Exodus Is Not the Cure—Justice Is
By Sirak Zena
Author’s Note
This response acknowledges Dr. Shimels Hussien’s credentials as an Associate Professor of Public Health. However, his recent article on Borkena, published on May 12, 2025, titled “Ethiopian Health Professionals’ Salary Increment Demand is Misguided: The Solution is Professional Secession from the Country,” raises serious concerns. Advocating for “professional secession” as a solution to the salary demands of Ethiopian health professionals is both alarming and disappointing, especially considering the vital role that public health experts play in policy analysis, advocacy, and community engagement.
The suggestion that Ethiopian doctors should ‘exit the country‘ rather than organize for systemic change is troubling. For a public health scholar to advocate for professional abandonment in an underdeveloped nation facing severe health inequities is counterintuitive—it abdicates the very responsibility that defines public health.
Public health is not a spectator sport. It demands active engagement, policy advocacy, and community-centered solutions, especially in fragile contexts like Ethiopia. To dismiss frontline physicians’ struggle for fair remuneration as ‘misguided’ misunderstands the fundamental role of public health professionals: to stand with the people, champion equity, and challenge systems that perpetuate injustice.
This critique challenges Dr. Shimels’ argument and reaffirms that public health experts are called not to retreat in the face of political decay but to advocate for the dignity and fair treatment of health professionals and the communities they serve.
1. Public Health and Professional Responsibility: A Misguided Premise
It is troubling that a public health professor would categorize Ethiopian physicians’ demand for fair remuneration as “misguided.” Physicians are not engaged in political theater; they are making a survival appeal. Their request is not for extravagance but for the bare minimum to uphold their professional duties and support their families.
Framing this as “unenlightened” reflects a profound detachment from the lived realities of healthcare workers. Public health scholars should champion these demands, not dismiss them. If defenders of public health fail to advocate for conditions that allow medical professionals to function, who bears that responsibility?
2. Agreement on Regime Policies and Refocusing on Healthcare Professionals
Dr. Shimels’s analysis of the regime’s policies is astute and difficult to refute. The deliberate creation of economic despair, particularly targeting professionals, is troubling in Ethiopia. However, while this political assessment is accurate, it should not lead us to abandon the fight for healthcare professionals’ rights.
Ethiopia’s political decay is undeniable. However, insisting that physicians solve this political crisis before seeking fundamental workplace justice is a false and unfair conflation. The struggle for fair remuneration and better working conditions for doctors and nurses can—and should—coexist with broader efforts for political reform. These are not mutually exclusive endeavors. Healthcare professionals have a unique responsibility to their patients and communities that transcends political strife. Their advocacy for improved conditions is critical to maintaining and enhancing the nation’s health infrastructure.
3. Ignoring the Sectoral Urgency of Healthcare
While Ethiopia’s economic crisis affects all professions, it’s crucial to recognize that healthcare is not just another sector but an essential public good. Teachers, engineers, and academics face similar hardships, but the collapse of the healthcare sector has immediate, life-and-death consequences.
Dismissing the doctors’ struggle under the broad argument that ‘all sectors are suffering’ dilutes the urgency and gravity of their situation. Structural reform and sectoral responsiveness are not mutually exclusive. Public health policy demands both.
4. The Ethical Imperative: Advocacy Over Abdication
The proposition of “professional secession,” as presented by Dr. Shimels, is not only defeatist but also poses a profound ethical dilemma with potentially devastating consequences. While it is understandable for individual health professionals to consider migration in search of better opportunities, framing mass departure as a strategic or national solution is deeply troubling. It reflects intellectual surrender and a misreading of public health ethics and responsibility.
Ethiopia’s healthcare system is already strained. Encouraging its most vital human resources—doctors, nurses, and other health professionals—to abandon their posts en masse would amount to prescribing a cure more deadly than the disease. Who will care for the most vulnerable if the healers themselves are gone? Such a move would further collapse an already fragile health infrastructure, deepen public health inequities, and undo decades of medical training and institutional development.
Moreover, the long-term impact of a health sector brain drain could leave the country ill-equipped to face future crises. The knowledge gap, service vacuum, and institutional decay that followed would set back Ethiopia’s progress for generations. No matter how well-intentioned, promoting exodus as policy is not pragmatism—it is abandonment.
Public health professionals have a unique ethical obligation: to use their expertise not only for patient care but also to improve systems and advocate for the well-being of the collective. They are bridge-builders between frontline realities and policy reform. Their duty is not simply to endure injustice in silence, but to challenge it through advocacy, organization, and public engagement.
Criticizing the regime’s oppressive policies is necessary, but it should fuel, not undermine, demands for justice within the health sector. Health professionals affirm their moral commitment and political clarity by staying and speaking out. They are not naive to decay but resist it from within.
Rather than endorsing silence through departure, we must elevate organized advocacy as the ethical and strategic path forward. Ethiopia needs more voices like theirs, not fewer. The fight for healthcare dignity is inseparable from the broader struggle for national renewal.
Defeatism Disguised as Logic
Dr. Shimels argues in his article, “Even a 100% increase—which is unlikely—would still leave professionals in abject poverty.” While the statement may reflect economic realism, it ultimately embodies a defeatist mindset that undermines the possibility of progress. Rather than serving as a call to action, it functions as a rhetorical dead end, suggesting that since the road is steep, there is no point in walking it. This fatalism, especially from a public health scholar, discourages advocacy and saps momentum from legitimate demands.
Although cloaked in realism, this assertion is ultimately defeatist and analytically shallow. It presents a grim scenario not to inspire action but to rationalize inaction. The fact that a 100% salary increase may still fall short of restoring professional dignity is not a reason to dismiss the demand—it is precisely why the demand is urgent. Progress is not achieved through all-or-nothing ultimatums but through incremental justice. To argue that modest gains are meaningless because they are insufficient is to perpetuate stagnation under the guise of realism. Ethiopian professionals are not asking for miracles but steps toward a dignified existence. Dismissing these steps because they are not leaps is a betrayal of logic and responsibility.
Exodus Is Not the Cure—Justice Is
As Dr. Shimels suggests, Ethiopian physicians’ struggle for fair remuneration is not a misguided plea but a professional, ethical, and humanitarian imperative. While his analysis of the political landscape is incisive, his proposed solution of “professional secession” is deeply flawed and potentially catastrophic for Ethiopia’s healthcare system.
Calling for a mass exodus of medical professionals is tantamount to prescribing a cure far deadlier than the disease. It reveals a misreading of healthcare workers’ ethical obligations and neglects the devastating consequences such an exodus would have on the country’s fragile public health system.
Yes, political decay in Ethiopia is real and concerning. But it cannot justify the abandonment of millions who rely on these professionals. Patients cannot flee their illnesses, and communities cannot migrate from their need for care. Encouraging those trained to heal to walk away from their duty is not reform but surrender.
Instead of retreating, we must transform frustration into a force for change. Ethiopia’s healthcare professionals must amplify their voices, not silence them through exit. They must demand justice—not only for themselves, but for every Ethiopian who deserves access to dignified, competent care.
Dr. Shimels’s stance underestimates the resilience and determination of Ethiopia’s medical community. Their persistence is not naïveté but a principled commitment to their profession and people. The accurate measure of a physician is not found in the comfort of foreign hospitals, but in the courage to serve under fire, in broken systems, for the sake of life and dignity.
Defeatism and abandonment are not viable options. The stakes are too high, and the cost too great. Every healthcare professional, public health expert, and concerned citizen must rally behind the call for justice, not exit. That is the ethical mandate. That is the public health duty.
The message to the regime and the world must be clear: Ethiopia’s healthcare professionals will not be driven out. They will stand, serve, and fight for the nation’s desperately needed transformation. This is not just their obligation—it is their destiny.
In Solidarity
We stand in full solidarity with Ethiopia’s doctors in their courageous fight for fair compensation, dignity, and the right to serve under just conditions. Their struggle is not isolated—it echoes the silent endurance of teachers in overcrowded classrooms and complicated lives, government workers grappling with shrinking wages, and taxi drivers navigating economic chaos to feed their families. This is a shared call for justice across all professions. It is a demand to be seen, heard, and valued. These professionals carry the nation’s weight in the face of neglect and hardship. They deserve not silence, but support, not abandonment, but alliance.
Editor’s Note : Views in the article do not necessarily reflect the views of borkena.com
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Mr Sirak. I’m a pediatric surgery (trained in Ethiopia, USA and Canada). The salary Ethiopia pays me is 110 usd. Check the internet yourself how much a pediatric surgery is paid in USA. Since last week, I am also forcefully prevented from private practice. Do you expect me to further waste my life??? Can I contribute to society while I’m sick?
The opinion of Dr Shimels is highly realistic, though it seems unpopular and not socially acceptable. Guess what? I wish I didn’t return to Ethiopia after doing my subspeciality in Ney Work. I wish I read sth like Dr Shimels’s oped when i was in 20s.
Now, I am 48 and I have only 10-12 to work as pediatric surgeon bc you are less likely to do fine surgery after 60. I need to immediately leave this country so that my remaining years would not be wasted.
Oh, Ethiopia is dead. Good only for cadres, and the lords of ignorance like the PP prosperity prophets.
Much respect to Dr Shimels