Tuesday, January 9, 2007

Where Are Our Nurses ?

Recently, I was in conversation with a friend who is in the business of preparing Indian Nurses to go abroad and work – brush up their English, sharpen their professional skills, assist them with their visas and placements and so on. She told me that business was booming and in spite of tightening immigration laws in many places, nurses, particularly Indian nurses were always in demand. She further told me that in places like the Philippines, there was actually a shortage of doctors and many health facilities were closing down as doctors were choosing to work as nurses. Last year, The Asian Pacific Post lately reported that about 6,000 doctors in the Philippines are studying to become nurses so they can find higher-paying jobs abroad. A doctor working in a government hospital in the Philippines earns only about 25,000 pesos (446 dollars) a month. A doctor could earn around 8,000 dollars a month while working as nurse overseas. Apparently, the phenomenon is slowing beginning to happen in India too.

If people migrate overseas for economic benefit alone, it is possible some times to sit back on our moral high horse and berate those who if they had stayed back might have contributed to the nation’s development. After all, the annual NRI jamboree, the Pravasi Bharatiya Divas, has just gone by and the Prime Minister has called upon overseas Indians to invest in their country of origin, not just financially, but intellectually, socially, culturally and emotionally as well. But the surprising thing is that it would seem that India’s nurses do not migrate, just because they want to be richer than you or me.

Although financial remuneration is an issue , dissatisfaction with working conditions and unhappiness with prevalent social attitudes towards nurses have been identified as being of crucial importance for the international migration of Indian nurses. It was found that nurses working in the private sector and from some linguistic and religious groups were particularly prone to migration. Nurses working in the government sector seemed to be more worried about being unable to adjust to working conditions abroad and therefore less keen to migrate. The fact that they enjoyed better pay scales, a more relaxed work atmosphere and more facilities may have also played a part here. What seemed to be vital to the decision to migrate for a large number of government sector nurses belonging to the so-called `Forward' and `Middle' Castes was that they were being crowded out of promotional avenues as a result of the government's policy of Reservations in Promotions for Scheduled Castes and Tribes.

Although the migration of nurses from India and the reasons for the same are relatively well documented, it may be safe to say that India has not just a social caste system but also a professional caste system where some professions are praised to the skies and some are berated. For instance, although the medical profession is rife with unethical practices and graft eating away at its very vitals, doctors are held in high regard. Nurses on the other hand, work longer hours for measly pay and emoluments and with hardly any social recognition and stature. A lot of effort and activism is going on in fighting social inequities and rightly so. But a lot still needs to be done to correct professional imbalances and reduce the gap in the pecking order. Only then can we afford to criticize nurses and others who are looked upon with professional and social disdain when they quit our shores and look for financially and occupationally lucrative pastures.

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