Pardee-CFLP-Remittances-TF-Report

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cians in the U.S. in 2000 (Clemens and Petterson 2007) would increase by 50percent the number of Liberian physicians who remained at home, and wouldcost less than $500,000 per year. The potential exists for minimal financial inputto yield substantial gains in the professional staffing of the health system in apost-conflict state.Yet if successful, this innovation could encouragea reverse of the “brain drain” and addto the supply of health professionals morequickly—and more cheaply—than new localmedical or nursing schools, which may stillsee their graduates disappear overseas.There are, inevitably, somechallenges. Mechanismswould be needed to verifythat the beneficiary of thecontinuing pension contributionsis practicing in thedisadvantaged country. Organizationsmust be identified to take on this verification task. Yet if successful, thisinnovation could encourage a reverse of the “brain drain” and add to the supplyof health professionals more quickly—and more cheaply—than new local medicalor nursing schools, which may still see their graduates disappear overseas.These pension fund contributions would be fitting reparations for countries thathave staffed their health system with imported professionals without incurringthe cost of their academic training. For countries recovering from humanitariancrisis, the “pension incentive” would be a low-cost way to encourage the reversemigration of professionals with the requisite clinical and cultural skills to rebuilda shattered health system.A first step would be to survey expatriate health professionals from somepost-conflict countries on the factors that bind them to the country of refuge,and those that would encourage them to return home. Response to the pensioncontinuation proposal could be explicitly tested in such a poll. If the results areencouraging, the proposal could then be field tested in a country like SierraLeone, with a development agency such as the UK Department for InternationalDevelopment continuing the National Health Service (NHS) pension contributionsfor returning health professionals, and advertising this opportunity throughthe NHS and expatriate networks. In a relatively small country like Sierra Leone,with active foreign assistance programs, it should be possible to confirm that therefugees receiving pension support do return and practice their profession. Theexperiment could be evaluated by monitoring professional registrations in bothcountries. If it accelerates the return of health professionals, the scheme could berolled out more broadly to post-conflict countries and other victims of the “braindrain” struggling to augment the health care workforce.Remittance Flows to Post-Conflict States: Perspectives on Human Security and Development 131
ReferencesClemens, M.A., and Petterson, G. 2007. New Data on African Health Professionals Abroad. Centerfor Global Development Working Paper #95. Washington DC: Center for Global Development.Donaldson, R.I., Shanovich P., Shetty P., Clark E., Aziz S., Morton M., Hasoon T., Evans G. 2012.A Survey of National Physicians Working in an Active Conflict Zone: The Challenges of EmergencyMedical Care in Iraq. Prehospital and Disaster Medicine 27:153–61.Doocy, S., Malik S., Burnham G. 2010. Experiences of Iraqi Doctors in Jordan During Conflict andFactors Associated with Migration. American Journal of Disaster Medicine 5:41–7.Fagen, P.W. and Bump M.N. 2006. Remittances in Conflict and Crises: How Remittances SustainLivelihoods in War, Crises, and Transitions to Peace. Washington DC: International PeaceAcademy.Finlay, J.L., Crutcher R.A., Drummond N. 2011. Garang’s Seeds: Influence on the Return ofSudanese-Canadian Refugee Physicians to Post-Conflict South Sudan. Journal of RefugeeStudies 24:187–206.Gale, W.G., Shoven J.B., Warshawsky M.J., eds. 2004. Evolving Pension System: Trends, Effects, andProposals for Reform. Washington DC: Brookings Institute.Hurd, M.D. 1996. The effect of labor market rigidity on the labor force behavior of older workers.In: Wide DA, ed. Advances in the Economics of Aging. Chicago: University of Chicago Press,11–60.Kinfu, Y., Dal Poz M.R., Mercer H., Evans D.B. 2009. The Health Worker Shortage in Africa: AreEnough Physicians and Nurses Being Trained? Bulletin of the World Health Organization87:225–30.Levitt, P., Lamba-Nieves, D. 2011. Social Remittances Revisited. Journal of Ethnic and MigrationStudies 37:1–22.Lindley, A. 2009. Remittances and Conflict: Some Conceptual Considerations. Jahrbücher fürNationalökonomie und Statistik 229:774–86.Mullan, F. 2005. The Metrics of the Physician Brain Drain. New England Journal of Medicine353:1810–8.Rao, M., Rao, K.D., Kumar, A.K., Chatterjee, M., Sundararaman, T. 2011. Human Resources forHealth in India. The Lancet 377:587–98.Scheffler, R.M., Mahoney, C.B., Fulton, B.D., Dal Poz, M.R., Preker, A.S. 2009. Estimates of HealthCare Professional Shortages in sub-Saharan Africa by 2015. Health Affairs 28:w849–62.Stilwell, B., Diallo, K., Zurn, P., Vujicic M., Adams O., Dal Poz M. 2004. Migration of Health-careWorkers from Developing Countries: Strategic Approaches to Its Management. Bulletin of theWorld Health Organization 82:595–600.132 A Pardee Center Task Force Report | October 2013
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Pardee Center TASK FORCE Report oct
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This series of papers, Pardee Cente
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AcknowledgementsThis Task Force on
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ITU International Telecommunication
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networks and migrant associations i
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to developing countries than other
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But most importantly, remittances a
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often mix in the countries of desti
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According to the World Bank estimat
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Because of its focus on the multidi
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eceiving remittances provides an en
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associations for post-conflict inst
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are proposed to avoid the associate
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Terry, D. 2005. Remittances as a De
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oader approach to post-conflict rem
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networks can be seen as “homogeno
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That personalized nature of hawala
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Customary law (xeer) and other trad
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the world (Lindley 2009, 531). Much
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ize the informal equal efforts to a
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struction and development. Means sh
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opportunities should focus on exist
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2. Dodd-Frank Act and Remittances t
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leadership. Formal payments systems
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and financial institutions. 26 Reso
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closures should be both in English
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issued a new proposed regulation De
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“closed network,” in which all
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Some guidance may be found in the p
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the use of mobile devices for money
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Foreign TaxesUnder the 2012 regulat
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will be available in all cases. CFP
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Section II: Remittances in Post-Con
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Sri Lanka. The conflict also result
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Figure 2: Current Account, Trade Ba
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flows came from migrant workers in
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Informal Remittance Channels in Sri
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tory authorities, with some calls f
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4. The Role of Remittances in Post-
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Figure 1: Liberia Per Capita Income
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associations, women’s groups, alu
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Remittances to LiberiaValue of Remi
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credit because of the need to be li
Page 88 and 89: Remittance Transfers in Sierra Leon
Page 90 and 91: Knowledge RemittanceThe Liberian di
Page 92 and 93: process furthermore was a pioneerin
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Page 96 and 97: Section III: Diaspora Networks andC
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Page 100 and 101: One of the main challenges for mobi
Page 102 and 103: 6. Transnational Remittances and De
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Page 106 and 107: annually during the 1990s to less t
Page 108 and 109: Figure 2: Transnational Vicious Cyc
Page 110 and 111: The transnational vicious cycle not
Page 112 and 113: emittance flows is mixed, as initia
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Page 116 and 117: areas. This issue can potentially b
Page 118 and 119: This is a breakthrough moment: afte
Page 120 and 121: Edwards, Sebastian and I. Igal Mage
Page 122 and 123: y La Distribucion Del Ingreso, 1st
Page 124 and 125: 7. Remittances and Community Resili
Page 126 and 127: For quantitative data collection, a
Page 128 and 129: Remittances are perceived as playin
Page 130 and 131: the affected population. Internatio
Page 132 and 133: ReferencesAddleton, J. 1984. The im
Page 134 and 135: 8. Filling the Gap in Health Staffi
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Page 141 and 142: 1. Remittances, Financial Inclusion
Page 143 and 144: networks, and communities. The role
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Page 147 and 148: the island of Kosrae, in the Federa
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Page 151 and 152: he organized a number of workshops
Page 153 and 154: Pardee Center Conference ReportsDev
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