Dr. Leahcim Semaj

Transformational Psychologist | Author | Speaker | Social Philosopher

Dr. Garth Rattray wrote something recently that I have not been able to put down. In his article on the state of our healthcare system and its effect on returning residents, he named a fear that lives quietly in the chest of every Jamaican abroad who still dreams of coming home: what happens to me here if I get seriously ill? It is not a small question. It is, in many ways, the question upon which a person’s entire retirement plan turns. And Dr. Rattray is right to raise it.

But I want to sit with a larger question underneath his question, because healthcare, as urgent as it is, is only one room in a much bigger house.

The real question is not why so many of our people hesitate to return. The real question is: what, exactly, are we inviting them back to?

I raised a version of this in an earlier piece, “The Migration Dilemma — Part 3: A Jamaica Worth Returning To (or Staying In).” https://thesemajmindspa.com/2026/05/15/the-migration-dilemma-part-3-a-jamaica-worth-returning-to-or-staying-in/

My argument then was simple, and I still believe it: patriotism is not a strategy. Love of country will make a man homesick, but it will not, by itself, make him get on a plane with his pension and his grandchildren and come home for good. People do not organize their lives around sentiment. They organize their lives around opportunity, safety, dignity, and their confidence – or lack of it – in tomorrow.

And here is the uncomfortable truth I keep returning to in my own reflection: we are not short on diagnosis. We have never been short on diagnosis. Jamaica has commissioned more reports, convened more task forces, and produced more strategic plans than almost any small nation I know of. The problem has never been that we do not know what ails us. The problem has been that knowing and doing have never quite managed to shake hands.

On Healthcare, and What It Really Represents

Dr. Rattray is correct that healthcare weighs most heavily on the returning resident who is sixty, seventy, or beyond – which, as regular readers of this space know, is a population close to my own heart and my own age bracket. At this stage of life, a man learns to make peace with many inconveniences. He can live with traffic. He can live with slow bureaucracy and the occasional blackout. What he cannot live with – what none of us can live with – is uncertainty in the moment his body fails him. A stroke does not wait for the ambulance to find the road. A heart attack does not care whether the specialist is on the island or on annual leave abroad.

Many of our returning residents have spent thirty or forty years inside healthcare systems that, whatever their flaws, offered something Jamaica has struggled to guarantee: predictability. A specialist you can reach. A diagnostic test you do not have to wait six weeks for. A system that, when it fails you, at least fails you slowly enough to be corrected.

So when I hear that healthcare is discouraging return migration, I do not hear a medical complaint. I hear an economic one. A developmental one. Ultimately, a psychological one – because at its root, it is a question of trust, and trust, as I will come back to, is the real currency we are short of.

The House Has More Than One Room

Healthcare is the room Dr. Rattray walked us into, and rightly so. But a Jamaica worth returning to is built on several rooms, and they all have to hold weight at the same time.

There is the room of safety. Here, for once, I want to acknowledge something encouraging: Jamaica has recently recorded one of its most significant reductions in violent crime in a generation. This should not be waved away or taken for granted. Crime has been, for decades, the single strongest force pushing our people out and keeping them from coming back. If this improvement holds – if it is sustained rather than seasonal – it may become one of the greatest competitive advantages this country has had in my lifetime.

There is the room of economic opportunity. People do not leave home because they dislike home. They leave because they want a life that home, at the time, could not offer them. Many of the sharpest minds in our diaspora would return tomorrow if they believed they could earn a decent living, build something of their own, and plan a future here with the same confidence they plan one abroad. No country develops quickly while its best-trained people are its biggest export.

There is the room of institutional effectiveness, and this is where Dr. Rattray’s frustrations with bureaucracy deserve a second look. Every returning resident I have ever spoken with has a story about a line, a form, a office that closed early, a system that seemed designed to test their patience rather than serve their need. These frustrations communicate something far more damaging than inconvenience. They tell a person, in a hundred small ways, that their time does not matter here. A nation that wants its people back must learn to say, through its institutions and not merely its speeches, that it respects the hours of a citizen’s life.

There is the room of education, which I rarely hear discussed in the same conversation as migration, though the two are joined at the hip. No country has ever built lasting prosperity without investing seriously in the minds of its children. If too many of our young people leave primary school without solid footing in literacy and numeracy, without the habits of critical thought, then we are compromising the very labour force that is supposed to receive our returning residents’ investment and carry this country forward. Education is not a soft social service to be funded when convenient. It is infrastructure, exactly as real as a road or a port – the difference being that a road moves cargo, and a school moves human potential.

And there is the room of the diaspora itself, which I have come to believe is Jamaica’s single greatest untapped resource – greater than our bauxite, greater than our beaches, greater than our world-class musicians and athletes combined. Our people abroad already send billions home every year in remittances. They invest, they visit, they mentor, they open doors from boardrooms in Toronto and hospitals in London. What they lack is not goodwill. What they lack is the system that would let their goodwill do more than survive on faith. They do not need another speech thanking them for their sacrifice. They need transparency they can verify, accountability they can trust, and confidence that what they build here will still be standing, and still theirs, when they arrive to see it.

The Room Nobody Wants to Enter: Our National Psychology

There is a deeper room in this house, and it rarely gets discussed at the policy table because it cannot be measured in a spreadsheet.

It is psychological.

People return to places where they feel valued. They remain in places where they feel respected. They invest where they feel hope rather than dread. Migration, in the end, is never purely economic. It is a search for meaning, and a verdict on where a person believes that meaning can be found.

I have heard the same sentence, in different words, from Jamaicans on three continents.

I love Jamaica. I do not trust Jamaica.

That sentence should trouble every one of us, because trust – not GDP, not GNP, not any figure the World Bank tracks – is the true foundation on which a nation is built. Trust in institutions. Trust in leadership. Trust that the rules that apply today will still apply tomorrow. When trust rises in a society, investment follows it the way water follows a slope. When trust falls, everything else we build on top of it, however well designed, eventually cracks.

We Have Had the Blueprint All Along

Here is what I find, at seventy-four, both frustrating and strangely hopeful: none of what I have written above is a new idea. Reliable healthcare, safer streets, better schools, efficient institutions, real economic opportunity, and genuine diaspora partnership – every one of these already lives inside our Vision 2030 documents, our commission reports, our academic literature, our sector plans. We have not been short of blueprints. We have been short of the discipline to build from one for longer than a single election cycle.

That is not a criticism aimed at any government in particular. It is a national character question, and national character questions are exactly the kind of work I have spent my life doing – the slow, unglamorous work of helping people and institutions close the gap between what they know and what they actually do.

The Question Before Us

The question is not whether our people abroad want to come home. Many of them do – you can hear it in the way they talk about Jamaica even after thirty years away, the way the accent softens and the eyes change when they mention it.

The real question is whether Jamaica is prepared to become the country they are willing to return to.

And I would go one step further than that. A Jamaica worth returning to is also a Jamaica worth staying in. The country that finally builds reliable healthcare, safer communities, better schools, and institutions that respect people’s time will not only welcome home its pensioners and returning professionals – it will hold on to its nurses, its teachers, its young entrepreneurs, and its families who have not yet decided to leave. The same work that draws the diaspora home is the work that keeps the rest of us here.

This has never really been a migration problem. It has always been a nation-building problem wearing a migration costume.

We already know what to do. We have known for a long time. The only question still standing between us and the answer is whether, this time, we are finally ready to do it.

The Best Is Yet To Come.