Women nurses from Kerala don't rush to the Gulf any more. From 2003, the US and UK have become favored destinations, ever since the two countries relaxed qualification norms for nurses. The money is good - a nurse in US/UK earns $35,000-50,000 annually; and several privileges - like a green card, housing and other facilities, come by easily.
Since India's Independence in 1947, Kerala has produced more nurses than any other state in India. By 1991, it had 62 nursing schools. And in 2003, 17 private nursing schools opened across Kerala.
Officials say that everyday almost 80-100 attestations are granted to nurses seeking jobs abroad. The demand is for both experienced and raw nurses.
While relaxation of rules is the primary reason for the rush to the US and US, the significant increase in the geriatric population in the two countries is also an important factor. Sony Thomas, a social worker, says:
"Because of the high health and living standards in the US and UK, people have a longer lifespan, resulting in more old age homes. And unlike in India, it is mandatory to have a proportionate number of social workers and nurses, depending on the number of inmates in the old age home."
However, the new boom has its flip side. During the entire 1990s, many girls from poor, agricultural, Christian families took bank loans, often by pledging property, and did the nursing course to get a job in the Gulf. Once in the Gulf, they not only found good jobs but earned enough to clear family debts. Most also married Indian men settled in the Gulf.
But in the US and UK, the scenario is a bit different. Says Minimol Mathew, who is working in a hospital in London for the last 18 months and is in Kochi for a holiday: "I will be here for a month, and hope to at least get engaged before I go back." Mathew is expressing the most immediate problem many young nurses in the UK and US experience: shortage of grooms.
"Kerala has been one of the biggest exporters of human resources to the Gulf for decades now. People with all kinds of qualifications went there. Getting a decent marriage proposal wasn't really difficult there. But it's different in other countries," says Mathew.
Mathew is right. Since the early 1970s, typists, laborers, engineers and architects - skilled and unskilled workers - all migrated from Kerala to the Gulf for better prospects. The Gulf was almost like another home for many Keralites. But things are different in the US and UK. First-generation Keralites in the UK and the US are generally highly-skilled professionals, like software engineers or management graduates. And they are not ready to settle down with nurses.
This stigma operates among Indian families who feel that nurses do the dirty job of touching "unknown" men. Researchers say that Indian nurses have never got their due because of this negative stereotyping.
The story of Kerala nurses who migrated abroad has been the focus of study for several researchers, primarily because instead of men migrating first, women went first, got settled in their jobs and later sponsored their husbands and families.
Sheba George, a postdoctoral fellow at the University of California, Los Angeles, in her recently released book, `When Women Come First: Gender and Class in Transnational Migration', says that in this unusual migration process, women became the "uncontested breadwinners" in their households which resulted in "drastic changes in gender relations..." However, she mentions that the women continue to face the stigma of performing a 'dirty'
"Although nursing is a sought-after profession abroad, Indians here still stigmatise it as dirty," says Ivy Cherian, who worked in the Gulf for three years before moving to the US in 2004. "Our people are happy about the money we bring home. But - though they don't tell us so openly - they feel that interacting closely with the sick is not `respectable'.
"No Keralite professional established in the UK or US wants to get married to a nurse - unless, of course, he falls in love with her. In fact, even if our husbands were not earning, we could single-handedly manage a family with only our salaries; but this would inevitably lead to emotional disturbances in the relationship. So we have to look for qualified men - but they are not interested in us!"
Kerala produces the maximum number of nurses in the country annually, and also 'exports' the highest number of nurses from any state. But nurses working within the state (mostly in the private sector) also face the same stigma: they are way down on the priority list in the marriage market.
While women continue to flock nursing schools, more and more young men in the state are opting for hotel management and social work as a career option. For a hotel management graduate or a social worker, monetary benefits are grim in Kerala, unless he pushes his way into an international NGO or a world-class hotel chain. However, things may change now that the demand for such professionals has increased in the US and UK. "We need a little time to position ourselves in the host country, but the salary and benefits are almost on par with that of the nurses," says Thomas.
This trend may also offer a possible solution to the shortage of partners for nurses in these two countries.