Migrant nurses in times of crisis

Blog post by Ester Gallo, University of Trento, Trento, Italy
 
My Identities article, ‘Utility workers: religion and the migratory stratification of foreign nurses across generations’, explores the role of Catholic institutions in shaping Indian nurses’ mobility pathways to Italy. The COVID-19 pandemic exacerbated the global demand for nurses, and in many parts of the Global North (such as Europe, UK, Canada or the US) the provision of healthcare relies on the recruitment of  staff educated in the Global South. India represents one of the most important sources for this international recruitment of qualified nurses, who tend to be women from poorer groups.
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The international mobility of migrant nurses raises numerous challenges. When countries invest in the training of healthcare workers ‘for export’ – often at the expense of educational quality, workers’ rights and retention – this can make it difficult for their own country to address healthcare needs due to nurse shortages. In receiving countries, foreign-born nurses are often hired through temporary contracts; mass emergency recruitment coexists with periods of unemployment, resulting in precarious working conditions.

My Identities ​article discusses how this global dependency – and the related mobility of migrant nurses from India – is rooted in colonial history, and in the transnational role of Christian networks in sustaining the supply of healthcare workers for the European demand. I take as a case in point women nurses coming from the southern Indian state of Kerala, who have migrated to Rome since the 1960s to work in private Catholic healthcare structures.
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In both Kerala and Italy, I conducted ethnographic research and interviews with women of different ages and migration cohorts. The aim of this research was to understand how these women make sense of their work and life experiences in Italy, their relationship with the Catholic Church and their future plans, as well as to explore how this has changed throughout the past sixty years.  

Women nurses from Kerala who come to Italy are often pioneer migrants in their families. While their work and remittances are important for their families’ mobility strategies, nurses in Kerala face discrimination from Hindu and Christian elites for betraying national care priorities in favour of neo-colonial affiliations, and for engaging with ‘dirty’ and ‘promiscuous’ work abroad. Catholic institutions in both Kerala and Italy act as guarantors of women nurses’ respectability and ‘proper’ work conduct. Drawing from a colonial repertoire, they depict vocational training as an evangelical activity that enhances the fate of marginalized groups: becoming a nurse enables young women and their households to escape from poverty. Nursing is seen as a better alternative to domestic work, particularly in countries with limited labour market opportunities for foreign workers such as Italy.

Training programmes in Catholic healthcare institutions in Rome orient Indian nurses’ technical preparation as well as religious identifications, thereby promoting by association their professionalisation and faith conformity. Catholic institutions often infuse migrant nursing programmes with moral and normative expectations: workers are expected to refrain from complaining about worsening work conditions and find inspiration in Christian ethics in order to fulfil their duties. This is particularly true for those who arrived in Italy after the 2008 economic crisis and face worsening working conditions due to severe cuts in public healthcare provisions and the consolidation of the private sector. 

The analysis offers a more nuanced understanding of the role of religion in the transnational mobility of healthcare workers. Catholic institutions can offer migrant nurses with employment opportunities and spiritual support at both ends of the migration process. Yet, their role is ambivalent insofar as they also contribute to the control and subordination of workers, partly by fostering an occupational culture that emphasizes the value of a gendered and faith-inspired vocation over labour rights.
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Migrant nurses’ accounts stress a tension in the way they conceived their identity as workers and believers. Catholicism can provide an overall source of identification with the host society; it may be valorised in terms of professional skills and work chances, particularly in the context of decreasing employment opportunities in the public sector. Religious values are deemed necessary to go beyond the ‘mere task’ of healthcare, and to forge the reputation and reliability of a ‘good nurse’ in terms of enduring emergencies and engaging with patients’ fragility. Yet, the Indian nurses who participated in my research also highlighted the exploitative nature of working in Catholic institutions, including long working hours and religiously-informed expectations towards daily sacrifice.

Further research would offer the opportunity to explore the role of religion in the transnational mobility of healthcare workers to compare different contexts and faiths, both within and beyond Europe. 

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Image credit: Photo by Mick Haupt on Unsplash

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Read the Identities article:
​Gallo, E. (2024). Utility workers: religion and the migratory stratification of foreign nurses across generations. Identities: Global Studies in Culture and Power. DOI: 10.1080/1070289X.2024.2438532

Read further in Identities:

Migratory stratifications: a new analytical tool for investigating social change

Displaced memories in the Trieste border area: a neverending historical entanglement

​Negotiating one’s own belonging: envisaging the Japanese (Im)migratory stratification through immigrant-origin youths’ narratives