This morning Laurie Garrett tweeted an important question: Given the latest death of a Filipina healthcare workers in Saudi Arabia, would expatriate HCWs run for home?
I suspect the answer is no.
That's because I'm reading a book by Gulf expert Christopher Davidson, After the Sheikhs: The Coming Collapse of the Gulf Monarchies. Among many other fascinating observations, he argues that the Saudis and other Gulf states are "rentier" economies: The monarchs make money off oil and the function of the local monarch is to distribute some of that money to local citizens. This amounts to a "ruling agreement": In exchange for no or low taxes, free or cheap housing, and guaranteed jobs, the locals agree to support the local emir or king. Otherwise they'd throw out him and his whole damn pretend-royal family.
To do the jobs needed for development, the monarchs import skilled and unskilled labour—mostly from South and Southeast Asia. Hence the hundreds or thousands of Filipino HCWs in the Gulf, and thousands more unskilled Bangladeshi and Pakistani labourers in Qatar imported to build football stadiums for the 2022 World Cup.
The expats have made their own ruling agreement: They know they're being exploited, but the money is still better than they could expect in a similar job back home. Their families (and their national economies) rely on remittances. Besides, experience has shown that those who complain too much about working conditions will be bundled onto a plane home with blinding speed.
So even if expat HCWs continue to fall ill and die, the vast majority will stay put. Partly this will be due to economic necessity, but mostly it will be due to sheer professionalism. HCWs have every reason to be scared of MERS, and every reason to be angry at sloppy infection control. But most will stick around because their patients need them.