1177 



An example of the needs-demands issue is that of the situation in 

 Istanbul, Turkey. The demand for physicians is so low in Istanbul 

 that the average M.D. sees fewer than 40 patients a week and cannot 

 earn an acceptable livelihood. Yet, the need, if defined in terms of 

 bringing health care in Istanbul up to European urban standards, is 

 such that all physicians working to capacity would hardly begin to 

 meet it.^^' Such disparities in demands and needs are not uncommon 

 in the LCDs. 



Thus the seriousness of brain drain lies within the eye of the be- 

 holder. Viewed from the LDC perspective of need, the effects are seri- 

 ous because the leadership in the developing country perceives the 

 larger requirements of developing and nation-building. Viewed from 

 the demand side, commensurate with the interests of the advanced 

 countries, the effects are not serious : Brain drain is an asset, relieving 

 the LDCs of surplus manpower which are regarded as a wasteful ex- 

 penditure of human i-esources. What appears to be brain drain, as 

 George Baldwin wrote, is really "overflow," and emigration of a sur- 

 plus elite becomes a safety valve for unwanted but unavoidable social 

 pressures. 



The essence of the differing perspectives seems to rest on the question 

 of whether or not the viewer takes the long-term or short-term view 

 of development. For the short-term, demand-oriented viewer, brain 

 drain can have only positive effects. As Mr. Baldwin said : "Clearly 

 the latter [that is, the economy's effective demand] is the more rele- 

 vant and realistic test to apply." ^°^ But for the long-term viewer from 

 tiie need-oriented perspectij^e, brain drain can have serious negative 

 effects, specifically, impairing future development. As Deena R. 

 Khatkhate, an Adviser in India's Central Banking Service, explained : 



The Phenomenon of brain drain is a consequence partly of the prevailing 

 tendency in some of the less developed countries to overproduce graduates and 

 partly of the social inertia in these societies preventing a full use of the available 

 trained manpower. Unavoidable though it is, it may not . . . be harmful, at any 

 rate in the long run, as it hastens the social, psychological, and attitudinal 

 changes in the economies of the emigrating countries which can be conducive to 

 more productive use of skilled manpower and other resources.'"* 



Supporters of the long-term need perspective would further point 

 out that a manpower reserve force of professionals of which Khatkhate 

 speaks, even though underemployed and overtrained, constitutes a 

 reserve pool for the future if and when demand may increase with 

 progress in development. In cases in which a surplus of a particular 

 profession exists — for example, medical doctors in the Philippines 

 and India— the reduction of the "pull" factor in the United States by 

 building sufficient medical schools, thus satisfying domestic needs and 

 demands with American manpower, would compel readjustments in 

 the Filipino and Indian manpower market. In this case the market it- 

 self would have its own corrective mechanism — and remedy for med- 

 ical brain drain. For the Filipino and Indian doctor (in-being or 

 aspiring), closed off from access to the American market, would prob- 



3»7 Shurclifif, op. dt., p. 1.^3. 

 3f« Baldwin, op. clt., p. 362. 



390 Deena R. Khatkhate, "The Brain Drain as a Social Safety Valve," Finance and Devel- 

 opment (March 1970), p. 39. 



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