THIRUVANANTHAPURAM, 12 April 2008 — Gulf countries or big Indian cities are no longer the favored destinations for Kerala nurses who have made their mark abroad and in major cities long ago.

The trend started in 2003 when the US and the UK relaxed qualification requirements. Nursing jobs in the West fetch an average of $43,000 (Rs1.7 million) annually besides affording privileges like a green card and housing and other facilities.

Most of the hospitals here run their own nursing schools and there are some 150 such schools functioning in the state. In neighboring Karnataka, more than 250 nursing schools thrive mainly on the aspirant nurses from Kerala.

There is no dearth of nurses here as hospitals have become training centers for them and enrolment rates are high. The nursing schools offer three-year diploma in general nursing and midwifery while some 20 colleges, both the government and private, offer B. Sc and M. Sc in nursing.

The patient-nurse ratio is 3:1 in the teaching hospitals and 6:1 in others. According to officials, some 100 attestations are granted every day to nurses seeking overseas jobs.

Earlier, they used to manage visas to Gulf countries (Saudi Arabia, the UAE, Kuwait, Oman, Qatar and Bahrain) by paying huge amount of money to the agents, borrowed against house or farmland, and end toiling for their families to clear the debts.

The visas to the UK and the US and other countries come with absolutely no charges and the entire expenses of recruitment and orientation training are met by the recruiting hospitals or their agents.

In most cases, women migrate first, get adjusted to their jobs and sponsor their husbands.

While 38 percent of the emigrant nurses from the state work in the US, the UK is the preferred destination for 30 percent, followed by Australia that hosts 15 percent of them. Only 12 percent migrated to the Gulf to take up nursing jobs there while two percent went elsewhere.

Training institutes for taking up professional and language competency tests like CGFNS (the Commission on Graduates of Foreign Nursing Schools) — certification program designed for general nurses educated and licensed outside the US —, TOEFL (Test of English as a Foreign Language) and IELTS (International English Language Testing System) are mushrooming even in small towns of the state. The US alone reportedly faces a shortage of 100,000 nurses thanks to its aging population. The demand is likely to continue at least for another decade.

In a 2005 presentation before the state assembly, former President A.P.J. Abdul Kalam advised the state to create “an army of nurses and paramedics to meet the rising demand for skilled health care personnel the world over.”

According to him, the state has the potential to produce one million nurses from “now to 2012” to meet the demand within India and outside. Kerala now produces some 7,500 nurses a year.

Not only meager salaries but social status also forces the ‘sisters’ to leave India. Ideally, there should be one nurse for one patient in critical-care units and one nurse for four patients in general wards but it’s not the case even in big hospitals in the country. The situation is worse in district hospitals and those below that level.

With less nurses left to handle more patients, quality care cannot be delivered. The girls do not want to go in for this profession and parents don’t prefer their daughters to be nurses, especially in north India, because of the low social status and almost 80 percent of nurses in India come from the four southern states — Kerala, Karnataka, Andhra Pradesh and Tamil Nadu.

In other countries, nurses are viewed with high regards like the doctors, though they earn less than doctors. Unlike in India, senior nurses may even earn as much as doctors. So nearly 20 percent of experienced nurses leave for greener pastures abroad.

Growth Pole Project

The National Commission for Enterprises in the Unorganized Sector (NCEUS) has selected Kollam district to implement its Growth Pole project aimed at revitalizing the unorganized traditional industries.

NCEUS Chairman Dr. Arjun K. Sengupta said the project envisages, among other things, identifying marketing opportunities for products from the unorganized sector.

The NCEUS wants Growth Poles to be developed throughout the country with all the economic incentives given to special economic zones (SEZs) and promoted through the public private partnership (PPP) model.

According to a survey by the commission, 77 percent of the country’s population has not benefited from the economic growth and they belong to the unorganized sector.

“The basic premise is that globalization, expansion of market forces and the arrival of foreign capital have all become realities and 92 percent of the total workforce in the country from the unorganized sector does not have social security schemes. We plan to give them some sort of sops for health care and even a pension through a provident fund,” Sengupta told reporters here.

The Rs1.52 billion “Kollam Growth Pole” project will focus on sectors such as cashew, coir and fishing. “Tourism will be a major component of the project. The idea is to use the potential of tourism to improve the income status of the workers in selected cashew, coir and fishing clusters,” he added.

The project cost would be shared by the federal and state governments, private sector and financial institutions. The project would adopt the cluster model development of enterprises, integrating various government schemes and providing the right kind of support to the workers for creating common facilities for their operational and marketing needs.

The project, which proposes a set of strategies with a five-year implementation period, is to be implemented through the District Industries Center in Kollam. The NCEUS wants 25 such growth poles to be developed in 25 states during the Eleventh Plan period in order to facilitate the growth of infant enterprises.