Representative Image / Illustration: Vijesh Viswam
The impact of Keralites on the nursing profession is unparalleled anywhere else in the world. The ubiquitous presence of Malayalee nurses in every hospital around the world should be a matter of great pride and honour for not only Keralites but all Indians. Great encomiums need to be showered on the Church, for identifying the potential of Malayali girls for this profession, starting innumerable nursing colleges in the State, grooming them for this onerous task, and facilitating their absorption in various hospitals throughout the world. The Malayali girls also rose up to the occasion, excelled in their new occupation, gained an unmatched proficiency and reputation as healers’ non-pareil. These Kerala nurses epitomize professional successful women, who by sheer dedication, will-power, dedication, and humanitarian service, have earned global recognition. International nursing recruitment agencies look up to Kerala to address the acute global shortage of qualified nurses. As a result many families in Kerala have transformed economically, substantial number of nurses and their families have migrated to Western countries, and are enjoying good lifestyles. An acute shortage of nursing professionals in Western countries has come as a boon for Kerala nurses. Their English language proficiency gave them a great tactical advantage over other nationalities. This should also be an eye-opener for our language-obsessed politicians that India’s unemployment problem would have been of an aggravated order, had many professions been imparted in local languages. The experience of Karnataka is very relevant. Despite the Union government’s push for technical courses to be taught in regional languages, the response has been very poor in the State. During the recently concluded CET-2022 counselling for engineering courses, only one student had chosen Kannada medium! People have more wisdom than politicians, and are less obsessed about language.
The global nursing shortage has been engaging the attention of healthcare policymakers for quite some time. In 2020, the first State of the World’s Nursing (SOWN) Report, published by the World Health Organization (WHO), revealed that the global nursing workforce was at 27.9 million and estimated there was a global shortfall of 5.9 million nurses. 17% of nurses globally are expected to retire within the next ten years, and 4.7 million additional nurses will need to be educated and employed in order to maintain current workforce numbers. In total, 10.6 million additional nurses will be needed by 2030.
This is a great opportunity for policy makers to resolve many current exasperating issues. The nursing profession can alleviate the massive unemployment haunting the young generation. Kerala's youth unemployment rate is over 40% as of April-June 2022 – one of the worst in the country, second only to Jammu & Kashmir. From October 2021 to November 2022, the highest unemployment rate in India was recorded in August 2022, with 8.28 percent. As of November 2022, the unemployment rate is estimated at eight percent. There are two aspects to this unemployment problem, firstly youngsters are not getting employment that matches their educational qualifications, and, secondly, youngsters are forced to engage themselves in other occupations, that have no relevance to their field of study. Engineering degrees are a concrete example of this situation. Due to lack of proper avenues many engineers do not have proper employment. Many engineering colleges lack proper infrastructure and teaching staff, and these colleges churn out many students of low calibre and capability, adding to the critical situation.
In December 2022, the Niti Aayog Vice Chairman revealed that about 45 per cent of management and 48 per cent of engineering students in the country are unemployed. Another disturbing aspect is the decreasing strength in higher education in the country. Politicians, bureaucrats, and economists are worried about the staggering unemployment figures staring at them, and nobody has any idea how to tackle this monster, which can affect the electoral fortunes of every political party. There is pressure to eradicate illiteracy, hence the Government is constantly increasing the number of universities, and colleges. This rampant increase has led to lack of quality education. Profit-crazy private managements, lack of skill education, massive corruption at all levels, focus on rote-learning methods, and shortage of faculty (both in quantity and quality) are the major issues plaguing higher education. Had the Government instead focused on elevating the nursing profession, the unemployment problem could have been controlled very effectively. The total apathy and lack of vision of our politicians and bureaucrats can be guessed from the simple fact that though Kerala contributes massively to the nursing force, there are just 12 nursing colleges with an intake of just 7320 students in the State (as on 31 st March 2021). There is not a single nursing college in Kerala which figures in the Top 20 Nursing Colleges of India!
Though Kerala had a pre-eminent claim for a national institute of nursing sciences in the State, the choice went to All India Institute of Medical Sciences (AIIMS) Bhubaneswar, College of Nursing which was set up in September 2013. This College of Nursing as part of AIIMS Bhubaneswar was established under the Pradhan Mantri Swastya Suraksha Yojana (PMSSY). It is a state of the art nursing college. The University Of Pennsylvania School Of Nursing (Penn Nursing) is the number one nursing school in the world according to a recent ranking by QS World University. Is it such an impossible task for our legislators to set up a similar nursing institution in Kerala? India does not have an exclusive nursing university, and Kerala can have the privilege of starting one if our legislators have the vision. We already have specialized universities like Kerala Digital University, Thunchath Ezhuthachan Malayalam University, also called Malayalam University, Kerala Kalamandalam, Indian Institute of Space Science & Technology, and many more.
Why an exclusive nursing university? This writer has had a ringside view of the travails of nursing students from Kerala, due to stints in two reputed Universities. As it is not a high revenue yielding subject like medicine, and management, many nursing institutions inside Kerala and outside, have very poor infrastructure and facilities for the students. Hostel conditions are pathetic, food is even worse. It is quite common to see up to six girl students cramped in a single room on bunk beds with a small ceiling fan. Such is their miserable existence in the hostels. For profit maximization, quality and quantity of food, are compromised. For accreditation by NAAC, the seven criteria for assessment are:
1. Curricular aspects
2.Teaching-learning and evaluation
3. Research, innovations and extension
4. Infrastructure and learning resources
5. Student support and progression
6. Governance, leadership and management
7. Institutional values and best practices.
A significant omission is the student hostel and boarding facilities. The entire emphasis is on the student academic development, the quality of hostel accommodation and mess facilities has not been reckoned as a factor even in Student Support and Progression criteria. This lacunae needs to be rectified if we are serious about ‘quality education’.
Be that as it may, the Kerala government has a golden opportunity to set up a world-class nursing university, with satellite colleges in all the 14 districts in the State. Even a Public-Private- Partnership (PPP) model can be envisaged to build a world-class nursing university, with foreign collaboration. Nursing is one great profession that can give ready employment as well as global opportunities, unlike other professions. It is also the only profession that simultaneously uplifts and empowers girls, their families and the nation.
The author is former Director General of National Academy of Customs, Indirect Taxes & Narcotics
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