Posted by Asha Mary Reji
As India continues to reel under the calamitous second wave with massive community spread and tolling deaths, the need for more nursing staff in the country’s healthcare system has never been more obvious than now. The Union Health Ministry data reveals the startling truth that there are only 1.7 nurses per 1000 people in India which is less than the World Health Organisation (WHO) prescribed minimum of 3. With many infected, including health care workers, India is going through the second-largest shortage of nurses in the world after Bangladesh.
Although India has 2.34 million registered nurses and midwives, the Indian Nursing Council data says that we are still short of 1.94 million nurses. The main cause of this shortfall in domestic nurses is the medical migration that happened over the past years. India is the second-largest country from where nurses are migrating after the Philippines and we have our nurses working all across the globe, especially in Gulf, OECD and in some Asian parts. As globalisation progresses and demand for the nurses continues, the migration statistics also escalates.
In India, the government medical sector provides the nurses with better salaries and benefits than the private medical sector. This salary gap between the private and government sector is a reason for the nurses in the private sector to migrate abroad. The need for a better-salaried job, financial independence, higher standard of living, safer working atmosphere, job security, freedom of choice and delaying of early marriage are the other reasons for nurses to migrate from India. Countries with a higher proportion of older age population, medical tourism and gulf nations where women do not take up the nursing profession due to cultural restrictions hence become the factors that add to this migration. Today more than 6.4 lakh Indian nurses work abroad, among which most of them are financially stable, few of them even took their families along with them and the rest are funding their kin living in their native states.
Education and salaried employment have been regarded as important indicators of women’s status. Although a bold and progressive step taken by nurses in India to migrate abroad in search of better socio-economic conditions, this also comes at a cost. Women stay away from their loved ones for years, some to never return, thus letting go of the simple joys of being with their families, because nurses in India are undervalued, underpaid and overworked. In May, Soumya Santhosh, a Malayali nurse working in Israel, was killed in a rocket attack. She was on a video call with her husband who lives in Kerala, when the attack happened and the call got abruptly cut. So, just as empowered the migration of the nurses from India seem, it is also a decision driven due to the country’s indifference to the state of nurses in India.
Women in Kerala with a high literacy rate stands out from the whole of India paving a scope and way for this migration. Instead of connecting girl’s education with its cultural value, many of them have seen it as a direct means to secure employment and to compete with men in the open market. However, in this process of brain drain, we lose our potential healthcare workers, who if the state had provided better opportunities with, would have stayed back and served the country. After all, when India is struggling through a bad second wave with an acute shortage of healthcare workers, we need to introspect where have we failed? How can India retain its healthcare workers within the state itself?
For one, Nursing Staff Exam should be conducted regularly and the recruitment and appointment of qualified staff have to happen regularly from time to time which was earlier not proper in India. Bihar Health Service Association reports that only 60%-70% of medical and paramedical seats are being filled in the state. These shortages of staff during the pandemic time will cause fatal consequences on COVID-19 patients. Another issue is regarding the appointment of nurses which is temporarily done on a contract basis for a short period. Most individuals show no interest to work for few months, as there is no income stability but a huge risk for their lives. So they prefer to not work by risking their lives over jobs that provide no financial security.
Yes, India could have been prevented this drain-out of nurses by providing them with a higher salary, better working conditions, flexible labour hours and enabling job security. The government of India was not successful in most of it and even today, nurses in India are not paid considerably for the tireless service they render. Their round-the-clock job, selflessness and sacrifice to save others life over their own and their family, really needs to be appreciated and rewarded with better remuneration than just some flower shower shows.
Asha Mary Reji, a first year MSc Economics student at Bengaluru Dr B.R Ambedkar School of Economics University. Field of interest includes caste, discrimination, environment, social political and economic research. You can find here on Instagram and Twitter.
Featured image source: Straitstimes