Regarding Sebastian Mallaby's Nov. 29 op-ed column, "How Africa Subsidizes U.S. Health Care":
African health workers aren't just being lured away by better salaries in rich countries. They are fleeing squalid and unsafe workplaces and staggering workloads. Retaining them -- and recruiting the million more that Africa needs -- will require a huge increase in African governments' own spending, vastly more donor help and a more flexible approach to national budgets by the International Monetary Fund.
Health care systems in Africa have been deteriorating for more than a decade, thanks in part to macroeconomic strategies imposed by the IMF that harshly limit hiring and expenditures.
Foreign recruiters should keep their hands off African health workers, but so should the economists whose austere approach to public spending is bleeding health systems to death.
HOLLY BURKHALTER
U.S. Policy Director
ERIC FRIEDMAN
Policy Research Associate
Physicians for Human Rights
Washington
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Sebastian Mallaby says that the United States should limit its "poaching" of African health care workers.
To borrow a line from H.L. Mencken, "There is always an easy solution to every human problem -- neat, plausible and wrong."
Limiting immigrant health workers, specifically nurses, would aggravate everyone's shortage. One incentive to go into nursing in developing countries is the knowledge that this is a field that allows for eventual immigration to the United States. Mr. Mallaby's proposal would discourage African students from going into medical fields since they would essentially be held hostage in their countries.
Most immigrant health care workers come here because they want a better life. I am a registered nurse, and most of the African nurses I know are go-getters who are furthering their studies and skill levels. They want to get ahead, and they know that won't happen in their homelands. No amount of subsidy from the United States would keep them in their countries.
The United States has a nursing shortage because we are not graduating enough nurses. Perhaps our inefficient medical system needs reform to attract new people into the field, as opposed to paying salary subsidies to African countries.
DAVID KANGAS
Germantown
