It's not often that one can say that Robert Mugabe is right, but his recent complaint about British (and no doubt Irish) recruitment of Zimbabwean doctors and nurses has some substance to it. Yes, of course, the man is bonkers, a frothing psychopath who has turned Zimbabwe, once the bread-basket of southern Africa, into a terrestrial copy of the Sea of Tranquillity. And yes, the entire Zimbabwean cabinet are millionaires, their money safely stashed in Swiss accounts, writes Kevin Myers
But he has a point, and not just about his country, but perhaps about all of Africa. For you can argue either way about debt relief for debt-ridden African countries. You can say that the debt is crushing the life out of African economies, or you can say the demands for repayments of the debt are reminders to the lunatics who run so many of these countries that they will be held answerable for their fiscal delinquencies.
Rights and wrongs
You can argue about the rights and wrongs of aid, even as President Mkapa of Tanzania spends £14 million of aid money on a personal jet, bringing his total to three, and another £28 million of aid money on an air traffic control system, presumably to ensure he doesn't collide with himself. Yet we do know some aid certainly does find its way to its intended target.
But the way that first world countries are recruiting doctors and nurses from third-world countries racked with famine and disease is simply abominable; as is the insensate greed with which we pursue our own personal health, while insisting that we do not sacrifice our wealth for such health.
We are health-obsessed, and are prepared for any price to be paid to maintain our medical services, provided that price is paid in part by the populations of economically under-developed countries. Our suction of the medical castes of much of Africa and Asia into our health systems, and our failure to discuss the ethics of this, compares with European attitudes to slavery in the 18th century. Don't ask uncomfortable questions about where we're getting what we need. Then it was cheap raw produce, now it is cheap health.
The Western world spends uncountable billions on squeezing a few extra years of life for its populations. In Ireland, we already spend over €8.5 billion on health. In the US, government-financed health schemes will cost $750 billion by 2012. The British plan to increase their health budget to £90 billion within two years. Yet despite these vast sums, the health services of all those countries would collapse without importing cheap labour from third-world countries.
These are precisely the countries where populations face catastrophe. Forty million people now have HIV/AIDS and, at about same the time the Americans will be spending $750 billion on their state-supported health schemes (never mind their private ones), most of the peoples of sub-Saharan Africa will have a life expectancy of under 40.
Now, what we should be doing is ensuring that doctors and nurses stay in these African countries, and that their hospitals function. The reverse is happening. Zimbabwe has fewer than half the number of doctors it needs to maintain minimum services.
Doctors emigrate
Most doctors emigrate within a year of graduation. Those who stay earn - in real terms, rather than the gibberish of Mugabenomics - €60 a month. Moreover, most hospitals are without the most basic equipment. So who can blame an African doctor for leaving? The developed world should be ensuring that medical aid and expertise are going to those countries experiencing the greatest and most catastrophic pandemic in global history. Yet the flow is the other way round, in large part because we expect "cheap" medical services. How many of us spend more on health insurance each year than we do on holidays? Almost nobody does, yet we expect possibly the most expensive personal service ever to come our way to be paid for mysteriously either by the state or by medical insurance companies, without true cost to ourselves.
Our populations are growing older as the life expectancy of the people of African countries plummets, and we strip those countries of whatever medical assets we find useful. Worse, our populations assume that they have a natural right to longer life expectancies, and this assumption unites left and right. It is a consensual creed that defines the way we think of ourselves and our society, a central orthodoxy of our political culture as unquestioned as once was the notion that tiny paupers make excellent child chimney-sweeps, that witches should be burnt alive and Africans enslaved.
Grisly future
We are creating a grisly future for the entire planet, one in which incontinent nonagenarians, babbling and drooling in their expensive first-world beds, are wiped, washed, changed and spoon-fed by nurses from the very countries where children, filthy, disease-ridden and unattended, perish by the million.
Maybe Africa is destined to lurch back into some desperate Dark Age, in which the skills of sowing and harvesting are forgotten and all sense of planning for the future is lost, as the population is reduced to caravans of plague-bearing nomad-bandits shuffling between the ruins of abandoned cities. Maybe that is inevitable; and maybe it's not. But history will not judge lightly those peoples who drew from Africa the medical skills that Africa needed most just as its journey to Golgotha began.