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Archived Comments for: The College of Medicine in the Republic of Malawi: towards sustainable staff development

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  1. Reversing the medical brain: an alternative suggestion

    John Lwanda, Primary Care Physician, Lanarkshire PCT, Scotland

    28 November 2007

    This paper, which is aimed at donors and medical service planners, can be critiqued from historical, epistemological and ethical stand points.

    Historical: The paper ignores the significant, largely political in nature, medical brain drain under the one party regime of Dr Banda and the brain drain in the multiparty dispensation due to global economic factors.

    Epistemological: Both sets of brain drain periods have produced a pool of indigenous Malawi doctors living abroad. This is a significant resource - of surgeons, dentists, physicians,obstetricians and other specialties that is not addressed in the paper.

    Ethical: The paper does not address the paradox where 'USD 40,000' is available to foreign volunteers and international salaries are paid to 'expatriate' specialists - but these funds are some how not available to attract back to Malawi indigenous senior specialists by using them to fund transitional packages.


    Lwanda, J. 2002. Doctoring the brain drain: the medical case of Malawi. In Zeleza, P. T. and Vesey, C. R. (Eds) African issues, XXX/1: 47 – 51. ISSN 0047-1607.

    Muula, A. 2006: Nationality and country of training of medical doctors in Malawi African Health Sciences; Vol. 6, no 2, 2006.

    Picazo, O.; Martineau, T.; Herbst, C.; Walker, C.; Govindraj, R.; Human Resources and Financing for the health sector. Ministry of Health and the World Bank document, accessed 14/11/06 at

    John Lwanda, MBCHB, FRCP, PhD

    Competing interests

    John Lwanda is a Malawian working in Scotland