Doctors recruited from some of the world’s poorest countries to work in UK hospitals say they’re being exploited – and believe they’re so overworked they fear putting patients’ health at risk.

A BBC investigation has found evidence that doctors from Nigeria are being recruited by a British healthcare company and expected to work in private hospitals under conditions not allowed in the National Health Service.

The British Medical Association (BMA) has described the situation as “shocking” and says the sector needs to be brought in line with NHS working practices.

The BBC has spoken to several foreign medics – including a young Nigerian doctor who worked at the private Nuffield Health Leeds Hospital in 2021.

Augustine Enekwechi says his hours were extreme – on-call 24 hours a day for a week at a time – and that he was unable to leave the hospital grounds. He says working there felt like being in “a prison”.

The tiredness was so intense, he says, there were times he worried he couldn’t properly function.

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Doctors from Nigeria have told the BBC they are being exploited in the UK, in an investigation that includes exclusive data from the British Medical Association.

Thread 🧵 1/ ⬇️https://t.co/8o4UaCYCA6

— BBC News Africa (@BBCAfrica) October 14, 2022

A new Amazon sorting facility in Woodbury, Minnesota, is taking its employees’ religious needs seriously, adding new “ablution stations” for ritual hand and foot washing and three rooms that people of any faith may use for prayer or meditation.

The 550,000-square-foot facility, which opened this month, employs about 300 Somalis and Somali Americans, many of them refugees from the generation-long civil war in the east African nation. Minnesota is home to as many as 80,000 Somali immigrants, more than half of those living in the United States. More than 99% of Somalians are Muslim.

A stop for packages moving between Amazon warehouses and their shipping destinations, the Woodbury center includes signs in Somali as well as translation services. Other accommodations for all employees include lactation rooms for nursing mothers and soundproof booths for phone calls.

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A new Amazon site in Minnesota has taken steps to welcome Muslim employees, but a local leader says Amazon still has a way to go. “They are not trend leaders. They are catching up,” said @Jaylanihussein of @CAIRMN. https://t.co/s2xRyIrEjx

— Religion News Service (@RNS) October 14, 2022

An economic ennui has settled in among workers after the experiences of the last few years, said Julia Pollak, chief economist with ZipRecruiter, and that ennui is showing up in the numbers.

Nearly 20 million people were laid off in a matter of weeks as the pandemic took hold, regardless of whether they had strong work ethics, good performance or loyalty to a company. Then the economic winds shifted just months later, and companies were suddenly desperate to hire. Firings and layoffs reached historic lows. Existing employees were often worked to the point of burnout, newbies with less experience were brought on at a higher wage and employers overlooked things that could have cost workers their jobs in the past.

Workers came away from all of this feeling like the connection between working hard and being rewarded was broken, Pollak said.

“That’s really discouraging to top performers,” she added.

The result: This year, productivity — the measure of how much stuff companies produce for each hour we work — has seen the biggest drop on record.

Productivity is down 4.1% on an annualized basis, the biggest decline since the government started keeping track of the number back in 1948. Since then, U.S. productivity had been on a steady upward slope. Until now.

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Job market swings over the past few years have dampened the motivation of many workers and led to a decline in productivity. Economists say that could have a profound effect on the country's well-being.https://t.co/zqIWkB9gv0

— NPR (@NPR) October 8, 2022

When Debbie Ricks lost her job as a server in March 2020, she decided to chase a long cast-aside ambition: She would try to become a photojournalist, and get away from her undertipping customers. Last year seemed to be the time for a professional leap.

She had unemployment checks coming in, $1,200 a month. She could supplement food stamps with the pasta and applesauce cans she found on the streets. Most important, every restaurant in Washington, D.C., seemed to be hiring; at any moment, she figured, she could line up a job. But this summer, as her savings dried up and the cost of food rose, she began to feel that many of those backup opportunities had evaporated.

“I do kind of feel like, ‘Oh, Debbie, you should’ve jumped on that,’” Ms. Ricks, 44, said. “But I wanted to get back into journalism, which is what I love.”

After months of a booming job market, which prompted workers to quit and raised wages across industries, the job openings rate declined in August. Layoffs rose slightly, to 1.5 million, though they were still below their historical average. With fears of a recession looming, workers who were flush with opportunities are beginning to feel the anxieties of tightened corporate budgets.

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The Job Market Has Been Like Musical Chairs. Will the Music Stop?: https://t.co/kXOMZjalDA

— Cameron Sebastian (@crsfinance) October 7, 2022

It is hard not to feel a sense of foreboding. As the Federal Reserve has tightened policy, asset prices have plunged. Stocks, as measured by the Wilshire 5000 all-cap index, have shed $12trn of market capitalisation since January. Another $7trn has been wiped off bonds, which have lost 14% of their value. Some $2trn of crypto market-cap has vanished over the past year. House prices adjust more slowly, but are falling. Mortgage rates have hit 7%, up from 3% last year. And this is all in America—one of the world’s strongest economies.

Rising rates will slow the American economy and should break the back of inflation. But what else will they break? Since the Federal Reserve raised rates again on September 22nd, global markets have been in turmoil. When the British government announced unfunded tax cuts a day later, fire-sales by pension funds caused the yield on government bonds (or “gilts”) to spiral out of control. Contagion then spread to the American Treasury market, which is as volatile and illiquid as it was at the start of covid-19. The cost to insure against the default of Credit Suisse, a global bank, has risen sharply. These ructions indicate the world is entering a new phase, in which financial markets no longer just reflect the pain of adjusting to the new economic context—pricing in higher rates and lower growth—but now also spread pain of their own.

The most catastrophic pain is felt when financial institutions fail. There are two ways they do so: illiquidity or insolvency. Tighter monetary policy is likely to prompt or reveal both.

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Rising rates will slow the American economy and should break the back of inflation. But what else will they break? https://t.co/9jMyduKXBk

— The Economist (@TheEconomist) October 5, 2022

Since the start of the 21st century, per capita growth dropped to less than half its previous 1950-2000 tempo. With the rate creaking along now at just over 1 percent per annum, incomes would take more than 60 years to double; from 1980-1999, the doubling pace was 31 years.

A significant factor in modern America’s slower growth — and the lower expectations it unforgivingly imposes — is the drop-off in work. The country is aging, of course, but population graying does not explain the collapse of employment for men of the 25-54 prime working age (women’s labor force participation rates have been declining too, but not as steeply). Nor can it account for the anomalous emergence of a peacetime labor shortage in post-pandemic America, even as workforce participation rates remain stuck well below pre-pandemic levels.

Instead, these are manifestations of a troubling, once unfamiliar but now increasingly entrenched syndrome. Call it the “flight from work.”

Although the unemployment rate for prime-age men in August was a mere 3 percent, only 86 percent reported any paid labor. The remaining 11 percent were labor-force dropouts — neither working nor looking for work. These “not in labor force” men, who now outnumber the formally unemployed by more than 4 to 1, are the main reason that the country’s prime male work rate has been driven below its 1940 level — when national unemployment rates were nearly 15 percent.

Astonishingly, yes, the United States has a Depression-scale work problem.

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The United States has a Depression-scale work problem. The prime-age male work rate is below its 1940 level. Labor-force dropouts are the main reason, Nicholas Eberstadt of @AEI writes in a guest opinion. https://t.co/GIPxUJ4Df3

— Washington Post Opinions (@PostOpinions) September 21, 2022

Joseph White, who lives in Nashville, lost his job at Guitar Center six months into the pandemic. But he says he’d had enough: The store was constantly short-staffed and customers were intractable. In one instance, a shopper pulled a gun on him for trying to enforce the company’s mask mandate.

“I’m tired, I’m broken down, worn out and old,” the 62-year-old said. “I was worked to death for so long that finally, I said, there’s no way I’m going back.”

He’s begun drawing on Social Security payments to make ends meet, and helps his wife run her small shop, Black Dog Beads. But White says he has no intention of joining the labor force again.

“Our quality of life is far better even though we have less income,” he said. “I got tired of being a commodity.”

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Reinvent jobs to be attractive to the 10,000 baby boomers turning 65 every day & the worker shortage is partially solved. Retirees will pursue encore work on their own terms, e.g, working remotely, 3-4 days a wk, unpaid leave opps, etc. #writingcommunity https://t.co/dDU79XuQRR

— J.B. Watson, Jr., Ph.D. (@GWashingtonInde) September 17, 2022

“Quiet quitters” make up at least 50% of the U.S. workforce — probably more, Gallup finds.

The trend toward quiet quitting — the idea spreading virally on social media that millions of people are not going above and beyond at work and just meeting their job description — could get worse. This is a problem because most jobs today require some level of extra effort to collaborate with coworkers and meet customer needs.

U.S. employee engagement took another step backward during the second quarter of 2022, with the proportion of engaged workers remaining at 32% but the proportion of actively disengaged increasing to 18%. The ratio of engaged to actively disengaged employees is now 1.8 to 1, the lowest in almost a decade.

The drop in engagement began in the second half of 2021 and was concurrent with the rise in job resignations. Managers, among others, experienced the greatest drop.

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Is Quiet Quitting Real? Jim Harter via @GallupWorkplace https://t.co/wWFaPQp6gU •At least half of the U.S. workforce is quiet quitting
•The workplace, amid the pandemic, got worse for younger workers

— Kitty Wooley (@kwooleyy) September 6, 2022

For Theresa Clarke, a retiree in New Canaan, Conn., the rising cost of living means not buying Goldfish crackers for her disabled daughter because a carton costs $11.99 at her local Stop & Shop. It means showering at the YMCA to save on her hot water bill. And it means watching her bank account dwindle to $50 because, as someone on a fixed income who never made much money to start with, there aren’t many other places she can trim her spending as prices rise.

“There is nothing to cut back on,” she said.

Jordan Trevino, 28, who recently took a better paying job in advertising in Los Angeles with a $100,000 salary, is economizing in little ways — ordering a cheaper entree when out to dinner, for example. But he is still planning a wedding next year and a honeymoon in Italy.

And David Schoenfeld, who made about $250,000 in retirement income and consulting fees last year and has about $5 million in savings, hasn’t pared back his spending. He has just returned from a vacation in Greece, with his daughter and two of his grandchildren.

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The poor are disproportionately affected by high inflation. They are *also* disproportionately affected by high unemployment — which is the likely consequence of the Fed's efforts to fight inflation.
My latest w/ @jeannasmialek:https://t.co/RpUDpci1e2

— Ben Casselman (@bencasselman) August 8, 2022

European workers have put in fewer hours than Americans for decades. Now, they are working even less than before the pandemic—almost one day a week less than Americans in 2021, according to data for the five biggest European Union economies.

Since the start of the pandemic, Americans have increased their working hours by about 1%, on average, while Europeans have trimmed theirs by around 2%, according to data about the five large EU economies from the Organization for Economic Cooperation and Development.