Nursing in the democratic Republic of India cuts a sorry saga. Its still in Jurassic era. The femme-oriented profession represents a perfect cross-section of the abject, rural, middle-class Indian woman: enduring, submissive, tolerant, obliging and expected to absorb everything and anything like a super-giant sponge. Even with all the social and financial leaps the nation has made, Nurses in India still shy away or are deliberately kept out of mainstream socio-political advancements.
I'm forced to come out of my short blogging hibernation because of two factors:
- The ongoing nurses agitations and not-so-surprising stories of cruel exploitation dribbling out from various corners of the nation.
- Being a Registered Nurse myself, it's my duty and responsibility to stand up and fight for the vocation which provides me my livelihood.
One aspect which increased the luminosity of the 'white frock', apart from the larger Catholic population, is the America-magnet, which was direct effect of the quality of Nursing education in Kerala. The reference books and curriculum is set cent-percent on Western standards which made that India-to-America transition a hell lot easier. The curriculum, especially the 3 year Diploma and 4 year Bachelor's Degree Course offers a comprehensive syllabus with generous clinical hours, on par with any advanced countries in the West. Precisely why Kerala Nurses are much sought after in the civilised world. But that's where the high standards in Indian Nursing end, unfortunately. I mean, with the curriculum.
Nobody bothers to glance into how well/ ill equipped our state or country is in helping nurses adhere to the Professional Code of Ethics, crucial in maintaining the standard and dignity of the profession. In the unregulated Private sector, a Nurse looks after 20-30 patients in a General ward when she should be handling 10; working hours are a gruelling 12-15 hours with lack of proper breaks, 6 days-a-week rosters, no sick leave or non-existent annual leave allocations, shift allowances are unheard of and a salary which would just about pay the laundry, transport and hairdressing charges. All this, after putting up with unruly administrators, Medical Officers, patients and relatives and an often pathetic infrastructure.
That's what you get for keeping awake all night watching over a living, breathing human? A securityman at the nearby morgue gets 10 times more for snoozing over dead bodies.
Worst of all, in such a female oriented profession, getting pregnant means a frightful prospect of losing the job by childbirth. Most private hospitals in our 'cultured' society does not provide nurses any sort of Maternity Leave or benefits; and they force the nurses to resign...Oh yes, life isn't fair, isn't it...Endure?
In plain words, this is modern day slavery.
The situation of these selfless women, and men, should've shaken up the pillars of any ethical, democratic society long time back...Well, that's what our society is NOT...Ethical or democratic. Or compassionate.
But in the 'emerging' India hungry for a change, Nurses eventually decided "Enough is enough!" and chose to wage the war themselves.
The first major upheaval which occurred in Asian Heart Hospital, Mumbai, following the suicide of a Staff Nurse, has opened the flood gates for similar onslaught on high-and-mighty managements across the country, including in Kerala. The feeble voices of a scattered, non-unionized females had never scared the fat-cow managements in the past, and some chose to retest their previously successful model of 'intimidation, threatening and abuse'. Some bosses tried 'Quotation gangs' while in Cochin, a luxury 'charity' Hospital run by a prolific 'Godwoman' used their influence to manhandle the striking nurses using the Police!
The strikes in Kerala, this time, have caused more than a flutter among the political and social circles. The iron fist and one-upmanship attempts by the Hospital administrators didn't yield the desired results as the agitation gained widespread public sympathy and support this time.There were funny sides too, the cream of it being the Indian Medical Association (IMA) asking the authorities to enforce ESMA on the strike; IMA is notorious for engaging in lightening strikes and arm-twisting tactics at the drop of a hat!
Perhaps if you look at it in another way, nurses severely missed a strong representative union like the IMA. The one's nurses had, the spineless Trained Nurses Association of India (TNAI) and accreditation bodies like the inefficient and corrupt Indian Nursing Council (INC) are just bad jokes to discuss here. I'm saying nothing more about those pitiable organisations...
The Govt, though reluctant at first, have come out in support of Nurse's agitation. Labour Ministry and the Honourable High Court took a good step forward to ensure that Nurses are paid minimum wages, at least 9000/month, and better leave and working conditions. Opposition Leader VS Achutanandan, social and political leaders, Women's and Youth Organisations and common public en masse stood behind the striking nurses this time.
Anyone who wants to see the bare facts, the Nurses are NOT fighting for a piece of the moon. A decent wage to feed themselves and their kids, safety and security at work, to practice their vocation within set guidelines and to earn their living with dignity and respect.
Who says it's too much?
The only belly-ache was from the greedy hospital administrators who thought they could nakedly violate the Minimum Wages Act (from Labour Dept website) for decades and could get away with it.
Let's think about this. It is a Nurse who receives each and every life born into this world into their arms, who watches over each breath of our near and dear ones at their worst times and who sacrifice their sleep to care for them at wee hours when we're fast asleep under the covers. What justice or culture is it to treat the guardian angels of life in such inhuman ways just because their collective voices didn't have enough dB to be heard over the cling of money? When even a lesser productive Govt clerk with basic education earns 5-digit salary, a fully qualified Nurse is thrown crumbs.
Nurses are inevitable components of any health set up; especially when India struggles to protect the health of Indian women who give birth to our next generation. The more power they're given, the better it is for the society.
We're going through a phase in our history where the oppressed and the subjugates rise...and revolt, bringing down great temples of power. The anti-corruption movement in India, the Arab Spring, the "Occupy" protests...and now the 'Angels' Uprising'. Sometimes we've to believe justice will be served, even if late.
excellent article...straight from the heart -- Aravind , UK
ReplyDeleteWell written article, hope it helps to bring in some change
ReplyDeleteThere are other serious problems that add to this dismal financial situation faced by nurses. A portion of the senior nurses in most rural/suburban areas havent even attended school. These "sisters " are in fact promoted ayammas who have learned the trade by imitating other nurses. A normal Indian wouldnt mind this situation thinking that at the end of the day she too is trying to provide for her family. But no one thinks of the fact that by allowing this to happen, the society is overlooking the grave risks that an untrained nurse pose: From something as small as a double punctured vein to really serious problems like wrong medications,wrong dosage, cross infection... the list is endless. These are the head sisters under whom the fresh graduates are assigned for training. I dont think I need to elaborate more on the outcome of such year long, unpaid training sessions.
ReplyDeleteI saw a clip where members of a christian mission were protesting against the strike by nurses. They were booed by the onlookers both sides of the street. Gives the clear picture of public sentiment. Church and 'Matha' preaches love for fellow humans, but the institutions run by them have shown zero percent respect to the real 'angels'.
ReplyDeleteWas wondering where you disappeared!
ReplyDeleteSince these hospitals are not taking peanuts from patients, then the least they can do is share the profit decently among their staff. When the daily wages of an odd man is RS. 450 in Kerala, how in the world have they fixed such salaries for a nurse! Anyway, it is good that the nursing profession was taken up by men too, else such an agitation would have never succeeded. all these years, it was easy to subdue the fairer sex.
It is a shame!
Thanks anish for the wonderful article. Having been associated in public healthcare in previous assignments, I have seen how nurses shortages (80% staffing shortage in some cases) affect patient care and ward management. They have to do execute multiple roles of attending to patient, security ( esp. the gynae wards were the worst, seems the entire village would descend for the labour) and of course adherence to doctor rounds etc. This induces an indifference in those who attempt to do this sincerely.
ReplyDeleteI donot have a direct experience with Pvt Sector, but ofcourse as you have pointed out. they seem to be the worst. It is as if the hospitals have been created for few doctors and profits. No wonder we see an exodus of nurses to better destinations which give them better money and most of all respect.
We pray the nurses succeed in their agitation for honourable wages. - deepsPosting this with your permission.
I cannot believe that this kind of unfairness was happening to the nurses of a highly rights conscious state like Kerala.
ReplyDeleteThat being said, I am an advocate of free market and I do not believe in strikes. If a nurse -- or any employee in any industry for that matter -- isn't getting what he or she deserve to get, then I would like that employee to quit their current job and join an employer who is ready to give what the employee is satisfied with. Demand and supply should decide what an employee's value should be; not strikes or labour department.
I wonder why the wages for nurses are this low; either we are having too many nurses, or there are some fundamental issues in the nursing industry that is preventing fairness to prevail. If former is the reason, then I wish some nurses consider changing their profession. If later is the case, then that needs to be addressed; increase of salary to 'minimum wages' set by Labour Department is not the solution!
I knew nurses were badly paid but only through your article did I realise how badly paid they are!! Not to mention the terrible working conditions... :-|
ReplyDeleteAll this for the thankless job that they do....
Vivek, its complicated. One reason was that the unions which were supposed to fight for Nurses have been inept and useless in every conceivable way. If you check history we can see that ONLY strong unionized bargaining have resulted in better pay and working conditions for working class. No employer has EVER gone to the employees and said "You poor things, you'll all be getting a 1000 $$ extra from tomorrow.
ReplyDeleteAnd as for the other options you've mentioned, after paying 4-5 lakhs for BSc Nursing and that too from the bank, its not a feasible option to hunt for another course. And Nursing is a Profession you need Attitude more than skills or knowledge. The latter two you pick up on way; so it's just not a job...its a spiritual experience for many.
Adding to what anish has said, there is indeed shortage of medical staff in our country and in particular nursing staff . A measly national health budget of 1% of GDP does not help in recruiting nurses where they are most required in public health facilities. Most of posts then are freezed.
ReplyDeleteThis malaise is more seen in our so called "free market" corporate hospitals where generally in a country like India where you have poor regulation in almost everything especially in health and education. MCI which is supposed to oversee these is itself known for a well entrenched corruption, last heard it was dissolved and reconstituted because of a corruption case. I donot know if any change has genuinely occured.
- Deeps
The absence of a platform to get together must have played a big role in the nurses' inability to demand; how will 1 nurse demand a deserving salary when there is a large lot available for 3000/month? Greedy Hospitals too might have exploited that soft attitude of nurses. Yes, it's complicated.
ReplyDeleteAnish, BTW, the IT sector has skilled [non unionized] employees who decide the value of their skills.
Their issues came to light only after boys too took to the profession and stood up to take their concerns to the world, otherwise the girls were helpless for all these years.
ReplyDeleteTheir issues came to light only after boys too took to the profession and stood up to take their concerns to the world, otherwise the girls were helpless for all these years.
ReplyDeleteHi
ReplyDeleteI am glad you wrote about this. I've been a caretaker recently for my relatives in hospitals and noticed that many people don't say a please and a thank you to the nursing staff.
True, sometimes new nurses under training do cause pain -- unintentionally -- one did not know how to take the BP and actually wrenched my relatives arm while trying to take the BP. But such instances are rare. I mean, if you are driving on the road, a nascent driver could jolly well hit your car.
On the whole nurses work diligently and their work needs to be respected. I would request all your readers to say please and thank you when they next deal with the nursing staff. In fact, I blogged about this issue sometime ago
Vivek, IT sector working and business dynamics are vastly different vis MNCs, demand-supply and other logistics. Nursing is different for the reasons I mentioned in the post.
ReplyDeleteThanks for your valuable feedback though :-)