In a recent encounter with a Nigerian doctor, when in hospital recovering from an illness, it emerged the owner of the soothing voice that aided one’s convalescence was unhappy. Not with her patient – a challenging case no less – but with her career in her country of birth.
And she is one of the more fortunate ones. As a doctor in a private hospital in a highbrow area of Lagos, she was relatively well-paid. And judging from what one garners from those long hours of forced idleness when admitted in hospital, this particular hospital gets a number of cases.
Imagine the irony: whereas the individual hopes to suffer less afflictions, if at all, the doctor’s joy comes from a case worth his or her time. The more complicated, the better. Still, a doctor’s experience, even in the best teaching hospital in the country, pales in comparison to that of lesser professionals in Europe and elsewhere.
Money is also a huge motivating factor. Still, whether in the United Kingdom (UK) or the United States (US), the experience does not always turn out as dreamed of. Racism is usually a problem. And career mistakes are punished severely. Nonetheless, those with some training in these parts (West Africa) beforehand are able to easily bank on a coping mechanism honed during their grinding student days.
Whereas other professionals, in financial services, law, and so on, could easily keep abreast of developments in their sectors, whether they are in their country or abroad, the peculiarities of the medical profession and rapid technological advances in the sector mean practitioners not adept in the most advanced and recent practices would find themselves no more than quacks over time.
Ironically, being initially trained in Nigeria allows for mastery in the old-school ways of medicine that tend to come in handy where practitioners have become “spoilt” with various technological aids. And in fact, the continent is wealthier by the experience garnered by its medical professionals abroad, who often give back in the form of free surgeries and so on.
How many Nigerian doctors actually seek greener pastures abroad? More than 60% of registered Nigerian doctors practice abroad. Most of the remainder who grudgingly ply their trade locally plan to cross the seas at the slightest opportunity. And despite the backlash against migrants in Europe and elsewhere, doctors and other advanced professionals are actively courted. Not entirely. The UK put a cap on the migration of skilled non-EU workers recently. Short of medical staff, the government has reversed itself. Now, migrant doctors with firm offers from UK hospitals do not have to worry about getting a visa: they will get placed. No doubt music to the ears of many aspiring Nigerian doctors.
The exodus comes at great costs for the country, though. There is one doctor for about 4,000 Nigerians at the moment. With more doctors heading abroad, that statistic would only get worse by the day. Quality healthcare is out of the reach of those that need it the most. The privileged, who can afford healthcare anywhere in the world, are ironically the ones with the means to avail themselves of the best locally.
To be fair, the authorities are not insensitive to the problem. A compulsory health insurance scheme for Nigerians in paid employment means almost anyone with a job would be able to afford basic and secondary medical care. Of course, it is another matter if the ailment is more advanced and requires extensive, sustained care; and perhaps more abroad. A newly-instituted patients’ bill of rights also means that any Nigerian, of any means, would not be subject to the gross abuse that many poor patients, who also tend to be ignorant of their rights, get subjected to with impunity. What would prevail in practice is another matter, though.
During my recent forced interaction with the medical world, each stage of treatment was presaged by a business executive brandishing a point-of-sale terminal: swipe your card, get treated. Quality medical care in Nigeria remains exclusive.
– Rafiq Raji
A Bad Omen? Emerging Markets ‘Most Crowded Trade’ For First Time
Investors made a U-turn on emerging markets, naming them the most crowded trade, in Bank of America Merrill Lynch’s survey for the first time in its history.
This marked a big reversal from last month, when fund managers said “short EM” was the third most-crowded trade – showing how fast the mood can shift in an uncertain market.
It could prove to be a bad omen for emerging markets, though, as assets named “most crowded” usually sink soon afterwards.
Previous “most crowded” trades have included Bitcoin, and the U.S. FAANG tech stocks, which led the selloff in December.
Emerging-market stocks .MSCIEF are up 7.8 percent so far this year, and flow data on Friday showed investors pumped record amounts of money into emerging stocks and bonds.
Emerging-market assets had a torrid 2018. Crises in Turkey and Argentina ripped through developing countries already suffering from a strong dollar and rising U.S. yields pushing up borrowing costs.
But a dovish turn by the Fed at the start of the year, indicating the world’s top central bank would not raise interest rates as quickly as previously expected, sparked fresh enthusiasm among investors.
Major asset managers and investment banks such as JPMorgan, Citi and BlueBay Asset Management ramped up their exposure to emerging markets in recent weeks..
The Institute of International Finance (IIF) predicted a “wall of money” was set to flood into emerging market assets.
However, there are some indications momentum may be waning. Analyzing flows of its own clients, investment bank Citi noted they had turned cautious on emerging-market assets over the last week, with both real money and leveraged investors pulling out funds following four weeks of inflows.
BAML did not specify whether the “long EM” crowded trade referred to bonds, equities or both.
Outside emerging markets, investors’ main concern remained the possibility of a global trade war. It topped the list of biggest tail risks for the ninth straight month, followed by a slowdown in China, the world’s second-largest economy, and a corporate credit crunch.
Overall, BAML’s February survey – conducted between Feb. 1 and 7, with 218 panelists managing $625 billion in total – showed investor sentiment had hardly improved. Global equity allocations fell to their lowest levels since September, 2016.
“Despite the recent rally, investor sentiment remains bearish,” said Michael Hartnett, chief investment strategist at BAML.
Investors remained worried about the global economy, with 55 percent of those surveyed bearish on both the growth and inflation outlook for the next year.
“Secular stagnation is the consensus view,” BAML strategists wrote.
Following this theme, investors were most positive on cash and, within equities, preferred high-dividend-yielding sectors like pharmaceuticals, consumer discretionary, and real estate investment trusts.
As investors added to their cash allocations, the number of fund managers overweight cash hit its highest level since January, 2009.
The least preferred sectors were those sensitive to the cycle, like energy and industrials – which BAML strategists see as good contrarian investments if “green shoots” appear in the global economy.
Worries about corporate debt were still running high, with this month’s survey showing a new high in the number of investors demanding companies reduce leverage.
Some 46 percent of fund managers find corporate balance sheets to be over-leveraged, the survey found, and 51 percent of investors want companies to use cash flow to improve their balance sheets. That’s the highest percentage since July 2009.
Europe, one of investors’ least-favored regions, showed a slight improvement. A net 5 percent reported being overweight euro zone stocks, from 11 percent underweight last month.
But investors’ reported intention to own European stocks in the next year dropped to six-year lows as the profit outlook for the region continued to lag.
Allocations to UK stocks increased slightly from last month but the UK remained investors’ “consensus underweight”, BAML said. It has been so since February 2016. -Reuters
-Josephine Mason, Helen Reid, and Karin Strohecker
South Africa’s Central Bank To Wait Until May For Next Rate Hike
The South African Reserve Bank will not raise interest rates again until May, according to a Reuters poll, taken after the central bank surprised many economists last month by adding 25 basis points to borrowing costs.
The median forecast in the poll of 25 economists, conducted over the past week, suggests the central bank will wait until May before hiking interest rates by another 25 basis points, taking its key rate to 7.00 percent.
The Reserve Bank increased its benchmark lending rate for the first time in nearly three years last month, saying the risk of higher inflation in the longer-term remained elevated and that it could not risk waiting until later to take action.
“Risks to the inflation outlook remain to the upside, on possible rand depreciation and above inflationary increases in administered prices, particularly electricity tariffs,” Investec economist Kamilla Kaplan wrote in a note.
She pointed out that debt-troubled state-run utility Eskom proposes to increase electricity tariffs by 15 percent a year for the next three years.
The poll predicted inflation would quicken to 5.3 percent next year from 4.7 percent in 2018.
A separate poll last week suggested the rand ZAR=D3 will erase around a third of the 10 percent gains it made in the past two months in the run-up to elections next May as strong volatility rattles the currency, adding to inflationary pressures.
However, the Reserve Bank reacts more strongly to any signs of second round effects on its inflation outlook rather than to currency weakness.
Another poll showed analysts are increasingly pessimistic about the prospect of an oil price rally next year, even though markets expect OPEC to cut output.
Wall Street rises on trade optimism
Brent crude LCOc1 eventually affects local inflation, from factories through to consumers.
South Africa’s Reserve Bank tries to keep inflation in the middle of its 3-6 percent target range.
The South African economy is expected to expand to 1.5 percent next year from 0.7 percent this year. The economy expanded 2.2 percent in the third quarter, taking the country out of recession. -Reuters
- Vuyani Ndaba
- Additional polling by Khushboo Mittal in Bengaluru
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