They are everywhere. Across India, across the world, taking care of patients, burning the midnight oil in the ICUs. Under gruelling pressure, working over time, mostly at the receiving end of both doctors and the patient’s relatives.
While no exact figures are available, a narrow estimate suggests that there are 22 to 25 lakh ‘registered’ nurses in India. Out of these, close to 15 lakh nurses work abroad in Gulf, Middle East, US, UK or Australia. A whopping majority of these nurses are from Kerala.
Minimum salaries with no employee benefits, harsh working conditions, exploitative recruitment agencies and death threats in countries like Egypt and Libya. At Kottayam, the nursing belt of Kerala, speak to any staff nurse or a nursing institute trainee, the list of concerns and problems seems endless.
It’s been two months since 32-year-old Reena came back from Iraq. The job cost her an education loan plus five lakh to the recruitment agency. Her ailing father made sure she gets married before leaving for the foreign land. For the next five years, the newly-weds met once or twice a year.
Reena’s husband, a male nurse at a hospital in Oman, has managed to retain his job but a lot of their savings are spent in taking care of a large and needy family.
In Kerala, the average salary of a nurse is eight to ten thousand rupees. For the same work, but better working conditions, you may get anything between 75 thousand to 1 lakh in Saudi. US may even pay you 1.5 to 2 lakhs a month. When I took a loan, I had a bright future in mind. I had to leave Iraq because it was getting dangerous. I lost eight months of my salary because the hospital kept delaying the payments. Now I am trying for Oman. We cannot have a baby till this gets settled.
So why is the election cacophony in Kerala silent over the issue of nurses? In Mallapuram – the hotbed of remittance economy in Kerala – while candidates visit Gulf and Middle East to campaign amongst overseas Keralites, nurses in and outside India are never seen as a major vote bank.
Father Jose from Catholic Bishops’ Conference of India, campaigned for the labour rights of the nurses while he was in Kerala. He says:
No one has ever talked about them in elections. They form a huge vote bank but they are scattered and their electoral representation is nil. NRI community from Mallapuram is rich and influential that contributes huge amounts to party funds, but nurses lack any such influence and there is no leadership to negotiate on their behalf.
In 2011, a suicide by a nurse from Kerala brought the community together and saw the first ever wide-spread strike across 150 hospitals in Kerala. The nurses wanted to highlight the issue of exploitation in the thriving private hospital industry. While it did lead to a few changes, the hospital managements united as nurses fragmented. The movement gradually died its own death.
Losing all hope, nurses in Kerala, prefer to stay away from agitations and controversies.
Twenty-six-year-old Stephy, a staff nurse at Kottayam’s biggest health centre and nursing institute, is counting her days in India. She aspires to go to Australia or Canada, but if middle east comes calling, she may find it hard to resist.
If I deny working for a lower salary, somebody else is ready to work for half my payment. So we don’t have many options. Government hospitals are still regulated but private hospitals have managed to keep salaries at a minimum. It’s too much work with no returns.
While Stephy sounds disappointed and annoyed by lack of unity and lobbying power, she clearly prefers to stay away from politics or any mention of elections.
Since 2011, hospital managements usually keep a close watch on such activities. We do have a few FB groups for nurses. They post memes and slogans for unity, but to be honest, I never share them. Nothing has ever made a change, so why invite trouble?
After this, I realised why speaking to staff nurses and trainees in the hospitals took me rounds and rounds of permissions, with endless requests to hide names and strictly no photography.
Awaiting salary corrections, better working conditions and a check on duping recruitment agencies, election issues for nurses in Kerala are all crucial. However, as Kerala goes to poll on 16 May this year, the electoral candidates have not even promised, let alone assured, a better survival to the nurses.
Private managements these days avoid hiring male nurses who are usually more vocal and demanding about their rights. ‘Sacrifice’ is the word that rules this profession, so strikes and unions are never talked about freely. We are trying to unite the community, but it has taken far too long.Roy K George, President, Trained Nurses Association, Calicut
(A few names in the story have been changed on request)
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