Angels In Distress: Indian Nurses In Gulf Work Under Exploitative Conditions
Nurses are being exploited in the GulfImage credit: ICN

Angels In Distress: Indian Nurses In Gulf Work Under Exploitative Conditions

“We are slaves in white dress,” says an Indian nurse who is working in a private hospital in the Gulf

Shifana S, an Indian nurse working in an Indian-managed hospital in Oman, prepared her resignation letter last week. As her manager is on leave, she is awaiting his return.

“We are on the frontline in fighting COVID-19. Outside this hospital, they will praise as angels. But inside the hospital, these Indian managers don’t even allow us to take a recess. We run to washrooms after 15 hours of continuous job. It is hurting us a lot. I am going to resign. I don’t want to die here,” Shifana said.

According to a medic in the same hospital, the nurses who are on the frontlines treating COVID-19 patients continuously for 15 hours are not even given leave either.

“Even when they are relieved from COVID wards, the very next day itself they are put in other departments. It is a very sad situation. Many are under severe stress,” the medic added.

Shifana knows that she is going to lose her end of service benefits if she resigns. And additionally, she will not be able to fly back to Kerala due to COVID-19 flight restrictions. But she has decided not to adjust to exploitation and risk her life anymore.

“I have decided to quit. It is not that I am not a committed person. It is to tell them that I am not a slave,” Shifana added.

Shifana’s case is not an isolated one. There are many migrant nurses, especially from Kerala working in Indian-managed super-specialty hospitals in the Arab Gulf, undergoing similar situations risking their lives.

There are around 250,000 positive cases in all six countries in the Arab Gulf with some 1200 deaths.

Exploitative Conditions For Indian Nurses

Most Indian nurses are either recruited directly private hospitals in the Arab Gulf or transferred from hospitals they are working in India to their Arab Gulf branches.

Only a few migrant nurses get jobs in government hospitals in the Arab Gulf. And during the last few years, as part of nationalisation policies, many of the Arab Gulf countries have reserved nursing posts for locals in government hospitals.

In private hospitals too, Arab nurses have to be recruited mandatorily up to a certain percentage of staff.

According to a source in the UAE, a large number of Arab nurses have withdrawn from the frontlines in the COVID-19 fight, which eventually resulted in staff shortage.

“This forced many hospitals to bring in nurses from India,” the source said.

While talking to The Lede, a source in one of the hospitals in Kerala from where nurses are sent to different Arab Gulf countries, said that “If a nurse in India is unwilling to fly to Gulf to work, then the hospital tells her to go on unpaid leave. And sometimes, they even threaten to terminate them.”

In Kerala, the majority of nurses come from middle-class or poor families, who take bank loans to complete nursing courses.

With low wages and contract employment, most of them struggle to repay these loans.

For many, at least five continuous years of the job are required to repay the loan. As a result, most would not dare to question the employer or refuse a job.

“We have to continue. But nobody is thankful for the risk we take. People praise us in media but if you hear our inside stories, you would agree slavery still exists in this world. We are slaves in white dress,” Josephine J, a Keralite nurse in Oman, said.

Josephine also added that even while doing this risky job, citing economic conditions, their salaries were cut by around 30%.

“The condition was that either we should agree to the slashed salary and continue, or quit and return,” she added.

Meanwhile, those nurses who are not on the frontline are also worried because hospital managements have not provided them with clinical masks.

Who Cares For Healthcare Workers?

In April, the World Health Organization (WHO) had said that nurses are on the frontline fighting COVID-19 but “an alarming failure” in the global supply of protective clothing and new Coronavirus tests – together with “unprecedented” overwork linked to global staff shortages - have highlighted how vulnerable they are.

“We are not being provided with enough masks and gloves. Clinical masks cost some $45. They are telling us to purchase it by paying from our pocket. I have bought masks and gloves. I don’t want to take risks,” Prijil C, a nurse in Qatar, said.

Prijil has been forced to work even after a Qatari who had come with road accident injuries was tested COVID-19 positive.

Prijil is a nurse in the orthopaedic department and she was not allowed to go on isolation during the first few days. But as other nurses and her family requested the hospital, she was allowed to go into isolation.

Luckily, she was not infected and she completed the 14-day quarantine before returning to work.

Meanwhile, a nurse working in a private hospital in Oman said that her friends – nurses - have tested COVID-19 positive but she and others have not been isolated.

“Those who been tested positive have been sent to isolation. We were in close touch with them; however, tests are not conducted on us and we are forced to work,” the nurse added.

Two Keralite nurses, one in Dubai and one in Saudi Arabia, had died due to COVID-19 last month.

Meanwhile, the International Council of Nurses (ICN) says in a statement released on Wednesday that more than 600 nurses have died from COVID-19 worldwide.

Founded in 1899, the International Council of Nurses is a federation of more than 130 national nurses’ associations.

Worldwide, there is no systematic and standardised record of the number of nurses and healthcare workers (HCWs) who have contracted the disease or died from it.

But ICN’s analysis, based on data from National Nursing Associations, official figures and media reports from a limited number of countries, indicates that more than 230,000 HCWs have contracted the disease, and more than 600 nurses have now died from the virus.

“For weeks now we have been asking for data about infections and deaths among nurses to be collected. We need a central database of reliable, standardised, comparable data on all infections, periods of quarantine, and deaths that are directly or indirectly related to COVID-19. Countries need clear reporting and monitoring mechanisms, and they should also include incidents of psychological, sexual, and physical violence against healthcare workers,” ICN CEO Howard Catton said in the statement.

“Without this data, we do not know the true cost of COVID-19, and that will make us less able to tackle other pandemics in the future. Florence Nightingale knew the importance of data in the fight against disease, and its lack, in this case, is potentially costing the lives of many nurses, devastating their families, and cutting off their careers in their prime,” Catton added.

ICN’s analysis shows that on average 7% of all COVID-19 cases worldwide are among HCWs, which means that nurses and other staff are at great personal risk, and so are the patients they care for.

Extrapolating ICN’s 7% figure to cover all countries means that around 450,000 of the world’s over six million cases could be among HCWs.

Many countries though are not recording data of infections of HCWs, which makes meaningful international comparisons extremely challenging.

Meanwhile, United Nurses Association (UNA) secretary-general Sujanapal Achuthan told The Lede that he is also getting complaints from Indian nurses working in the Arab Gulf in Indian-run hospitals.

Founded in 2011, UNA is a professional association of registered nurses in India.

“Issues we hear from the Arab Gulf are worrying ones. We are concerned about it,” Sujanapal said adding that the majority of the cases they get from the Arab Gulf are from hospitals run by Keralites.

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