Physician Migration in the Global South between Cuba and South Africa

Abstract

Transnational physician migration has concerned states' health and migration policies for many years. Recent developments have increased attention to the outcomes of these flows in the global south, where physician emigration is undermining public health policies. Cuba's exporting of medical professionals presents an alternative dynamic, based upon both an ideology of humanitarian solidarity and a need to secure hard currency earnings. The benefits and challenges arising from a bilateral agreement between Cuba and South Africa to supply Cuban doctors to South Africa and training at the Latin American Medical School (ELAM) for South African medical students are addressed. The benefits of skills enhancement and professional development are noted, as well as the economic benefits for both the Cuban government and individual doctors, while concerns with the appropriateness of the medical training provided at ELAM for the South African health context and the sustainability of the current policy are discussed. Strategic bi‐lateral agreements offer a productive route towards more sustainable management of skilled migration. When migration agreements include skills training, attention is needed to ensure the training provided is appropriate to the destination context: attention needs to be paid to the appropriateness of the medical training afforded to South African medical students in Cuba for health requirements in South Africa. International migration agreements can form part of a broader policy suite aimed at realizing public health and other development priorities. However, attention must be paid to the suitability and sustainability of the outcomes of these practices.

Where are they working? A case study of twenty Cuban-trained South African doctors

“…South Africa has been a major beneficiary of the Cuban medical internationalism programme. The initiative, launched between 1996 and 2002, started with the placement of more than 450 Cuban-origin doctors and medical lecturers who were deployed for service to South Africa 11 and it extended to the enrolment of South African (SA) students for medical training under the Nelson Mandela-Fidel Castro collaboration. The graduates from the South African Cuban Medical Collaboration (SACMC) receive medical training in Cuban settings on condition that they return and practice in South Africa’s public sector for a period that equates to the time that they had benefitted from the scholarship.…”

Managing In- and Out-Migration of Health Workforce in Selected Countries in South East Asia Region

“…A number of studies have examined health worker migration since the 2006 World Health Report Working Together for Health. 4 - 6 Kingma provided a comprehensive picture of the complexity of international migration of nursing personnel in 2007, showing that OECD countries relied heavily on foreign trained nurses. For example 30 000 nurses and midwives educated in sub-Saharan Africa were employed in seven OECD countries.…”

“…This resulted in a large number of unemployed nurses seeking jobs abroad. Hammett 6 explored physician migration across the global south, while Yeates and Pillinger 7 noted that apart from the WHO Global Code of Practice on the International Recruitment of Health Personnel in 2010, knowledge about the nature and range of global policy actors, policy responses and initiatives in human resources for health (HRH) migration remained very limited. They argued for better monitoring of migration flows and of ethical recruitment practices.…”

Harnessing Migration for Inclusive Growth and Development in Southern Africa

“…This requires further multivariate analysis by country of origin, migration category, date of arrival and geographical location for meaningful explanation beyond general gender discrimination. Tunisia and India to import skilled migrants, especially in the health sector 34. Mauritius has imported temporary workers from Bangladesh, India and China to work in construction and manufacturing 35.…”