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December 29, 2004

Ironically, the giant sucking sound Ross Perot talked about really exists--but it's the sound of the U.S. economy sucking up money, goods and workers from other economies.

It's not that Washington is run by a cabal bent on stripping the Third World of its resources, nor that we are approaching the final crisis of capitalism. Mainly, it's that the immense wealth, productivity and openness of First World economies, including the United States, attracts resources from the Third World in what should be an almost eleemosynary relationship.

But the relationship is less beneficial for poorer countries when the workers who are being drawn to the First World are nurses and doctors. A Sebastian Mallaby column from last month in the Washington Post discusses the issue in some detail. African nurses, trained by their governments to serve the pressing basic health care needs of developed countries, are coming to the U.S. and Europe to take care of our aging populations. "It's hard to weigh the issues here: the right of individuals to seek a better life by emigrating and the poverty trap that they entrench by doing so," Mallaby writes.

There were interesting responses to Mallaby's article in the letters page of the Post. One correspondent wrote "I am a registered nurse, and most of the African nurses I know are go-getters who are furthering their studies and skill levels. They want to get ahead, and they know that won't happen in their homelands. No amount of subsidy from the United States would keep them in their countries." Other writers noted the squalid working conditions of African health workers--which can be not just uncomfortable, but dangerous: The New York Times writes that in Malawi, a quarter of health workers have AIDS.

Part of the problem is the inefficient nature of First World health care industries, which spend huge sums on convalescent care for the elderly and whose populations are increasingly afflicted by lifestyle diseases that will require even more nursing attention in the future. And medical productivity seems to lag behind that of the rest of the economy--that, or medicine is a luxury good: Rich nations seem to transform themselves into nations of hypochondriacs, seeking treatments for previously unremarkable or nonthreatening diseases. (Less cynically, of course, the very fact of wealth and stability changes the health care challenges a country faces. Few people in war-torn famine-ridden countries live long enough to die of cancer or heart disease.)

In health care, then, as in food production, the First World's economic relationship with the Third really does seem to have harmful effects. Without nurses and doctors, for instance, how are developing countries supposed to fight malaria and TB--much less the more complicated treatment regimes that are required to arrest the spread of AIDS? And African countries face health care problems that the First World has all but forgotten about: the Times writes that 1 in 89 births in Malawi results in the death of the mother. A comment in the Times from an African nurse now living in Britain (which attracts more African health professionals than the U.S.) is revealing. "Here, you go into wards, they're spic and span, like hotels," she said admiringly. And this, said of the National Health.

Posted by Paul Musgrave at December 29, 2004 11:19 AM

Comments

Posted by: PunchTheBag at December 29, 2004 06:42 PM | permalink

Posted by: Aaron at December 30, 2004 05:50 PM | permalink