Travel ban to prevent health worker migration in Guyana: a human rights violation?

Facing with enormous lost of health workers from external migration, the Government of Guyana resorted to a punitive measure to prevent graduating nurses from moving out of the country. Travel ban has been issued so that they "cannot leave the country without permission for the next three years."

The Guyana Human Rights Association came out against this measure. They argue for a more constructive measures that would improve working conditions as well as prevent out-migration. According to the Nursing Association Head, the health system is poorly conducive to the work of these health care staff.


Counter Migration By Effective Policies Not Vindictiveness

Executive Committee
Guyana Human Rights Association
June 2 2007

In a desperate bid to quell the outflow of skilled Guyanese, the Public Service Ministry (PSM) has extended to domestically trained nurses, the clumsy and punitive measures applied to those trained overseas. Participants about to complete a one-year midwifery course taking place at the Nursing School in Georgetown. have been instructed by Ministry of Health personnel to hand in their passports by Monday, June 4 - a week before final exams - to be stamped to the effect they cannot leave the country without permission for the next three years. Students without passports have been instructed to obtain photographs and stamps and complete the application forms.

The Guyana Human Rights Association (GHRA) understands that this new punitive requirement is being applied not only across all the nursing schools in Berbice, Demerara and Linden but across the four main courses being offered in the nursing profession: Nursing Assistants (2 years contracted service), Professional Nursing students (3 years contracted service), Single-trained Midwifery Programme (18 months contractual service) and Post Basic Midwifery.

The GHRA is calling on the PSM to immediately rescind this directive and to replace the unfair, counter-productive and seemingly vindictive policies applied to qualified Guyanese with sensible, fair and evenly-applied incentives for qualified people to remain in Guyana. Moreover, traveling Guyanese already have to contend with the narco-trafficking image the
country has earned for itself, as well as the recent indignity of rapid-testing for the HIV virus. Such stamps in passports are a deterrent to other countries granting visas, they may otherwise approve.

Guyana has the highest brain-drain of any country in the world, around 86% according to reputable international statistics. This constitutes a resounding vote of 'no confidence' in the future of Guyana. Apart from the general factors propelling skilled workers to leave Guyana, Government action towards graduates has much in common with old soviet-style suspicion of any one leaving the country. To obtain permission to attend a conference abroad, for example, requires contracted public servants to lodge a surety of G$2.5mn. In addition, petty bureaucratic procedures are then used to exhaust and frustrate applicants until time runs out. GHRA is aware, for example, of the three scholarships made available for TB/HIV and Prison personnel by PAHO in 2006, only one was taken up, the other two falling victim to the truly Byzantine procedures imposed on public servants. As the migration statistics illustrate, this approach has been a resounding failure.

Expanding the travel ban to domestically trained nurses is the thin-end of the wedge which will undoubtedly be extended to all graduates of tertiary education if the Ministry is allowed to have its way.

The twenty candidates on the midwifery course are contracted "to serve the Government in any appointment for the minimum period of three years".

Furthermore "if a student refused to fail to accept any appointment offered by the Government ., he/she shall immediately become liable to repay the Government the full amount of allowances/salary paid to him/her by the Government during his/her training". Re-imbursing Government for the cost of training should graduates not wish to work in the public sector is a
standard and sensible arrangement. However, the language of the contract and the terms are unnecessarily threatening and onerous. Nor does the contract give any specific cost for expenses incurred. No mention whatever is made of having one's passport stamped.

Moreover, the cost of local training should take into account the comments made by Head of the Nursing Association, Marva Hawker in May 2006 to the effect that Guyanese nurses still function on a daily basis with antiquated equipment: "simple equipment like the thermometer has not been updated. We still have to flick the old types to get the mercury down". In other words, there has been no significant investment in midwifery training equipment which needs to be re-covered.

Migration rates among trained nurses in recent years are probably the highest of any profession, imposing great hardship on those who have remained. The GHRA understands that the twenty nurses about to qualify as midwives have between three and 16 years services as trained nurses behind them. In other words, to date they have resisted the attractions of working abroad. However, none of this cuts any ice with the bureaucrats and politicians. Rather than provide incentives so that they continue to see Guyana as a place to build their future, the PSM seems bent on driving them to join their colleagues abroad.

Short-sighted vindictive measures are not a substitute for policies which respect the rights of citizens to freedom of movement. Addressing a Conference in Jamaica last month, Dr. Eddie Greene, Asst. General-Secretary of CARICOM commenting on mass migration of Caribbean professionals noted that 50,000 nurses had migrated over the past ten years. Dr. Greene also
referred to the fact that the Council on Human and Social Development (COHSOD) had called for an overall policy of managed migration and noted that the matter would be discussed at the historic Conference on the Caribbean taking place in Washington on June 19-21 2007. He said it will focus particularly on the medical and health specializations.

The government of Guyana should take advantage of the Washington Conference to promote policies focused on the recipient countries paying the economic cost of training professionals who migrate there. Stamping restrictions in passports is a lazy and crude substitute for addressing the causes of the migration problem.