Nurse Migration from South Africa and the Ethics Discourse

  • Colleen McNeil-Walsh


The negative consequences of migration have led to an ethics discourse in which the central concern is the diminished ability of developing countries to provide adequate care at a time of extensive outmigration of health professionals (World Health Assembly, 2004). The purpose of this chapter is twofold; first to situate South Africa in this ‘brain drain’ discourse and second to consider the place of nurse migrants through a ‘discourse from within’. The debate around the outmigration of health professionals from developing countries has paid little attention to the perspectives of health professionals themselves (Mensah et al., 2005). This chapter aims to show how the everyday experiences of nurses as professionals and migrants result firstly, in a particular set of interests and desired outcomes of migration, which to some extent conflict with other stakeholders in the migration debate (Xu and Zhang, 2005: 578), and secondly, in a different vantage point from which nurses engage with the ethical debate in the context of migration. By paying attention to the position of nurses within the broad ethics discourse, an alternative discourse is identified, in which nurses are located at the centre.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Aitken, L., Buchan, J., Sochalski, J., Nichols, B. and Powell, M. (2004), ‘Trends in International Nurse Migration’, Health Affairs, 23(2), 69–78.CrossRefGoogle Scholar
  2. Alkire, S. and Chen, L. (2006), ‘“Medical Exceptionalism” in International Migration: Should Doctors and Nurses Be Treated Differently?’ in K. Tamas and J. Palme (Eds) Globalising Migration Regimes: New Challenges to Transnational Cooperation, Aldershot: Ashgate.Google Scholar
  3. Bach, S. (2007), ‘Going Global? The Regulation of Nurse Migration in the UK’, British Journal of Industrial Relations, 45(2), 383–403.CrossRefGoogle Scholar
  4. Bailey, T. (2003), ‘Skills Migration’, HSRC, Human Sciences Development Review 2003, Pretoria: Human Sciences Research Centre, 234–55.Google Scholar
  5. Bhorat, H., Myer, J-B. and Mlatsheni, C. (2002), ‘Skilled Labour Migration from Developing Countries: Study on South and Southern Africa’, International Migration Papers no. 52, International Migration Programme, Geneva: International Labour Office.Google Scholar
  6. Chikanda, A. (2005), ‘Nurse Migration from Zimbabwe: Analysis of Trends and Impacts’, Nursing Inquiry, 12(3) 162–74.CrossRefGoogle Scholar
  7. Cock, J. (1984), Maids and Madams: A Study of the Politics of Exploitation, Johannesburg: Raven Press.Google Scholar
  8. Davenport, R. and Saunders, C. (2000), South Africa: A Modern History, London: Macmillan.CrossRefGoogle Scholar
  9. Dumont, J. and Lemaitre, G. (2005), Counting Immigrants and Expatriates in OECD Countries: A New Perspective, OECD Social and Employment and Migration Working Papers no. 25.Google Scholar
  10. Dumont, J. and Meyer, J. (2004), ‘The International Mobility of Health Professionals: An Evaluation and Analysis Based on the Case of South Africa’, Trends in International Migration, Paris: OECD.Google Scholar
  11. Farham, B. (2005), ‘Migration of Health Professionals’, Lancet, 366(9481), 199–200.CrossRefGoogle Scholar
  12. Hallam, J. (2000), Nursing the Image: Media, Culture and Professional Identity, London: Routledge.Google Scholar
  13. Kapur, D. and McHale, J. (2005), The Global Migration of Talent: What does it Mean for Developing Countries? CGD Brief, Washington: Washington Center for Global Development.Google Scholar
  14. Kingma, M. (2006), Nurses on the Move: Migration and the Global Care Economy, New York: Cornell University Press.Google Scholar
  15. Mensah, K., Mackintosh, M. and Henry, L. (2005), The ‘Skills Drain’ of Health Professionals from the Developing World: A Framework for Policy Formulation, London: Medact.Google Scholar
  16. Milton, C. L. (2007), ‘The Ethics of Nurse Migration: An Evolution of Community Change’, Nursing Quarterly, 20(4), 319–23.CrossRefGoogle Scholar
  17. Nursing and Midwifery Council (2005), Statistical Analysis of the Register for 2004/2005, [accessed 14 June 2009].
  18. Nursing and Midwifery Council (2008), Statistical Analysis of the Register for 2007/2008, [accessed 14 June 2009].
  19. Nursing and Midwifery Council (2008), Registering as a Nurse or Midwife in the United Kingdom. For Applicants from countries outside of the European Economic Area [accessed 14 June 2009].
  20. Ogilvie, L., Mill, J., Astle, B., Fanning, A. and Opare, M. (2007), ‘The Exodus of Health Professionals from Sub-Saharan Africa: Balancing Human Rights and Societal Needs in the Twenty-First Century’, Nursing Inquiry, 14(2), 114–24.CrossRefGoogle Scholar
  21. Raatikainen, R. (1997), ‘Nursing Care as Calling’, Journal of Advanced Nursing, 25(6), 1111–15.CrossRefGoogle Scholar
  22. Ramphele, M. (2005), ‘Disparities, Development and International Migration’, COMPAS (Centre on Migration, Policy and Society) Annual Lecture, 1 February 2005, London [accessed 21 March 2007].Google Scholar
  23. Rogerson, C. and Crush, J. (2008), ‘The Recruiting of South African Health Care Professionals’, in J. Connell (Ed.), The International Migration of Health Workers, London: Routledge.Google Scholar
  24. Sevilla, J. (2006), ‘An Economic View on Brain Drain’, in K. Tamas and J. Palme (Eds), Globalizing Migration Regimes: New Challenges to Transnational Cooperation, Aldershot: Ashgate.Google Scholar
  25. Wickramasekara, P. (2003), ‘Policy Responses to Skilled Migration: Retention, Return and Circulation’, Perspectives on Labour Migration, 5E, Geneva: International Labour Office.Google Scholar
  26. World Health Assembly (2004), International Migration of Health Personnel: A Challenge for Health Systems in Developing Countries, WHA 57.19, Geneva: World Health Organization.Google Scholar
  27. Xu, Y. and Zhang, J. (2005), ‘One Size Doesn’t Fit All: Ethics of International Nurse Recruitment From The Conceptual Framework of Stakeholder Interests’, Nursing Ethics, 12(2), 571–81.CrossRefGoogle Scholar

Copyright information

© Colleen McNeil-Walsh 2010

Authors and Affiliations

  • Colleen McNeil-Walsh

There are no affiliations available

Personalised recommendations