Brain exodus and ‘loincloth remedies’

Thursday 17th August, 2023

There has been an unnervingly rapid deterioration of the public health sector during recent years. Health Minister Keheliya Rambukwella is bellowing hollow rhetoric and stretching the truth, and the government is all at sea. As if the crushing shortages of medicines and equipment affecting the state medical institutions were not enough, government doctors are migrating in large numbers. Some of them are sending their resignation letters after leaving the country. (They seem to have taken a leaf out of ousted President Gotabaya’s book!)

More than 2,000 doctors have already left for overseas employment, according to media reports quoting the health sector trade unions. Thousands of other medical officers including specialists are likely to follow suit, we are told. This is a worrisome proposition. Absit omen! The government is solely responsible for having brought about this unfortunate situation by bankrupting the country, jacking up income taxes unconscionably and creating a sense of uncertainty about the future among all citizens.

Frustrated Sri Lankan professionals have been left with a choice between fight and flight, so to speak. Some of them have plucked up the courage to fight for their rights and others have opted for flight (read migration). It is not only doctors who are leaving the country in droves; engineers, nurses, other health workers, university dons, and IT specialists are doing likewise. This is the fate that awaits an unfortunate nation which comes under a pall of uncertainty with politicians and their kith and kin living the high life while others are suffering.

Having let the grass grow under its clumsy feet, the Health Ministry has suddenly adopted some measures to restrict doctors’ foreign travel with a view to preventing them from leaving the country for good. But such restrictions will yield the desired results only in a country like North Korea, where the dictates of ruthless rulers take precedence over the people’s democratic rights. The Health Ministry’s belated efforts to prevent doctors from leaving the country reminds us of the lyrics of a beautiful Sinhala song, ‘hithin yana aya athin alla navanthannata ba …’ (roughly rendered into English it means ‘there is no way one can stop a person who has made up his or her mind to leave …’)

Rules and regulations have been available all these years to prevent state employees from leaving the country without permission, but they have not helped prevent brain drain. There is no gainsaying that it is wrong, both legally and morally, for public officials to migrate in violation of bonds they have entered into with the state, and legal action has to be instituted against them in case of defiance. But there is said to be more than one way to skin a cat or shoe a horse. A doctor can always resign before leaving the country if she or he is not granted leave or permission to go overseas; it has been reported that some post-intern medical graduates have not even cared to take up appointments as they are planning to go abroad; some of them have already migrated, according to press reports. If their unauthorised migration amounts to a breach of bonds they have signed, they can make payments thereon and clear legal barriers for securing foreign employment. How does the government propose to deal with this problem?

What the government should do is to try to tackle the causes of the doctors’ exodus, which is pushing the state health institutions to the brink of collapse. Instead, it has chosen to sort out the effects of the issue. Needless to say, this strategy is as futile as ‘using a loincloth to control dysentery’, as a local saying goes. Let the Health Ministry be urged to engage the protesting professional associations urgently, and discuss ways and means of managing the human capital flight.

The phenomenon of brain exodus is multifactorial, and the tackling of it requires a proper study thereof and a multi-pronged strategy. Not all reasons that doctors and other professionals have given for their hasty migration are acceptable or convincing, but the fact remains that the government is driving them away and therefore duty-bound to clean up the mess of its own making.

Perhaps, one only hopes against hope when one asks the government to make an intervention to stop the exodus of doctors, for it is doubtful whether the ruling party politicians are aware of the value of qualified physicians; it may be recalled that they promoted a herbal syrup produced by a shaman called Dhammika Bandara as a cure for Covid-19. Maybe they think they will be able to run the government hospitals with the likes of Bandara, who even took the then Health Minister Pavithra Wanniaarchchi and Speaker Mahinda Yapa Abeywardena for a ride. Else, they would have gone all out by now to prevent the government doctors from migrating.