Year: 1986
Setting: Pierre and Marie Curie University, Paris, France
Position: Assistant professor in tropical diseases
It is my sixth year of teaching tropical diseases to post-grads at Pierre and Marie Curie University in Paris. After lectures, students often stick around to chat with me. Over the weeks I have gotten to know them better. Some are older than I am. One is a medical doctor from Cameroon who just received her specialty degree in ophthalmology in France. I ask about her career plan. She says she was sent by her government, from which she received a grant, and was poised to be the first eye doctor in her country. Only one for more than 10 million people! Unfortunately, she has decided that she will not return to her native country and will work in France instead, purely for professional reasons. For example, she has learned that for some diseases, the treatment of choice is laser therapy. Currently, there is no laser device in Cameroon and she does not have the financial resources to buy one. Her government has told her that it cannot make a commitment for such an investment because, after the financial aid she was given, it would look like she is receiving preferential treatment.
I inquire among other students. The majority plan to remain in France, and their motivations vary. One works at a hospital and is involved in an exciting study that will take at least five years to be completed. He will then follow a research track. Another cannot share his political opinions publicly in his country or he would go to jail. Another earns much more in France and has to support his extended family. Another has met a French student and they want to marry and raise kids in Bordeaux. Another has allergies that have completely disappeared in the temperate and dry climate of southeastern France. Another says the crime rate is high in her country and she fears for her life if she shows any signs of wealth.
In my view, it is a tragedy that the financial investments of France and the students’ home countries will not be put to best use, and that the students will not provide their medical services where they are needed the most. Twenty-four years later, I look at the situation of students from developing countries who are being trained in France and the United States. Sadly, not much has changed. The brain drain continues unabated. Although much has been written and promised to address the issue, a great deal more remains to be done.
Lesson for the doctor: Remember the words of John F. Kennedy: “Ask not what your country can do for you -- ask what you can do for your country.”
Yann Meunier, MD, is the health promotion manager for the Stanford Prevention Research Center. He formerly practiced medicine in developed and developing countries throughout Europe, Africa and Asia. Each week, he will share some of his experiences with patients in remote corners of the world.
