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Posted on Sustainabilitank.info on July 14th, 2007
by Pincas Jawetz (pj@sustainabilitank.info)

www.iom.int
 unobserver at iom.int

IOM is The International Organization on Migration. It has 120 UN Member States in its membership – in this sense it is an Intergovernmental organization. Other 20 UN Member States are Observers. A further list of 71 Observers are IGOs (Inter-Governmental Organizations) or NGOs (Non-Governmental Organizations). They are active in more than 320 Field Locations, with about 5,500 staff working on over 1,600 projects.   Detailed information you can find at : www.iom.int/jahia/jsp/index.jsp

IOM is not a UN affiliate – this because it allows equal status to other organizations besides the Member States. We shall see how NOT being under full control of the UN makes IOM into a really effective organization.

We bring up here the example of a IOM activity involving Honduras – a country suffering from unemployment and poverty – and countries in need of people in the agricultural sector. IOM works with the people themselves and NOT their governments – in doing so the people are the main beneficiaries of this IOM intervention. The information is from the July 13, 2007 Briefing to the Press from IOM    unobserver at IOM.int   www.IOM.int

“HONDURAS – Temporary Labour Migration to Canada – A first group of 10 Honduran migrants are today traveling to Canada to participate in a six-month temporary labour migration project.

The group was hired to perform seasonal agricultural work at the El Dorado Farm in the province of Alberta.

The migrants will earn a salary seven to eight times greater than the minimum wage in their country.

Following an agreement signed between IOM and the Honduran government, IOM is identifying employment opportunities in North America and Europe to help alleviate high unemployment and poverty affecting a wide sector of the population.   The agreement specifies that priority is given to those living in extreme poverty.

IOM provides technical assistance in the selection and recruitment stages, support in obtaining travel documents and visas, makes all the travel arrangements and accompanies the migrants to Canada.

According to the US Department of State Bureau of Western Hemisphere Affairs, Honduras is one of the poorest and least developed countries in Latin America, with nearly two-thirds of Hondurans living in poverty.   Although historically dependent on exports of coffee and bananas, the economy has diversified over the past 20 years with the development of non-traditional exports such as oriental vegetables, cultivated shrimp, melons, and the tourism industry as well as the establishment of a growing maquila industry (assembly plants for export), which employs approximately 130,000 Hondurans.

Remittances from Hondurans living abroad, the vast majority of whom reside in the United States, amounted to US$2.3 billion in 2006, which represents 15 per cent of the country’s foreign exchange earnings and over 20 per cent of its GDP.

For more information contact Evelyn Andino at IOM Tegucigalpa, Tel: + 504 220 11 00, Email:  eandino at iom.int”

We read the above after I returned from a meeting at the Carnegie Council For Ethics In International Affairs, Merrill House, 170 East 64th Street, New York, NY 10021, tel: (1-212) 838-4120

The 3-5 PM meeting, organized by Devin Stewart, Director, Global Policy Innovations   www.policyInnovations.org, being developed into “The Central Address For A Fairer Globalization.”

The speaker was Dr. Federico Macaranas, the Executive Director of the Asian Institute of Management (AIM) think tank, Manila, The Philippines, that provides input also to the World Bank, whose topics was:

ETHICS OF THE BRAIN DRAIN IN THE DEVELOPING WORLD: THE CASE OF PHILIPPINE HEALTH PROFESSIONALS.

It was announced that he will discuss how poor nations cope with the challenges of globalization using their comparative advantage in human resources to serve the needs of the developed industrial world. For him the case of the Philippine health professionals (nurses, doctors, hospital managers) is just an example of the problem.

We were told that AIM will be looking into many topics including questions about the China ethics in trade. The example he will be talking here deals with the global shortage in human health professionals to care for the aging Western population while it leaves behind despoiled health systems in the developing world that are now   at risk.

His hour long presentation was followed by a very interesting Q&A period and all of this led me to realize that in effect the government of the developing country has turned the human resources into a commodity that it mines, and exports, like others do with their country’s oil or iron ores.

In this particular case, the Philippine government has taken no steps to figure ways that can allow this freedom of movement of its people and institute programs that create the needed educational-institutional frames to make this without harming the people that move to other countries and the people left behind. The remittance of earnings becomes a target that makes for the government not taken practical steps to streamline this movement. Instead we were told of closing of needed hospitals because of depletion of good personnel – be these nurses, doctors or management. The best moved on, and those that were left are unable to continue running the facility.

In the Globalization of Trade and Services we expected also Incentives the speaker said. “We originally expected movement of goods, but we got also movement of humans. When you take out talent from a poor country, this is like Sharks in the water of talent.”

AIM was founded with Harvard University in 1960 to develop case material for management courses. Dr. Macaranas’ analysis concluded that it would take $3 billion to replace the Philippine nurses in the US. In effect this is the cost to the Philippine economy. Because of loss of personnel at least 200 hospitals have closed in the Philippines and in another 800 hospitals at least one wing was closed. Often these are in the poorest districts. So the hospital crisis in the Philippines now, shows the failure of the Philippine government to act in the face of this brain drain. He wants a pro-active solution that makes possible such a movement without harming the Philippine people under conditions when in remunerative terms it is more convenient for a Philippine doctor to work as a nurse in the US. Also, many doctors have obtained also MBAs – to be able to act as hospital managers. Remember the power of the US Medical Association – these new migrants can be anything in the US except be actual doctors! This migration is not just a national scandal at both ends – it is in effect a global scandal.

Dr. Macaranas wants to reach a balanced situation when:

1. Migration should be out of choice rather then some financial push.

2. Some sort of a 2 year obligatory service for having obtained all that free education in the Philippines.

3. A taxing system on the recruiters who make tremendous profits from providing this human cargo for the upkeep of older people in the US, and other countries as well.

4. Codes of Conduct for recruiters.

With the problem having become also a problem of instructors and directors for the schools in the Philippines, because of this completely unrestricted migration, there is now a shortage of trainers to provide this human cargo!                   It has become a case when success has shot its own feet. The idea is that the nurse is trained in a hospital and in the US she has only to be retooled to IT medicine. But the exit of the hospital trainers is now shotcomming both – the local population and the industry that works for this human export. A UK-South African bilateral agreement is setting now the standard and has become a model. The migration is helped by this program and it has a training aspect to it – the results – 2/3 of emigrees to the UK are now in the health profession. The Philippines wants to hold a health migration meeting next year with the participation of the World Migration Organization (the IOM), World investors, and people sponsoring a future World Migration Foundation.

This is something Dr. Macaranas would like to see to develop into a private – public partnership that creates conditions that can continue to allow the free movement of the people, but also see that this does not leave behind harm to the developing country. These health workers are needed all   over, and even in a country like Japan that tries to remain a homogeneous society, its aging population must allow the coming in of these health workers – so, their preparation must be done in a cross borders kind of public-private partnership.

The IOM has already a Global Commission on Nurses, but the governments do not yet talk to each other. This – to be created – facility that is a public-private-partnership (PPP) has to be outside the UN proper. This because the best that can be expected at the UN is that governments will talk to each other, but this is a problem of the people first. All stake-holders must be part of the process-building of a solution. And let us not forget, we really do not want to bring about restriction to human movement that is based on fre will.

Ms. Phillips, a strong backer of the Carnegie Council, put this in blunt terms: This is an issue of Sovereignty vs. the Global Humanitarian Issue.

Other questions brought out the Thai Medical Tourism issue where it is cheaper to come to Thailand for certain medical procedures. Similarly Europeans flock to Eastern European countries. Medicare remains a problem because they do not pay for treatment abroad – but the Japanese already allow older people to reside, and be covered, when living in tropical countries abroad. So part of this issue will involve also putting limits on the American Medical Association’s privileges to dictate US health-care conditions.

Further, the international reaches of Philippine medical schooling is a growing potential for the Philippines – this also will have to be dealt with. Already nurses from other 9 ASEAN countries are allowed into the Philippines. There are several Catholic Schools that bring in Chinese students. In those cases, the foreign country has to finance an equal number of rooms and lab spaces for Philippine students. So this is a start idea for these larger multi-stakeholder partnerships. The Chinese investors are already looking to establish hospital schools in Cebu. Dr. Macaranas suggested that the Libyans, interested in developing Muslim nurses, could do the same in Mindanao.

We did not exactly like these last suggestions, even though we understand the positive and practical side of these suggestions. To us this is really the further commoditization of people – with a less kind view – one could even think of the mining of these poorer countries for human resources like it was done not in the colonial times, but rather in the days of the trade of slaves. OK – this time it might be sometimes a more benevolent condition – but – is it really substantially different?

When the meeting was over we continued to talk with the speaker, and we realized that he is completely aware of all these implications and thus the importance for the Carnegie Council For Ethics in International Affairs to continue to dig into this subject.

Will it be possible to turn the highly tooted “Free Trade” subject, into an honest “Fair Trade” subject?                                                     How will this connect to Sustainable Development?                                                                                                                                                                                                                                                     Is there any hope for States that have no mineral resources? Will they be able to develop their human resources without delving into mining them for export, for the sake of their “remittances.”

Personally, I am aware of Philippines in New York that left children back home in the care of mother or an older aunt. Also, I have seen the Sunday “Meet” of the Philippine nurses in Hong Kong, Tel Aviv, and other places. That is when they have a chance to get advice for troubles that they may have in their employment. But can you imagine such a meeting in Riyadh? What about the human rights of these semi-slaves, or sometimes really enslaved women?

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