1144 



TREND TOWARD URBANIZATION 



Another social factor that creates "push" conditions for professional 

 manpower in the LDCs is the world trend toward urbanization. In- 

 variably, intellectuals concentrate in cities. Cities are centers of wealth, 

 opportunity, and intellectual intercourse. Educational and cultural 

 institutions, hospitals, seats of governments, and major industries are 

 generally located in urban areas. Life is also more comfortable in the 

 cities than in many rural areas. Intellectuals can, moreover, share com- 

 mon professional interests with friends and colleagues living in close 

 proximity with one another in an urban environment.^^^ 



A special problem arises in the LDCs where the surplus educated 

 elite are concentrated in urban areas. Unable to be absorbed into the 

 economy, this elite represents, at least potentially, a social hazard for 

 the country and an opportunity for brain drain to the advanced coun- 

 tries, because they are usually unemployed or underemployed. This 

 elite shuns the countryside where in some professions, such as medicine, 

 a need exists. According to Dr. Marcos, in Manila there is one doctor 

 for every 671 persons; in rural areas the ratio is 1 for every 5,000.^^^ 

 Yet, the Philippines has a surplus of doctors. Of a total of 28,000 

 M.D.s, one-half practice in Manila and other cities, one-fourth are not 

 practicing at all, and the other fourth immigrate to the United 

 States.^^^ In India, another country with a surplus of M.D.s, 60 percent 

 of the rural clinics in East Punjab are without doctors.^^* 



The same is true of Bolivia where 51 percent of its annual output of 

 M.D.s applied for immigration to the United States in 1965, at a time 

 when most of the country's rural areas were inadequately served by 

 doctors.^^" (The habit of concentrating in the great metropolitan areas 

 continues after foreign medical graduates (FMGs) come to the United 

 States. They shun the rural areas where the medical need is great and 

 settle in the large cities. In 1970, 90.8 percent of all FMGs were located 

 in 300 Standard Metropolitan Statistical Areas, a percentage that has 

 remained constant since 1963.) ^so 



Urbanization in the LDCs with the problems it creates for the edu- 

 cated elite, particularly that of their allocation for optimal social use, 

 and the special preference of this elite for city life as opposed to the 

 country, creates "push"' conditions for the dispossessed and discon- 

 tended intellectual. If there is a way out through emigration to an 

 advanced country, he will take it if he can. The CIMT study stated 

 the problem and its resolution very succinctly: "People [i.e. profes- 

 sionals] prefer to remain in cities, even if they are unemployed. If 

 these unemployed or underemployed people are given a choice of 

 migrating to rural areas in the country or of migrating to another 

 country, they tend to choose the latter." -^^ 



^ CIMT Study, p. 683. 



2*9 Rowland, op. cit., p. 4. 



=»7 1>ublln, op. cit.. p. 875. 



''ss Report, Ditchley Park Conference on Brain Drain, 1968^ p. 16. 



2^ Report of U.N. Secretary General, Outflow of Trained Personnel from LDCs, Nov. 5, 

 1968, p. 45.85. 



2«o AMA, FMG Study. 1971, pp. 13-14. 



^^ CIMT Study, p. 683. The Ditchley Conference report made a similar observation : 

 "Many doctors and other professionally qualified people prefer to emigrate rather than 

 work in rural areas." (p. 16). 



