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The day that Cornelius Normeshie decided not to continue working as a doctor for a state hospital in Ghana began again, with disappointment. A mother whose child was just two weeks old complained of headaches and high blood pressure.
But Normeshie could not handle her, he did not have the right equipment. So he called an ambulance to take the woman to another hospital. The driver, however, Normeshie remembers three years later, replied: "We can not come, we have no gas left."
Normeshie made the decision to resign. He says, "Nothing is worse than knowing that you could help the patient, but you simply lack the means and equipment."
Linnéa Kviske
Cornelius Normeshie
Cornelius Normeshie, 31, now works as a medical director for Global Brigades, an international American organization that seeks to counter medical undersupply in Ghana. But next year he also wants to give up this job and leave with his wife and two children his homeland Ghana.
Ghana is considered a model country in sub-Saharan Africa, its democratic structures are stable and economic growth is one of the highest in the region. But Cornelius Normeshie still has enough - and many reasons to go: the frustration of medically poor conditions. The desperation that it means to see people die again and again. Add to that the bad pay, the rampant corruption. And the feeling that the state does not care enough about its citizens does not offer them enough.
About every second doctor in Ghana leaves the country after the training, they see no future for themselves here - although they are so urgently needed. In many places health care collapses all the more.
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The so-called brain drain, the emigration of well-trained minds, affects many countries around the globe - whether emerging or industrialized. But less developed countries are particularly affected by the brain drain of their well-trained professionals.
And the trend is even stronger: The number of doctors trained in Africa, for example, who emigrate to the US, increased by more than 25 percent between 2005 and 2015. If you look only at sub-Saharan Africa, the numbers are even more extreme: migrated in the year 2005, 2014 doctors in the US, it was 10 years later already 8150.
As a result, the World Health Organization (WHO) launched a Code of Conduct in 2010 to prevent medical personnel from migrating. The Code recommends that you refrain from recruiting from certain countries. At the same time, WHO does not want to limit the chance and the right to emigrate, somewhat contradictory.
Linnéa Kviske
Many Ghanaians earn their money on the street, they can hardly afford medical care
The government in Ghana has also been trying for some years to stem the brain drain: more doctors have been trained, salaries raised by doctors, nurses and professors.
However, the measures are obviously not enough. Scientists speak of push and pull factors when describing what motivates emigrants to leave their homes. Above all, the low salary, the high workload and the poor working conditions are the push factors for many, says Joseph Kofi Teye, director of the Center for Migration Studies at the University of Ghana in Accra.
"The workload is high, it's frustrating, there's a lack of equipment, and there are just too many patients per doctor," says Teye. There are 5555 patients in Ghana for a doctor. The WHO recommends a ratio of one to 1,000. In Germany, a doctor does not even care for an average of 250 people. In Ghana, a young doctor earns 4,000 Cedi in the first year after completing his medical studies, about 667 euros - that's the price of a cheap two-room apartment in the city center of Accra.
Linnéa Kviske
Joseph Kofi Teye
At the same time, Ghana has made great strides in recent decades. Meanwhile, the West African state, such as India, Tunisia and Ukraine, is one of the lower-income countries.
But as wealth increases, so does the likelihood that the population will emigrate. According to scientists, the likelihood is highest when countries have gross domestic product of $ 8,000 to $ 13,000 per capita. After that, the probability of migration usually decreases again.
Teye once left Ghana to study in the UK. However, when the university offered him a job in his home country, he returned. "It is important for the government to turn to the diaspora abroad and to make concrete offers to potential returnees," says the professor.
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The doctor Cornelius Normeshie sits in his living room and weighs his four-week-old baby in his arms. The two have only known each other for two days, because Normeshie's son was born in the USA. That was no coincidence, but a conscious decision. Normeshie's wife Ekua flew to the United States before giving birth, giving birth to the baby alone. So it has the US citizenship and can thus live without major problems in the US or many other countries. And that's what his father dreams of.
Normeshie has friends in Munich, Birmingham and Boston. He knows that things will not get easier there. And he also knows that he is considered a doctor in Ghana. "If you're one of the top five percent of your generation, you study medicine, and when you're done, you know you can do it, you're one of the country's smartest minds," says Normeshie. But with this knowledge, the expectations of one's own life also increase.
Almost a third of his former fellow students have already emigrated, estimates Normeshie. And, of course, he knows that his homeland suffers greatly from a shortage of doctors.
Linnéa Kviske
Cornelius Normeshie with his four week old baby
"The question is," he says, "what did Ghana give us, that we should not do it?"
Seth Kofi Abrokwa, 32, is one of those who have already left. He completed his medical studies in Ghana, but then nothing happened. "Like 180 other doctors this year, I was sitting at home because the government had no money to hire us," says Abrokwa. "We wrote letters, gave interviews on the radio and waited for months to finally get a job."
Nothing helped. Abrokwa felt abandoned by his country and applied to universities throughout Germany. A further study is for many the springboard abroad. Abrokwa has now been living in Berlin for more than a year, studying International Health and working as a student assistant at the Robert Bosch Institute. "I do not want to be rich or famous," he says. "I want to do something meaningful with my life and change other lives."
more on the subject
The exodus of skilled workers has negative consequences for countries like Ghana, but there are also positive ones. Because many a migrant returns temporarily or permanently - with new ideas, experiences and knowledge. Authorities try to reinforce such trends. For example, at the end of 2017, the German Development Ministry (BMZ) set up a counseling center in the partner country Ghana to help returnees find jobs or find housing or through loans.
Even Abrokwa has not given up everything in his homeland. South of Accra, he now runs a small chili farm with a few employees. He is currently trying to get friends and acquaintances on board who have studied agriculture, business administration and IT to make a real business out of it. About once a year he flies to Accra himself and looks for the right. "My dream is to return to Ghana one day," says Abrokwa. But then not only as a doctor, but also as an entrepreneur.
This article is part of the project Global Society, for which our reporters report from four continents. The project is long-term and supported by the Bill & Melinda Gates Foundation.
What is the project Global Society?
Under the title Global Society, reporters from Asia, Africa, Latin America and Europe will be reporting on injustices in a globalized world, socio-political challenges and sustainable development. The reportages, analyzes, photo galleries, videos and podcasts appear in the Politics Department of SPIEGEL. The project is long-term and will be supported over three years by the Bill & Melinda Gates Foundation (BMGF).
Are the journalistic contents independent of the foundation?
Yes. The editorial content is created without the influence of the Gates Foundation.
Do other media have similar projects?
Yes. Major European media such as "The Guardian" and "El País" have created similar sections on their news pages with "Global Development" or "Planeta Futuro" with the support of the Gates Foundation.
Was there already similar projects at SPIEGEL ONLINE?
SPIEGEL ONLINE has already implemented two projects in recent years with the European Journalism Center (EJC) and the support of the Bill & Melinda Gates Foundation: The "Expedition The Day After tomorrow" on Global Sustainability Goals and the journalistic refugee project "The New Arrivals" Several award-winning multimedia reports on the topics of migration and escape have emerged.
Where can I find all the publications on the Global Society?
The pieces can be found at SPIEGEL ONLINE on the topic page Global Society.