LOCAL SKILLS AND GLOBAL MARKETS? THE MIGRATION OF HEALTH WORKERS FROM CARIBBEAN AND PACIFIC ISLAND STATES

摘要

This article examines the migration of skilled health workers (SHWs)from two island regions. Although migration of SHWs is not new, current trends indicate a growing, and increasingly complex, global care chain, where migration from relatively poor island states, with significant health problems, to developed nations, with expanding needs, represents both an inverse care law and a continued brain drain. Income differentials, poor working conditions, the presence of kin in other countries, and recent active recruitment, all contribute to rising migration. Increased problems for the delivery of health services in most island states have followed. Small island states are likely to continue losing their SHWs, without major changes in recruitment practices in the developed world. Consequently, and especially in the Caribbean, the response has been to develop a form of 'managed migration' and even to 'train for export' rather than seek to make incremental changes that would barely discourage emigration.