itself a non-immigrant country, has put in place policies to attract skilled professionals. In this respect there will always be “pull factors” present in the developed world that will draw qualified professionals towards them. These factors may include better education, better living standards, higher incomes and better research facilities. In my view the reasons people are leaving Ghana could be found in the economic conditions in Ghana which have resulted in very high levels of unemployment, poor salaries/wages and poor health services just to mention a few. Corruption is also endemic. One finds it necessary to pay a bribe to get a routine service from a Government office. There are also lack of adequate facilities, infrastructure, including communication and transport, resources, technology and opportunities to harness human capital eg chemists have very little resources to manufacture some drugs locally, assuming patent issues can be resolved, resulting in some leaving to places where facilities and technologies are available. The education system has been allowed to run down resulting in the elite and those who can afford it sending their children to study abroad. Students should realise that when they vandalise school property they are making an already bad situation worse. Higher education has been broadly and badly underfunded and appears not to produce sufficient numbers of the highly skilled personnel required for a knowledge nation. The high incidence of poverty has resulted in poor living standards. Many Ghanaians are complaining that their current income levels are insufficient to pay the bills and they have no hope of achieving a dream of owning a roof over their heads. Not all who are leaving are doing so because of money. Some leave as a result of frustration with the system, the job situation and lack of opportunities for advancement. The psychological burdens imposed upon some people who want to do the “right things” in the midst of corruption and red tape may be more important than monetary considerations. Furthermore, when people are not paid salary/wages for months how are they expected to survive especially in a country with no unemployment or special benefits. I am yet to know of a person in any developed country or an MP or CEO in Ghana who has to pay a bribe to get their salary/wages/or allowances or retirement benefits paid to them. What should be done I am sure most professionals would like to stay in Ghana and I hear of people overseas wanting to come back and settle. If we are to make any inroads into the brain drain, we need to adopt realistic strategies. Many of the strategies that have been suggested include: providing incentives, improving salaries and instituting bonds for the professionals trained at the countries expense. These are all very good but in my view the only way out of the vicious cycle we find ourselves is good governance. One of the central planks of this is stemming corruption. The effects of corruption on the economy are well known but for the purposes of discussion I will list a few. Corruption distorts public policy, it leads to inefficient economic outcomes, accountability is weak; impedes long-term foreign and domestic investment, misallocates resources and the most important in my view is that it undercuts the nation’s ability to raise revenue. This could lead to higher taxes and rates being levied on fewer and fewer taxpayers and this in turn reduces the ability of the country to provide essential public services eg health and education. The result is a vicious cycle of increasing corruption and unproductive economic activity. As some scholars have argued corruption is a symptom of fundamental economic, political and institutional causes. Tackling corruption effectively means tackling the underlying causes and not the symptoms. We need to reform government institutions and this could include “real” civil service reform, improved budgeting, improving customer service and a strengthened legal and judicial system. Many public officials including Ministers and Parliamentarians either consciously or unconsciously contrive a multitude of incomprehensible paper trail and a procedural maze that makes it impossible for many people to find their way through. This is a means to boost their egos and make money. Lets untangle red tape and throw it out. Let us ask ourselves what will be the result of streamlining this or that process eg passports. Why can’t the issue of passports be streamlined to eliminate middlemen and bribery? In many countries you just pick a passport form from the post office, complete the form, attach the originals of the required documentation and pay the lodgement fee at a post office counter or the passport office and between 1-10 days your passport is delivered to your address. All employees in whatever capacity they find themselves should take a hard look at themselves and realise that that 50,000 cedis bribe has denied the government some revenue and that means that a road may never be constructed or an incentive cannot be provided to keep a professional in the country or a journal essential for research cannot be purchased. All of us should realise that when we say “go come tomorrow”, we are probably delaying the commencement of a productive enterprise or adding to the frustration of a professional who just wants a research grant approved. When appropriate duty is not collected the government is denied that revenue and so that polyclinic would not have the medicine required. When MPs do not attend Parliament and still collect their pay cheques or refuse to pay their car loans or vacate government bungalows or use their official cars for non official business and still charge it to the consolidated fund or when people in high offices use their positions to amass wealth for themselves, breach their duty of due diligence or breach the duty in relation to conflict of interest, they should think of the examples they are setting. We need to get out of the vicious cycle and stop arguing about whether “the egg or the chicken came first”. We need to start somewhere. There must be the political will ie bipartisan approach to tackle some of these problems. The Government, the Opposition, the opinion leaders in society, including Judges, the clergy and those in positions of responsibility in the society have to set the example and get things started. We need to establish infrastructure and methodologies to facilitate economic growth. This is where the international community might assist but again when we take the first 10% of the loan for ourselves that investment will not generate the required growth in the Ghanaian economy. The international community can also assist with debt relief, favourable trade terms and we might also have bilateral agreements based on the transfer system for footballers. We need to create opportunities for research, innovation and entrepreneurship at home and stimulate a return flow of migrants and capital. Returnees can bring valuable management experience and skills and access to global networks. They may even bring capital. When a Ghanaian professional on arrival suggests changes, they are branded “too known” and their efforts undermined. To achieve the return flow we need to change our attitude towards the few that return.

Since it is difficult to persuade professionals to return we should use the diplomatic missions abroad to tap into the skills abroad. Most Ghanaian Diplomatic Missions abroad have some sort of register of skills but how many of these have been used. What guidelines have been put in place for selection? I am aware that some Ghanaian professionals have not completed the skill audit of the missions because some of the missions are out of touch with the people. They do not even answer phone calls or respond to emails.

We do not need foreign loans or foreign help for most of these things to happen. It can be done. Countries like Singapore and Botswana have done it. What is needed is the goodwill of all and leadership by example by the President and his Ministers, MPs and CEOs of the various corporations and government businesses. I believe that Ghanaians will be prepared to “tighten their belts” if they see their leaders set the example and provide the benchmark.