A month ago I shared a video about a village in Bulgaria, the “rapidly shrinking country”. Next door to Bulgaria is Romania which is also seeing its population evaporate. About 3.4 million Romanians have left the country in the ten years since its entry into the EU in 2007, a huge proportion of a population that now numbers about 19.5 million. According to the Population Reference Bureau, the country’s population is expected to sink by over a fifth in the next 30 years. Indeed, if this is accurate, this could be the steepest population drop in the world – a dubious distinction if ever there was one!

This ongoing population decline is due to familiar factors that most of the Western world experience: low birth rates and rising mortality rates. But at the same time, the large-scale emigration from Romania to Western Europe means that it cannot rely on net migration to cover the natural population decline. This migration flow is particularly acute among young educated Romanians who leave for better economic opportunities elsewhere. The scale of the problem can be seen in the health sector; about 43,000 doctors left the country in the years 2007-2017. Across the country, 26 percent of all doctor positions are vacant. In particular there is a shortage of emergency physicians and anaesthetists. The country is training young doctors and then seeing them leave – an example of how Europe’s open borders can help the wealthy Western countries at the expense of their poorer eastern counterparts.

(And Romanian doctors are not just fleeing to other EU countries. I worked in a New Zealand law firm with a man from Romania who was about 20 years older than me. He had been a trained surgeon before moving to New Zealand and was retraining as a lawyer. Aparently New Zealand didn’t accept the medical training in Romania as sufficient to allow one to practice medicine straight away!)

Although the Romanian government has doubled wages in the health sector over the past year, there is a real struggle to retain doctors, particularly in rural areas. In fact it may be that the doctor shortage is actually getting worse: in 2017 and 2018 up to 10,000 doctors left Romania. Some in the country are pinning their hopes on Brexit forcing Romanian doctors and nurses to return home from the UK, but that might be a thin reed to base one’s hopes on. Somewhat laughably, Romania’s needless bureaucracy means that even if doctors decide to return home, it will take months before the necessary paperwork is completed so that they will be allowed back and in to work… At least a declining population will require fewer doctors…

Marcus Roberts is co-editor of Demography is Destiny.