Effects of nurse migration on the source country
One of the most obvious and favorable effects of nurse migration on the source country, especially in developing nations, is the considerable money sent home from nurses abroad each year. Some of the developed recipient countries boast that the remittances overseas sent back by migrant nurses provide much needed financial support to the source countries [8]. The WHO estimated that overseas healthcare workers sent approximately $70 billion to their source countries in 1995 [8]. Unfortunately, however, much of the money is not reinvested back into the healthcare system [22].Although overseas nurses sent back large sums of money to their home countries, it was unable to offset the loss of skilled nurses. Nurses migrating from developing to developed countries are often leaving behind an already disadvantaged system [23]. Migration of these nurses from poorer nations creates a vicious cycle in their healthcare system. The undesirable work conditions and low compensation spur health professional immigration to more developed countries. This in turn results in an increased workload and deleterious work conditions in the source country, which further prompts more nurses to migrate away from the home country. Sub-Saharan Africa suffers from 25% of the world's disease burden yet they only have 1.3% of the trained health workforce and 1% of the world's financial resources, which includes loans and grants from abroad [24]. Thus, the nursing shortage is more severe and felt more strongly in the source countries. The migration drains the source countries of desperately needed skilled personnel.Nurse migration can also be beneficial to the source country. Nurses working abroad can aid in the development of transnational connections and partnerships. Moreover, if the nurses return to their home nation, they bring with them enhanced skills and new ideas[25]. In developing countries specifically, the experience gained by nurses working abroad in more developed nations may enhance the knowledge and skills and build the self-confidence of their home healthcare practice. Because of these potential benefits, nurse migration can be seen as a double-edged sword for the source country. Research has shown, however, that the negative impacts of nurse migration far outweigh the benefits [26], [27] and [28].Another negative effect that source countries experience in the wake of nurse migration is the educational expenditure. Developing nations often publicly fund or subsidize nursing education. When publicly funded nurses move to a new country, the source country loses both the healthcare professional and the money invested in their education [29]. Thus, it is as if the poorest countries are subsidizing the cost of educating healthcare workers for wealthier nations. Approximately 70% of nursing graduates from the Philippines move abroad [30].The large percentage of migrant nurses raises the question of whether migration is an individual's choice and/or right or if they are escaping a social responsibility. This question prompts important questions on human rights, social and international justice, and the complex relationship between them. Serving within the national healthcare system is a nurse's social responsibility, particularly when the source country has invested significantly in their education. Nurses may be seen as immoral or socially irresponsible for leaving their developing country behind to go to another country for personal reasons. Alternatively, these nurses also have the right to migrate to obtain better living conditions, career advancement, and professional development opportunities.