African Medical Migration: Nigerian Doctors in the USA between Conflicting Priorities of Moral, Economic and Professional Commitment
Final Report Abstract
This research project explored the experiences of Nigerian trained physicians who migrated to the US and the UK from the 1980s onwards. Situated at the intersection of contemporary political debates on the brain drain (and brain gain) and theories of medical anthropology and migration in an age of globalization, the focus was placed on their experiences as highly skilled migrants and traversers of a transnational biomedical landscape. By drawing on individual professional life stories, the research illuminated how migrated Nigerian physicians disconnect from and (re)connect to diverse local social and biomedical contexts, establishing themselves professionally abroad while at the same time trying to influence health care services in Nigeria through transnational endeavors. The findings are based on ten months of fieldwork in the US, where 71 Nigerian trained physicians were interviewed, most of whom lived and worked in and around New York City, as well as on three months of fieldwork in the UK, where an additional 24 life stories of Nigerian physicians were collected mainly in London. Apart from the semi-structured life story interviews, participant observation was conducted during a medical mission of Nigerian health professionals to Nigeria and numerous conferences of geoprofessional organizations as well as charity events. With partly extensive field stays in all these localities and with a large body of life stories that reflect migration experiences over a period of 40 years, this research provides a fine-grained picture of the transnational oscillation between different social and professional contexts in the migration of physicians. In particular, the research focused on the following aspects: 1) The physicians’ formative years of medical training and practice in Nigeria and their ambiguous memories of the Nigerian biomedical landscape; 2) The migration experiences of Nigerian trained physicians during different decades, highlighting the frictions and migration regimes that shaped their transnational trajectories; 3) The doctors’ adaptation to their new professional environments in the US and the UK once they had overcome the challenges of visa regimes and the accreditation of their foreign medical degrees; 4) The physicians’ connectedness to social and professional contexts in Nigeria, highlighting the multi-directionality of the transnational social spaces that they have created through going abroad. Overall, the research shows that the migration of highly skilled health professionals cannot be reduced to strong economic notions of brain drain (or gain). Current policy recommendations aimed at limiting health professional migration ignore the fact that the biomedical workforces in countries such as the US and the UK have become intrinsically international; that international medical graduates actively shape the ways in which they gain access to the health care workforces abroad; and that they make vital contributions not despite of but because of their biomedical training in another biomedical context. Lastly, the research on the doctors’ ongoing connectivities to biomedicine in Nigeria highlights the importance of not only looking at return migration but of focusing on the involvement of geo-professional associations as well as individuals in the endeavor to improve health care services to the Nigerian population at large through temporary return.
Publications
- (2018) Introduction to Special Issue “Transfigurations of Health and the Moral Economy of Medicine: Subjectivities, Materialities, Values”; Zeitschrift für Ethnologie 143 (1) 1-20
Kehr, Janina; Dilger, Hansjörg; van Eeuwijk, Peter
(See online at https://doi.org/10.7892/boris.142320) - (2018): Introduction to Special Issue “Im/Mobilities and Dis/Connectivities in Medical Globalization: How global is Global Health?” In: Global Public Health 13 (3): 265-275
Dilger, Hansjörg and Dominik Mattes
- (2018): State-of-the-art or the art of medicine? Transnational mobility and perceptions of multiple biomedicines among Nigerian physicians in the U.S. In: Special Issue “Im/Mobilities and Dis/Connectivities in Medical Globalization: How global is Global Health?”, ed. by Dominik Mattes and Hansjörg Dilger; Global Public Health 13 (3): 298-309
Schühle, Judith
(See online at https://doi.org/10.1080/17441692.2017.1337799) - Traversing Transnational Biomedical Landscapes: An Ethnography of the Experiences of Nigerian Trained Physicians Practicing in the US and UK”. Dissertation, Freie Universität Berlin, 2018. 400 S.
Schühle, Judith
