The plight of India's nurses is grim. Wages are low. Working conditions are poor. And if you threaten to quit, well, your employer might just hold onto your credentials so you can't apply for another job.
That's right, working as a nurse in India's underfunded, overcrowded health care system has more than a little in common with bonded labor, Shahina KK writes for this week's Open.
"Salaries for nurses vary widely. In most private hospitals in Kerala, a large number are paid as little as Rs 2,500 [$50] per month. Most are overworked, with their duty-time stretching to 16 hours in a majority of cases," Shahina reports. "And for all their hard work, they are treated poorly. If they have access to a staff canteen, it is often separate from that of doctors and with distinctly lower-quality food served. Most appalling, however, is the bondage they are wrapped in by the legal-looking documents they are typically made to sign when they join. Under these work contracts, they must pay sums of up to Rs 2 lakh [$4000] to buy their freedom if they opt to leave before a pre-set period of time (often a few years)."
It took the high-profile suicide of a nurse who'd managed to earn an education despite a poor, rural background to start the ball rolling. But now nurses are banding together to fight these unfair labor practices and agitate for better wages. Through the United Nurses Association (UNA), which started as a Facebook group, nurses have taken on 100-odd hospitals in Kerala -- nominally India's most labor-friendly state, and also the breeding ground for most of India's nurses, two-thirds of whom are Malayalee.
As Shahina puts it, "In Kerala, the UNA’s struggle has become something of a mass movement. As [UNA founder] Jasmin claims, 'All political parties, trade unions and social organisations in Kerala support us.' The association has issued notices to around 100 hospitals in the state, asking among other things for minimum wages as fixed by the Government (around Rs 15,000 per month [$300]), termination of the bond system, eight-hour duty, health insurance, risk allowances, and freedom from exploitation at work. Hospital managements have had to sit up and listen."