New US law could cripple Indian Hospitals (Rediff India)

[ From: Rediff India Abroad
[ Date: 06.07.06

New US law could cripple Indian hospitals

Wednesday, July 5, 2006

There are 1,800 nursing vacancies in public health
centres across Tamil Nadu; but in the last two years the
state government has been unable to fill them up because
of a shortage of qualified nurses.

There are 118,000 nursing vacancies across United States
hospitals, and the deficit could reach as high as 800,000
in the next decade.

The irony is that Tamil Nadu is running short of nurses
because nursing graduates from the state -- and from
across India -- are bound for greener pastures in the US.

In the last few years, nursing has become the easiest
route to the US Green Card as American hospitals are
frantically scouting for nurses from developing
countries, especially India and the Philippines.

Every year, India produces more than 30,000 nursing
graduates. Nursing school authorities say almost all of
these nursing graduates are also training to take the
CGFNS (Commission of Graduates of Foreign Nursing
Schools), TOEFL (Test of English as Foreign Language),
TWE (Test of Written English) and TSE (Test of Spoken
English) examinations.

To be considered for nursing assignments, Indian nurses
have to take the above mentioned four tests, and must
have valid nursing licences from recognised institutes.

In the last one year, scores of American hospitals have
put in requests with manpower consulting agencies and
nursing schools across India for recruiting nurses.

A number of nursing colleges in India are also tying up
with hospital groups in America for supplying nurses.

As a result, the quality of health services across Indian
hospitals is suffering because of shortage of nurses.

"Every nursing graduate wants to go abroad. They do not
want to serve the country. The rush of Indian nurses to
countries like the US is putting our healthcare system in
malady," says Annamma Mathew, a nursing superintendent
who earlier worked with St John's Medical College,
Bangalore.

Mathew, who now works in a private hospital in
Coimbatore, says Tamil Nadu is one of the worst hit by
the shortage of nurses.

"Last year the Tamil Nadu government advertised for some
1,500 nurses in the primary health centres. But the
Health Department did not get enough applications," says
Mathew.

"Indian nurses want to go abroad, especially to Europe,
the Gulf and the US because the pay packets there are
very good compared to the pitiable salaries that Indian
hospitals offer to nurses," Mathew adds.

A nurse in an Indian hospital earns a starting salary of
less than $2,000 a year. In the US, that figure is at
least $36,000.

Vineeta Ramachandran, director of Kochi-based nursing
recruitment agency Nurses Abroad, says the sad state of
Indian hospitals and poor pay are the main reasons for
the exodus of Indian nurses abroad.

"Added to this, the new Immigration Bill in the US would
open throw open the gates to Indian nurses. I am getting
15 applications every day from nurses who want to go
abroad," Ramachandran says.

Last month, Kansas Republican Senator Sam Brownback
sponsored a proposal in the US Senate that aims to remove
the limit on the numbers of nurses who can immigrate to
America.

Moving the new provision in the Immigration Bill,
Brownback said it was needed to help America cope with a
growing nursing shortage.

Health experts in India say the new, relaxed US
immigration provisions for nurses would have an impact on
countries like India and the Philippines, which are
already sending thousands of nurses to America every
year.

Says Dr Paul Abraham, who heads a Bangalore-based non-
governmental healthcare organisation called Centre for
Health and Social Action: "The exodus of nurses from
countries like India to the US will surely strain the
health systems (in those countries)."

"In India, already many hospitals are reeling under
severe shortage of nurses. Now I think every Indian nurse
would try to go to the US if the new immigration rule
comes into force," Dr Abraham says.

He says international standards prescribe the nurse-
patient ratio per shift to be 1:5 in a general ward and
1:1 in the intensive care unit. "But in India, the nurse-
patient ratio is pitiable. For instance, the J J Hospital
in Mumbai has a 1:70 nurse-patient ratio. That is, one
nurse is forced to take care of an average of 70 patients
who visit the hospital daily," he says.

What is the way out?

"(There are) no short cuts," says Dr Abraham. "The
government has to sanction more nursing colleges. And a
condition has to be laid down that a nurse should work
compulsorily five years in India before she goes abroad,"
he says.

Agrees Madhu Devan, member, Trained Nurses Association of
India: "The pay scales of nurses in India also have to go
up. The government should also increase the number of
nursing institutes across the country."

Some states are waking up to the crisis. Kerala -- that
has produced more nurses than any other state in India --
now has 85 nursing schools. In 1991, it had only 45. The
Maharashtra Nursing Council has granted official
recognition to 70 more nursing colleges in the last two
years.

More and more young men are also opting for a nursing
career because of the bright job prospects abroad.

Suju Mathew, son of a Kerala school teacher, opted for
nursing studies. "I have joined for the three year
nursing degree course in a Mangalore college. In my
class, there are 10 boys and 30 girls," he says.

Does Suju like to work as a nurse? "Yes, but not in
India," says the 19 year old. "I want to go to America.
And nursing is the only solution."

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