Politics of precarity: Gendered subjects and the health care industry in contemporary Kolkata Panchali Ray; Oxford University Press Rs.1,250; Pages 260 – Mohan Rao (The Book Review) The Covid-19 pandemic is here to stay and we have to learn to live with it. In addition to the many things the pandemic has exposed — neglect of public health, disastrous implications of privatisation of healthcare, the lack of public health infrastructure and ignorance of the social roots of ill-health and disease — there’s the utter inadequacy of nursing and frontline staff. Overworked and underpaid, ASHA (Accredited Social Health Activist) workers in Karnataka, for instance, have been forced to call a strike. Even worse, these ‘warriors’ are expected to work long shifts without rest or proper protective equipment. It’s in this context that Panchali Ray’s ethnographic work assumes great significance. This is a truly fascinating and well-written book that traverses disciplines and texts, and is marked by empathy towards her respondents. It’s multidisciplinary, exploring the lives of nurses in contemporary Kolkata. It is based on studies of three sites in Kolkata, a government hospital, a private nursing home and private hospital. These are sites where it is difficult to gather data. The author has spent time with 100 healthcare workers, besides interviewing managers. Among the healthcare workers, the following strata were identified: registered nurses, private sisters, and attendants. The historical continuity from colonial times is striking. Dr. Hilda Lazarus, the first Indian female in the Women’s Medical Service in 1917 spoke about the need for “good quality nurses, without whom healing is not possible… it was an art… that called for cultivated and cultured women from good families”. Nursing cannot be carried out by working class or lower caste women, like dais. As the author writes: “This was the heart of the ‘nurse problem’: devalued and stigmatised as menial, sexual, and servile labour, nursing was perceived as an occupation over-represented by women from lower-caste and/or working-class communities”. At one time, it was believed that the professionalisation of nursing education would change things. But public health has been neglected in India, and a consequence has been nursing education. The lack of jobs for trained nurses in India is matched by the plethora of jobs abroad, as nurses’ migration to the rich countries assumes significance. At the same time, there has been phenomenal growth of nursing schools that churn out unregistered nurses for private sector hospitals, nursing homes and clinics, burgeoning in neo-liberal India. Young women from desperately poor and predominantly lower caste families enter as unregistered nurses, working up to 14 hours per day, at appalling pay rates — less than the minimum wage for manual labour. Unsurprisingly, none of them wants her children to enter this profession. Indeed many would themselves like to leave it, if they had other options. A rung below the unregistered nurses are the ‘private sisters’ and attendants, who earn even less under more exploitative working conditions. A private sister earns around Rs.3,300 per month if she works…
