Indian nurses migration and the reshaping of gender roles in India

Gender Perspectives on Globalization

The social impact of globalization: case of Indian nurses migration

The globalization advent can be dated back to the post WWII era leading to the cold war period where countries increasingly chose the nations that they aligned their diplomatic, political and economic allegiances to. This trend was informed by the global economic trends that prevailed after the WWII and the need for economic allies in order for a country and to some extent a region to survive. The World Bank (2014a) advances globalization as the increased interdependence of countries on each other due to the ever increasing finance, trade, human resources and ideologies at the global level. It is characterized by the significant increase in the international trade patterns and the establishment of cross-border investments and these are noted to be the two major characteristics of globalization as sated by Mrak M. (2000:Pp3-6) and these cannot be overlooked.

Abstract

This paper will delve into the social influence that the globalization trend has take, especially in line with the human resources relocation across borders that are becoming more fluid allowing population flow across the world, creating a more beefless world each day. The case in point within the scope of the paper is the issue of female nurses' migration in India and how this plays a role in the disruption and the reshaping of the role of gender in India. In as much as globalization might have started after the WWII, it really intensified in the years leading to 1980s. This is when there was a massive change and technological advancement that made transport and communication much cheaper and faster as well as the liberalization of trade and capital markets and cross border investment, this is the period that this paper will focus more on within the context of India nursing profession.

A number of international institutions came into being in the course of globalization like the World Bank, the IMF, World Trade Organizations and General Agreement on Tariffs and Trade (GAAT) which helped make the capital markets more fluid and uniform, the labor capital inclusive. These bodies have all along helped in opening up the market and promoting free trade as opposed to the protectionism tendencies that were the norm before the onset of globalization and the subsequent bodies. This opening up of markets also got extended to the labor markets where professions were no longer confined to a given country or a given region, but went far beyond the conventional borders. This has seen the movement of labor and skills plus professions across the globe with subsequent consequences being felt by the concerned nations. There is a significantly high exportation of labor from the least developed nations whose economies are weak as compared to the nations with better established economies (International Organization for Migration, 2006:Pp3). The motivations for this type of migration of labor, the effects and the consequences for both countries will be a subject of discussion in this paper as well.

Thesis

The process of globalization has disrupted and reshaped the gender norms and led to extensive migration of the women nurses in particular from India to other parts of the world, with accompanying consequences.

Shortage of nurses in India

The health needs of the people of India are not taken into serious consideration when it comes to employment of nurses. The graveness of the situation is seen from the heath indicators of India which point at a serious lack of human resources in this particular sector. The health indicators of India in comparison to other countries have it that it still experiences quite high mortality rates standing at 41 dead infants before attaining one year for every 1,000 births (The World Bank, 2014b). The disparity in the nurses to patient ratio is also indicative of a gross shortage of nurses within the country with the nurse to population ratio standing at 0.80:1000 as at 2004. The need for nursing services is noted to be direr in the rural India than in the urban areas bearing the lack of facilities, poor road infrastructure and the lack of incentives for the nurses to keep working in the rural areas. Generally, the nursing profession in India lacks the needed professional status in the country, they are offered low and unattractive salaries, and even there is little recognition within the community. It is also worth noting that most of the learning institutions work as appendages to the hospitals and not independently as is required due to lack of enough facilities (Senior K., 2010).

International migration of nurses from India

The aforementioned appalling working and environmental conditions have occasioned a mass migration of nurses from India. Apparently the situation seems to be self perpetuating since the bad working conditions in the country informs the migration of the nurses to other countries and this migration causes a further shortage each year hence a cycle that is unlikely to end any soon, hence the more interest in this subject.

India has been discovered as the new place to source for well trained and English speaking nurses especially for the developed nations that have acute shortage of nurses. The immigration, however, is not a new phenomenon but can be traced back to the 1970s when a few Indian nurses started to migrate to other countries, particularly in the Gulf to work in the newly built hospitals there, due to the better salary prospects and the ability to send back home money to build homes and such like amenities. These were the first generation of migrant nurses and this trend continued to the present times since little has changed over the years in Indian nursing fraternity (International Labor organization, 2013).

Apart from the local demand for medical services, the demand abroad in countries like U.S., UK, Canada has made nursing a more lucrative career in India. In 2005, the number of nurses migrating from India to other nations stood at well over 60,000 and due to these huge numbers of migrants, India has been one of the most recognized among the countries where nurses go to practice their nursing. The advantage that India has in securing jobs in the developed nations is the large resource pool as well as the competence in English. The other factor is the similarity of the educational patterns where majority of the states use the same system hence the quality is easily gauged making the recruitment easier as noted by Nagarajan R., (2010).

A more interesting angle is the realization that nursing is mainly taken up by the female students which is considered widely as part of many families' strategy for a longer process. It is noted that majority of the nurses in India come from the lower-middle class families. Taking a daughter for the nursing courses is an expensive venture for these lower-middle class families and they invest not just money but their hopes too with faith that their investment in the daughter will pay back well. Migrating from India to go work outside the country is seen as one of the best fruits of investing in the girls. The remittances back home that the women sends once they start working abroad, are not just considered as good for the family's economic betterment, but are also saved for the ultimate dowry that will be paid by the girl's family to the man when the time for the marriage finally comes, since this is the Indian culture (Gill R., (2011:Pp55). These remittances back home are seen to be central to raising the social status of the family as a whole hence goes beyond the individual lady who goes for the training and a job abroad. The migration may also be seen by some families as a way of relieving the lady from the strict and controlling norms of the Indian culture. This is how the nursing profession and the migration, which has been made easy by the globalization trends, becomes a tool for gender manipulation. A family would rather have a girls go for the course rather than a man hence this has led to the nursing profession to be largely seen as a profession for the women. It reshapes the gender norms where instead of having equal opportunities and preferences for both genders, nursing is gendered so much that it becomes inclined towards the female gender. Once the lady is educated by the father and most of the time the extended family, she becomes more of a family property that is controlled and must use her newly acquired position of a nurse abroad to benefit the entire family, as principle and necessity (Kumari R, & Shamim I., n.d:Pp10-11).

It is further noted that most women in India take up the nursing profession and study it because they have plans to work abroad as Pavan M.V. (2012) of The Times of India notes. A common and outstanding reason for this is the fact that once a lady goes to the outside countries, then they stand a higher chance of getting married. This is mainly based on two major considerations which are stereotyped; one is that she is viewed as a lady who comes from a better off social class or has helped the family to move higher in the social ladder hence will be able to pay the dowry, and secondly, the man that she marries will have better chances of moving to join her in the foreign land and hence get a better paying job there as well. This disrupts the traditional gender roles in the Indian context where after marriage the man was meant to be the provider. Here, it turns out that the migration, made possible and easy by globalization turns the woman to be seen as a source of employment. This is the reality of migration of nurses in India, indeed, the prospecting marriages are usually categorized into three as follows; the first is the lady working abroad and with a working permit takes the lead, the followed by the nurse working abroad but without a working permit and the last in the ladder of preference is the lady who has finished her nursing course and has applied for a job abroad (Kumari R, & Shamim I., n.d:Pp81-82). The ladies have hence lost their individualism and gender roles and are now looked at as commodities to be graded and these are the adverse effects of globalization which have roots in the early 1970s as noted above.

The above situation of categorization is understandable since the issue of pay makes a great difference once a lady gets to the foreign land. For instance, in India, a nurse will be paid Rs. 2500 per month and yet the same nurse may end up earning Rs. 40,000 per month in a foreign land, it is this disparity that exacerbates the migration hence redefining the gender roles altogether. Most of the Indian nurses often migrate to the gulf countries or the Western countries. The migration to the Gulf countries is seen to be relatively easier than to the Western world due to the migration conditions that are in place (Kumari R, & Shamim I., n.d:Pp120-121).

Among the preferred nations in the gulf are UAE, Kuwait, Qatar, Bahrain and Oman since they offer better salaries and better livings standards as compared to Saudi Arabia and Yemen. However, even in these preferred Gulf nations, the women Indians face a lot of social and religious restrictions. Here, these female nurses have no opportunity at all to become citizens, they cannot own a business or even a house in these Gulf nations and also have few educational opportunities available even for their children. The married women who are heading to the gulf cannot be given a family visa hence cannot bring their families, only men are allowed to (Sharma K.D. et.al, 2013:Pp120). These social and religious restrictions deprives the female nurses the chance to continue playing their rightful roles in the society of being a mother and because of the possibility of getting a job across the borders, they are forced to change their roles by even leaving the family with the husband and explore the provisions of globalization.

There are stringent rules in place for these nurses seeking migration to the western nations since there are tougher tests that have to be passed and this means higher fees for preparation and also higher agency fees for the western nations as compared to the Gulf countries. These conditions prompt many nurses to use the Gulf countries as transitional areas where they work to raise the finances needed for these extra costs to make it to the western world and work there. They also prefer getting the relevant required experiences in the gulf countries in readiness for the western nations since these are more recognized than those of India (The Economic Times, 2014).

Unemployment is a structural problem in India for a number of decades now hence the only logical way that individual nurses tend to use to solve this is through massive migration to other nations. These migrations started as a normal way of looking for employment for the starving skilled nurses but slowly turned to be an enterprise where women used it to have their family problems solved. The movement to other nations has been widely facilitated by the global trends that have seen transport, communication and diplomatic agreements fortified but the flip side is that it has led to the female gender being used and appropriated as the family and the society at large deems suitable to them, changing the gender roles in the Indian society significantly. The migration has also left the mother country with little standard-quality services in nursing. The loss of the highest trained and qualified nurses has brought adverse effects to the mother country and led to the collapse of the health systems in the country.