ABSTRACT
A well-established structure and a dual culture of migration have become established in the Pacifi c. Skilled health workers have moved to take advantage of superior wages and salaries, training and research opportunities and working conditions for themselves, and to better the lifestyles of their children and extended families, through education, social change and remittances. Migration is likely to continue, especially where there have been structural reforms that reduce public sector employment, wages and salaries remain unequal, working conditions are diffi cult and kin are increasingly overseas where demand is increasing. Policies that redress such diverse circumstances have proved diffi cult for small island states, while governments have rarely sought to intervene in the process of international migration. Indeed, once concerned over the diverse costs of migration, islanders, from individuals and households to extended families and national governments, are increasingly likely to seek out new migration opportunities.
