Sveinsson, Kjartan Páll
(2015)
Swimming against the tide: trajectories and experiences of migration amongst Nigerian doctors in England.
PhD thesis, London School of Economics and Political Science.
Abstract
High emigration countries tell a confusing story of how migration cycles can contribute to the sustainable economic development of some poor countries in some ways but hamper it in others. A number of social, economic and political factors – on local, national and global levels – interact to influence success, or lack thereof, in activating diasporas to contribute to the development of their home countries. Various actors – including states, civil society, and minority groups – within the 'transnational social space' impact on migrants' capacity to send 'social remittances' and engage with transnational processes. This study looks at a particular cadre of highly skilled migrants – Nigerian doctors working in the NHS in England – as a lens through which to explore these broader processes. Africa has: 3% of the world's health-workers; 11% of the global population; 24% of the global burden of disease.
Yet 28% of sub-Saharan African doctors have left the continent to practice medicine in a handful of OECD countries, with enormous social and economic costs to sending countries.
The NHS is highly dependent on overseas doctors – 28% are trained overseas, and 75% of these are from low income countries. Yet there is a long history of discriminatory practice towards overseas doctors in the NHS. Overseas doctors tend to be over-represented in lower grades, and under-represented in senior positions: the higher up the NHS hierarchy you look, the whiter the doctors become.
This study traces the migratory trajectories of 32 Nigerian doctors who have studied and/or worked in England, their experiences of professional development within the NHS, and their involvement in community and transnational activities that induce (or hinder) the transfer of skills and resources. Their narratives are connected to broader aspects of immigration policy, structural discrimination, and transnational processes to explore how their place within the transnational social space impacts on their ability to obtain transferable knowledge, and how they use this knowledge to make a contribution to the development of the healthcare sector in Nigeria.
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