Co-chair of the global commission on international migration and chair of global capital ventures, Ramphele says leaders should demonstrate that they take their people seriously or risk losing the best of them to countries where they will be more appreciated. She points out that outward migration of people is a facet of globalisation all over the world in which people migrate to places that have dynamic development, demographic patterns that show high levels of skills, entrepreneurship and energy and to places that have consolidated democracy.
“People don’t migrate to autocracies,” she says. Africa, notwithstanding the positive momentum generated by NEPAD and other reform initiatives, still has negative dynamic processes generating severe underdevelopment. “We have young, uneducated and unwell populations. We have democratic deficits and unless we do something about retaining those we train and creating a positive climate for people with skills who can feel that Africa is a place they want to be, we are going to be left behind.”
Taking nursing in South Africa as a typical example, Ramphele says nurses in that country are highly skilled, undergo lengthy training and work hard, and yet they are not valued by the society they serve.
“The UK, US, Canada and Australia, on the other hand, appreciate that without properly qualified nurses they can’t run their health sectors. Accordingly they focus on recruiting and retaining nurses from a global pool. They reward them appropriately in terms of salary and conditions, and they thoroughly out-compete us. So women leave their homes in Africa and migrate to foreign countries not because they don’t want to live in Africa, but because they are tired of being the handmaidens who are not adequately appreciated.”
The world is becoming more integrated, she says, and the human mobility game is as old as the human race.
“People have always moved around, but today there’s a significant increase in such movement in terms of numbers. Over the last 25 years, numbers of migrants have doubled to the current levels of around 200 million people living outside their country of origin.”
She maintains that the sheer size of the number of migrating people holds dire lessons for Africa’s leaders and they should take heed of what such a phenomenon is saying.
“It is part of who we are as people to always move in search of greener pastures. Which is why, in this increasingly interconnected world, you’d better guard over your human and intellectual capital base because, if you don’t, they can easily move to where they are better appreciated and rewarded.”
Ramphele maintains that human mobility is a facet of globalisation and it benefits those who are better positioned to compete for skills in the global economy. “Take India,” she says by way of example, “it invested heavily in the 50s, 60s, 70s and 80s in institutes of technology. In the 1990s, the US found itself with a techno-skills shortage and so it imported, via the H2 visa, people to drive their technology revolution in Silicon Valley. What’s happened to those people? Many, if not most, have gone back to India where they are creating huge wealth by nurturing India’s outsourcing industry which is a big winner.
“You don’t see this reverse migration happening in Africa. Why? It is because people are waiting for opportunities to develop here. We’ve had freedom in South Africa for 11 years and people have come in, but more have left. Some of those who have wanted to come back have discovered the country has monopolistic regulations with regard to information technology. Our connectivity costs are amongst the highest in the world and bandwidth is inadequate. We’re shooting ourselves in the foot.”
RAMPHELE insists that Africa’s leaders need to be more strategic and appreciate that their people have value not just in their home countries, but also in the rest of the world.
“Like a company, you protect your market,” she says. “You don’t lose it to others. You must nurture your people and create a vision to keep them at home. And day-to-day life must match that vision.
“South Africa has a great vision of being democratic, non-sexist, non-racial. But, at the same time, we have more violence, more domestic abuse and violence against women and children today than we had prior to 1994. There is a big gap between this vision and the practice on the ground because of a failure to educate people about democracy and inculcate the values embedded in our constitution.”
She maintains that South Africa needs a transformative agenda that is not only educational, but also in the way it aligns the social and political ideal with the everyday reality of everyday people. The dichotomy is that South Africa has a law enforcement system where violence against women and children is something law enforcers know they have to deal with because that’s what they are paid to do, but feel inadequately resourced to deal with it.
“But right now, our policemen still feel unappreciated. They’re also under-paid and under-resourced. And so you can have all the wonderful human rights policies that you like, but if you don’t actually create an environment where those policies can be implemented, monitored, evaluated and acted upon where there are gaps, you really should go back and look at what can you do better.”
Ramphele disagrees strongly that, especially South Africa, cannot afford to pay its nurses, teachers and policemen better salaries and offer better conditions. “We can afford to pay municipal managers enormous salaries, some get a million rands a year and more, and they’re not creating even a hundredth of the value of a teacher, or a nurse or a policeman,” she says. “In this regard this country has its priorities completely upside down. We have not prioritised the social sector or regarded them as an important investment in human and intellectual capital. We pay some people over-inflated salaries.
“Parliamentarians are paid huge amounts compared to our critically-needed nurses, policemen and teachers, and we still expect to have well-functioning schools and health systems. We can’t. It’s not a matter of money, it’s a matter of priorities. It’s also about conditions of service. And it’s about respect. This year’s intake of medical student interns is a good example. By the beginning of November, those students were still waiting for their internship allocations. Do you think those skilled people are going to work beyond the minimum required time? They’ll be gone as soon as they’ve qualified – because they have been treated with less than the respect they deserve.”
Ramphele maintains that Africa still has a long way to go in learning how to manage itself in the 21st century.
“Running a country today is like running a business. If you don’t husband your human resources, harness and retain them you will lose them to the competition, and the global competition is fierce.”
Ramphele also blames a pervasive apathy by the African public to the plight of such civil servants. “We as citizens of Africa have failed in our stewardship, to the extent that we do not agitate for such changes that would improve the quality of our democracy. We get the leaders we deserve.”
Ramphele believes that prevailing remuneration and conditions of service for nursing sisters in the private medical industry sector is also facing challenges, as it is in government healthcare sectors.
“The private health sector is, of course, profit-driven and will pay only what it has to, but that’s a short-term view. Unfortunately, many private sector healthcare companies in this and other parts of the world take the short-term rather than the longer term view. If these nurses were to migrate, as many of them already are, then the cost of training new nursing sisters, providing the experience and then getting them up and running, is much more than paying them a decent salary over their careers.”
A doctor in a large practice in Johannesburg’s northern suburbs says margins in the healthcare sector are too tight to pay their nursing staff as much as they like to.
“Doctors also have to be businesspeople these days,” she says. “The financial medical care pie is being cut into ever smaller pieces as healthcare assumes corporate proportions, especially in the medical aid industry and all the administrative fees that consumes. But we don’t have a problem in hiring nursing sisters. The second we advertise, we have hundreds of qualified applicants who’d like to get out of the government health service, and also because we pay better than the government and offer more conducive working conditions.”
Ramphele, however, fears that nurses worldwide in the private sector are paid what they are because they are women, and because “there is a view that they are not as highly valued as doctors and technicians”.
She says effecting change is not about storming barricades.
“As a citizen, you set about such things in a dignified manner. It’s like being a shareholder in a company. You don’t storm the CEO’s office. You go to shareholders’ meeting and demand explanations. With the government you don’t have to wait for elections to voice your disapproval. There are other opportunities to make yourself heard – through the media, through various business associations and civic forums.”
She believes, however, that Africa’s business leaders could be doing more in confronting such transformation issues. “And this is because, in many cases, they themselves are not the transformative leaders that they should be. If corporate heads, given their leverage over the workplace and business processes in this continent, were exemplary as transformative leaders, then the politicians would respond more positively.”
Ramphele’s work with the Global Commission on International migration, and her commitment to social and human development, place her in a particularly influential position to challenge Africa’s status quo on social development issues.
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