With 46 Indian nurses stranded in a hospital in Tikrit, Shaju Philip meets some of their families in Kerala. Their stories reveal why these young women risk their all to work in strife-torn countries such as Iraq. Photographs by Nirmal Harindran
A short climb up a steep, leech-ridden hill-road ends in front of a two-room mud and brick house. A blue plastic sheet hangs over the broken tiled roof so that rain water doesn’t directly fall onto the cow-dung plastered floor. The wall has a calendar of Pope Francis with his saying, “the humble Church of the poor people”.
Teena V John, 24 | Pottanplavu Village
I prayed to God that let those abducted not be nurses: Lilly, mother of Teena V John
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Teena V John’s journey to Tikrit, Saddam Hussein’s birthplace in Iraq, began from this house on Vaithal hills at Pottanplavu village in north Kerala’s Kannur district. She is one of 46 nurses from Kerala who are trapped in a hospital in Tikrit, the city north of Baghdad that fell to insurgents last week.
Vadakkemulanjanal John and his wife Lilly, both farm workers, stare at the distant hills as they talk about their daughters — the elder daughter Tintu is a nurse in Libya and the younger one, Teena, is in Iraq. Their son Tijo is a farm worker.
“Teena went to Iraq last August and Tintu to Libya last December. In Libya, nurses are told to be wary of terrorists while they go out to buy provisions. Only last month, Teena had told Tintu that she should join her in Iraq. There was no trouble then,” says Lilly.
The family does not have a TV and don’t subscribe to newspapers. Electricity reached the hills only eight months ago. Last Wednesday, as Lilly tuned in the radio on her return from work, she was shaken by the news that 40 Indians had been abducted in Iraq. Since her mobile phone account had no balance, she went to the nearest house down the hill to get more details.
“I prayed to God that let those abducted not be nurses. I want my daughter alive. We are poor, but we can at least live together. I don’t know what happened there. My fear is that Tijo is not telling us everything,” she sobbed.
Teena and Tintu did a diploma course in General Nursing and Midwifery (GNM) from a college in Vijayawada, Andhra Pradesh. Teena, who completed the course in 2011, moved to Iraq after a two-year stint in a Delhi hospital. She had quit her job in Delhi four months earlier, expecting that the visa would reach in a week. The wait lasted four months, before she took the flight to Baghdad.
The family had mortgaged one acre to take an educational loan of Rs 3.5 lakh for their daughters. Besides, they also availed of an agricultural loan of Rs 90,000 for their nursing course. Last year, Lilly took a loan of Rs 1.20 lakh from two local self-help groups of which she is a member.
For the last three months, Tintu has not sent the family any money. “Teena and Tintu had no choice but to go to these troubled countries. It was our last resort. We had to repay these loans. So far, I have managed to pay back only Rs 15,000 to the self-help group. Both my daughters have to be married off. They had hoped to repay the loan and build a small house somewhere down the hill,’’ says Lilly.
Soumya K, 25 | Kudiyanmala Village
After Tikrit fell into the hands of militants, Soumya did not talk much when she called: Valsamma, Soumya’s mother
For the last one week, Kavumburath Valsamma of Kudiyanmala village in Kannur hasn’t gone to the neighbouring farm where she works as a labourer. Her husband Baby is home too — for the last six months, he has been under treatment for cancer. Their second daughter, Soumya, who worked at the Tikrit Teaching Hospital in Iraq, was the family’s lifeline, but now that is snapping.
Valsamma and Baby have four daughters. The wedding expenses of their eldest daughter and Soumya’s nursing education had set them back financially — Baby had to sell parts of his one-and-a-half acres and is now left with only 10 cents. When Soumya got a job in Iraq, they thought life would be on track again, but news of the turmoil in Iraq has hit them hard.
“Our third daughter is studying for her computer diploma and the youngest one is in class four. With my husband unwell, Soumya’s salary was our only hope. But the hospital in Tikrit hasn’t paid her for the last three months,” says Valsamma. “After Tikrit fell into the hands of the militants, Soumya did not talk much when she called us. All she said was that she was safe. She cried when she spoke to her father. He was diagnosed with cancer after she left for Iraq.”
Like many other low-income families, Soumya studied a course in General Nursing and Midwifery and worked for three years in Bangalore and Delhi before moving to Iraq. “We did not want her go to Iraq. But she insisted on going on a two-year visa,” says Baby.
In hindsight, Baby says, he is lucky he didn’t apply for an educational loan to fund his daughter’s nursing education. Instead, he sold his property and moved to a smaller house.
Valsamma says she wants her daughter back at the earliest. “With my daughters studying and my husband unwell, I don’t know how we’ll manage. But I can’t leave Soumya in danger there,” she says.
Sini Chacko, 23 | Madambam Village
We sent Sini to Iraq because a nurse working in Baghdad had told us that it’s a safe place to work: Alice, Sini’s mother
Nellikkakandathil Chacko and wife Alice of Madambam in Kannur are worried about their daughter Sini but say she should stay on if the situation eases a bit.
It’s Sini’s salary that sustains the family. She is the one who is bearing the educational expenses of their youngest daughter Minu who, too, is a nursing student. “We have two acres of agricultural land but we hardly get anything from it. If the situation gets better, Sini should continue in Iraq. Salaries in Kerala are very low. Sini doesn’t want to come back now. She is hoping things will get better,’’ says Chacko.
Sini studied her GNM course in Davanagere, Karnataka, before joining as a nurse in a private hospital in Delhi. Last August, she left for Iraq and has been working in the Tikrit hospital ever since.
“We sent Sini to Iraq because a nurse from our village has been working in Baghdad for the last two years and had told us that it’s a safe place to work,” says Sini’s mother Alice.
She says that for people like them who are too poor to shell out money for visa, Iraq and other strife-torn places are a good option. “A nurse visa to Australia or UK would cost Rs 10 to 15 lakh, whereas the same to Iraq would cost only Rs 1.5 lakh to 1.75 lakh. The poor can only look forward to jobs in Iraq,’’ says Alice.
Ramiya Jose, 24 | Pulingo Village
Everyone is saying our nurses are safe. But, how can anyone be sure?: K M Jose, father of Ramiya
At Pulingo village in Kannur, K M Jose says his daughter Ramiya never knew that she was going to Tikrit. Since her colleagues were going to Baghdad and several seniors were already there, Ramiya wanted to move from Delhi, where she worked in a private hospital, to Baghdad. “I agreed,’’ says Jose.
Ramiya, who had a one-year visa, wanted to extend her stay till next December, but her father did not agree and asked to her to return in August after her visa expired.
Jose said he was planning to get his daughter married by then. “Proposals had come. But now everything is uncertain,’’ Jose says. “Everyone is saying our nurses are safe. But, they have not seen the world outside since they joined duty last August. How can anyone conclude that they are safe?’’
Jose did not take a loan to sponsor Ramiya’s nursing course in Hubli in Karnataka. But a decade ago, he was forced to sell the two acres of land he owned in in Wayanad to pay off his debts.
“Now I only have 60 cents of land. Since that does not give me any income, I have been working as a farm labourer, but cannot anymore because of my ill health. My son, who works with a private firm, is the only one who earns now. For the last three months, even Ramiya has not received her salary.’’
Shonu K | Madambam Village
For nurses from economically weaker families like ours, we can only hope to go to Iraq or Africa: Renu, sister of Shonu
Kanjiramkalayil Elsamma had barely recovered from the trauma of her husband’s death in a road accident in January when the news of her daughter Shonu being stuck in Iraq hit her. At their home in Madambam village in Kannur, Elsamma and her daughters Renu, a nurse in Delhi, and Reshmi, a class 12 student, wait for news from Shonu.
She says her husband Alex, a small-time contractor, wanted his three daughters to excel in studies. He took an educational loan of Rs 5 lakh and sent both Shonu and his eldest daughter Renu to study GNM in Mangalore. After a brief stint in a Kerala hospital, Renu moved to Delhi and Shonu joined her a year later.
Last August, Shonu left for Tikrit. “I too could have gone to Iraq, but since my parents were against the idea, I stayed back,” says Renu. But Shonu attended the interview in Delhi without informing her parents and landed the job. “Shonu was worried about the educational loan our father had taken. She knew she wouldn’t get our parents’ permission if she asked for it. So she simply went ahead. We have no way of repaying the loan and now, our father’s death has added another Rs 1 lakh to our debts,’’ says Renu.
Renu says Shonu went to Iraq because the selection process is easier. “We have no tests such as ILTES to go to Iraq. Those who clear the interview get selected. For nurses from economically weaker families like ours, we can only hope to go to Iraq or countries in Africa.’’
Elsamma now hopes that Shonu will find work elsewhere in Iraq as the embassy has promised to help nurses find jobs in hospitals in safer areas. “I have lost my husband. I don’t want my daughter to sacrifice her life just because we have a loan to repay,’’ says Elsamma.
The Journey to Iraq
Kerala nurses have, for long, migrated across the world and several have worked in Iraq over the past few decades. But war and strife in the country, along with the opening of new avenues in other countries, have reduced the flow of nurses.
According to a 2013 The Lancet report, health services in Iraq have been struggling to recover from years of war and political interference. It claims that the health workforce is not adequately distributed in the country. The Iraq Ministry of Health said the ratio ought to be one physician per 1,000 people and four nurses per physician. With a population of 32,22,7000, Iraq only has 7.8 doctors and 14.7 nurses per 10,000 people, said the report. Thus, Iraq has been recruiting nurses in large numbers over the past few years.
It is far cheaper for an Indian nurse to get a work visa to Iraq as compared to other destinations in the Gulf or Europe. Two years ago, a nurse’s visa to Iraq was available for less than Rs 1 lakh. Most of the nurses who went last year paid an average of Rs 1.5 lakh. The Iraq health ministry also does not not insist on any tough professional test.
These two factors make Iraq an attractive avenue for nurses from poor families who cannot pay large amounts of money — sometimes as much as Rs 10 lakh — for visas. Iraq also became a destination for nurses who had studied either general nursing or the midwifery course. The average monthly salary offered is Rs 35,000.
Many Kerala villages, particularly those with a Christian population, have success stories of nurses who have gone abroad. They build huge houses, create wealth in the rural areas, take their husbands with them and create aspirations among village girls. A number of nurses now employed in Iraq hail from economically backward families in villages along the Western Ghats.
Kerala Non-Resident Keralites Affairs Department CEO, P Sudeep, said the state does not have any comprehensive data on the number of nurses currently employed in Iraq. Most leave the country from Delhi or other major cities. Thus, finding even a rough number is impossible, he says.