Why Kerala Nurses Are Forced To Go Outside India for Jobs

The salaries paid doesn’t give them enough to meet their daily needs, let alone repay education loans, nurses say.

Image used for representational purposes.

(Photo: PTI)

*Nimmy joined a General Nursing and Midwifery Nursing course after completing her Class 12. Nimmy took a loan of Rs 1.5 lakh to pursue the three-and-half-years course. After completing it in 2011, she started working in a private hospital in Bengaluru. After two years, she moved to Kolkata where she worked for another three years. However, her jobs, both in Bengaluru and Kolkata, didn't pay enough to pay the monthly installment of the loan and then send a decent amount of money back home to her family.

"The initial salary for the job in Kolkata was Rs 7,500 per month, which was then raised to Rs 13,000 per month. In Bengaluru, the salary was around Rs 20,000 per month," Nimmy told TNM. She then migrated to Israel in 2019, where she now works as a caregiver and receives a salary of around Rs 1.5 lakh a month. Nimmy's life is a classic example of how scores of Keralites choose even conflict-affected countries to make a decent living. She represents many who had to migrate to faraway destinations for work, in order to not only pay their education loan but to even make ends meet.

Migration: Result of Meagre Salaries and Hefty Instalments

"The number of people who get nursing degrees in Kerala is very high. Even families who are financially well off invest in a nursing education for their children,” Irudaya Rajan, an expert on Kerala migration trends, told TNM. Those who cannot afford to pay for their children’s nursing education take loans. “The loan needs to be paid back from what they start earning. This is one of the basic reasons they immigrate, to earn more money and pay back loans," he added. Irudaya Rajan was a faculty member at the Centre for Development Studies in Thiruvananthapuram. Currently, he is the Founder Chairman of the International Institute of Migration and Development.

"The salary of nurses working at private hospitals in Kerala is very low. At some hospitals, it's even lower than the wages given under the Mahatma Gandhi National Rural Employment Guarantee Scheme, under which a daily wager gets paid Rs 200 per day. So by working in any of the private hospitals in Kerala, these nurses won’t be able to earn enough to return the money spent on their education. Hence they are forced to try for jobs in foreign destinations,” Irudaya Rajan added. “Also, the nurses are made to sign bonds for two years in the hospitals here where they work for meager wages, but working in a foreign country enables them to earn a fair sum of money and allows them to repay their loans,” he further said.

"If we began talking about our plight, there would be no end to that,” said *Raji, a nurse hailing from Idukki. “In Kerala, nursing is one of the most underpaid jobs. We earn less than what daily wage workers make,” she said. “For a labourer in Kerala, the daily wage ranges between Rs 800 and Rs 900 per day, in addition, their other expenses like food are taken care of. But for a nurse, the daily wage is less than Rs 400, while the working hours are even longer,” she further added. Raji, who now works in Israel, said that she chose a nursing career with the hope that it would enable her to find a job easily and secure her future. “But reality hit after completing my studies. If we were duly paid in our country, we wouldn't be forced to leave our land," Raji told TNM.

A Keralite, Soumya Santhosh from Idukki, was working in Ashkelon in Israel when she was recently killed in an airstrike. Like Nimmy, Soumya, too, came from humble family background and financial constraints had forced her to choose Israel for work. "Even for a family of four, we need at least Rs 10,000 to meet expenses for a month, however careful we are. How could we even send Rs 1,000 back home besides setting aside money for repayment of the loan, with a monthly salary of  Rs 7,500 or Rs 13,000?" Nimmy asked.

In fact, nurses working in private hospitals in Kerala had staged months-long protests between 2017 and 2018 to get a pay revision. As per the government notification issued owing to the protest, the minimum wages for nurses raised to Rs 20,000. Prior to that, a pay revision was last implemented in January 2013.

Migration Trends: Why and Where?

According to Raji, apart from being underpaid, what also worries nursing graduates is the lack of respect for the profession in Kerala. "In Israel, it's altogether a different situation, the respect we get is huge. It's a solace when we live in an alien land, leaving our children and family back at home," Raji added. In a survey carried out by Irudaya Rajan and KC Zachariah, a researcher who also specialises in migration, there are 21,21,887 emigrants from Kerala across the world. While the study is done every five years, no specific data is available with the department on which countries are more popular to work in for non-resident Keralites.

Irudaya Rajan said a shift in the migration trend of Keralites began in the last 10 to 15 years. Now, from the Gulf Cooperation Council (GCC) countries, Keralites are moving to other parts of the world. "It's not just Israel, countries in Europe such as Germany are becoming sought-after destinations for jobs among Keralites," he said.

*Names changed

(This story was published in The News Minute and has been republished here with permission.)