Feature: India's healthcare sector hit by nurses leaving for better pay, treatment overseas

NEW DELHI, March 21 (Xinhua) -- Maryam, a nursing professional from the southern Indian state of Kerala, left her job last month at a privately-run hospital in New Delhi and headed to Dubai where she had found a new job. In comparison to her salary in India, she would be making multiple times more.

"Abroad we get proper respect, a much better salary and above all working conditions are far better than in India," she said.

Similarly, Teresa is in the process of moving to Dublin in Ireland. She has been interviewed and at present is completing the paperwork to move to the new destination. Teresa was working in a private hospital in Kerala for the past three years.

"I can make five times what I used to get here for a month in just seven days," she said. "Contrary to the practice of making us work for much longer shifts without paying extra money, in foreign countries they pay extra money for the extra hours."

Maryam and Teresa are like hundreds of nursing professionals in their field, who migrate out of India to secure their future.

Better working conditions and handsome monthly salaries are luring them from India to work in Gulf countries and Europe. People affiliated with the sector say the prospects for nurses have multiplied especially after the COVID-19 pandemic.

DEARTH IN KERALA

Back home, however, the move has added to the dearth of nurses in hospitals, especially in the private sector.

An association of private hospitals said the worst-hit state is Kerala.

It is a known fact that nursing professionals from Kerala are acclaimed the world over and there is a huge demand for them both in India as well as abroad.

According to Kerala Private Hospital Association (KPHA), the state has faced a shortage of about 30 percent of nursing staff in its hospitals for the past year. The situation has turned grim, especially after the COVID-19 pandemic. Over the last year, there have been frequent resignations of skilled nurses every month.

"The worst part is that it has been difficult to find replacements for all of the open positions," Hussain Koya Thangal, the president of KPHA, said. "Everyone talks about the fact that India needs more doctors. There is no doubt about that but one must remember that nurses are the backbone of our healthcare system and any kind of hospital-based healthcare delivery is centered around them."

KPHA described the scarcity of nurses in private hospitals as an emergency situation in Kerala healthcare. The shortage of trained nurses has been found in intensive care units, operation theaters, and emergency departments, where experienced personnel are required to handle the equipment and procedures.

According to KPHA, for the smooth functioning of the healthcare sector, there was a need for a 1:5 doctor-nurse ratio.

REASONS FOR MIGRATION

As per the available information from the local government, from Kerala, 7,143 nursing professionals went to the Gulf in 2020. The number jumped to 9,098 in 2021. The association, quoting estimates from some local newspapers, said the total number of nurses who went abroad in the 2022 year had surged further, topping 23,000.

Many countries have waived their mandatory norms like a minimum of three years experience and even nurses fresh out of college are getting jobs overseas.

"The demand for Kerala nurses after COVID-19 increased a lot, especially in Gulf countries. Now they don't need any experience and many European and other Western countries are even facing an acute shortage of nurses," Thangal said.

"Moreover, these countries are in need of auxiliary nurses in senior care facilities and nursing homes. So our nurses do not require any nursing registration or special courses or even any language tests to work abroad."

The nurses can even take their families along with them.

"Previously to take their families along, nurses had to wait for about six months to a year, but now they can take their families whenever they are going," said Sajad Ahmad, a job consultant working with a consultancy that hires nursing staff for Gulf countries.

"Apart from good pay, the work environment in these countries is better and nurses are given proper respect like doctors, which is not the case in India."

Post-COVID-19, many countries have prioritized the health sector and started new hospitals, thus creating more job opportunities for nurses and doctors.

Earlier, the migration of nurses was more to the Gulf countries. However, there is a lot of demand for nurses in European countries, including Britain as well.

KPHA has sent representatives to the Kerala University of Health Sciences and the local government, explaining the situation.

"We have requested the government make some changes in the new nursing college criteria so that new colleges' education is in with private hospitals. The Indian Nursing Council says the criteria for starting a nursing college is a hospital with more than 100 beds, whereas in Kerala the condition is that hospitals should have more than 300 beds," Thangal said.

PAN INDIA SCENARIO

Every year, many precious lives are lost in India due to the dearth of trained nurses. According to a World Health Organization (WHO) report published in 2021, India would require at least 4.2 million more trained nurses by 2024 to take care of its over 1.44 billion expected population.

Against the WHO norm of three nurses per 1,000 people, India stands at 1.7 nurses per 1,000 people. The poor nurse-patient ratio in the hospitals is leading to prolonged working hours, increased workloads on the existing staff, and finally low quality of treatment.

Experts say each year, India produces around 200,000 nurses, of which approximately 40 percent to 50 percent leave the country for foreign employment within a few years of acquiring practical experience in Indian hospitals.

The shortage of nurses is affecting healthcare in India despite the country being among the largest exporters of trained nurses globally.

Estimates say approximately 6.4 million Indian nurses are employed in foreign countries.