Florence Nightingales of Kerala Fight for Better Wages & Win

Written by E.P. Anil | Published on: August 18, 2017
The recent success of the Nurses Union which is not affiliated to any trade unions or any of the political parties to make its strggle for better wages in Kerala is unprecedented. In the last 25 years, no trade union has been able to achieve such a substantial margin in salary revision. In the neo liberalization era more and more agitations are taking place independently, not under the leadership of established trade unions.  


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During the neo liberal era, primary and secondary sectors were over thrown and the service sector became the most preferable field for the capitalist mode of production.  In a society where agricutural production has been stagnant and its income is low , the speculative culture within the services has been dominating the ‘growth economy. This transformation is now predominant in our country.   

Kerala has a robust and excellent system of health care. Within the national human development index, it is the state which is at the very top. Its literacy, zero population growth, low mother and child mortality rate and high life spans are the cumulative result of a very systematic health care network throughout the state, achieved through a public health care system with dedicated health workers. 

Kerala is also blessed with an efficient nursing staff, working all over the world. In Kerala, It is prestigious for a middle class family to have girls opt for nursing as a career as the choice opened several opportunities. They were well paid and this income resulted in the family’s economic status improving. Since the1990s, the area of health care has transformed slowly and oriented towards the health industry. (State’s health and educational institutes were merit oriented until the self-financing institutes were born by 1995)   Self-financing Educational institutes are today working as business hubs. The attarctive advertisements and lures of these hubs meant that more and more health workers were rendered jobless and were working at lower income benefits (salaries) Due to the international economic crisis (since the Gulf war), opportunities in the Gulf and other foreign countries were lost and unemployment became a reality.These national and international factors made health workers rendered unemployed and those who remained withn, were much less paid. 

Today, welfare oriented health care is missing in Kerala.  Limitations of Public system are increasing and business oriented super specialty hospitals are attracting even the middle class. People are encouraged to undergo more and more health checkups and take more medication. Though the state population is only 3% of the national population, the sale of medicines in Kerala is around 10%. This leads to iatrogenic diseases.(disease by over medication). Scanning centers are mushrooming everywhere. 

In the last 25 years the average health expense of a Keralite has increased from Rs 85 to Rs  10000.  This is not a good signal. 10 lakh families have been thrown into BPL category due to the highly expensive private hospital treatments. Health education is also very expensive. Fees for a medical student in 1990 was Rs 750  is now increased to 6.5 lakh. This is not an exceptional case.

Compared to other states  organised labour is well paid here.  Traditional labourers in agro, small scale industry, construction etc are being protected. Since literacy is cent percent, un skilled labour is on the decline.This causes the migration of labour into Kerala from outside.  Kerala is the highest consumer state in India.  Glittering multi plex malls for gold, cloth, home appliances are visible across the state, open at all hours, with neon lights. But the workers at these malls are poorly paid. Unaided schools and hospitals are not an exception either. This is largely because of the lack of organised workforce in these sectors. Besides 90% of the working force consists of women.  Trade unions themselves are usually male dominated and have not been successfully in extending organisations within the service sector. 

Kerala has an attractive policy of Minimum Salary for sales girls under the Shops and Trade act, specific to this state. Despite this, however, employees are being cheated. Political parties are unable to take up these issues with powerful chains.  This policy requires that a minimum salary of Rs. 86oo to a sales girl is a must (this is, by the way less than the wage in Kerala for an unskilled worker). The policy, on paper guarantees 100% extra wages for over time duties and also demands that if any such establishment employs more than 50 girls in a mall/ shop, accommodation facilities are to be provided. Besides, provident fund, gratuity annual bonus etc are ensured by the Shops & Trades department. But these  rules are violated by many business groups.     

In the private hospital sector, treatments are expensive but all health workers except senior doctors are poorly paid. Nurses, who play a key role in patient health care –and enter the profession after successfully completing a 3.5 to 4 year course, after which they register with Nursing council, do not get commesurate wages.

Nurses in Kerala are less paid than welsewhere though the Keralite nurse is oft preferred for her patience and sensitivity. There have been many attempts to fight against the odd  working conditions. But family situations, gender and the lack of trade unionism were their hurdles. The managements of Hospitals (as well as schools) are  mainly  generation business groups like NRIs, religions, monks and political parties. They are good with politicians and beaucrats and many of them are pseudo philanthropists and well placed in the public sphere. 

Most nursing students are studied with the support of educational loans and  are unable to pay  bank loans as well as for the lively hood.  Three years ago, the state government had appointed a commission to declare the minimum salary of nurses ( Dr.Balaraman Commssion) . The commission proposed that  a hospital shall pay a minimum salary of 12800 rs for a nurse with other social allowances, overtime etc. but even this recoomendation was not implemented on time.

So, nurses have begun agitating for a demand of minimum Rs 20,000 rs + as allowances. The Supreme Court made an observation indicating that the minimum salary of nurses should be Rs 20000. Even then, hospital managements were not ready to listen and, at the last stage of the agitation, the state government took the initiative to bring both parties to a settlement. This was a huge success of the Nurses Union which is not affiliated to any trade unions or any of the political parties. In the last 25 years, no trade union has been able to achieve such a substantial margin in salary revision. In the neo liberalization era  more and more agitations are taking place independently, not under the leadership of established trade unions.  

The Victory for the Nurses in Kerala for their minimum rights  is an impulse to  other workers who are being deprived of a dignified wage in all sectors.