Table Of Content‘Based on a rich study of Nepali nurses and their migration journeys to the
UK, this book makes excellent contributions to the study of the gendered
migration of healthcare professionals in the context of global health inequal-
ities.Suitablysubtitledas“TheDreamsandTrapsofNepaliNurses”,itoffers
excellent accounts of the experiences, struggles, and successes of female
Nepali nurses in the UK. Adhikari offers a powerful ethnographic critique of
dominant stereotypical representations of Nepali women. It will be of parti-
cular interest to those studying the migration of healthcare professionals and
gender and development.’
—Jeevan R. Sharma, University of Edinburgh
‘Nurse migration and mobility continues togrow in magnitude, and the flows
become more varied and complex. The implications for policy at national,
regional, and global levels become ever more pronounced. This book adds
new insights into the lived experience of the nurses who move, and in parti-
cular it improves our understanding of the dynamics that are in play in Asia,
a region that includes many countries with significant nursing shortages, and
the UK, a popular destination country for Asian nurses.’
—James Buchan, University of Technology, Sydney (UTS)
Migrant Health Professionals and the
Global Labour Market
This bookoffers a fresh perspective on gender debates in Nepal and analyses
how the international migration of the first generation of professional female
Nepali nurses has been a catalyst for social change.
With unprecedented access to study participants in Nepal (the source
country), following them and their networks in the UK (the destination
country), this ethnographic study explores Nepali nurses’ migration journeys,
relocation experiences, and their international migration ‘dreams’ and
aspirations. It illustrates how migrant nurses strive to manage social and
professional difficulties as they work towards achieving their ultimate migra-
tion aims. The book shows that nursing shortages and international nurse
migration areissues of gender,onaglobalscale, and thatthe currenttrendof
privatisation in health systems makes the labour market vulnerable, and sti-
mulates international migration of health professionals. Arguing that inter-
national nurse migration is an integral part of the globalisation of health, the
author highlights key policy strategies that are useful for global nursing and
health workforce management.
A well-informed and much-needed study of nurse migration in the global
healthcare market, this book will be of interest to professionals and aca-
demics working in nursing studies, health and social care studies, gender and
international migration studies, and global health studies, as well as South
Asian studies.
Radha Adhikari is a Nepali nurse and a Research Associate at the Centre for
South Asian Studies, University of Edinburgh, UK.
Routledge/Edinburgh South Asian Studies Series
Series Editor:
Crispin Bates and the Editorial Committee of the Centre for South Asian
Studies, Edinburgh University, UK.
The Routledge/Edinburgh South Asian Studies Series is published in asso-
ciation with the Centre for South Asian Studies, Edinburgh University – one
of the leading centres for South Asian Studies in the UKwith a strong inter-
disciplinary focus. This series presents research monographs and high-quality
edited volumes as well as textbooks on topics concerning the Indian sub-
continent from the modern period to contemporary times. It aims to advance
understanding of the key issues in the studyof South Asia, and contributions
include works by experts in the social sciences and the humanities. In accor-
dance with the academic traditions of Edinburgh, we particularly welcome
submissions which emphasise the social in South Asian history, politics,
sociologyandanthropology,baseduponthickdescriptionofempiricalreality,
generalised to provide original and broadly applicable conclusions.
The series welcomes new submissions from young researchers as well as
established scholarsworking on South Asia, from any disciplinary perspective.
Provincial Globalization in India
Transregional Mobilities and Development Politics
Edited by Carol Upadhya, Mario Rutten and Leah Koskimak
Global Health Governance and Commercialisation in India
Actors, Institutions and the Dialectics of Global and Local
Edited by Anuj Kapilashrami and Rama V. Baru
Space, Utopia and Indian Decolonization
Literary Pre-Figurations of the Postcolony
Sandeep Banerjee
Migrant Health Professionals and the Global Labour Market
The dreams and traps of Nepali nurses
Radha Adhikari
Forafulllistoftitles,pleasesee:www.routledge.com/asianstudies/series/RESAS
Migrant Health Professionals
and the Global Labour Market
The Dreams and Traps of Nepali Nurses
Radha Adhikari
Firstpublished2020
byRoutledge
2ParkSquare,MiltonPark,Abingdon,OxonOX144RN
andbyRoutledge
52VanderbiltAvenue,NewYork,NY10017
RoutledgeisanimprintoftheTaylor&FrancisGroup,aninformabusiness
©2020RadhaAdhikari
TherightofRadhaAdhikaritobeidentifiedasauthorofthisworkhas
beenassertedbyherinaccordancewithsections77and78ofthe
Copyright,DesignsandPatentsAct1988.
Allrightsreserved.Nopartofthisbookmaybereprintedorreproducedor
utilisedinanyformorbyanyelectronic,mechanical,orothermeans,now
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Trademarknotice:Productorcorporatenamesmaybetrademarksor
registeredtrademarks,andareusedonlyforidentificationandexplanation
withoutintenttoinfringe.
BritishLibraryCataloguinginPublicationData
AcataloguerecordforthisbookisavailablefromtheBritishLibrary
LibraryofCongressCataloging-in-PublicationData
Names:Adhikari,Radha,author.
Title:Migranthealthprofessionalsandthegloballabour
market:thedreamsandtrapsofNepalinurses/RadhaAdhikari.
Description:1.|NewYork:Routledge,2019.|
Series:Routledge/EdinburghSouthAsianstudiesseries|
Includesbibliographicalreferencesandindex.
Identifiers:LCCN2019032547(print)|LCCN2019032548(ebook)|
ISBN9780367344252(hardback)|ISBN9780429325731(ebook)|
ISBN9781000729689(adobepdf)|ISBN9781000729832(mobi)|
ISBN9781000729986(epub)
Subjects:LCSH:Medicalpersonnel,Foreign.|Nursing--Nepal.|
Emigrationandimmigration.|Braindrain.|Labormarket.
Classification:LCCR697.F6A342019(print)|
LCCR697.F6(ebook)|DDC610.73095496--dc23
LCrecordavailableathttps://lccn.loc.gov/2019032547
LCebookrecordavailableathttps://lccn.loc.gov/2019032548
ISBN:978-0-367-34425-2(hbk)
ISBN:978-0-429-32573-1(ebk)
TypesetinTimesNewRoman
byTaylor&FrancisBooks
Contents
List of illustrations viii
Acknowledgements ix
List of abbreviations xi
Introduction: Nursing, gender, and the political economyof female
migration in Nepal 1
1 Professional nursing education and the labour market situation in
contemporary Nepal 21
2 The international migration market economy: decision-making,
planning, and preparation 52
3 Arriving and surviving in the UK: navigating a new set of
professional challenges 75
4 ‘There is avast difference from what I had thought’: professional
life in the UK 99
5 Negotiating with new realities: family and social lives in the UK 122
6 Concluding discussion: professional nursing in Nepal and nurse
migration to the UK 145
Appendix 163
Bibliography 165
Index 175
Illustrations
Figures
2.1 IEC billboards in Putalisadak, Kathmandu 60
3.1 Total numberof Nepali (Nepal-educated) nurses registered by the
NMC (UK) 77
5.1 A flyer for the NNA-UK’s charity fundraising event in London 138
5.2 Nurses in the diaspora celebrating a Nepali festival at the
Nepalese Embassy, London, August 2018 139
5.3 Chanda and Maheshwor’s baby’s first rice-feeding ceremony,
Scotland, January 2017 140
Tables
1.1 Overviewof all nurse education programmes in the 2018–2019
academic session 29
1.2 Growth of nursing education programmes: SN, BN, and B.Sc.,
1991–2019 30
3.1 Nepal-educated nurses on the NMC UK register, up until 31
March 2019 78
4.1 Nurses’ professional mobility before and after migration to the
UK 105
5.1 Nurses’ husbands and their social/professional mobility after
migration 131
Acknowledgements
This book is inspired by the many professional colleagues with whom I have
worked and socialised during my professional career in Nepal, the UK and
indeed internationally. They currently occupy various positions and fulfil
diverse roles, as clinical practitioners, academic researchers, health policy
makers and migrant healthcare professionals. In my everyday life, everyone
with whom I have interacted has been affected by international nurse migra-
tion inonewayoranother,so it has become everybody’sbusiness,and indeed
a social norm. This was the wellspring of my research.
First and foremost, I would like to thank all the Nepali nurses, and their
families, whom I met in Nepal and in the UK, who shared their deeply per-
sonal experiences of being a nurse in Nepal, and in the case of those who
have moved to the UK, of their experience of migration. Many granted me
their precioustimeafter finishinglongshifts,andsomeaftercompletingnight
shifts. All nurse Didi Bahini and their families have been unfailingly welcom-
ing and extremely accommodating. This book would not have been possible
without their unreserved willingness to share their personal experiences with
me and, through introducing me to their colleagues, inviting me to join their
social world. There are too many to name individually, but I thank them all
for their full participation throughout the research process, and continued
engagement for many years afterwards, up to the present day.
In Nepal, numerous professional colleagues have been a huge support for
me, while I was desperately trying to piece together the complex jigsawof the
politicsandneweconomyaroundprofessionalnurseeducation,thecapricious
labour market and international migration business in the country. Once
again there are too many to name; however, I would like to thank senior
colleagues, nurse managers in institutions I visited, including the President of
the Nursing Association of Nepal and the Board members; staff members at
the Centre for Technical Education and Vocational Training, the Nepal Nur-
sing Council, Maharajgunj Nursing Campus, Lalitpur Nursing Campus,
Pokhara Nursing Campus, Biratnagar Nursing Campus, and many private
colleges, and Thapathali Maternity Hospital, Tribhuwan University Teaching
Hospital and many other hospitals. I thank all the nursing students whom I
met during my fieldwork. Without their information, it would not have been
