At no time during the past quarter of a century has there been substantial return migration to Pacific island states, despite the centrality of an ideology of return. Return has been greatest where distances have been less and economic opportunities greater, and consequently, least in more remote islands and regions (Connell 2009). Limited return migration is at least partly due to the significant differences in income levels between the island states and the metropolitan periphery, but also to a host of social and economic factors.

Those who have moved back to the Pacific from overseas stressed that the factors that resulted in their return migration (other than, or alongside, bonding) included climate, safety and the relaxed pace of life, or simply the familiarity of the home country and the presence of kin, where discrimination was less likely to be a problem—indicating how crucial social, political and economic stability is to return migration. However, they were unlikely to mention economic reasons for return. Few migrants returned because of conditions in the health sector or any great desire to return to work there. Where health workers returned to Pacific island states because of perceived economic benefits—such as the ability to open a store—these lay outside the health care system, which became, for some, mere supplementary employment. Returning workers within the health sector, though willing to contribute to the sector, were likely to resent the nepotism they found (which was quite different from the meritocracy of metropolitan states and hindered promotion and innovation), alongside a range of other problems, and stay for a relatively short period of time. Many migrants find return difficult, facing lower wages and standards of living, difficulty in establishing businesses and, simply, culture shock. Their success and their return were sometimes resented, both in the workplace (where they sought to make changes and introduce new ideas, etc.) and in local society (Maron and Connell 2008). The returnees had changed but, less obviously, so too had their homeland.

The skills drain is likely to continue, especially where there have been structural reforms that reduce public sector employment, where wages and salaries remain unequal, working conditions are difficult and hierarchical, international recruitment intensifies and many kin are overseas. For the health sector, the emigration of skilled workers has been widely seen as the most dramatic and significant example of the ‘brain drain’ from the Pacific islands, yet many do return. While relative numbers indicate that a considerable skills drain constitutes an imbalance, return migration is greater than might have been expected, where a general ‘myth of return’ has been suggested and where almost all migration from the Pacific island states has been of settlers rather than contract workers. While numbers may be small, their impact is significant for both social and economic development, in terms of gains to health services (through new skills and wider experience, and simply, additional labour) and to the economy for their (partial) investment of overseas-generated incomes. Most health workers who have returned have gained substantially in enhanced skills and experience overseas. Moreover, most have retained considerable local knowledge, education and expertise and are therefore in a position to integrate their new skills into the health system in a culturally sensitive manner (though this may not always be easy). Yet many are dissatisfied (for example, with the pace of life, hierarchical structures and their own inability to implement change), and return migration may be simply a stage in a cycle of continued migration, especially in the smaller states, where opportunities are relatively few and promotion prospects poor. Return migration, particularly of skilled workers, is therefore more problematic than for most other returnees.

On balance then, even for those who have established businesses or returned to good jobs, returning tends to be a social rather than an economic phenomenon. Indeed, given that many migrants return to look after relatives and thus may not have returned at times of their own choosing, their success is the more remarkable. Return migrants may be potential ‘agents of change’ but conformity is usually more appreciated than change.

Return results in some degree of confusion and uncertainty about roles and identities, enhanced by the expectations placed on returnees by individuals and social institutions, their own recognition that they had changed, and their inability to meet others’ expectations. Ambivalence is at the core of the Pacific ‘culture of migration’, where skills must be acquired overseas but dependent families remain at home. In a sense, Pacific islanders are similar to the Miskito Indians of Nicaragua who have been described as ‘leaving in order to stay’ and for whom migration has become a ‘way of maintaining the family by leaving the family; and it is also a means of going away without leaving’ (Nietschmann 1979, 20, 22). This is no less true of skilled migrants and emphasises how migrants are seemingly forever caught between two or more worlds as they strive to support their extended households while on journeys that are never complete in a transnational world.