Skills and Knowledge

According to WHO (2006), if health workers return, they bring significant skills and expertise back to their home countries. However, just depending on foreign experience and externally innovated technologies may hinder the way of development of domestic technologies and professionals (WHO, 2006). According to Dodoo et al. (2006), there is lack of data for empirical analysis that may lend credence to the concept of brain drain as a purely negative phenomenon. Although plausible arguments exist on the negative effects of brain drain on the source country, strong arguments abound on the potential positive impact of brain drain to the individual migrants and their families, and on human capital stock in the source countries. The United Nations Development Program’s (UNDP, 2007) case evidence on brain gain based its conclusions on modernisation theory and dependency theory to predict long-term positive effects due to direct return or network building process of the emigrated knowledge elite. Hunger (2002); De Haas (2009) opine that a qualitative gain arises from the experiences the migrants gather by living in a developed country. Talented people make a positive contribution to economic welfare whether they have much infrastructure to work with or not (Hall, 2005; Vinour, 2006). In countries where physical inputs for research and science are absent, the exercise of their own intellectual capability as the principal resource involved is likely to be of special value (Hall, 2005). The value and effectiveness of individuals depends on their connection to the people and organizations that enable knowledge creation, and together constitute a propitious environment (Hart, 2006).

The healthcare professionals such as nurses contribute their knowledge, clinical and research skills to their native countries by developing collaborative training programmes, research

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projects and teaching their own fellow citizens (Dodani and LaPorte, 2005). A substantial body of work on the theoretical aspects of the brain drain reflects on transfer of skills and knowledge from the sending countries (Bhagwati and Hamada 1974; Bhagwati and Partington, 1976; Stark et al., 1997; Abdelbaki, 2009). Scientists, political leaders and decision makers in developing and developed countries, and international development agencies, need to appreciate the social and synergistic nature of knowledge sharing so that policies and education systems promote and enable research and development (Dodani and LaPorte, 2005). Literature by Singh Das (2002) points out that the controversy on the brain drain debate is worthless because the sending and the receiving countries could both utilize the skills of these professionals in the global economic market, as well as the individual skilled migrant. Instead of focusing on brain drain, Singh Das (2002) encourages scholars mostly Africans to use the term brain gain or brain exchange.

Developing countries may consider encouraging or supporting their highly skilled professionals to take part in brain circulation, instead of trying to contain them or seek their permanent return (Iravan, 2011; Gaillard and Gaillard, 1997). The mobility of the highly skilled is a normal process in an increasingly interdependent environment. It is not associated with the loss, but with the circulation of trained workers within a global labour market. In the same vein, individual migrants are conferred a particular role as development actors. As is often the case in globalisation debates, discussions have also built upon the importance of transnational networks, new communication technologies, and the role of knowledge in economic development (Levatino and Pecoud, 2012).

2.6.1.3.1 Brain Drain to Brain Circulation

Hovart (2004) highlights that brain drain is not a permanent loss of highly skilled and educated people who are the vital driving force for any country as there is now a paradigm shift from brain drain to brain circulation (Cao, 1996; Meyer and Brown, 1999). Cao (1996) pinpoints that in this era of globalisation, when cultural barriers are dismantling, strategies and policies that seek to block or hinder the movement of highly skilled personnel are bound to be ineffective and unacceptable. It is also the case as Cao (1996) hints that the international mobility of human capital is driven more by global market considerations over which national governments have little or no control Some of the national governments include South Africa, Zimbabwe, Ghana (Bradly, 2014) and Malawi (Vidal 2015). The international mobility of highly skilled personnel (HSP) is a contributor to and a consequence of globalisation. It is also one of the indicators of the interdependence and convergence of the world economy. Cao (1996) states that, international mobility of human capital is an ongoing and global phenomenon that is neither permanent nor irreversible. Therefore, instead of devising policies and strategies

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that seek block or hinder the mobility of HSP, Cometto et al. (2013) opine that adopting effective policies to address international health workforce migration requires both understanding the local drivers of (inward or outward) migration, as well as identifying evidence-based policy options.

There is an increasing mix of temporary and permanent migration (Timur, 2000) with a noted growth in temporary migration (Findlay and Lowell, 2002). The return rate is quite high at least 50 percent of skilled emigrants return from most stints abroad, which tend to be for a period of 5 years (ibid). Literature by Buchan et al. (2005) finds that 85 percent of the international nurses plan to stay in the United Kingdom for 5 years or less. The business world of the rich countries are discussing with great interest the phenomenon of reverse brainpower. When countries like Taiwan, Korea and Japan in the past, India and China most recently, create the right environment of openness of freedom from governmental restraints and of promotion of science and free market economy, there is hope for the return of expatriates (Vidyasagar, 2006). The UNDP report identifies the return of IT companies backed by Indian expatriates to the city of Bangalore as one of India’s success stories (Kanth, 2005 quoted in Vidyasagar, 2006). Brain circulation shifts the emphasis from either blocking the brain drain or seeking the permanent return of those highly skilled and educated emigrants to more flexible and realistic approach that seeks to minimise the detrimental effect and maximise the benefits of lost human capital through migration.

Brain circulation is a multi-dimensional strategy implemented through different policy options. These include encouraging the temporary return of lost human capital for visits; maintaining a virtual contact with the home country through global advances in communication technology; setting up Diaspora networks and, most importantly, matching these policies with a genuine improvement in the home country’s political, social and economic environment (Cao, 1996). In addition, ‘long term strategies to promote economic growth are needed to enable developing countries to re-attain and draw back their highly skilled and address the negative effects of brain drain’ (Quaked, 2002:153). Other indirect preventative or protective measures such as democratisation and socio-economic development can help minimise loss through brain drain without the need to prohibit migration (Iredale, 2009). Brain circulation as migration form and strategy is seen as both a cause and a consequence of political and socio-economic development in both source and destination countries. In this sense, a well-developed scientific infrastructure, higher investments in the science sector and the stability of a consolidated democratic government that assures human rights and academic freedom all provide a suitable environment that allows this form of migration to occur (Horvat, 2004).

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Literature by Hovart (2004) states that brain circulation plays an important role in the success of a country’s transitional process of economic development and democratic consolidation by utilising the reservoir of knowledge and skills located in those expatriate nationals if the political will exist. According to Borjas and Bratsberg (1996), average skilled workers have a tendency of return migration. As the economic environments of the sending country improve over time, it becomes appealing for skilled workers to migrate back to their country. Stark et al. (1997) present a model that allows for heterogeneous ability individuals. Literature by (Mountford, 1997; Stark et al., 1997, 1998; Beine et al., 2001; Stark, 2004) makes a case for brain-drain induced brain gain. The researchers assume that if a proportion of skilled workers migrate and earn a higher wage abroad, the brain drain raises the expected return on education. This in turn induces additional investment in education in the source country, which may result in a net brain gain, which in turn leads to increased welfare and growth, assuming that the resulting brain gain is larger than the initial brain drain.

However, based on both static partial and general equilibrium conditions, Schiff (2005) argues that the positive net brain gain claims might be an exaggeration and shows that a beneficial brain drain cannot take place since a net brain loss is likely during the transition between brain drain and brain gain. In these two works, only those migrants with relatively lower abilities return to the sending country. In reality, return migrants could be skilled workers and could bring the new human capital acquired in the receiving country back to the sending country.

In terms of the economic incentives that attract migrants back to the sending country, Borjas and Bratsberg (1996); Mayr and Peri (2008) pay their attention to the wage premium because it serves as the instrument in attracting brains back to their motherland. However, the challenge is to keep skilled professionals at home through various incentives. Return of the brainpower, however, occurs in small doses and in few countries. According to Heenan (2005), as many as 1000 former US immigrants leave US every day. This expresses severe concerns that such reverse brain drain may create a generation gap in human capital for America. The poor countries also express the same fears.