“A gift of God”

"Keep them for two years, then help them go abroad ("A gift of God,” Parsiana, February 7, 2007).” This sentence, inadvertently perhaps, conveys to the reader that the new Bel-Air College of Nursing and its collaborators at the University of Illinois-College of Nursing (UIC-CON) along with Minu and Mehroo Patel, sponsors of the program, promote, encourage and facilitate India’s nurses to migrate after two years to the USA. The opposite is true.

Minu and Meh-roo Patel sponsor and support the new Bel-Air College of Nursing and its collaboration with UIC-CON in order to advance professional nursing to the level of a learned professional discipline it enjoys in the USA, owing to excellent and enhanced education. Professional nurses are on par with physicians and other allied health professionals. The Bel-Air College of Nursing is afforded the opportunity to rise above the standard curricular requirements of a baccalaureate degree, due to this collaboration.

Educational excellence, surpassing any currently available, will result in professional satisfaction, peer recognition and community respect. Starting with the Bel-Air College of Nursing, our hope is that the dynamic will spread throughout India. Educated and respected nurses will not see a need to migrate to other countries. The trend of nurse migration will slow down and later even reverse. This is what the UIC-CON collaboration with Bel-Air College of Nursing is all about.

Dr MEHROO M. PATEL

Westchester, Illinois, USA

I do not agree with the interpretation given to one phrase in the article which is a factual presentation of the prevailing situation. When read in context it is evident that the comment is not regarding the Bel-Air College of Nursing or the students who would be passing out. It is about the nurses who currently work at Bel-Air. Like many other hospitals in India, Bel-Air also faces the problem of nurse retention. In fact the paragraph suggests that I am making an extra effort to keep the nurses longer than they would have stayed normally. To put the record straight, let me clarify that Bel-Air has a very clear policy to encourage all staff members, including nurses, to work with Bel-Air as long as possible.

When you say "Educated and respected nurses will not see a need to migrate to other countries” it suggests that nurses who migrate lack in educational excellence and professional satisfaction. In fact the opposite is true. It is mostly the excellent nurses who migrate faster. The main reason for nurse migration is the huge difference in the pay package. A nurse who gets a monthly salary of Rs 15,000 in Delhi can earn Rs 2.5 lakhs in Los Angeles. Over simplifying it to a question of education and respect is ignoring the huge economic factor which has driven migration from the beginning of human history.

I am not a proponent of nurse migration either but I would like the issue to be discussed realistically and without prejudice. The opponents of nurse migration often quote data to prove that the recipient countries gain at the expense of the source countries which suffer in terms of health, economic and social parameters.

Ninety percent of the nurses in India are from the state of Kerala which is much larger in size and population than many countries in Europe. Hence there is already migration from Kerala to different states in India and then to various countries of the world. But the human development and healthcare indicators like maternal mortality ratio, infant mortality rate, life expectancy at birth, births attended by skilled personnel, education index and literacy rates of Kerala are on par with — and even better than — those of developed countries. Kerala has not suffered on the education, health and social development fronts despite large scale nurse migration. It is the only state in India with 100 percent literacy which even many European countries cannot boast of. In the Indian situation, Kerala is the source state for the nurses and all the other Indian states are recipients. All the health, social and economic indicators of the source state are significantly higher than those in the recipient states. Since Indian states are larger in size and population than many EU countries, the application of national averages and conclusions drawn to prove nurse migration as draining the health of source countries need not be universally true.

Migration has to be mainly viewed against the backdrop of economics and huge imbalances on global salary levels. When the world is fast becoming one community the basic ethical and legal consideration must be an approach which does away with national borders and barriers and imbalances created by the rich and the powerful.

Fr. TOMY KARYILAKULAM

Administrator, Bel-Air Hospital, Panchgani