I looked up coyotes and wasn't really concerned, but did bring Havoc and Kenya in and took them out before bed with Kenya on lead and Havoc close by. Coyotes and dogs just belong to the same species; they don't appear to be a threat to one another. I certainly wasn't as worried about a lone coyote as I was about that lone cougar.
This morning the news headline that caught my attention was about the poaching of health workers from Sub Saharan Africa.
I have strong feelings about this for a couple of reasons, but first some of the statistics noted:
There are now more Malawian doctors practising medicine in Manchester than in Malawi.
The ratio of patients to doctors in Malawi is 1:50,000; in Canada it is 1:500
The first few comments on the story came from sex trade workers advertising for customers and two bigots. Jokester is the one I told you about before. He said:
The only reason anyone who can get out might stay would be for malaria, aids, to get hacked to bits with a machete and/or "necklaced". Doctors and other educated people are targets in the violence that has been going on forever. Most only have one life to live and would prefer to spend it trying to help people that can be helped rather than waste it where there is no hope whatsoever. Only a fool would miss the opportunity to take his family and get out while he can. Why condemn yourself to this?
The other one: ASBOBCT, added this:
Who cares? These people have just as much of a right to move to better their existence as the jigs suffering from AIDS and poverty. Let em do as they please.
I guess what they don't realize is that countries like Malawi end up with a net loss when their Malawian trained doctors leave the country to practise elsewhere. Not only are they left with a terrible shortage of doctors for a population that is faced with terrible health care problems, but there is a big financial loss as well.
Almost all of the African countries heavily subsidize the post secondary education of their best and brightest. In Kenya a year of university costs $400 (less than a year of high school) if the student is "called" to the university. The top 5% get called, and the very top students among those are the medical students. The balance of the cost of educating them is paid by the government (likely foreign aid dollars).
Our Canadian situation can be compared to that in the developing world. We train doctors and nurses at considerable cost to the Canadian tax payer. Then the USA lures our medical practitioners away with salaries they could never earn in Canada. Canada then poaches from the developing world.
The Hull Hospital doctor who made a mess of my right hand was a Haitian.
The doctor at the Gatineau Hospital who saved Sam's life by performing an emergency high forceps delivery on Kerry was from one of the Caribbean islands.
Two examples of poaching in our family alone.
Back in Haiti there is one fewer careless orthopaedic surgeon.
Back on that Caribbean island there is one fewer excellent obstetrician.
We are denuding countries that need their doctors, and we are losing our own to a richer country.
Money talks ...
We can also use the language of money. We should be expecting our Canadian trained doctors to stay in Canada to practise until their debt is paid ... or they should have to come up with the money before they leave the country.
And that should also apply on a provincial level.
Quebec provides the cheapest post secondary education in Canada and cannot afford to pay its doctors as much as richer provinces like Ontario, B.C. and Alberta.
What we see happening internationally is also happening within the political borders of Canada.
If this seems unfair or an infringement on human rights, I will point out that I received a loan/bursary from my Quebec School Board to attend Queen's University back in 1965. I signed a contract agreeing to pay back the money with 5 years service, or be held responsible for the balance. That seemed very fair to me.
2 comments:
It isn't just money, it is conditions that make doctors unwilling to stay. If in Canada we can't get doctors to serve rural communities and the high north, can we expect that doctors from developing countries will have any interest in staying in political hotspots?
Its not really any different than the argument that people shouldn't pull their kids from the public system when its failing their child, because it means fewer dollars going into those schools that need it the most. Well any parent who is pulling their child will tell you their child has one chance at an education and they aren't going to use that little person as a pawn in a larger political battle. These best and brightest have families relying on them - huge estended families of individuals, and I think when they leave its with those individual people on their mind.
In Canada, we all pay school taxes to one of the publicly funded systems whether we have children in the system or not, so I am not sure how that argument works here.
The developing countries whose doctors are actively being poached are not all political hot spots. Malawi, for example, is very calm. While someone was having surgery done because of an accident, the doctor's cell phone rang several times. The doctor said, "It is people trying to recruit me to go to their country."
I am not saying that doctors should be held captive in the country that educated them; all I am saying is that the developed countries are offering unheard of amounts of money to these people who are desperately needed by the country that invested in them, and they should have to pay back that investment or stay where they are needed.
This is not a rant against the doctors who are tempted, but rather a concern about how we are poaching from places that cannot afford to educate and then lose valuable people. The article I was commenting on was based on an international medical study that concluded that such poaching should be an international crime.
When I talked to my own doctor about the Haitian surgeon, she was concerned about the poaching but also about the exodus from Canada and the amount of public money invested in those doctors' educations.
If someone wants to practise in the US perhaps he should have to buy himself an American medical school education ... or he should have to repay the Canadian taxpayer.
If this were the case we would have more doctors in Canada and we would not need to poach from the developing world.
The African continent cannot afford this kind of brain drain.
And neither can Canada.
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