Help wanted: proposals to address emigration of Caribbean teachers and healthcare workers
Help wanted: proposals to address emigration of Caribbean teachers and healthcare workers
Brain drain plagues the Caribbean, but Global Skills Partnerships and recruitment of workers from abroad may be able to help
Se puede acceder aquí a una versión en español traducida por inteligencia artificial.
Une version française traduite par intelligence artificielle est accessible ici.
Een Nederlandse versie vertaald door kunstmatige intelligentie is hier beschikbaar.
The Caribbean faces many human mobility challenges: exodus from Haiti and Cuba, slow-moving expansion of free movement within Caricom, and transit migration and smuggling of extra-continental migrants en route to the US, to name a few. But emigration is perhaps the challenge felt most acutely in the Caribbean, from engineers to accountants to entrepreneurs to researchers and beyond. The loss of the region’s teachers and healthcare professionals is a particular concern highlighted by politicians, workers’ associations, and the media—from countries as diverse as Barbados, Dominica, Guyana, Jamaica, Suriname, and Trinidad and Tobago.
As explained in a report I co-authored with colleagues from MPI and IDB last year:
“Most Caribbean countries face challenges related to the emigration of health-care professionals, often to countries in the Global North, such as the United States and United Kingdom. This results in a shortage of personnel in many Caribbean countries’ health-care systems, most notably of nurses. For example, 40 percent of vacant nursing positions in the anglophone Caribbean in 2015 were reportedly left vacant because of out-migration. And the problem is not going away: among 573 Caribbean healthcare professionals surveyed by the Pan American Health Organization in 2018, three in five reported they would emigrate if given the opportunity. Interestingly, after the United States, United Kingdom, and Canada, the principal destinations for nurses leaving Caribbean countries are within the region: The Bahamas and the Cayman Islands.”
And in terms of teachers, UNESCO’s 2019 Global Education Monitoring Report specifically highlighted the Caribbean in a section on teacher shortages and the impacts of emigration:
“Caribbean countries have experienced high teacher emigration in recent decades, not least due to active recruitment efforts from the United Kingdom and the United States. Facing shortages in public schools in the early 2000s, the New York City Board of Education increased international recruitment, attracting hundreds of teachers from the Caribbean, particularly Jamaica and Barbados (Penson and Yonemura, 2012): 350 came from Jamaica in 2001 alone (Hadley Dunn, 2013). For small island states, even relatively few emigrating teachers can create significant shortages (Bense, 2016).”
To put those figures in perspective with more recent data, Jamaica has reportedly lost 10% of its teacher workforce in the last two years, including 1,538 departures in just 9 months in 2022.
The most obvious and ideal solution is to strengthen the quality of job opportunities at home for native workers in the Caribbean and to create meaningful options for their career growth and promotion. Migration and emigration are normal phenomena, but it is important to invest in improving working conditions and salaries to provide more competitive offers at home and reduce the incentives of looking abroad. As noted by the head of the Caribbean Union of Teachers to Loop News, in addition to emigration, some teachers have wholly left the profession “because they were overworked, underpaid, and undervalued.”
At the same time, though, the tough reality is that wages are simply much higher abroad. Even aggressive efforts to improve salaries will be unable to compete—let alone doing so while maintaining fiscal sustainability. In Suriname, for example, a recent initiative to provide a “brain drain allowance” to improve recruitment and retention has been awarded to more than 5,500 healthcare workers. Its impact on slowing emigration or promoting return of those abroad, however, has been unclear, and it has also been plagued by reports of late or missing payments.
Highlighting the financial incentives to emigrate, a 2021 study by researchers George et al. at the University of KwaZulu-Natal and the University of the West Indies found that even among new teachers, Canada offers over double the purchasing power parity (PPP)-adjusted salary offered in countries such as Jamaica and Suriname. And PPP-adjusted salaries are over triple the value for some mid- and late-career Caribbean teachers in the US.
As a result of these economic opportunities abroad, the emigration of highly educated professionals from the Caribbean is often cited as a classic example of “brain drain.” Although there is a growing literature on “brain gain” (see, for example, Gibson and McKenzie 2011), the potential long-term benefits appear a distant hope in the face of pressing labor needs in the region’s schools and hospitals.
Amid this context, the following three opportunities are not a panacea, but they hopefully offer the potential to help address this key challenge in the region:
Developing Global Skills Partnerships focused on teaching and health care with common countries of destination such as Canada, the Netherlands, the UK, and the US
Introducing teaching abroad fellowship programs to recruit early career professionals from outside the region
Expanding pathways for migration of healthcare professionals, including through travel work programs
Global Skills Partnerships
Michael Clemens developed the concept of Global Skills Partnerships (GSPs) in 2014 with the bold idea that countries of origin and destination might set up bilateral labor migration agreements and develop public-private partnerships to help fund and train workers, some of whom would ultimately undergo labor migration and some of whom would remain at home. The idea was beneficial for all: a win for countries of origin, who gain subsidized training of skilled workers and ideally remittances from their skilled nationals abroad; a win for countries of destination and their businesses, who receive skilled workers to meet specific labor gaps at a relatively cheaper training cost; and a win for the migrants and training beneficiaries themselves, who receive greater opportunities, whether they want to pursue them at home or abroad.
These types of partnerships offer an opportunity for the Caribbean region. Common countries of destination for Caribbean educators and healthcare workers such as Canada, the Netherlands, the UK, and the US could help finance the training of Caribbean nationals, some of whom would migrate and some of whom would remain at home, strengthening the local labor force. Amid a feeling of uncontrolled emigration and loss of talent in the region, GSPs would offer greater stability and planning for Caribbean countries, as well as subsidized education and training to improve opportunities and capacity at home. Generating concrete opportunities increases the incentives for locals to enter these fields of need, as evidenced by a recent paper at The Review of Economics and Statistics which found that for every Filipino nurse that emigrated, nine new nurses that did not migrate were trained and licensed.
As a result of this opportunity, the World Bank is currently exploring opportunities for GSPs in the Caribbean, focusing on Belize, Grenada, and Jamaica as potential countries of origin and training. The project is still under analysis and in development, but may concentrate on the healthcare, teaching, and tourism sectors. IOM has also taken the lead with facilitating planning of a similarly styled Skills Partnership Agreement between Suriname and Belgium focused on the healthcare sector. Negotiations are in progress, and they hope to launch that initiative soon.
Amid reports that Canada is looking to increase immigration of healthcare workers, including through expanded funding for foreign credential recognition, Guyana has sought the North American country’s assistance in training Guyanese nurses for local, Caribbean, and Canadian markets. Already, Guyana’s president has said that “the Guyana government would be opening talks with development partners to have Guyana’s nursing institutions accredited by Canadian standards,” per Demerara Waves. Establishing a GSP partnership between the two countries could be highly beneficial on both sides, and particularly so considering Guyana’s growing regional weight amid the country’s oil boom. As one of the larger countries in the region, Guyana could even host the training for Caribbean nationals from other countries, too, building on the regional, multinational education model of the University of the West Indies.
The Netherlands also offers a potential path: Dutch-speaking Surinamese have long migrated to the country (which hosts 67% of Suriname’s diaspora). There is already a high level of collaboration (and dependency) between Surinamese hospitals and the Netherlands: per Surilines, 9 of 11 of Suriname’s hospitals have their “own collaboration agreement(s) with Dutch counterparts.” Indeed, there are no institutions to provide specialist training for doctors in Suriname, leading many to migrate to the Netherlands for such study. A 2012 agreement compels these students to return, as explained by IOM, but nothing prevents them from emigrating once more; many Surinamese doctors and nurses work in the Dutch Caribbean or the Netherlands. Building on this foundation, a GSP agreement between the two countries could expand capacity and bolster the local healthcare system in Suriname while still providing migrant labor abroad, albeit now with clearer expectations of who may stay and who may go. This could also look to create synergies with the new IOM initiative between Suriname and Belgium once it is off the ground and established.
Learn more about the GSP model at Center for Global Development’s platform here.
Teaching abroad fellowships
Beyond efforts to promote training at home and a more “plannable” emigration scheme, there is also opportunity to be found in opening up greater legal pathways for immigrant labor in the Caribbean. One such model could be the development of teaching abroad fellowships.
Countries such as Spain and France host recent graduates from abroad to teach English and other classes, offering a modest stipend to cover living expenses. This fills labor gaps—often in more rural or underserved communities—and offers these temporary migrants concrete work experience, as well as an exciting and new experience abroad early on in their career.
The Caribbean could look to replicate this model. What young adult, particularly a child of the diaspora, would not be equally attracted to such an opportunity in the Caribbean? Of course, the region is not just a series of shiny resorts on the water to attract tourists—it is so much more than that (and Europe is similarly not just a series of quaint villages and cosmopolitan cities). But there is a similar allure of new adventure, of new food and culture and opportunity. And with such a broad diaspora base in countries such as the US, UK, and Canada, there is already a pool of potential talent that could be further inclined to take part.
In addition to measures to recruit from the diaspora, teaching abroad fellows could also be recruited in an effort to target a key challenge currently faced by schools in multiple countries across the region, particularly in Guyana and Trinidad and Tobago: a lack of Spanish speakers to attend to a growing population of Venezuelan migrants (and their school-age children). This could target bilingual and Spanish-speaking young adults in the US, as well as turning to the Spanish-speaking countries of Latin America as a potential solution. Teaching abroad fellowships could be a key response to the need for English as a Second Language (ESL) teachers in certain countries of the Anglophone Caribbean.
Granted, this proposal relies on short-term labor and would likely be small and difficult to scale to the level necessary to completely solve the challenge at hand. But it would begin to help bridge labor gaps and get teachers in classrooms, not to mention improve cultural connection and create greater bonds that may ultimately facilitate greater trade and development opportunities. Some migrants may naturally establish roots and look to stay in the longer-term, while others still may see their receiving communities as a second home and look to travel and maintain relationships despite their return to their country of origin.
Expanding travel work programs
In a similar vein, expanding pathways for migration of healthcare professionals to the region, including through travel work programs, may help respond to some labor needs. In the US, for example, travel nurses switch between hospitals, filling gaps on a temporary basis. Some of these roles are at times international, and looking to recruit these individuals to the Caribbean could be an attractive proposition in a similar way to the idea above of teaching abroad fellowships.
Travel work programs could also seek to expand beyond simple recruitment from country A to country B, instead taking the form of bilateral agreements for mutual labor migration, with migrants temporarily exchanging places. One side receives greater income than available at home, while the other receives new opportunities abroad in an international manifestation of more typical locally- and nationally-based travel work programs.
In this model, healthcare workers in the Caribbean would spend part of the year in another country—likely in the Global North, where salaries are higher—while travel healthcare workers would move in the other direction. Similarly to GSPs, this creates clearer expectations and planning for countries losing their professionals to emigration, while additionally providing a replacement, in theory.
The drawback here is the potential that Caribbean healthcare workers abroad may wish to extend their stay in higher-paying countries of destination, creating imbalances in the functionality of such a program. Even still, the current emigration-immigration balance does not show a positive outlook for the region’s ability to fill labor needs. As a result, programs looking to begin to more clearly manage and plan for emigration may at minimum support more effective development planning.
Concluding thoughts
Ultimately, these three proposals are not a panacea. Instead, they look to foster discussion and innovation to begin to better address this key challenge of emigrating teachers and healthcare workers in the Caribbean. It will be crucial that any efforts to act on these proposals ensure fair and just arrangements in any bilateral (or multilateral) agreements and look to include local stakeholders in the development and implementation of the specific policies.
Many countries in Latin America face similar types of issues to those of emigration and brain drain in the Caribbean, although such a crisis is perhaps more immediately pressing and at the forefront of policy concerns in the Caribbean region. There is something to be learned from this experience for the whole of the hemisphere, particularly as more and more migrants turn north looking for opportunities and refuge and as demographic dividends slowly fade away. Questions of demographics and labor supply may seem far off in the future for many countries of the region, but these impending challenges may be closer than they appear.