The least we could do now

On this International Nurses Day, CSES salutes all the front line warriors against the COVID-19 pandemic for their relentless struggles and efforts. Read a note on the global presence of nurses from Kerala written by our Associate Fellow Dr. Parvathy Sunaina

Since the end of 2018, the health care workforce across the world, three out of five of whom are nurses, have been on the forefront fighting a global health crisis, COVID-19. Even in the past, during health threats such as outbreak of severe acute respiratory syndrome (SARS) in 2003, Ebola virus disease in 2014, the Middle East respiratory coronavirus (MERS-CoV) outbreak in 2015, andZika virus disease in 2016, the role played by the nursing community in disease control and prevention of spread of infection has been pivotal. There is no better day than today, the International Nurses Day, to acknowledge the service of this nearly 30 million work force spread across the globe, during these trying times.  One in eight of these nurses are practising in countries different from the ones they were born in and nurses from India are the largest constituent among these nurses who have migrated, followed by Philippines. It is also known that among the nurses who have migrated from India, the largest share is from Kerala, which has a long history of migration for employment.

Around this time last year, when the United Kingdom was being ravaged by the Corona virus, erstwhile  British MP Anna Soubry, in an interview, remarked “…some of the best nurses that we learn from actually, are from South India, from Kerala in particular”. This has been the scenario not only in the UK, but also in many parts of the world that were affected severely by the pandemic, be it the United States or the countries in the Middle East, as nurses from Kerala form a significant portion of the nurses in many of these countries. As per a WHO Study Report on “Migration of Nursing and Midwifery Workforce in the State of Kerala” published in 2017, of the nurses who have migrated from Kerala to other countries, 57% are in the Middle East, with Saudi Arabia being the most favoured destination (22%), followed by the United Arab Emirates (15%) and Kuwait (12%). While nurses migrating to USA comprise around one-tenth, those to UK and Canada is around 5-6 percent. A smaller share goes to countries such as Australia, Germany, Ireland, Italy, Maldives, and Singapore (2% to 3%). It is not only with respect to nurses migrating overseas, but also within the country , nurses from Kerala form a significant share of the nursing force. And as India is grappling with the deadly second wave of the COVID-19, nurses from Kerala are a prominent presence among the frontline workers in the other states as well. Destinations within India that are most favoured by the nurses from Kerala are also unfortunately, the most hit by the pandemic; namely; Delhi (32%), Maharashtra (20%) and Karnataka (19%).

It needs to be understood that just as there are factors such as better salaries and working conditions, job security, access to advanced technologies and career development that pull these nurses towards other countries, there are also very strong factors such as long working hours, poor salaries, stigma, lack of dignity, etc. in the home state and country that push these nurses to migrate.  In the 2017 Malayalam movie Take-off, the protagonist, Sameera, a nurse working in the war-torn region of Iraq;  remarks “Daivathinte maalakhamar ennulla vilippere ulloo sir…vilikkunnavar aarum maalakhamaarude veettile avastha chodikkarilla” (the term god’s angels are just for namesake, no one enquires what the condition of the angels’ houses are). Today, being the International Nursing Day, as we acknowledge and sing odes to the Florence Nightingales braving it out for us on the frontline, let’s not forget that they too have families and the risk they are putting themselves in, to save and protect us. Let’s not forget that every day they are having to cope with grave issues such as the death of colleagues, fear of their own death, increased workload, and increased complexity in the workload, given the ever-increasing mutations of the virus and consequent changes in the symptoms and gravity of the scenario.

The least we, as responsible citizens can do, is to not add to their workload. Let’s not forget that we, unlike them and all other frontline workers, including doctors, health workers, sanitation workers, paramedics, technicians, have the privilege of sitting at home. So, let us all be responsible, and adhere to all the safety protocols issued to fight the corona virus, and stay home, and stay safe. And even after we are done with this pandemic, let us continue to respect, appreciate, and support them.