“Poaching” or “Exiling”

Megan McArdle at Instapundit describes another case of Lancet’s preaching that probably deserves the Shannon approach: apparently it is a “crime” to “poach” third world health professionals. While there is much to be said for a sense of duty and a sense of loyalty to one’s home turf, most of us consider the importance of those ties as the business of each doctor.

It does, however, make me curious about a phenomenon I’ve noticed locally but have no idea of its breadth. Some of our readers may have a context.

We have many doctors who think of themselves as Indian – and are, in culture, religion, cuisine, languages, etc. (I don’t know any well, but many preferred Montessori, so each daughter had friends from among this group. My first two children were delivered by one of those doctors.) Some of these professionals – mainly doctors – came to our provincial area from places like Uganda. Doctors, like all immigrants, are pulled by a desire for security and money, pushed by economic and political upheavals. I’m not sure why we should expect them to ignore the pull of money. But, I wonder if the Lancet considered other motivations, as well. Citizens (whether Ugandan doctors or Mexican homebuilders) of a country ruled by law, which encourages transparency and believes that businesses (e.g., doctor’s offices) thrive best when there is a high level of confidence that the future will not differ drastically from the past are less likely to leave.

11 thoughts on ““Poaching” or “Exiling””

  1. “there is much to be said for a sense of duty and a sense of loyalty to one’s home turf”

    That “sense” is over-rated IMO – immature barbaric jealousies (ala Romeo and Juliet’s feuding clans) too often result.

    If the aliens land tomorrow and have a better way to live, I’d say “beam me up”. So too the Ugandan, seeing our slipping culture, still far superior to his homeland, makes the leap. The remnants of the Protestant ethic combined with a free market ends up approximating an orderly meritocracy: Who can blame him?

  2. In the specific case of Uganda, people of Indian descent fled for their lives. Idi Amin initiated a deadly purge. He was content to kill a few and exile the rest. I went to college with a guy whose family fled after living their for three generations.

    Throughout most of the world, doctors more often than not belong to ethnic minorities who face persecution from the majorities. It happened to jews in europe, Indians in Africa, Chinese in Indonesia, etc. Cultures that for centuries concentrated on business, literacy and scholarship generate a disproportional number of doctors in the modern world. They also do better in economically and this inevitably draws the envy of the majority and ethnic cleansing occurs.

    I imagine that a lot of doctors end up in the developing world because they fled oppression and bigotry in their homelands.

  3. Tyouth, For me, a sense of place has always been grounding and very important. It has also been important for both the family I came from and the one I married into. But I don’t expect other people to share that passion. And I really don’t care if Nebraska is #1 in football; if they never played another game I wouldn’t notice it. Of course, I’ve never been threatened and thrown out of the land where my people lived for generations.

    Shannon, as usual, is helpful – I didn’t know the exact length but had noticed in the obituary of a parent of a local doctor Uganda was listed as birthplace. Such an experience surely would not require anyone to feel a responsibility to practice in a third world country.

  4. The Lancet would appear to have a mixed motive of protecting rentier interests at home while engaging in the socialist’s hubris of presuming the right to decide other people’s lives for them abroad.

    Of course, that kind of arrogance might also be an occupational hazard in the case of physicians .

  5. If you are a Malay,would you rather be treated by a “Bamiputra” or an “overseas chinese” doctor? The Chinese are discriminated against and there is a system of affirmative action. No one should have to stay in such a place.If one would rather be killed by someone of one’s own ethnicity,well that is a choice.

  6. Anything in the Lancet about high school drop out, lefty actors poaching third world babies? Or rich white europeans poaching the best beaches, reefs, surf waves, hotels, coca beans, coffee beans, oil, minerals, diamonds, art works, wood in third world countries? I suppose we should ban that from export, or use. Also the importation of western movies, medicines that put out of work the local shanman, cars, shovels, shoes, buttons and all sorts of ruin to the local craftsman.

  7. Ginny, understood. Loyalty depends upon which social unit we think about in addition to being very dependent upon the situation.

    Just by the way, not long after commenting here last night, and before getting into bed I opened a new (to me) book: “The Portable Graham Greene”. I found that the last entry was “The Virtue of Disloyalty”. Of course I went to that entry first. It was, of all things, an address given by Greene in 1969 upon his being awarded the Shakespeare Prize by the U. of Hamburg.

    In the four page address he takes Shakespeare to task for not being disloyal to the crown and it’s oppressive ways. He refers to S. as the “bourgeois poet on his way to the house at Stratford and his coat of arms” and suggests that the bard is deficient in that he did not have, unlike other writers (Solzhenitsyn, Pasternak, Ginsberg, Dante, Hugo), an anti-establishment view. These other authors were often persecuted for their writing and Greene takes that to be a virtue. Greene mentions Southwell, (apparently an anti-establishment contemporary poet) who “died on the scaffold after three years of torture. If only S. had shared his disloyalty we could have loved him better as a man.”

    Greene suggested that “the story-teller’s task (is) to act as the devil’s advocate, to elicit sympathy …. for those outside the boundaries of State approval”. This seems to be an extraordinarily limited view of an author’s purpose. It also seems queer for Greene to have expressed that view at that particular forum. Perhaps Greene’s was a liberal mind overheated by the turbulent times of the late 60s.

  8. While there is much to be said for a sense of duty and a sense of loyalty to one’s home turf, …

    Most people in the developing world don’t have a sense of emotional attachment, call it patriotism, towards the states or nations in which they reside. Most countries have borders created for the connivence of european colonial powers which bear no relation to ethnic distribution of the people. The nation (ethnic) state is very rare outside of Europe. Most people only have a strong sense of attachment to there extended family and they view immigration as a means of helping those people they truly care about.

    Europeans have a very culturally myopic view of the world. They rather arrogantly believe that their experiences represent the human experience. The Lancet article seems reasonable to Europeans because it Europeans would consider it disloyal for someone educated by a nation-state to abandon their ethnic group and emigrate.

  9. Well, I fit the description (although the comment initials are not in reference to a degree). Born in India, raised in the US.

    My parents were very proud of India, they were the children of raised in the new, free India. They were a different kind of ‘boomer’.


    They wanted to give their children a better life and that trumped everything else. Which fits the culture. Fits a lot of cultures, actually. Plus, it was considered glamorous to come to the US; fun and exciting and interesting. The sort of multi-culti Namesake (novel and movie, my father didn’t like it all) narrative where it’s awful here in the US doesn’t fit the narrative of a lot of that early generation who came here to the US from India. They liked it, okay? I mean, they just generally liked it. And they focused on establishing their kids and medicine seemed safe in a foreign land.

    “Why did you push me so hard, Mom?”
    “How could I come all the way over here and have you fail?”

    Anyway. It’s interesting.

  10. Oh, just saw Thatcher on the top of the blog.

    Anyone watch the Thatcher speeches on CSPAN- history? Just wonderful. Just wonderful.

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