Ethiopia suffers from a medical shortage or brain drainthat has severely affected its already fragile health care system. The country has a very low physician-to-population ratio,whilemany in the medical community continue to leave in great numbers. Aphenomenological approach was used in this study to explore the lived experiences of medical doctors who have left Ethiopia, with contemporary migration theory serving as the conceptual framework. The central research question focused onwhy Ethiopian medical doctors leave their country and what can be done to retain them. Participants were 10 medical doctors of Ethiopian origin who live and practice medicine in the Washington, DC metropolitan area. Participantswere purposively selected, and in-depth interviews and a focus group discussion were used to collect data from them. The study followed Moustakas' recommendations for phenomenological analysis, which representeda modification of the Stevick-Colaizzi-Keen method. The themes that emerged during data analysis have economic, political, professional, and personal dimensions. The findings includelow pay, lack of professional development, poor working conditions, the threat of political persecution, fear of contracting HIV, and inability to participate in health care decision-making. Recommendations accordingly include offering pay raises and fringe benefits, creating opportunities for professional development, improving working conditions, and limiting political interference in the health care system. Implications for positive social change include the fact that stemming the outflow of medical doctors could help save the lives of thousands of Ethiopians threatenedby preventable and curable diseases.

Thesis advisor: Donald Cox / I investigate the effect of the medical brain drain on health in sub-Saharan Africa. Such information would be invaluable to policymakers; if doctors are likely to emigrate, there is little benefit in investing in their training. Previous work has mostly been limited to measuring correlations, which fail to illuminate causal pathways; countries with weakly structured healthcare systems may have both poor health and high physician emigration. I address the problem with an instrumental variable. For African countries with historic colonial ties to the United Kingdom or France, I used immigration policy changes in these European nations to instrument for the medical brain drain. Higher rates of medical brain drain cause decreased physician density, decreased rates of measles immunizations among children, and increased rates of HIV prevalence in sub-Saharan Africa. Therefore, I conclude that targeting physician emigration would help improve health in the region. / Thesis (BA) — Boston College, 2013. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program. / Discipline: Economics Honors Program. / Discipline: Economics.