Whose Charity? Africa's aid to the NHS (2)
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Dear Colleagues
There is obviously something very wrong when well trained medi-
cal professionals leave a place (which is home) where they are
really needed and migrate to a strange place where the need is
an order of magnitude less. Something is wrong. The situation is
quite obscene.
Sanjoy Nayak suggested: "Act now to demand that the UK Govern-
ment financially compensate countries for the staff that work in
the NHS. Tell John Hutton MP, Health Minister in charge of Human
Resource issues, that it is time for the government to do the
right thing."
Well, it would be nice if a government would do the right thing,
but is it reasonable for anyone to expect that they would actu-
ally do the right thing. In any event, what is the right thing?
If government is going to "pay" for Africa's aid to the NHS, a
starting point might be to take ALL OF THE PAYROLL TAX associ-
ated with the person and put that in a trust fund for salaries
of health service personnel in the person's country of birth and
country of training. The trust fund would not be handed over to
the general fund of government (for unaccounted use driven by
local politics and power) but would be used under a totally
transparent and accountable manner to pay staff at community
health facilities (hospitals, clinics, care services, etc.). The
key is that 100% of the funds gets to pay for staff that are
critically needed in the communities.
Frankly, though this might be very sensible, an idea like this
will not happen.
But the problem still needs to be addressed. What is the prob-
lem? Professional Africans are leaving Africa because the local
economic opportunities are essentially zero. Local leadership,
international experts and the official relief and development
assistance (ORDA) community have to take a huge amount of blame
for this. Why have national assets produced wealth for interna-
tional corporations, international banks, high level politi-
cians... and poverty for the country as a whole? WHY? HOW? The
challenge is to help communities improve their quality of life
by using the resources they have. The people resources is one of
the keys. Also local natural resources... which sadly have been
taken over by the political elite and their friends and interna-
tional predators. Rule of law has been hijacked in the name of
profit and at the expense of justice and equity. Professional
people should be able to earn and get paid a decent local salary
in order to stay in their homeland to do needed work.
If only "phantom aid" could reach people like local professional
health staff rather than being consumed by consultants and re-
searchers and experts who live their lives in London, or Paris,
or Washington or Boston or New York... If only....
What to do?
Change will happen fast as soon as there is transparency and ac-
countability. People will do what suits them as long as they can
get away with it. As soon as bad things get to be visible, then
people can be held accountable. It is very simple. And because
it is so simple, it raises a huge question about why the experts
and the World Bank and the UN and the ORDA organizations have
never seen fit to do anything practical about it for forty (40)
years.
Let's get together and make excellence in transparency and ac-
countability the norm rather than the exception.
Sincerely
Peter Burgess
Tr-Ac-Net in New York
Tel.: +1-212-772-6918
mailto:peterbnyc@gmail.com
The Transparency and Accountability Network
With Kris Dev in Chennai India
and others in South Asia, Africa and Latin America
http://tr-ac-net.blogspot.com