Coming home is a journey. It begins with a dream. And Ila dreamt it on 23 April.
A nurse at the 250-bed Max Hospital in north Delhi, Ila has been away from her home in Kerala for eight long years. Exhausted after spending two hours handing over her patients at the end of her eight-hour shift, she still manages a smile. She has missed lunchtime at the hostel she shares with other nurses, all of whom are living away from their families. So we grab a bite at a McDonald’s nearby. The food isn’t what she’s used to, but she’s learnt to live with it. “I have adapted to Delhi,” she says in heavily accented Hindi. She is happy because the food and the cramped living space may soon be in the past. Because she can finally go home. Sooner than later.
At midnight on 23 April, Kerala became the first Indian state to fix a minimum wage for nurses. With a base rate of Rs 20,000 ($292) per month, it established that nurses like Ila were dignified professionals whose value needed to be acknowledged. This sentiment will only grow and spread across the country, Ila believes. And she is not alone.
Around 2.1 million Indian nurses, the majority of whom work across the country and a minority who are either employed overseas or retired, are hoping for better salaries and working conditions. Importantly, they also want more authority in the private healthcare sector.
Since the late 19th century, nursing in India has been associated with serving and training. This is largely down to British social reformer and statistician Florence Nightingale, known as the founder of modern nursing, who spent some time in India. However, since the turn of the century, the growth in privately-funded hospitals in the country has given birth to a new idea—nurses’ right to appropriate wages.
Traditionally, doctors have viewed nurses as mere assistants. Hospitals saw them as cheap labour. Patients considered them customer care employees. The lack of appreciation took its toll. For an Indian nurse, the first priority is a job overseas; the second, a government job. Only in the absence of these two do nurses want to work with private hospitals. This has resulted in an attrition rate as high as 60% at private hospitals.
In 2011, the Delhi-based Trained Nurses Association of India (TNAI) moved the Supreme Court seeking better working conditions and improved pay. The apex court ordered the government to form a committee to determine ideal wages for nurses. The committee was unequivocal in its view—private and government hospitals must pay nurses a minimum wage of Rs 20,000 a month. This was a huge relief, given that nursing wages used to be as little as Rs 2,500 ($36) to as high as Rs 17,000 ($248).