Dystopia and Disengagement: Diaspora Attitudes Towards South Africa

the southern african migration programme

Dystopia anD Disengagement: Diaspora attituDes towarDs south africa

migration policy series no. 63 Dystopia anD Disengagement: Diaspora attituDes towarDs south africa

Jonathan crush

series eDitor: prof. Jonathan crush

southern african migration programme (samp) 2012 acknowleDgements The author is CIGI Chair in Global Migration and Development at the Balsillie School of International Affairs and Honorary Professor at the University of Cape Town. He wishes to thank the following for their assistance with the survey on which this report is based: Abel Chikanda, Mary Caesar, Wade Pendleton, Cassan- dra Eberhardt and Ashley Hill. The research was funded by the IDRC.

Printed by Megadigital, Cape Town contents page executive summary 1 introDuction 4 moving to canaDa 7 the kaplan view 12 conclusion 19 enDnotes 21 migration policy series 22

list of tables table 1: annual income of canaDian population anD 9 south african immigrants in canaDa table 2: assets in south africa by year of immigration to canaDa 11 table 3: cultural practices of south african canaDians 11 table 4: comparisons of canaDa anD south africa 12

list of figures figure 1: cartoon commentary on the huntley case 6 figure 2: immigration to canaDa from south africa, 1980–2009 8 MMIGRATIONigration PPOLICYolicy SERIESerieS NnOo. 4563

eExecutiveXECUTIVE sSummaryUMMARY

n 2008, Southealth workers African are Brandon one of Huntleythe categories was given of skilled refugee profession- status in ICanada byals the most Canadian affected Immigrationby globalization. and Over Refugee the Boardpast decade, (IRB). The unprecedentedthere decision, has emerged based a on substantial Huntley’s body claim of thatresearch as a thatwhite tracks South HAfrican he patternswas the ofvictim international of racial persecutionmigration of in health South personnel, Africa, caused aassesses firestorm. causes Interest and consequences, in the case was and particularly debates policy intense responses in South at globalAfrica itselfand national where the scales. decision Within was thisderided literature, in the themedia case and of Souththe South Africa African is governmentattracting growing lodged interest.a formal Forprotest almost with 15 the years Canadian South Africagovernment. has been Over 140the targethigh-profile of a ‘global South raiding’ African of academics skilled professionals also filed a by petition several protesting devel- theoped decision countries. with How the to Canadian deal with Highthe consequences Commission of in the Pretoria. resultant Within out- weeks,flow of thehealth Canadian professionals Minister is aof core Citizenship policy issue and forImmigration the national had gov- lodged anernment. appeal against the IRB decision with the Federal Court of Appeal. Some haveThis claimed paper thataims the to todecision examine of policythe Canadian debates andGovernment issues concerning to seek to overturnthe migration the decisionof skilled of health the IRB professionals was motivated from the by acountry desire and to appease to Southfurnish Africa. new insights This is on highly the recruitmentunlikely. Rather patterns, the of Canadian skilled health government per- wassonnel. concerned The objectives about the of precedent-settingthe paper are twofold: nature of the case and that it couldQ set +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H the stage for a flood of applications from similarly unskilled white South Africansment of seeking skilled professionalsa route into Canada. from South Africa in the health In latesector. 2010, The Justice paper James draws Russell upon of a thedetailed Federal analysis Court ofof recruitmentAppeal issued an extendedadvertising judgment appearing upholding in the theSouth Canadian African Medical government’s Journal appeal for and sendingthe period the Huntley 2000-2004 case and back a seriesto the of IRB interviews for reconsideration. conducted with The Supremeprivate Court recruitingof Canada enterprises. declined to hear an appeal of this judgment in mid-2012,Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< so the case will be got back to the IRB. Huntley’s lawyers are confidentkey of stakeholders a second success in the atSouth the African IRB, indicating health sector, that the the attentionpaper given tooffers his case a series will ofmake recommendations him a marked manfor addressing if he is returned the problem to South of Africa. However,skilled health Justice migration. Russell These provided recommendations a systematic and are painstakinggrounded demolitionin both of virtually South Africanevery element experience of the and original an interrogation IRB decision of inter-and it seems highlynational unlikely debates that and Huntley ‘good will policy’ ever practice be able tofor prove regulating that he recruit- quali- fies for refugeement. protection status in Canada. The case may still drag on for severalThe morepaper years, is organized however, into as five Huntley sections. would Section be entitled Two positions to institute a seconddebates round about ofthe appeals migration in the of courtsskilled if health his claim professionals is rejected within this time. a widerIn constructingliterature that a discussesnarrative theto convince international IRB judgemobility William of talent. Davis that heSection qualified Three for reviews protection research under on the the UN global Refugee circulation Convention, of health Huntley pro- andfessionals, his lawyers focusing attempted in particular to show upon that debates he had relatingbeen the to victim the experience of a series ofof countries racially-motivated in the developing personal world. assaults Section and that Four the moves state the had focus failed from in itsinternational duty to protect. to South None African of these issues supposed and provides attacks new were empirical ever reported mate- torial the drawn police from which the survey proved of rather recruitment awkward patterns for his and case. key However,interviews this wasundertaken explained with away health with sector the circular recruiters argument operating that in sinceSouth the Africa. police did nothingSection whenFive addresses whites were the questionsattacked, ofthere changing was no policy point interventions in reporting thein assaults.South Africa Huntley’s towards recounting the outflow of his of experiencesskilled health make professionals interesting and reading the butrecruitment they were of not, foreign in fact, health central professionals to the Davis to work decision. in South Africa. The

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EXECUTIVE SUMMARY Here we focus on what Davis called the “lifeline” of the Huntley decision: that is, the case made by Huntley’s lawyer, Russell Kaplan and his ealth workers are one of the categories of skilled profession- sister Lara Kaplan, that all whites in South Africa are being systematically als most affected by globalization. Over the past decade, targeted because of the colour of their skin. Justice Russell rejected this there has emerged a substantial body of research that tracks argument, and the selective evidence presented by the Kaplans, in its patterns of international migration of health personnel, entirety. He designated their portrayal of the situation in South Africa the H “Kaplan view.” The core elements of the Kaplan view included assertions assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is that all Black South Africans hated white South Africans; that the country attracting growing interest. For almost 15 years South Africa has been was experiencing “reverse apartheid; that black South Africans have “no the target of a ‘global raiding’ of skilled professionals by several devel- regard” for the lives of white South Africans; that most violent crimes are oped countries. How to deal with the consequences of the resultant out- committed by black against white South Africans; that the police will do flow of health professionals is a core policy issue for the national gov- nothing about the crimes committed against white South Africans; that ernment. white South Africans are undergoing a form of racial genocide; and that This paper aims to to examine policy debates and issues concerning there is systematic discrimination against whites in the workplace. Justice the migration of skilled health professionals from the country and to Russell concluded that the Kaplan view was rooted in the personal experi- furnish new insights on the recruitment patterns of skilled health per- ence of violent crime by the Kaplan family itself in South Africa. sonnel. The objectives of the paper are twofold: This paper argues that to attribute the Kaplan view purely to the nega- Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H tive personal experiences of the Kaplan family in South Africa is to take ment of skilled professionals from South Africa in the health too narrow an interpretation. The central elements of the Kaplan view are sector. The paper draws upon a detailed analysis of recruitment not unique to the Kaplan family but are produced and reproduced by the advertising appearing in the South African Medical Journal for white South African diaspora in Canada more generally. The evidence for the period 2000-2004 and a series of interviews conducted with this assertion comes from a survey of 1,485 South African immigrants in private recruiting enterprises. Canada conducted by SAMP in 2010, some 80% of whom had left South Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< Africa after 1990. key stakeholders in the South African health sector, the paper Between 1991 and 2006, just over 19,000 South Africans moved to offers a series of recommendations for addressing the problem of Canada, a migration that shows few signs of letting up. Most South African skilled health migration. These recommendations are grounded immigrants to Canada are white, highly skilled and educated with many in both South African experience and an interrogation of inter- professionals in their ranks. They enter Canada as permanent residents in national debates and ‘good policy’ practice for regulating recruit- the economic class. South Africans in Canada are high income earners. ment. For example, 26% of the survey respondents earn more than $200,000 a The paper is organized into five sections. Section Two positions year and 43% earn more than $100,000 (compared with only 6% of the debates about the migration of skilled health professionals within a overall Canadian population.) wider literature that discusses the international mobility of talent. The survey respondents reported visiting South Africa relatively often Section Three reviews research on the global circulation of health pro- (only 18% had never been back since arriving in Canada) although only fessionals, focusing in particular upon debates relating to the experience 20% return at least once a year. The rest make episodic visits and the vast of countries in the developing world. Section Four moves the focus from majority of all visits are connected with family issues and events. Most international to South African issues and provides new empirical mate- have family in South Africa to visit. Half of the respondents (54%) have rial drawn from the survey of recruitment patterns and key interviews taken out Canadian citizenship and another 30% are permanent residents. undertaken with health sector recruiters operating in South Africa. South Africans in Canada are neither large nor frequent remitters. Forty- Section Five addresses the questions of changing policy interventions in two percent had never remitted funds to South Africa and only 13% do so South Africa towards the outflow of skilled health professionals and the on a monthly basis. Patterns of asset holding in South Africa show system- recruitment of foreign health professionals to work in South Africa. The atic disinvestment over time. Allied to this pattern of disinvestment are low levels of interest in return migration to South Africa.

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EXECUTIVETheSUMMARY survey also collected information about the attitudes and perceptions of this group towards their country of origin. The dystopian views advanced byealth the Kaplanworkers view are onein the of Huntleythe categories case fit of comfortably skilled profession- within a broader narrativeals most about affected South by Africa globalization. by white Over South the Africans past decade, in Canada. A considerablethere number has emerged of survey a substantial respondents body portrayed of research South that Africa tracks as an extremelypatterns violent of society international in which migration whites liveof health in a constantpersonnel, state of Hfear and anxiety. Many argued that whites were targeted not because they assesses causes and consequences, and debates policy responses at global ownand nationala disproportionate scales. Within share thisof the literature, wealth in the a highlycase of unequal South Africa society, is but simplyattracting because growing of their interest. colour. For The almost idea 15that years the whiteSouth population Africa has isbeen under siegethe target because of aof ‘global their skin raiding’ colour of extendsskilled professionals well beyond bypersonal several knowledge devel- ofoped incidents countries. of crime How and to deal violence. with theThe consequences theme of racial of targetingthe resultant was drivout-- enflow home of health by the professionals frequent use is ofa coreterms policy such issueas “apartheid for the national in reverse” gov- and “reverseernment. discrimination.” Attacks on white farmers feature prominently in the Thisnarratives paper andaims are to toused examine as a platform policy debatesfor broader and commentaryissues concerning on the supposedthe migration brutality of skilled of Africa health and professionals all Africans. fromPersonal the countryand hearsay and tostories offurnish violent new crime insights were on laced the withrecruitment vituperative patterns accounts of skilled of the health callous per- and indifferentsonnel. The response objectives of the of thepolice paper and are the twofold: government. AnotherQ +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H recurrent complaint was how affirmative action discriminated against whites.ment of There skilled is professionals no sympathy from for or South understanding Africa in theof thehealth reasons for thesesector. policies The nor paper of how draws they upon personally a detailed might analysis have benefitedof recruitment educationally advertisingand economically appearing from in the the racist South policies African of theMedical apartheid Journal govern for - ment. Instead,the period they 2000-2004 represent themselves, and a series and of interviewswhites in general, conducted as victims. with In manyprivate cases, therecruiting sense of enterprises. outrage spills over into overtly racist diatribes aboutQ Africa 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< and Africans. To rationalisekey stakeholders their departure, in the South disengagement African health and sector, decision the neverpaper to return tooffers South a series Africa, of recommendations this post-apartheid for diaspora addressing draws the onproblem the same of narrativeskilled reservoir health of images migration. as the These lawyers recommendations in the Huntley case. are grounded It is therefore inadequatein both South to conclude African that experience the Huntley and an case interrogation was simply of a inter- rather egregiousnational but exceptional debates and miscarriage ‘good policy’ of justice. practice Huntley for regulating is, in many recruit- ways, emblematicment. of a more general and troubling discourse about South Africa thatThe circulates paper isamongst organized white into South five sections. Africans Sectionin Canada. Two positions debates about the migration of skilled health professionals within a wider literature that discusses the international mobility of talent. Section Three reviews research on the global circulation of health professionals, focusing in particular upon debates relating to the experience of countries in the developing world. Section Four moves the focus from international to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the recruitment of foreign health professionals to work in South Africa. The

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EXECUTIVE SUMMARY introDuction ealth workers are one of the categories of skilled profession- n mid-2004, South African Brandon Huntley entered Canada on a als most affected by globalization. Over the past decade, Itemporary residence permit in order to work as an amusement park there has emerged a substantial body of research that tracks attendant, having worked in Cape Town as a bartender, cleaner, parking Hpatterns of international migration of health personnel, lot attendant and lawn sprinkler salesman.1 He returned to South Africa assesses causes and consequences, and debates policy responses at global at the end of 2004 when his permit expired. In June 2005, he came to and national scales. Within this literature, the case of South Africa is Canada for a second time and worked for another 18 months with the attracting growing interest. For almost 15 years South Africa has been same company. After the expiry of this work permit at the end of 2007, he the target of a ‘global raiding’ of skilled professionals by several devel- remained in Canada illegally. He married (and later divorced) a Canadian oped countries. How to deal with the consequences of the resultant out- and unsuccessfully tried to enlist in the Canadian armed forces. Finally, in flow of health professionals is a core policy issue for the national gov- June 2008, more than a year after his work permit had expired, Huntley ernment. lodged an application for political asylum in Canada with the Immigration This paper aims to to examine policy debates and issues concerning and Refugee Board (IRB). In August 2008, he appeared before IRB judge, the migration of skilled health professionals from the country and to retired lawyer William Davis, along with his South African-born Toronto furnish new insights on the recruitment patterns of skilled health per- lawyer Russell Kaplan. Kaplan’s sister, Lara, appeared as a corroborating sonnel. The objectives of the paper are twofold: witness for Huntley. Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H Huntley, a former resident of the Cape Town suburb of Mowbray, ment of skilled professionals from South Africa in the health claimed to have been physically attacked a number of times since 1991. sector. The paper draws upon a detailed analysis of recruitment He claimed all these attacks were racially motivated, because his attack- advertising appearing in the South African Medical Journal for ers used derogatory racist epithets including “settler”, “Boer” and “white the period 2000-2004 and a series of interviews conducted with fuck.” Huntley had not reported any of the incidents to the police, arguing private recruiting enterprises. that the police were incompetent and racist and would do nothing when Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< a white person was attacked. The state’s supposed “failure to protect” key stakeholders in the South African health sector, the paper meant that he had a legitimate claim to refugee status in Canada. William offers a series of recommendations for addressing the problem of Davis concluded that “the evidence of the claimant and the witness and skilled health migration. These recommendations are grounded the documentary evidence shows a picture of indifference and inability in both South African experience and an interrogation of inter- or unwillingness of the government and the security forces to protect national debates and ‘good policy’ practice for regulating recruit- White South Africans from persecution by African South Africans.”2 ment. Huntley was “a victim because of his race (white South African) rather The paper is organized into five sections. Section Two positions than a victim of criminality” and his fear of persecution was real. Davis debates about the migration of skilled health professionals within a concluded, in a statement that was widely derided, that Huntley “would wider literature that discusses the international mobility of talent. stand out like a ‘sore thumb’ due to his colour in any part of the country.”3 Section Three reviews research on the global circulation of health pro- Davis’s extraordinary decision to grant Huntley refugee status in Canada fessionals, focusing in particular upon debates relating to the experience unleashed a firestorm of media attention, political protest and commentary of countries in the developing world. Section Four moves the focus from in the blogosphere.4 international to South African issues and provides new empirical mate- The Huntley decision was widely condemned and ridiculed in both rial drawn from the survey of recruitment patterns and key interviews Canada and South Africa (see Figure 1). In September 2009, 142 South undertaken with health sector recruiters operating in South Africa. African academics, including several university vice-chancellors and Section Five addresses the questions of changing policy interventions in deputy vice-chancellors, petitioned the Canadian High Commissioner in South Africa towards the outflow of skilled health professionals and the South Africa.5 The petition criticised the “outrageously distorted represen- recruitment of foreign health professionals to work in South Africa. The tation” of contemporary South Africa and suggested “the sad truth is that this case demonstrates not the perilous condition of white South Africans,

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EXECUTIVEbut theSUMMARY kinds of things some people are still willing to believe about Africa and Africans, based on assumptions that continue to circulate in the white worlds they ealthshare.” workers The Southare one African of the governmentcategories of initiallyskilled profession-accused the Canadian governmentals most affected of racism by globalization. until it was informed Over the that past thedecade, IRB is an independentthere body has and emerged that the aFederal substantial Government body of researchis not accountable that tracks for IRB decisionspatterns about ofrefugee international protection. migration The South of health Africans personnel, then lodged Han official complaint about the IRB decision through diplomatic channels. assesses causes and consequences, and debates policy responses at global andWithin national weeks scales. of Within the decision, this literature, Canadian the Immigration case of South Minister Africa Jasonis Kenneyattracting applied growing to theinterest. Federal For Court almost of 15 Appeal years Southfor a reviewAfrica ofhas the been decision.the target South of Africana ‘global Foreign raiding’ Affairsof skilled Minister professionals Nkosazana by several Dlamini-Zuma devel- claimedoped countries. that the How Canadian to deal government’s with the consequences decision to ofappeal the resultantthe IRB deciout-- sionflow “bearsof health testimony professionals to the is stronga core policy bilateral issue political for the relations national betweengov- ourernment. two countries.” 6 Conservative commentators sympathetic to Huntley sawThis this paperrather aimsas evidence to to examine of Canada policy bowing debates to politicaland issues correctness concerning and appeasementthe migration of of the skilled South health African professionals government. from However, the country It seems and tohighly unlikelyfurnish newthat insightsthe Canadian on the government’srecruitment patterns action had of skilled anything health to do per- with Southsonnel. African The objectives pressure asof the Harperpaper are government twofold: has consistently shown littleQ interest +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H in courting South Africa on any issue at all. What seems more likelyment is ofthat skilled the governmentprofessionals viewed from South the IRB Africa decision in the as health a danger- ous precedentsector. thatThe neededpaper draws to be upon contested. a detailed If allowed analysis to of stand, recruitment it would potentiallyadvertising have opened appearing the door in the to Southan unwanted African flood Medical of refugee Journal claims for from whitethe Southperiod Africans 2000-2004 like and Huntley. a series of interviews conducted with On 24private November recruiting 2010, enterprises. Justice James Russell of the Federal Court of AppealQ 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H

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Figure 1: Cartoon Commentary on the Huntley Case

For some, the Huntley case confirms the “dysfunctional nature” of the refugee protection system in Canada.12 Four years after first lodging what most legal commentators would probably see as a “manifestly unfounded” refugee claim and nine years after he first came to Canada on a temporary work permit, Huntley remains in the country. There seems little prospect of a speedy deportation, the kind of protracted outcome which partially explains, though hardly justifies, the single-minded determination of the Canadian government to impose draconian restrictions on would-be refugee claimants entering Canada.13 Ironically, the South African refugee protection system (modelled to some degree on the Canadian and similar examples) has the opposite problem: that is, a widespread failure to protect the rights of asylum seekers who are deported to other countries in their tens of thousands every year with a minimum of due process.14 Another important aspect of the case concerns the nature of the argument advanced in support of Huntley’s claim to be a “white refugee.” While the hearing took place in camera, there is sufficient documentation in the public domain (especially in the form of the IRB judge’s justification for his decision to grant refugee status and the court documents from the subsequent Federal Court appeal) to permit a fairly detailed reconstruction of the legal strategy adopted by Huntley’s lawyer Russell Kaplan and the arguments advanced in support of the claim. Here, we must distinguish between the actual details and merits of Huntley’s claim for refugee status (which are detailed in Justice Russell’s judgment and are therefore not discussed any further here) and the general narrative about South Africa constructed by Russell and Lara Kaplan, which Justice Russell at different times labelled “the Kaplan view”, “the Kaplan family view” and the “Kaplan family point of view.”

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EXECUTIVEThisSUMMARY report first examines the key elements of the “Kaplan view,” which Davis of the IRB had described as the “lifeline” of the Huntley case.15 Justice Russellealth saw workers the Kaplan are one view of asthe emanating categories from of skilled the personal profession- expe- riences and alsemotional most affected involvement by globalization. of Russell Overand Lara the pastKaplan decade, including “the fate of histhere brother has emerged (in South a substantialAfrica) and body the close-knit, of research mutually-sup that tracks - portive naturepatterns of the of Kaplan international family.” 16migration Less charitably, of health he personnel,noted that Lara HKaplan’s testimony was “little more than a personal view propagated from assesses causes and consequences, and debates policy responses at global withinand national a prosperous scales. andWithin successful this literature, white South the caseAfrican of South family Africa that, sinceis theattracting end of apartheid,growing interest. finds the For ‘good almost life’ 15they years lived South before Africa 1994 hasnot beenas good asthe it targetwas.”17 of However, a ‘global theraiding’ Kaplan of skilledview cannot professionals be adequately by several understood devel- if itoped is viewed countries. purely How through to deal the with lens theof the consequences Kaplan family’s of the own resultant experiences. out- Rather,flow of healthit is necessary professionals to situate is a core the policy Kaplan issue view for within the national the context gov- of theernment. broader post-apartheid emigration movement of white South Africans to Canada.This paper The aims key to argument to examine here policy is that debates the Kaplan and issues representation concerning of Souththe migration Africa as of dystopia skilled healthis completely professionals consistent from with the countrya broader and narrative to aboutfurnish the new country insights that on circulates the recruitment within thepatterns post-apartheid of skilled Southhealth African per- diasporasonnel. The in Canada objectives and of beyond. the paper The are evidence twofold: for this assertion is to be foundQ in +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H a recent survey of the attitudes of ex-South Africans in Canada conductedment by ofSAMP. skilled professionals from South Africa in the health sector. The paper draws upon a detailed analysis of recruitment moving to cadvertisinganaDa appearing in the South African Medical Journal for the period 2000-2004 and a series of interviews conducted with ne privateof the major recruiting continuities enterprises. in South Africa-Canada relations before OQand 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< after the end of apartheid is the flow of human resources from one to key the stakeholders other. Before in 1990, the South Canada African was health one (albeit sector, comparatively the paper minor) offers international a series of refuge recommendations for opponents for of addressing the apartheid the problem regime andof white liberalsskilled who health were migration. deeply pessimistic These recommendations about the country’s are future.grounded The end of apartheidin both South accelerated African the experience flow of South and an Africans interrogation to Canada, of inter- and fundamentallynational changed debates the and profile ‘good ofpolicy’ the immigrants practice for (Figure regulating 2). Between recruit- 1991 andment. 2006, just over 19,000 South Africans moved to Canada, bring- ing The the paper total numberis organized to 40,000.into five Since sections. then, Section between Two 1,200 positions and 1,400 Southdebates Africans about the have migration immigrated of skilled to Canada health each professionals year, raising within the aoverall totalwider nearer literature to 50,000. that discusses This steady the international movement shows mobility few of signs talent. of letting up.Section Russell Three and reviews Lara Kaplan research were on bornthe global and raisedcirculation in South of health Africa pro- and immigratedfessionals, focusing legally to in Canada particular as adults, upon debatesthough relatingat different to thetimes. experience Brandon Huntleyof countries did innot. the He developing was one ofworld. a small Section number Four of moves South the Africans focus from(less thaninternational 2,000 in to2010) South who African migrate issues temporarily and provides to Canada new empirical for work mate- under therial country’sdrawn from rapidly-growing the survey of Temporaryrecruitment Foreign patterns Worker and key Program. interviews18 undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the recruitment of foreign health professionals to work in South Africa. The

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EXECUTIVE SUMMARY Figure 2: Immigration to Canada from South Africa, 1980-2009 3 500 ealth workers are one of the categories of skilled professionals most affected by globalization. Over the past decade, 3 000 there has emerged a substantial body of research that tracks patterns of international migration of health personnel, H 2 500 assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is attracting growing interest. For almost 15 years South Africa has been 2 000 the target of a ‘global raiding’ of skilled professionals by several devel- oped countries. How to deal with the consequences of the resultant out- 1 500 flow of health professionals is a core policy issue for the national government. 1 000 This paper aims to to examine policy debates and issues concerning the migration of skilled health professionals from the country and to 500 furnish new insights on the recruitment patterns of skilled health personnel. The objectives of the paper are twofold: 0 Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H ment of skilled professionals from South Africa in the health 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 sector. The paper draws upon a detailed analysis of recruitment advertising appearing in the South African Medical Journal for Most South African immigrants to Canada are highly skilled and the period 2000-2004 and a series of interviews conducted with educated with a disproportionate number of professionals in their ranks. private recruiting enterprises. They enter Canada as permanent residents in the economic class, filling Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< skills gaps in the Canadian labour market. The post-apartheid migration key stakeholders in the South African health sector, the paper of professionals and other skilled workers from South Africa to the United offers a series of recommendations for addressing the problem of Kingdom, the United States, Australia, New Zealand and Canada is com- skilled health migration. These recommendations are grounded monly viewed as a “brain drain” with negative impacts for South Africa.19 in both South African experience and an interrogation of inter- In 2009, South Africa’s High Commissioner to Canada, Dr Abraham national debates and ‘good policy’ practice for regulating recruit- Nkomo, complained publicly that South African doctors migrate “at a very ment. high cost” to South Africa causing “a huge loss” of investment in education The paper is organized into five sections. Section Two positions and training.20 Repeated efforts by the South African government to get debates about the migration of skilled health professionals within a Canada to place a moratorium on the hiring (or poaching, in its words) of wider literature that discusses the international mobility of talent. South African skills have met with little success.21 Section Three reviews research on the global circulation of health pro- A more detailed economic and social profile of the South African fessionals, focusing in particular upon debates relating to the experience diaspora in Canada emerges in an online survey conducted in 2010 by of countries in the developing world. Section Four moves the focus from SAMP.22 The survey was completed by 1,485 respondents. Of these, 83% international to South African issues and provides new empirical mate- had emigrated to Canada after 1990. The survey provided an opportunity rial drawn from the survey of recruitment patterns and key interviews for respondents to elaborate in writing on issues such as why they left undertaken with health sector recruiters operating in South Africa. South Africa, why they came to Canada, what links they maintained with Section Five addresses the questions of changing policy interventions in South Africa and whether they would ever return to South Africa. A total South Africa towards the outflow of skilled health professionals and the of 638 respondents chose to share their views on these issues, some at recruitment of foreign health professionals to work in South Africa. The considerable length. The majority (59%) of the respondents immigrated to Canada under

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EXECUTIVEthe economicSUMMARY class of entry. Another 11% entered under the family spon- sorship class, 4% to study and 4% in the provincial nominee class. None had been admittedealth workers as asylum are oneseekers of the or categoriesrefugees. Only of skilled 6% of profession- those com- pleting the als survey most were affected temporary by globalization. workers (Huntley’s Over the past means decade, of entry). The respondentsthere arehas aemerged highly educated a substantial group: body 56% of had research obtained that a trackstertiary education qualificationpatterns of international in South Africa migration and another of health 21% personnel, a technical or Hvocational diploma or certificate. Some 28% also had a professional quali- assesses causes and consequences, and debates policy responses at global fication.and national Forty-three scales. percentWithin thishad continuedliterature, thetheir case education of South outside Africa South is Africa.attracting South growing Africans interest. in Canada For almost are high15 years income South earners Africa compared has been to thethe target overall of Canadian a ‘global raiding’ population of skilled (Table professionals 1). For example, by several 26% devel- of South Africanoped countries. respondents How whoto deal immigrated with the consequences to Canada after of the 1990 resultant earn moreout- thanflow of$200,000 health professionalsa year (compared is a core with policy only 1%issue of forthe the overall national population.) gov- Orernment. again, 43% earn more than $100,000 compared with 6% of the overall population.This paper At aims the otherto to examine end of the policy spectrum, debates only and 14%issues earn concerning less than $25,000the migration a year, of compared skilled health with 44%professionals of the local from population. the country and to furnish new insights on the recruitment patterns of skilled health per- Table 1: Annualsonnel. Income The of objectives Canadian Populationof the paper and areSouth twofold: African Immigrants in Canada Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=HCanadian population South Africans in Canada Less than $25,000 ment of skilled professionals44.1 from South Africa in14.4 the health $26,000 – $50,000 sector. The paper draws29.2 upon a detailed analysis of19.6 recruitment $51,000 – $75,000 advertising appearing 15.2in the South African Medical12.4 Journal for $76,000 – $100,000 the period 2000-2004 and5.7 a series of interviews conducted10.8 with $101,000 – $200,000private recruiting enterprises.4.7 16.6 More than $200,000Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H<1.0 26.2 Source: Statistics Canada,key SAMP stakeholders Survey in the South African health sector, the paper offers a series of recommendations for addressing the problem of A greatskilled deal health of international migration. These attention recommendations is currently focusedare grounded on the role andin potential both South of African African diasporas experience as agentsand an ofinterrogation development of in inter- their countriesnational of origin. debates23 This and phenomenon ‘good policy’ – known practice as diasporafor regulating engagement recruit- – rests uponment. close personal, professional and economic linkages with “home” andThe takes paper a variety is organized of forms into including five sections. remittances, Section investment, Two positions knowledge anddebates technology about the transfer, migration educational of skilled exchanges, health professionals philanthropy, within charitable a donationswider literature and returnthat discusses migration. the Aninternational obvious question, mobility then,of talent. is whether SouthSection Africans Three reviews in Canada research are on an the engaged global diaspora circulation with of attitudeshealth pro- and activitiesfessionals, commensurate focusing in particular with that upon status. debates Certainly, relating the to surveythe experience respond- entsof countries reported in visiting the developing South Africa world. relatively Section oftenFour moves(only 18% the focushad neverfrom beeninternational back since to South arriving African in Canada) issues and although provides only new 20% empirical return atmate- least oncerial drawn a year. from The therest survey make episodicof recruitment visits and patterns the vast and majority key interviews of all visits areundertaken connected with with health family sector issues recruiters and events. operating Most inhave South family Africa. in South AfricaSection to Five visit addresses (79% have the brothers questions and of sisters, changing 76% policy have interventionsparents and 52% in haveSouth grandparents Africa towards there). the outflow of skilled health professionals and the recruitmentOn most measures,of foreign healthhowever, professionals there is a clear to work pattern in South of disengagement Africa. The

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EXECUTIVE SUMMARY from South Africa.24 Half of the respondents (54%) have taken out Cana- dian citizenship and another 30% are permanent residents (all of whom ealth workers are one of the categories of skilled profession- are recent immigrants eligible for citizenship after a period of continuous als most affected by globalization. Over the past decade, residence in Canada). South Africans in Canada are neither large nor there has emerged a substantial body of research that tracks frequent remitters. Forty-two percent had never remitted funds to South patterns of international migration of health personnel, Africa and only 13% do so on a monthly basis. Half have never remit- H ted goods since arriving in Canada. Funds and goods are remitted almost assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is exclusively to family members for their immediate use. There is no collec- attracting growing interest. For almost 15 years South Africa has been tive remitting and no broader pattern of remitting, for example to support the target of a ‘global raiding’ of skilled professionals by several devel- community projects. oped countries. How to deal with the consequences of the resultant out- In the year prior to the survey, less than 3% of the respondents had flow of health professionals is a core policy issue for the national gov- bought a house or property in South Africa, exported or imported goods ernment. from either country, or invested in a business in South Africa. Looking This paper aims to to examine policy debates and issues concerning ahead, 86% thought it unlikely that they would invest in the country. the migration of skilled health professionals from the country and to Only 25% said it was likely that they would make a charitable donation furnish new insights on the recruitment patterns of skilled health per- that would benefit South Africa and 14% that they would send money for sonnel. The objectives of the paper are twofold: a development project in South Africa. Less than 1% belonged to a dias- Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H pora association in Canada and less than one in ten belonged to a South ment of skilled professionals from South Africa in the health African alumni association, a South African ethnic or cultural association, sector. The paper draws upon a detailed analysis of recruitment a professional association in Canada or an NGO or faith organization in advertising appearing in the South African Medical Journal for Canada with links to South Africa. the period 2000-2004 and a series of interviews conducted with Patterns of asset holding in South Africa show a systematic trend of dis- private recruiting enterprises. investment over time. Only a minority of those who immigrated between Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< 1990 and 2010 still hold assets in South Africa (in total, 28% have a bank key stakeholders in the South African health sector, the paper account, 16% have investments, 11% have savings, 10% own a house, 6% offers a series of recommendations for addressing the problem of own land and only 1% own a business in South Africa) (Table 2). If these skilled health migration. These recommendations are grounded assets are cross-tabulated with the year of entry to Canada, in every case in both South African experience and an interrogation of inter- almost 40% or more of the asset holders had immigrated in the previous national debates and ‘good policy’ practice for regulating recruit- five years. By contrast, less than 10% of those still holding these assets ment. arrived in Canada between 1990 and 1994. The paper is organized into five sections. Section Two positions Allied to this pattern of disinvestment are low levels of interest in debates about the migration of skilled health professionals within a return migration to South Africa. Only 14% said they had given a great wider literature that discusses the international mobility of talent. deal of thought to returning to live in South Africa. Even fewer (6%) said Section Three reviews research on the global circulation of health pro- it was likely they would return to live and work in South African within fessionals, focusing in particular upon debates relating to the experience two years. Slightly more (11%) said it was likely within the next five years. of countries in the developing world. Section Four moves the focus from These findings are a sobering contrast with an earlier SAMP survey of international to South African issues and provides new empirical mate- health professionals in South Africa itself, which found that 47% had given rial drawn from the survey of recruitment patterns and key interviews a great deal of thought to leaving the country.25 undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the recruitment of foreign health professionals to work in South Africa. The

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ETableXECUTIVE 2: Assets Sin UMMARYSouth Africa by Year of Immigration to Canada Assets Year of Immigration ealth workers1990–1994 are one of1995–1999 the categories2000–2004 of skilled profession-2005–2010 % holding assetals most affected% of asset by globalization.% of asset Over% of the asset past decade,% of asset there has emergedholders a substantialholders body ofholders research thatholders tracks Bank account 28.1patterns of international6.3 12.1migration of health31.6 personnel,50.0 Business H1.5 3.7 7.4 37.0 51.9 assesses causes and consequences, and debates policy responses at global House and national10.0 scales. Within6.1 this literature,11.1 the case31.1 of South Africa51.7 is Investmentsattracting15.7 growing interest.9.5 For almost14.1 15 years South37.4 Africa has39.0 been Land the target 6.1of a ‘global raiding’4.5 of skilled15.4 professionals31.8 by several devel-48.3 Savings oped countries.11.4 How to 4.8deal with the11.6 consequences34.0 of the resultant49.6 out- Source: SAMPflow Survey of health professionals is a core policy issue for the national government. This paper aims to to examine policy debates and issues concerning South Africans who have emigrated to Canada since the end of apart- the migration of skilled health professionals from the country and to heid therefore progressively disengage economically from their country of furnish new insights on the recruitment patterns of skilled health per- origin, confining their interactions to a narrowing circle of friends and rela- sonnel. The objectives of the paper are twofold: tives who still live there. At the same time, the survey suggests that they Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H remain quite engaged psychologically and culturally with South Africa. ment of skilled professionals from South Africa in the health The first marker of this is their sense of personal identity. Despite the fact sector. The paper draws upon a detailed analysis of recruitment that over half are now Canadian citizens, 88% agreed/strongly agreed with advertising appearing in the South African Medical Journal for the statement “being from South Africa is an important part of how I view the period 2000-2004 and a series of interviews conducted with myself” and 82% agreed/strongly agreed with the statement “I feel strong private recruiting enterprises. ties with people from South Africa.” This sense of a South African identity Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< is expressed in and reinforced by various cultural practices including eating key stakeholders in the South African health sector, the paper foods from South Africa (92%), listening to South African music (83%), offers a series of recommendations for addressing the problem of wanting their children to know about South African culture (82%), read- skilled health migration. These recommendations are grounded ing newspapers from South Africa (77%) and so on (Table 3). On every in both South African experience and an interrogation of inter- measure, more than 50% of respondents responded in the affirmative. national debates and ‘good policy’ practice for regulating recruitment. Table 3: CulturalThe Practices paper isof organizedSouth African into Canadians five sections. Section Two positions Activity debates about the migration of skilled health professionals within% a Yes Eat traditionalwider foods literature from South that Africa discusses the international mobility of talent. 92 Listen to musicSection from SouthThree Africa reviews research on the global circulation of health83 pro- Want your childrenfessionals, to know focusing about the in cultureparticular of South upon Africa debates relating to the experience82 Read an onlineof countries or print newspaper in the developingfrom South Africa world. in the Section past year Four moves the focus77 from international to South African issues and provides new empirical mate- Consulted a website relating to South Africa in the past year 76 rial drawn from the survey of recruitment patterns and key interviews Joined a social networking group that is associated with South Africa in the past year 61 undertaken with health sector recruiters operating in South Africa. Find that most of your best friends are from South Africa 60 Section Five addresses the questions of changing policy interventions in Want your children to learn a South African language 56 South Africa towards the outflow of skilled health professionals and the Closely followedrecruitment political events of foreign in South health Africa inprofessionals the past year to work in South Africa.53 The Source: SAMP Survey

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EXECUTIVE SUMMARY Identification as South African and engagement in practices and activities consistent with that self-identity does not, however, translate into ealth workers are one of the categories of skilled profession- a positive set of ideas and images about the country. Asked to compare als most affected by globalization. Over the past decade, Canada and South Africa on a variety of social, economic and political there has emerged a substantial body of research that tracks indices, respondents consistently gave Canada higher scores (Table 4). On patterns of international migration of health personnel, three key indicators that resonate with the Huntley case (personal and H family safety; racial, ethnic and cultural tolerance; and prospects for job assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is advancement), over three-quarters of the respondents rated Canada more attracting growing interest. For almost 15 years South Africa has been strongly. Other indicators on which a large majority rated Canada higher the target of a ‘global raiding’ of skilled professionals by several devel- included upkeep of public amenities, income and medical services and oped countries. How to deal with the consequences of the resultant out- treatment. On only one indicator, social life, was South Africa rated higher. flow of health professionals is a core policy issue for the national gov- Russell Kaplan has said that Brandon Huntley’s claim for refugee status ernment. in Canada was a test case for “informing the world what a sickly place This paper aims to to examine policy debates and issues concerning South Africa is for many white South Africans.” In Kaplan’s view, the case the migration of skilled health professionals from the country and to “contributed towards placing the plight of many white South Africans in furnish new insights on the recruitment patterns of skilled health per- South Africa on the world stage.”26 In other words, Kaplan’s objective was sonnel. The objectives of the paper are twofold: not simply to obtain refugee status for his client but to open the door for Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H further claims by white South Africans by presenting the situation in South ment of skilled professionals from South Africa in the health Africa in a certain light. The next section examines how the “Kaplan view” sector. The paper draws upon a detailed analysis of recruitment constructs South Africa and whether this view has any resonance amongst advertising appearing in the South African Medical Journal for the South African diaspora in Canada. the period 2000-2004 and a series of interviews conducted with private recruiting enterprises. Table 4: Comparisons of Canada and South Africa Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< Better in Better in No difference South Africa No opinion % key stakeholders in the South African health sector, the paper Canada % % % offers a series of recommendations for addressing the problem of Personal and family safety 98 0 1 1 skilled health migration. These recommendations are grounded Upkeep of public amenities 92 2 2 4 in both South African experience and an interrogation of international debates and ‘good policy’ practice for regulating recruit- Racial, ethnic and cultural tolerance 84 3 9 4 ment. Prospects for job advancement 77 8 10 5 The paper is organized into five sections. Section Two positions Level of income 69 12 11 7 debates about the migration of skilled health professionals within a Medical services and treatment 69 22 7 2 wider literature that discusses the international mobility of talent. Level of taxation 31 28 26 15 Section Three reviews research on the global circulation of health pro- Social life 33 47 17 3 fessionals, focusing in particular upon debates relating to the experience Source: SAMP Survey of countries in the developing world. Section Four moves the focus from international to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews the kaplan view undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in n his judgment, Justice Russell spoke of the “excesses” of Lara’s testimony South Africa towards the outflow of skilled health professionals and the Ito the IRB and observed that she was not the most objective witness to recruitment of foreign health professionals to work in South Africa. The call to bolster Huntley’s claim for refugee protection.27 In his view, Russell Kaplan was also not the most objective counsel that Huntley could have chosen to represent him.28 Justice Russell’s conclusion was based primarily 1 12 kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk MMIGRATIONigration PPOLICYolicy SERIESerieS NnOo. 4563

EXECUTIVEon theS UMMARYKaplans’ highly emotional account at the IRB hearing in which they both wept while Lara recounted the details of the torture of their brother, Robert, by threeealth blackworkers assailants are one in of his the South categories African of skilledhome inprofession- 1997. The Kaplan familyals clearlymost affected had a “heavy by globalization. emotional Overinvestment the past in decade,the outcome of this case”there and “wantedhas emerged to assert a substantial their view body of ‘reverse of research apartheid’ that tracks before the world.” patternsJustice Russell of international was careful migration not to criticise of health them personnel, for this, reserv- Hing his negative remarks for William Davis, who had taken a very different assesses causes and consequences, and debates policy responses at global viewand nationalof the testimony. scales. Within As Davis this had literature, noted: “(Larathe case Kaplan) of South brought Africa to is the hearingattracting from growing her own interest. personal For experience,almost 15 years a vivid South and Africa detailed has accountbeen ofthe what target is takingof a ‘global place raiding’ in South of Africaskilled todayprofessionals vis-à-vis by the several African devel- South Africansoped countries. and the How white to South deal with Africans the consequences and the indifference of the resultant of the mainly out- Africanflow of healthpolice professionalsforce to protect is a them.core policy White issue South for Africans,the national she gov-alleges, areernment. no longer welcome in South Africa.”29 JusticeThis paper Russell aims concluded to to examine that Davispolicy was debates “captivated” and issues by concerning the Kaplans’ interpretationthe migration of of skilled what whathealth was professionals happening from in South the country Africa and to whites.to Hefurnish summarised new insights the keyon theelements recruitment of the patternsKaplan viewof skilled of South health Africa per- as follows:sonnel. The objectives of the paper are twofold: Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H reasonsment of andskilled regard professionals all whites fromas equally South responsible Africa in the for healthapartheid, believingsector. The that paper they draws “should upon be aeradicated detailed analysis and stomped of recruitment on like an ant”advertising (in Lara appearing Kaplan’s inwords); the South African Medical Journal for the period 2000-2004 and a series of interviews conducted with whichprivate is recruiting in 200 percent enterprises. of all the minds of white South Africans” Q(in 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< Kaplan’s words); key stakeholders in the South African health sector, the paper towardsoffers a seriesthem; of recommendations for addressing the problem of skilled health migration. These recommendations are grounded Africansin both South and South African African experience society andis “brutal”; an interrogation of international debates and ‘good policy’ practice for regulating recruit- Africansment. against white South Africans; The paper is organized into five sections. Section Two positions debates whiteabout South the migration Africans; of skilled health professionals within a wider literature that discusses the international mobility of talent. Sectioncahoots” Three reviews with black research criminals; on the global circulation of health professionals, focusing in particular upon debates relating to the experience of countriesdeserve in thewhat developing is happening world. to themSection for Fourhistorical moves reasons the focus and from it is international“payback to Southtime for African the blacks”; issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews undertakenSouth with Africans health is sector “some recruiters kind of genocide”; operating andin South Africa. Section Five addresses the questions of changing policy interventions in South Africaadopted towards and promotedthe outflow policies of skilled aimed health at replacingprofessionals white and South the recruitmentAfricans of foreign with black health South professionals Africans into positions work in Southof power Africa. and influ The- ence.30

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EXECUTIVE SUMMARY Lara Kaplan’s statements to the Huntley hearing included the following on “reverse apartheid” in the police force: ealth workers are one of the categories of skilled profession- (The police) never do anything. What police? There is no als most affected by globalization. Over the past decade, law and order there, there is no proper police force. It’s free there has emerged a substantial body of research that tracks reign in South Africa, kill who you want and get away with Hpatterns of international migration of health personnel, murder…. They are so poorly paid they get backhands, it’s full assesses causes and consequences, and debates policy responses at global of fraudulence and corruption and there is no proper police and national scales. Within this literature, the case of South Africa is force like there was prior to 1994. They could not handle it attracting growing interest. For almost 15 years South Africa has been even if they wanted to and to be honest I don’t think they the target of a ‘global raiding’ of skilled professionals by several devel- want to. They don’t care, if you are white South African and oped countries. How to deal with the consequences of the resultant out- you report a case it’s like, you know, sorry, I’m busy. I’m on my flow of health professionals is a core policy issue for the national gov- teabreak. That’s the perception… They – everybody includ- ernment. ing the police force – seems to believe that if you are a white This paper aims to to examine policy debates and issues concerning South African and you are attacked it’s because you deserve the migration of skilled health professionals from the country and to it. It’s coming to you, it’s due to you, it’s long overdue.31 furnish new insights on the recruitment patterns of skilled health personnel. The objectives of the paper are twofold: Russell Kaplan deposited a selection of lurid South African newspaper arti- Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H cles detailing an array of violent crimes, attacks against white farmers in ment of skilled professionals from South Africa in the health rural areas and affirmative action that had supposedly “stripped the coun- sector. The paper draws upon a detailed analysis of recruitment try of 75 percent of its skilled population and is responsible for the depriva- advertising appearing in the South African Medical Journal for tion of the constitutional and social rights of the white population.” Justice the period 2000-2004 and a series of interviews conducted with Russell examined these and concluded that Davis had relied on material private recruiting enterprises. that was “strong on opinion but not on facts” and that, far from supporting Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< the case, actually contradicted the allegations of criminality based on racial key stakeholders in the South African health sector, the paper discrimination against white South Africans.32 Russell criticised Davis for offers a series of recommendations for addressing the problem of ignoring the IRB’s own National Discrimination Package’s List of Docu- skilled health migration. These recommendations are grounded ments on South Africa that provided an alternative perspective on crime in both South African experience and an interrogation of inter- and violence in South Africa and for not reviewing “more authoritative, national debates and ‘good policy’ practice for regulating recruit- objective and less emotionally partial sources.” ment. Justice Russell appears to have thought that the Kaplan view was a The paper is organized into five sections. Section Two positions direct reflection of the Kaplan family’s personal experiences in South debates about the migration of skilled health professionals within a Africa. The question here, though, is whether the Kaplan’s construction wider literature that discusses the international mobility of talent. of South Africa as a racial dystopia is not part of a broader discourse that Section Three reviews research on the global circulation of health pro- circulates within the white South African diaspora abroad. Certainly, fessionals, focusing in particular upon debates relating to the experience Kaplan’s representation of South Africa as a dystopia is echoed and rein- of countries in the developing world. Section Four moves the focus from forced by groups such as “We are White Refugees” that assiduously follow international to South African issues and provides new empirical mate- and comment on the Huntley case, organised an online petition against rial drawn from the survey of recruitment patterns and key interviews the Canadian government’s decision to appeal the IRB decision, continu- undertaken with health sector recruiters operating in South Africa. ously add to the reservoir of negative imagery about post-apartheid South Section Five addresses the questions of changing policy interventions in Africa, and hearken back to the “good old days.”33 But to what extent is South Africa towards the outflow of skilled health professionals and the the Kaplan view echoed more broadly within the South African diaspora recruitment of foreign health professionals to work in South Africa. The in Canada? The argument here is that the dystopian views advanced by Russell and Lara Kaplan sit comfortably within a broader narrative about

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EXECUTIVESouthS AfricaUMMARY by white South Africans in Canada. The evidence is to be found in the responses of respondents to the SAMP diaspora survey. A considerableealth workers number are of onesurvey of the respondents categories portrayed of skilled Southprofession- Africa as an extremelyals most violent affected society by inglobalization. which whites Over live thein a past constant decade, state of fear and anxiety:there has emerged a substantial body of research that tracks HI waspatterns personally of international attacked and migration assaulted of eight health times personnel, in one assessesyear. causes My and eldest consequences, daughter was and robbed debates and policy held responses at gunpoint at global and nationalthree times scales. in Withinone year. this My literature, house was the robbed case of twiceSouth in Africa one is attractingyear, growing whilst I interest.was in the For house almost (Respondent 15 years South No. 26).Africa has been the target of a ‘global raiding’ of skilled professionals by several devel- oped countries.Crime was How a big to factordeal with in mythe decisionconsequences to move of the away resultant from outflow ofSouth health Africa. professionals Myself and is a fourcore other policy family issue members for the national had been government.carjacked over the years. My immediate family and relatives Thishad paper been aims victims to to ofexamine robbery policy and ordebates burglary and ofissues some concerning sort. the migrationIt was just of skilled a matter health of time professionals before someone from the was country murdered and to furnish(Respondent new insights No. on 107).the recruitment patterns of skilled health personnel. The objectives of the paper are twofold: QI +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=Hrealised that sleeping with a gun under my pillow was not normalment ofpractice. skilled Theprofessionals statistics fromat the South time Africawere that in theone health out ofsector. three Thewomen paper would draws be uponraped, a detailedand if you analysis were raped,of recruitment you wouldadvertising contract appearing HIV/AIDS. in the That South equals African a death Medical sentence Journal for for methe (Respondent period 2000-2004 No. 345). and a series of interviews conducted with private recruiting enterprises. QI 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H

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EXECUTIVE SUMMARY is under siege because of their skin colour extends well beyond personal knowledge of incidents of crime and violence. Here there are clear echoes ealth workers are one of the categories of skilled profession- of Lara Kaplan’s claim that the violent attack on her brother is evidence of als most affected by globalization. Over the past decade, a genocide against whites of which the world is unaware: there has emerged a substantial body of research that tracks After Nelson Mandela was elected president the situation Hpatterns of international migration of health personnel, instead of being resolved was flipped around in South Africa, assesses causes and consequences, and debates policy responses at global and everyone who was white was now being racially discrimi- and national scales. Within this literature, the case of South Africa is nated against. This involved jobs, education, and all other attracting growing interest. For almost 15 years South Africa has been aspects of life (Respondent No. 419). the target of a ‘global raiding’ of skilled professionals by several devel- oped countries. How to deal with the consequences of the resultant out- The only links I maintain with Africa are with my family flow of health professionals is a core policy issue for the national gov- members. I would return only if the political regime were to ernment. change to one that is ‘white-friendly’ and doesn’t actively This paper aims to to examine policy debates and issues concerning want to get rid of me. I view the current political climate in the migration of skilled health professionals from the country and to SA as genocide in the making, and believe the levels of so- furnish new insights on the recruitment patterns of skilled health per- called ‘crime’ are encouraged as a way to rid the country of sonnel. The objectives of the paper are twofold: white people (Respondent No. 217). Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H ment of skilled professionals from South Africa in the health I think a lot of people are totally unaware of what is really sector. The paper draws upon a detailed analysis of recruitment happening in SA. I have to say that SA is one of the most advertising appearing in the South African Medical Journal for beautiful countries in the world, however corruption, crime, the period 2000-2004 and a series of interviews conducted with affirmative action and reverse apartheid makes it very dif- private recruiting enterprises. ficult to live there. There is very little or no future for white Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< South Africans. The crime is not petty crime, it’s barbaric, key stakeholders in the South African health sector, the paper senseless (Respondent No. 353). offers a series of recommendations for addressing the problem of Attacks on white farmers feature prominently in the narrative and are used skilled health migration. These recommendations are grounded as a platform for broader commentary on Africa and Africans: in both South African experience and an interrogation of international debates and ‘good policy’ practice for regulating recruit- The infamous Boer killings started, and what that means is ment. basically if you are a white farmer you will be slaughtered The paper is organized into five sections. Section Two positions for your land because the black majority feels that it’s theirs debates about the migration of skilled health professionals within a to begin with, even with their lack of education and history wider literature that discusses the international mobility of talent. sense (Respondent No. 419). Section Three reviews research on the global circulation of health professionals, focusing in particular upon debates relating to the experience I emigrated because the Government took my farm and gave of countries in the developing world. Section Four moves the focus from it to the Black people who now are not effectively and eco- international to South African issues and provides new empirical mate- nomically managing it. I emigrated because we had several rial drawn from the survey of recruitment patterns and key interviews farm attacks and murdering of farmers in our region without undertaken with health sector recruiters operating in South Africa. any help of anyone. The media does not inform Canada about Section Five addresses the questions of changing policy interventions in the “quiet WAR” going on in Africa right at this moment South Africa towards the outflow of skilled health professionals and the (Respondent No. 222). recruitment of foreign health professionals to work in South Africa. The Every day we read about white people who get killed in their homes and are living in fear for their lives. Jobs are being

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EXECUTIVE StakenUMMARY away from the white population. Thank God for the white brain power for many years whom the black people hate in SA.ealth If it wasworkers not forare them, one of SA the would categories have beenof skilled the same profession- as East, alsWest most and affected North Africaby globalization. (Respondent Over No. the 166). past decade, Personal andthere hearsay has emergedstories of aviolent substantial crime body were of laced research with thatvituperative tracks Haccounts of patternsthe callous of internationaland indifferent migration response ofof healththe police personnel, and the government:assesses causes “Get ridand of consequences, the criminal government,” and debates policy wrote responsesone, “and at get global rid of theand butchersnational andscales. the Within police thisforce literature, that is absolutely the case ofuseless South as Africa they workis mainlyattracting on bribes”growing (Respondent interest. For No. almost 499). 15 years South Africa has been theAnother target of persistenta ‘global raiding’ theme of with skilled clear professionals echoes of by the several Kaplan devel- view concernsoped countries. what theHow respondents to deal with refer the toconsequences as “reverse of discrimination” the resultant out- (i.e. affirmativeflow of health action professionals and Black isEconomic a core policy Empowerment issue for the or BEEnational in the gov- South Africanernment. lexicon). None of the over 600 respondents showed any sympathy withThis or appreciationpaper aims to for to theexamine rationale policy behind debates these and corrective issues concerning policies or ofthe the migration fact that of they skilled personally health professionalsmight have benefittedfrom the country educationally and to and economicallyfurnish new insights from the on racist the policiesrecruitment of the patterns apartheid of skilledgovernment. health Instead, per- theysonnel. generally The objectives represented of thethemselves, paper are and twofold: whites in general, as victims: Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H Thement government of skilled professionals couldn’t care from less South about Africa the future in the of health my children.sector. The The paper government draws upon couldn’t a detailed care less analysis about ofsafety recruitment and security.advertising As longappearing as they in the achieve South their African political Medical ambitions Journal for whichthe period basically 2000-2004 consists andof putting a series blackof interviews women conductedthen black with menprivate (and recruiting make your enterprises. way up through the different lighter Qcolour 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< schemes and sexes until you get to white men) into any jobkey whether stakeholders they have in the the South ability African to do it health or not sector,(Respondent the paper No.offers 67). a series of recommendations for addressing the problem of skilled health migration. These recommendations are grounded As a family physician in South Africa I was forced by the in both South African experience and an interrogation of inter- ANC government to take on a black previously disadvan- national debates and ‘good policy’ practice for regulating recruit- taged partner as part of affirmative action. Now you have ment. to ask yourself if such a partner is a family physician and The paper is organized into five sections. Section Two positions qualified is he or she still disadvantaged? After the so-called debates about the migration of skilled health professionals within a watering down (drop in standards to accommodate him/her) wider literature that discusses the international mobility of talent. mickey mouse qualification he or she left university with, I Section Three reviews research on the global circulation of health pro- was expected to drop my standards to help this candidate. fessionals, focusing in particular upon debates relating to the experience This would have resulted in me doing the work as a physi- of countries in the developing world. Section Four moves the focus from cian and guarding my own patients against my underqualified international to South African issues and provides new empirical mate- black partner. I refused to drop standards and saw emigration rial drawn from the survey of recruitment patterns and key interviews as the only option. My family members were murdered and undertaken with health sector recruiters operating in South Africa. the spineless South African Police Service failed them. It was Section Five addresses the questions of changing policy interventions in and still is just a matter of time before the ongoing policy of South Africa towards the outflow of skilled health professionals and the genocide against my white South African countrymen and recruitment of foreign health professionals to work in South Africa. The women will be completed (Respondent No. 66).

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EXECUTIVE SUMMARY The white population of South Africa, argued one, has no future “because they are now at the bottom of the list for employment opportunities” ealth workers are one of the categories of skilled profession- (Respondent No. 578). Many recounted personal experiences of victimiza- als most affected by globalization. Over the past decade, tion, for example, “When my husband lost his job in SA we realised the there has emerged a substantial body of research that tracks future looked scary since we could not survive on my salary and he was patterns of international migration of health personnel, unlikely to find employment because of BEE” (Respondent No. 610). The H idea that Black Economic Empowerment (BEE) turns whites into victims assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is is especially common: attracting growing interest. For almost 15 years South Africa has been A co-worker was promoted to a Management position despite the target of a ‘global raiding’ of skilled professionals by several devel- not being able to operate a computer (I therefore had to do oped countries. How to deal with the consequences of the resultant out- all her typing and e-mails) – yet she earned almost double my flow of health professionals is a core policy issue for the national gov- salary (Reason given: B.E.E)!! (Respondent No. 26). ernment. This paper aims to to examine policy debates and issues concerning I was laid off at Telkom on management level, because I’m the migration of skilled health professionals from the country and to white. They had to ‘correct’ the numbers by having less furnish new insights on the recruitment patterns of skilled health per- white managers. Crime levels reached a high of family being sonnel. The objectives of the paper are twofold: murdered and raped just because they are white people. I will Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H never return. I am too afraid I will get a letter again spelling ment of skilled professionals from South Africa in the health out that I lose my job because I’m white. We can send billions sector. The paper draws upon a detailed analysis of recruitment of dollars to Africa and the Black people will waste it with advertising appearing in the South African Medical Journal for corruption like they have been doing for ages – don’t you read the period 2000-2004 and a series of interviews conducted with the news over there? (Respondent No. 57). private recruiting enterprises. Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< This final verbatim quotation draws attention to a recurrent motif that key stakeholders in the South African health sector, the paper Canada and the West does not know or care about what is happening to offers a series of recommendations for addressing the problem of whites in South Africa: skilled health migration. These recommendations are grounded As a white person I was always very liberal when living in in both South African experience and an interrogation of inter- SA and had the highest hopes that everyone, especially the national debates and ‘good policy’ practice for regulating recruit- blacks, would have a better life after Mandela’s release and ment. the end of apartheid. However the ANC hopelessly failed The paper is organized into five sections. Section Two positions its own people in my opinion, and the rise of characters like debates about the migration of skilled health professionals within a Malema, who will surely be the next president, will lead SA wider literature that discusses the international mobility of talent. to the same fate as Zimbabwe. But oh to be politically correct Section Three reviews research on the global circulation of health pro- in Canada is more important than anything else, so let the fessionals, focusing in particular upon debates relating to the experience people be murdered in the hundreds of thousands without of countries in the developing world. Section Four moves the focus from any Canadian press coverage, and continue to live in poverty international to South African issues and provides new empirical mate- and zero hope for the future and rather sing the praises of the rial drawn from the survey of recruitment patterns and key interviews great hero Mandela to make us feel good about ourselves here undertaken with health sector recruiters operating in South Africa. in North America. Never acknowledge the realities for fear of Section Five addresses the questions of changing policy interventions in uttering what could be interpreted as racist. South Africa towards the outflow of skilled health professionals and the In many cases, the sense of outrage about Canadian attitudes spills over recruitment of foreign health professionals to work in South Africa. The into overtly racist diatribes about Africa and Africans. The unreconstruct- ed apartheid-era racist content of these narratives is not analysed further

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EXECUTIVEhere becauseSUMMARY there is no evidence from the Huntley case that Huntley, or the Kaplans, are motivated by racism. If anything, the Kaplan view seems to find the ealth supposed workers “genocidal are one of war” the againstcategories whites of skilled quite profession- understand- able given theals mosthistory affected of the bycountry globalization. and the Over“natural” the pasthuman decade, desire for revenge. there has emerged a substantial body of research that tracks Hpatterns of international migration of health personnel, conclusionassesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is attractinghe merits growing of Brandon interest. Huntley’s For almost claim 15 for years refugee South status Africa in Canadahas been will Tthe targetshortly of be a re-assessed‘global raiding’ by the of Immigration skilled professionals and Refugee by several Board devel-following theoped finding countries. of the How Federal to deal Court with that the the consequences original judgment of the wasresultant unreason out-- ableflow andof health strewn professionals with errors andis a coreprocedural policy irregularities.issue for the nationalMedia attention gov- willernment. no doubt escalate as the hearing draws closer and a new judgment is announced.This paper aimsAs this to topaper examine has argued, policy debatesthe dystopian and issues picture concerning of South Africathe migration painted ofby skilled lawyer health Russell professionals Kaplan and from witness the Laracountry Kaplan and toat the originalfurnish newIRB hearinginsights ison not the peculiar recruitment to these patterns two individuals of skilled healthbut circulates per- moresonnel. broadly The objectives within the of Souththe paper African are twofold: diaspora in Canada, in virtually everyQ detail. +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H To whatment extent of skilled is this professionals narrative of from South South Africa Africa as dystopia in the thehealth stuff of everydaysector. interaction The paper and conversation draws upon abetween detailed South analysis African of recruitment Canadians? To whatadvertising extent and appearingthrough what in the channels South Africanis this narrative Medical fed, Journal sustained for and amplifiedthe period by new 2000-2004 information, and astories series and of interviews anecdotes conductedfrom South with Afri- ca? Is thisprivate narrative recruiting particular enterprises. to South Africans in Canada or does it have looserQ spatial 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< boundaries and broader connectivities? The first two questions cankey only stakeholders be addressed in throughthe South further African research. health However, sector, the some paper comments onoffers the thirda series question of recommendations are in order. In forSeptember addressing 2009, the theproblem “We Areof White Refugees”skilled health website migration. launched These an online recommendations petition to the are UNHCR grounded and various governmentsin both South on African behalf ofexperience Huntley. Inand all, an the interrogation group gathered of inter- 1,026 signatures.national The petitioners debates and were ‘good drawn policy’ from practice a wide variety for regulating of countries recruit- but the list wasment. dominated by white South Africans in South Africa (53% of the Thesignatories) paper is followedorganized by into the five United sections. States Section (11%), Two Australia positions and New Zealanddebates about(9%), theEurope migration (7%), theof skilled United health Kingdom professionals (6%) and withinCanada a (5%). Manywider literatureof those signing that discusses the petition the international also left comments mobility that of talent.directly echo aspectsSection of Three the Kaplan reviews view research about on the the situation global circulationand fate of whitesof health in Southpro- Africa.fessionals, In otherfocusing words, in particular the Kaplan upon view debates is certainly relating not to the constrained experience by Canada’sof countries national in the boundaries. developing The world. narrative Section of Four South moves Africa the as focusdystopia from is likelyinternational to originate to South and be African reinforced issues by and sections provides of the new white empirical population mate- in Southrial drawn Africa from itself the and survey is an of example recruitment of what patterns Steyn andand keyFoster interviews call “white talk”undertaken and “resistant with health whiteness.” sector 34recruiters operating in South Africa. SectionThere Five is no addresses question the that questions post-apartheid of changing South policy Africa interventions has experienced in unprecedentedSouth Africa towards levels ofthe violent outflow crime. of skilled But, ashealth Justice professionals Russell observed, and the it isrecruitment quite another of foreign thing healthto suggest professionals that all crime to work against in South whites Africa. is racially The motivated and part of a broader campaign of genocide. None of the

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EXECUTIVE SUMMARY respondents in the SAMP survey made any reference to the disproportionate impact of violent crime on the country’s black population.35 In the ealth workers are one of the categories of skilled profession- Kaplan view, only whites are victims. A 2010 survey of a representative als most affected by globalization. Over the past decade, national sample of South Africans painted a very different picture.36 The there has emerged a substantial body of research that tracks survey found that other racial groups were significantly more vulnerable patterns of international migration of health personnel, to theft and physical attacks than whites: 11% of whites had experienced H a physical attack on them or their family members in the previous year, assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is compared to 18% of Black Africans and Indians and 17% of Coloureds. Or attracting growing interest. For almost 15 years South Africa has been again, while 29% of whites reported a theft from their home in the previous the target of a ‘global raiding’ of skilled professionals by several devel- year, the equivalent figure for other racial groups was 45% for Indians and oped countries. How to deal with the consequences of the resultant out- Coloureds and 37% of Black Africans. Fear of crime was also more intense flow of health professionals is a core policy issue for the national gov- amongst other groups: for example, 11% of whites said they lived in con- ernment. stant fear of crime in their own homes compared with 19% of Coloureds, This paper aims to to examine policy debates and issues concerning 20% of Black Africans and 54% of Indians. However, when asked which the migration of skilled health professionals from the country and to was the most important problem facing the country, 22% of whites said furnish new insights on the recruitment patterns of skilled health per- crime and security (a concern of only 5% of Black Africans). In contrast, sonnel. The objectives of the paper are twofold: 41% of Black Africans said that unemployment was the major problem Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H compared with only 11% of whites. Given the Kaplan view that affirmative ment of skilled professionals from South Africa in the health action and BEE are denying employment opportunities to whites this, too, sector. The paper draws upon a detailed analysis of recruitment is an important corrective finding. advertising appearing in the South African Medical Journal for The final issue concerns the pervasiveness of the Kaplan view of racial the period 2000-2004 and a series of interviews conducted with genocide within the white South African diaspora in Canada. On the one private recruiting enterprises. hand, it might be objected, asking people their reasons for leaving South Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< Africa will inevitably draw responses that focus on the threat to life and key stakeholders in the South African health sector, the paper security. On the other, there was no compulsion and no additional probing offers a series of recommendations for addressing the problem of involved in collecting the narratives. They were voluntarily offered and skilled health migration. These recommendations are grounded there were few contrary views. While some narratives were more extreme in both South African experience and an interrogation of inter- than others, they were all of a type and have resonance in the Kaplan view national debates and ‘good policy’ practice for regulating recruit- articulated at the Huntley hearing. We certainly cannot conclude that the ment. view is held and internalised by all South Africans in Canada. For example, The paper is organized into five sections. Section Two positions a small proportion of the respondents (around 20%) do engage in some debates about the migration of skilled health professionals within a of the activities more typical of an engaged diaspora and see a role for wider literature that discusses the international mobility of talent. themselves in the development of South Africa. However, the dominant Section Three reviews research on the global circulation of health pro- diaspora view of South Africa from Canada is that it is, at best, a racial fessionals, focusing in particular upon debates relating to the experience dystopia and, more accurately, a site of systematic racial destruction of the of countries in the developing world. Section Four moves the focus from white population. international to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews undertaken with health sector recruiters operating in South Africa. Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the recruitment of foreign health professionals to work in South Africa. The

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eEnXECUTIVEDnotes SUMMARY

1 Federal Court ofealth Appeal, workers File areNo oneIMM-4423-09, of the categories Minister of skilled of Citizenship profession- and Immigration v Brandonals most Carl affected Huntley, by globalization. 24 November Over 2010, the Para. past 216. decade, 2 IRB Ruling: Brandonthere Carl has emergedHuntley aRPD substantial File/No. body Dossier of research SPR: MA8-04910 that tracks at www.cbc.ca/news/pdf/huntley-decision.pdfpatterns of international migration(accessed of26 health September personnel, 2012). 3 Ibid. H assesses causes and consequences, and debates policy responses at global 4 A Googleand nationalsearch in scales. 2009 Withinfound that this the literature, case had the been case the of Southsubject Africa of 113,000 is press attractingstories and growing articles; interest. see Federal For almostCourt of15 Appeal, years South File NoAfrica IMM-4423-09, has been Ministerthe target of Citizenship of a ‘global and raiding’ Immigration of skilled v Brandonprofessionals Carl by Huntley, several devel- Affidavit from Stephanieoped countries. Gude, How 2 November to deal with 2009, the Para. consequences 3. of the resultant out- 5 “Brandonflow ofHuntley: health Anprofessionals Open Letter is a tocore Canada, policy 13issue September for the national 2009” at gov- http:// www.scribd.com/doc/20519947/FF-04-b-142-SA-Academics-Open-Letter-to-ernment. Canada-Re-Brandon-HuntleyThis paper aims to to. examine policy debates and issues concerning 6 “Dlamini-Zumathe migration Welcomes of skilled Canada’shealth professionals Decision from On the Huntley” country Immigration and to Watchfurnish Canada new 21 insights October on the2009 recruitment at http://www.immigrationwatchcanada. patterns of skilled health per- org/2009/10/21/dlamini-zuma-welcomes-canadas-decision-on-huntley/sonnel. The objectives of the paper are twofold: 7 Federal CourtQ +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H of Appeal, File No IMM-4423-09, Minister of Citizenship and Immigration vment Brandon of skilled Carl professionalsHuntley, 24 Novemberfrom South 2010, Africa Para. in the254. health 8 Federal Courtsector. of Appeal, The paper File Nodraws IMM-4423-09, upon a detailed Minister analysis of ofCitizenship recruitment and Immigration vadvertising Brandon Carlappearing Huntley, in the24 NovemberSouth African 2010, Medical Para. 220. Journal for 9 Ibid., Para. 231.the period On the 2000-2004 idiosyncratic and naturea series ofof IRBinterviews decision-making, conducted with see S. Rehaag, “Troublingprivate Patternsrecruiting in enterprises. Canadian Refugee Adjudication” Ottawa Law Review 39(2)Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H<(2007-8): 335-65. 10 N. Barbeau, “Huntleykey stakeholders Takes Another in the SouthRoute Africanto Stay inhealth Canada” sector, The the Star paper 6 July 2012. offers a series of recommendations for addressing the problem of 11 J. Gould, C. skilled Sheppard health and migration. J. Wheeldon, These “A recommendations Refugee from Justice? are grounded Disparate Treatment in inthe both Federal South Court African of Canada” experience Law and& Policy an interrogation 32(4) (2010): of 454-86. inter- 12 S. Gallagher, national “Canada’s debates Dysfunctional and ‘good Refugeepolicy’ practice Protection for regulating System: Canadian recruit- Asylum Policyment. from a Comparative Perspective” Public Policy Sources No. 78, Fraser Institute,The paper Vancouver, is organized 2003. into five sections. Section Two positions 13 A. Kaushaldebates and about C. Dauvergne,the migration “The of skilled Growing health Culture professionals of Exclusion: within Trends a in Canadianwider Refugee literature Exclusions” that discusses International the international Journal of Refugee mobility Law of 23(1)talent. (2011): 54-92.Section Three reviews research on the global circulation of health pro- 14 R. Amit,fessionals, “Protection focusing and in Pragmatism:particular upon Addressing debates relating Administrative to the experience Failures in Southof Africa’s countries Refugee in the Statusdeveloping Determination world. Section Decisions” Four moves Research the focusReport from for Forcedinternational Migration Studies to South Programme, African issues Wits andUniversity, provides Johannesburg, new empirical 2010. mate- 15 Ibid., rialPara. drawn 173. from the survey of recruitment patterns and key interviews 16 Ibid., undertakenPara. 229. with health sector recruiters operating in South Africa. 17 Ibid., SectionPara. 207. Five addresses the questions of changing policy interventions in 18 D. NakacheSouth Africaand P. towardsKinoshita, the “The outflow Canadian of skilled Temporary health professionals Foreign Worker and Prothe- gram:recruitment Do Short-Term of foreign Economic health Needs professionals Prevail over to workHuman in SouthRights Africa.Concerns?” The Study No. 5, Institute for Research on Public Policy, Montreal, 2011.

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EXECUTIVE SUMMARY 19 R. Joudrey and K. Robson, “Practising Medicine in Two Countries: South Afri- can Physicians in Canada” Sociology of Health & Illness 32(4) (2010): 528-44; ealth workers are one of the categories of skilled profession- J. Crush and W. Pendleton, “Brain Flight: The Exodus of Health Professionals als most affected by globalization. Over the past decade, from South Africa” International Journal of Migration, Health and Social Care 6(3) there has emerged a substantial body of research that tracks (2011): 3-18. patterns of international migration of health personnel, 20 “Africa says Canada is stealing MDs” Prince George Citizen 19 August 2009. H 21 H. Grant, “From the Transvaal to the Prairies: The Migration of South African assesses causes and consequences, and debates policy responses at global and national scales. Within this literature, the case of South Africa is Physicians to Canada” Journal of Ethnic and Migration Studies 32(4) (2006): 681-95. attracting growing interest. For almost 15 years South Africa has been 22 J. Crush, W. Pendleton, A. Chikanda, C. Eberhardt, M. Caesar and A. Hill, the target of a ‘global raiding’ of skilled professionals by several devel- “Diasporas on the Web: New Networks, New Methodologies” In C. Vargas- oped countries. How to deal with the consequences of the resultant out- Silva, ed., Handbook of Research Methods in Migration (Cheltenham: Edward flow of health professionals is a core policy issue for the national gov- Elgar, 2012). ernment. 23 S. Plaza and D. Ratha, eds., Diaspora for Development in Africa (Washington DC: This paper aims to to examine policy debates and issues concerning World Bank, 2011). the migration of skilled health professionals from the country and to 24 J. Crush, A. Chikanda and W. Pendleton, “The Disengagement of the South furnish new insights on the recruitment patterns of skilled health per- African Medical Diaspora in Canada” Journal of Southern African Studies, 38(4) sonnel. The objectives of the paper are twofold: (2012): 927-49. Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H 25 Crush and Pendleton, “Brain Flight.” ment of skilled professionals from South Africa in the health 26 Russell Kaplan, “Huntley Accomplished ‘African White Refugee’ Objectives” at sector. The paper draws upon a detailed analysis of recruitment http://why-we-are-white-refugees.blogspot.ca/2010/12/huntley-accomplished- advertising appearing in the South African Medical Journal for african-white_5407.html. the period 2000-2004 and a series of interviews conducted with 27 Federal Court of Appeal, File No IMM-4423-09, Minister of Citizenship and private recruiting enterprises. Immigration v Brandon Carl Huntley, 24 November 2010, Para 177. Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< 28 Ibid., Para. 180. key stakeholders in the South African health sector, the paper 29 Ibid., Para. 184. offers a series of recommendations for addressing the problem of 30 Ibid., Para. 204. skilled health migration. These recommendations are grounded 31 Ibid., Para. 190. in both South African experience and an interrogation of inter- 32 Ibid., Para. 210-229. national debates and ‘good policy’ practice for regulating recruit- 33 See http://why-we-are-white-refugees.blogspot.ch/ and http://www.thepeti- ment. tionsite.com/1/minister-of-citizenship-immigration-canada/ The paper is organized into five sections. Section Two positions 34 M. Steyn and D. Foster, “Repertoires for Talking White: Resistant Whiteness in debates about the migration of skilled health professionals within a Post-Apartheid South Africa” Ethnic and Racial Studies 31(1) (2008): 25-51. wider literature that discusses the international mobility of talent. 35 G. Silber and N. Geffen, “Race, Class and Violent Crime in South Africa: Dis- Section Three reviews research on the global circulation of health pro- pelling the ‘Huntley’ Thesis” SA Crime Quarterly 30(2009): 35-43. fessionals, focusing in particular upon debates relating to the experience 36 Z. Ismail, “Is Crime Dividing the Rainbow Nation? Fear of Crime in South of countries in the developing world. Section Four moves the focus from Africa” Afrobarometer Briefing Paper No. 96, Cape Town, 2009. international to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews undertaken with health sector recruiters operating in South Africa. migration policy series Section Five addresses the questions of changing policy interventions in South Africa towards the outflow of skilled health professionals and the 1. Covert Operations: Clandestine Migration, Temporary Work and Immigration recruitment of foreign health professionals to work in South Africa. The Policy in South Africa (1997) ISBN 1-874864-51-9

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2.E XECUTIVERiding theS UMMARYTiger: Lesotho Miners and Permanent Residence in South Africa (1997) ISBN 1-874864-52-7 3. International Migration,ealth workers Immigrant are one Entrepreneurs of the categories and of South skilled Africa’s profession- Small Enterprise Economyals most (1997) affected ISBN by 1-874864-62-4 globalization. Over the past decade, 4. Silenced by Nationthere Building: has emerged African a substantial Immigrants body and of Language research Policythat tracks in the New HSouth Africapatterns (1998) ofISBN international 1-874864-64-0 migration of health personnel, assesses causes and consequences, and debates policy responses at global 5. Left Out in the Cold? Housing and Immigration in the New South Africa and national scales. Within this literature, the case of South Africa is (1998) ISBN 1-874864-68-3 attracting growing interest. For almost 15 years South Africa has been 6. Tradingthe Places: target of Cross-Border a ‘global raiding’ Traders of skilledand the professionals South African by several Informal devel- Sector (1998)oped ISBN countries. 1-874864-71-3 How to deal with the consequences of the resultant out- 7. Challengingflow of Xenophobia:health professionals Myth and is a Realities core policy about issue Cross-Border for the national Migration gov- in Southernernment. Africa (1998) ISBN 1-874864-70-5 8. Sons of This Mozambique: paper aims Mozambican to to examine Miners policy and debates Post-Apartheid and issues concerning South Africa (1998)the ISBN migration 1-874864-78-0 of skilled health professionals from the country and to 9. Womenfurnish on thenew Move: insights Gender on the and recruitment Cross-Border patterns Migration of skilled to health South per- Africa (1998)sonnel. ISBN The1-874864-82-9. objectives of the paper are twofold: Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H 10. Namibians on South Africa: Attitudes Towards Cross-Border Migration and ment of skilled professionals from South Africa in the health Immigration Policy (1998) ISBN 1-874864-84-5. sector. The paper draws upon a detailed analysis of recruitment 11. Building Skills:advertising Cross-Border appearing Migrants in the and South the African South AfricanMedical ConstructionJournal for Industry (1999)the ISBNperiod 1-874864-84-5 2000-2004 and a series of interviews conducted with 12. Immigration &private Education: recruiting International enterprises. Students at South African Universities and TechnikonsQ 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< (1999) ISBN 1-874864-89-6 13. The Lives andkey Times stakeholders of African in the Immigrants South African in Post-Apartheid health sector, Souththe paper Africa (1999) ISBN offers1-874864-91-8 a series of recommendations for addressing the problem of 14. Still Waiting skilledfor the health Barbarians: migration. South These African recommendations Attitudes to Immigrants are grounded and Immigration (1999)in both ISBN South 1-874864-91-8 African experience and an interrogation of international debates and ‘good policy’ practice for regulating recruit- 15. Underminingment. Labour: Migrancy and Sub-contracting in the South African Gold Mining IndustryThe paper (1999) is organized ISBN 1-874864-91-8 into five sections. Section Two positions 16. Borderlinedebates Farming: about the Foreign migration Migrants of skilled in South health African professionals Commercial within Agricul a - ture (2000)wider literatureISBN 1-874864-97-7 that discusses the international mobility of talent. 17. WritingSection Xenophobia: Three reviews Immigration research and on the the Press global in Post-Apartheid circulation of healthSouth Africapro- (2000)fessionals, ISBN 1-919798-01-3 focusing in particular upon debates relating to the experience 18. Losingof Our countries Minds: in Skills the developing Migration andworld. the Section South AfricanFour moves Brain the Drain focus (2000) from ISBNinternational 1-919798-03-x to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews 19. Botswana: Migration Perspectives and Prospects (2000) ISBN 1-919798-04-8 undertaken with health sector recruiters operating in South Africa. 20. The BrainSection Gain: Five Skilledaddresses Migrants the questions and Immigration of changing Policy policy in interventions Post-Apartheid in SouthSouth Africa Africa (2000) towards ISBN 1-919798-14-5the outflow of skilled health professionals and the 21. Cross-Borderrecruitment Raiding of foreign and Community health professionals Conflict into thework Lesotho-South in South Africa. African The Border Zone (2001) ISBN 1-919798-16-1

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EXECUTIVE SUMMARY 22. Immigration, Xenophobia and Human Rights in South Africa (2001) ISBN 1-919798-30-7 ealth workers are one of the categories of skilled profession- 23. Gender and the Brain Drain from South Africa (2001) ISBN 1-919798-35-8 als most affected by globalization. Over the past decade, 24. Spaces of Vulnerability: Migration and HIV/AIDS in South Africa (2002) ISBN there has emerged a substantial body of research that tracks 1-919798-38-2 patterns of international migration of health personnel, H 25. Zimbabweans Who Move: Perspectives on International Migration in Zimba- assesses causes and consequences, and debates policy responses at global bwe (2002) ISBN 1-919798-40-4 and national scales. Within this literature, the case of South Africa is attracting growing interest. For almost 15 years South Africa has been 26. The Border Within: The Future of the Lesotho-South African International the target of a ‘global raiding’ of skilled professionals by several devel- Boundary (2002) ISBN 1-919798-41-2 oped countries. How to deal with the consequences of the resultant out- 27. Mobile Namibia: Migration Trends and Attitudes (2002) ISBN 1-919798-44-7 flow of health professionals is a core policy issue for the national gov- 28. Changing Attitudes to Immigration and Refugee Policy in Botswana (2003) ernment. ISBN 1-919798-47-1 This paper aims to to examine policy debates and issues concerning 29. The New Brain Drain from Zimbabwe (2003) ISBN 1-919798-48-X the migration of skilled health professionals from the country and to furnish new insights on the recruitment patterns of skilled health per- 30. Regionalizing Xenophobia? Citizen Attitudes to Immigration and Refugee Policy sonnel. The objectives of the paper are twofold: in Southern Africa (2004) ISBN 1-919798-53-6 Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H 31. Migration, Sexuality and HIV/AIDS in Rural South Africa (2004) ISBN ment of skilled professionals from South Africa in the health 1-919798-63-3 sector. The paper draws upon a detailed analysis of recruitment 32. Swaziland Moves: Perceptions and Patterns of Modern Migration (2004) ISBN advertising appearing in the South African Medical Journal for 1-919798-67-6 the period 2000-2004 and a series of interviews conducted with 33. HIV/AIDS and Children’s Migration in Southern Africa (2004) ISBN 1-919798- private recruiting enterprises. 70-6 Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< 34. Medical Leave: The Exodus of Health Professionals from Zimbabwe (2005) key stakeholders in the South African health sector, the paper ISBN 1-919798-74-9 offers a series of recommendations for addressing the problem of skilled health migration. These recommendations are grounded 35. Degrees of Uncertainty: Students and the Brain Drain in Southern Africa in both South African experience and an interrogation of inter- (2005) ISBN 1-919798-84-6 national debates and ‘good policy’ practice for regulating recruit- 36. Restless Minds: South African Students and the Brain Drain (2005) ISBN ment. 1-919798-82-X The paper is organized into five sections. Section Two positions 37. Understanding Press Coverage of Cross-Border Migration in Southern Africa debates about the migration of skilled health professionals within a since 2000 (2005) ISBN 1-919798-91-9 wider literature that discusses the international mobility of talent. 38. Northern Gateway: Cross-Border Migration Between Namibia and Angola Section Three reviews research on the global circulation of health pro- (2005) ISBN 1-919798-92-7 fessionals, focusing in particular upon debates relating to the experience 39. Early Departures: The Emigration Potential of Zimbabwean Students (2005) of countries in the developing world. Section Four moves the focus from ISBN 1-919798-99-4 international to South African issues and provides new empirical material drawn from the survey of recruitment patterns and key interviews 40. Migration and Domestic Workers: Worlds of Work, Health and Mobility in undertaken with health sector recruiters operating in South Africa. Johannesburg (2005) ISBN 1-920118-02-0 Section Five addresses the questions of changing policy interventions in 41. The Quality of Migration Services Delivery in South Africa (2005) ISBN South Africa towards the outflow of skilled health professionals and the 1-920118-03-9 recruitment of foreign health professionals to work in South Africa. The 42. States of Vulnerability: The Future Brain Drain of Talent to South Africa (2006) ISBN 1-920118-07-1

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43.EXECUTIVE Migration SandUMMARY Development in Mozambique: Poverty, Inequality and Survival (2006) ISBN 1-920118-10-1 44. Migration, Remittancesealth workers and Developmentare one of the incategories Southern of Africaskilled (2006)profession- ISBN 1-920118-15-2 als most affected by globalization. Over the past decade, 45. Medical Recruiting:there The has emerged Case of a South substantial African body Health of research Care Professionalsthat tracks (2007)H ISBN 1-920118-47-0patterns of international migration of health personnel, assesses causes and consequences, and debates policy responses at global 46. Voices From the Margins: Migrant Women’s Experiences in Southern Africa (2007) and national scales. Within this literature, the case of South Africa is ISBN 1-920118-50-0 attracting growing interest. For almost 15 years South Africa has been 47. The Haemorrhagethe target of a of ‘global Health raiding’ Professionals of skilled From professionals South Africa: by Medicalseveral devel- Opinions (2007)oped ISBN countries. 978-1-920118-63-1 How to deal with the consequences of the resultant out- 48. The Qualityflow of ofhealth Immigration professionals and Citizenship is a core Servicespolicy issuein Namibia for the (2008) national ISBN gov- 978- 1-920118-67-9ernment. 49. Gender, This Migration paper andaims Remittances to to examine in policy Southern debates Africa and (2008) issues ISBNconcerning 978-1- 920118-70-9the migration of skilled health professionals from the country and to 50. The Perfectfurnish Storm:new insights The Realities on the ofrecruitment Xenophobia patterns in Contemporary of skilled health South per- Africa (2008)sonnel. ISBN The978-1-920118-71-6 objectives of the paper are twofold: Q +CDFCJ=895B5I8=HC:H<9CF;5B=N5H=CB5B8D5HH9FBGC:F97FI=H 51. Migrant Remittances and Household Survival in Zimbabwe (2009) ISBN 978-1- ment of skilled professionals from South Africa in the health 920118-92-1 sector. The paper draws upon a detailed analysis of recruitment 52. Migration, Remittancesadvertising and appearing ‘Development’ in the in SouthLesotho African (2010) Medical ISBN 978-1-920409- Journal for 26-5 the period 2000-2004 and a series of interviews conducted with 53. Migration-Inducedprivate HIV recruiting and AIDS enterprises. in Rural Mozambique and Swaziland (2011) ISBN 978-1-920409-49-4Q 5G98IDCBH<956CJ95B5@MG=G5B8588=H=CB5@=BH9FJ=9KGK=H< 54. Medical Xenophobia:key stakeholders Zimbabwean in Accessthe South to Health African Services health in sector,South Africa the paper (2011) ISBN 978-1-920409-63-0offers a series of recommendations for addressing the problem of 55. The Engagementskilled of health the Zimbabwean migration. These Medical recommendations Diaspora (2011) are ISBN grounded 978-1- 920409-64-7in both South African experience and an interrogation of inter- 56. Right to the Classroom:national debates Educational and ‘good Barriers policy’ for practice Zimbabweans for regulating in South recruit- Africa (2011) ISBNment. 978-1-920409-68-5 57. Patients WithoutThe paper Borders: is organized Medical into Tourism five sections. and Medical Section Migration Two positions in Southern Africadebates (2012) aboutISBN the978-1-920409-74-6 migration of skilled health professionals within a 58. The Disengagementwider literature of thatthe Southdiscusses African the internationalMedical Diaspora mobility (2012) of talent.ISBN 978-1- 920596-00-2Section Three reviews research on the global circulation of health pro- 59. The Thirdfessionals, Wave: focusing Mixed Migration in particular from upon Zimbabwe debates to relatingSouth Africa to the (2012) experience ISBN 978-1-920596-01-9of countries in the developing world. Section Four moves the focus from international to South African issues and provides new empirical mate- 60. Linkingrial Migration, drawn from Food the Security survey andof recruitment Development patterns (2012) and ISBN key 978-1-920596- interviews 02-6 undertaken with health sector recruiters operating in South Africa. 61. UnfriendlySection Neighbours: Five addresses Contemporary the questions Migration of changing from policy Zimbabwe interventions to Botswana in (2012)South ISBN Africa 978-1-920596-16-3 towards the outflow of skilled health professionals and the 62. Headingrecruitment North: The of foreign Zimbabwean health Diasporaprofessionals in Canadato work in (2012) South ISBN Africa. 978-1- The 920596-03-3

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southern AfricAn MigrAtion ProgrAMMe