West Bengal, the fourth most populated state with the highest population density, is also the fourth largest source of migrant labour and desperately needs a major overhaul of its health facilities.
UNHEALTHY WEST BENGAL: Since the horrific rape and murder of a female doctor on night duty at the RG Kar Medical College and Hospital, Kolkata on August 9, the spotlight has been on the plight of doctors. The equal if not worse condition of nurses, the backbone of health services has not received the attention it deserves. The World Health Organization (WHO) estimated that about 115,000 healthcare workers globally and potentially as many as 180,000 died due to Covid-19 by October 2021. The excessive workload on those who survived led to burnout and large numbers quitting the profession or retiring early. There was a shortage and high turnover of healthcare workers when there was an increased need for them, For more than four decades of my career, nurses predominantly from Kerala assisted me with surgery but now many of the nurses in our hospital are migrants from West Bengal and numerous patients are from there. In a recent letter to the West Bengal government, the Indian Medical Association has stated “Peaceful ambience and security are not a luxury. They are a prerequisite. ”
MIGRATION WITHIN INDIA: Health workers migrate for the same reasons as other people: to improve financial conditions for themselves and their families; for better personal and professional prospects; and to escape harsh social, economic, or political environments. West Bengal was once India’s most developed state but has suffered poor governance for decades. Inadequate investment in health facilities by the government and by private entities has led to very high unemployment rates among doctors and nurses in West Bengal. Those employed have low remuneration and abysmal facilities, many lacking even basic human necessities for their employees and patients. The deteriorating law and order situation has further worsened matters, leading to mass migration of health workers to other parts of India and abroad. West Bengal, the fourth most populated state with the highest population density, is also the fourth largest source of migrant labour and desperately needs a major overhaul of its health facilities. The ability to migrate within India and abroad with their specialized training is a major incentive to choose a career in the health industry.
INTERNATIONAL MIGRATION: The WHO has predicted a global shortfall of 10 million health workers of all types by 2030. India is by far the largest source of migrant doctors. Philippines, India, and Poland are the leading sources of migrant nurses internationally. The United States, the United Kingdom, Canada, New Zealand, Australia, and Gulf nations have been the top destinations. Newer destinations are France, Germany, Sweden, Switzerland and Japan. The Gulf nations have traditionally frowned upon their women joining the nursing profession. All these except the Gulf nations have wealthy ageing populations needing nursing care in hospitals and for those living in old people’s homes. The Triple Win program of Germany is designed to recruit foreign-born nurses. Canada and Australia have points systems to attract immigrant nurses. In India and the Philippines, training schemes have shifted to suit the needs of international markets rather than local conditions. The Indian government has opened numerous medical colleges and hospitals amid severe shortages of doctors and nurses. In the absence of adequate facilities, security, and compensation for our nurses and doctors, jobs in the health services sector will eventually remain unfilled, affecting the adequacy of health services. They will migrate to affluent countries and become a source of remittance instead of powering our health services. We need to urgently enhance our health facilities to take care of our growing population and also become the biggest destination for medical tourism.
Dr P.S. Venkatesh Rao is Consultant Endocrine, Breast & Laparoscopic Surgeon, Bengaluru.