As one account concluded: ‘Unfortunately the French health professionals participating in the caravans spent less than a month in Senegal, while their Senegalese counterparts come to Europe to stay for their whole professional life’ (Kane 2010: 12). A state role is still much needed, but as migration becomes more important such DIY self-help associations are pointing one way forward. Over a two-year period, 20 Ghanaians, the majority of whom were doctors, returned briefly to Ghana.