His Parents' Death Gave Him A Mission: Stop The Medical Brain Drain

Enlarge this image toggle caption Ryan Lash /TED Ryan Lash /TED

When Chris Ategeka was a boy of 7 in Uganda, his parents died of HIV/AIDS. And his brother, not yet 5, died of malaria.

Today he's 32. He's got a degree in mechanical engineering from the University of California, Berkeley (where he was the commencement speaker for the college of engineering at his graduation in 2011). With his entrepreneurial spirit, he could have followed classmates to Silicon Valley.

But he didn't.

In his TED Fellows talk in Vancouver this week, he explained how his personal history set him on a different path.

"My journey started when I was seven," he said. "These deaths were traumatic but also very unnecessary. If the country had functioning health systems both my parents and my brother would be alive today."

So after graduation, Ategeka felt a sense of urgency to return to Uganda, which he'd left at age 21: "There was no better place to go than to work with the problem that has haunted me my whole life."

In his talk, he focused on the brain drain for medical workers in his home country and continent — and the nonprofit he started, Health Access Corps, to change things.

"In the U.S., where I went to school, the doctor-patient ratio is 1:390, one doctor for 390 people." In some African countries, the ratio might be more like 1:20,000 or more.

The problem, as he sees it, is that upon graduation from medical school on the African continent, newly minted health care workers are hired away for more money elsewhere, pulling the talent from developing countries to, as he says, "slightly developed countries and Western countries."

Is the issue of brain drain in the medical profession something you've thought about your whole life?

No, it's evolved. If you look at my work, it's evolved from building village ambulances, basically motorcycles and bicycle ambulances — we weld them and we build them — and from there we built mobile hospitals, basically giant buses that you transform into a mobile hospital. You have a doctor, a lab and a pharmacy inside a bus that goes out into the village and serves the population. And that also came from necessity. You drop off people at the hospital and they just lay on the floor. There's no medicine, no equipment, no doctors, no nurses. This problem popped up over and over. We had the same problem with mobile hospitals. We had the facility but it was hard to find trained staff. And that's why we went ahead to investigate more in order to find out where the root problem of the cause is — and as it turns out there's a huge brain drain.

There is a severe shortage of medical schools in Africa. Can you describe how the brain drain affects those who do graduate from medical school?

As soon as they graduate, someone is already at their doorstep to give them a job elsewhere. It's easy to sell because the [local] pay is low or no pay, so they hop on a plane, hop on a bus. We lose a lot of people that way, and no one is tracking where the ones who graduated go.

What did this situation lead you to do?

It led me to create a fellowship program [for] doctors, nurses and midwives that pays your salary for two years at a rate that is competitive to the local market. It's a nonprofit, and the money comes from grants. We're working on the data that will detail the outcomes of the fellowship and we expect to release the data in the next year to 18 months."

The governments know the problem exists but they have their own agendas and priorities. And the misconception is that a doctor who just graduated, they're highly talented, highly educated and don't need any help. By thinking that way, we lose them because we can't compensate them or pay them enough to stay.

Has this been successful?

We've been around for about six years. We are still building our data sets to quantify the magnitude of the problem and what the solution should be.

What's the biggest challenge?

To create policy that will allow the retention of health care professionals in underserved regions. We're not shooting to make a lot of money and sustain a big organization. All we're going for is to create an umbrella of a number of doctors, nurses and midwives who have a collective voice, a semi-union of some kind, and then, at that point, we can present our case with data to governments and write that into policy. Then the organization would shut down and be done.