Thiruvananthapuram: If not for the hardworking 'Florence Nightingales' of Kerala, life would be tough for thousands of families in the state. As nurses, these women not only care for those in pain the world over but also serve as a lifeline for their kith and kin back home.
One estimate says at least 20 percent of annual remittances to the state from abroad are from women, most of them nurses.
Mariakutty Thomas, 60, from Kottayam, who worked in Bahrain for over 25 years, in a way represents the nursing community from Kerala working abroad.
'I was the eldest in my family. When my father died about 30 years ago we were left helpless. I was a nursing student then. Soon after completing the course, a neighbour helped me find a job in Bahrain.
'I worked hard there. Now I am happy seeing my nieces and nephews doing well in life,' said Thomas, who never married.
Thousands of families in Kerala are indebted to nurses like her, solely depending on the income from their remittances.
A huge majority of them are employed in the Middle East, the US, Britain, other European countries and Australia.
S. Irudayarajan, chief of the migration unit at the Centre for Development Studies here, has done a series of surveys on migration in the state. He said it was unfortunate that no separate studies had been done on migrating nurses.
'In our latest study, we have found out that 15 percent of migrants from Kerala are women, of which a huge majority are nurses. Also, about 20 percent of annual remittances from abroad are made by women, most being nurses,' said Irudayarajan.
According to him, there are more than 2.1 million Keralites outside India, with close to 85 percent in the Middle East. The total annual remittances made by the diaspora comes to around Rs.50,000 crore.
With nursing becoming a sought after career predominantly among the middle class and lower middle class families, nursing education has also become a lucrative business, especially in the private sector.
There are more than 120 private nursing schools in the state that offer courses, both diploma and degrees, in nursing.
However, finding a job overseas does not come cheap. The current going rates charged by placement agencies for a qualified nurse to work in Britain or Australia is around Rs.6 lakh.
But Raju Nair from Thiruvalla, a driver in a private company, is a happy man.
'My eldest daughter is working in a Sydney hospital. I spent about Rs.6 lakh to send her there after she cleared the qualifying exams in Melbourne. She repaid all the money in six months,' Nair said.
He added: 'My youngest daughter is in the nursing final semester now. She is also getting ready to go to Australia. Believe me, if not for this (nursing) career, life would have been very tough for my family.'
Molly Abraham, 33, a nurse in Qatar, tells a story of hard work and sacrifice.
'Life is tough. My eight-year-old son and my husband are in Kottayam. I have been working in Qatar for five years. We are saving every bit to complete our dream home,' she said.
'I will continue for one more year in Qatar because we want to save some money as well. Without the job, I don't think we could have bought a car and built a home in such a short time,' Abraham said.
Monthly salaries for nurses in the Middle East start from the equivalent of Rs.50,000 upwards, while in the US, Britain and Australia, it begins at Rs.1.5 lakh.
According to data provided by the Kerala State Nursing Council, 8,496 BSc nurses and 10,972 diploma nurses were given registration last year.
'The number has been growing by around 20 percent every year since the past few years when several private nursing education institutes opened up,' said an official.
However, a section of aspiring nurses find it tough to pass the eligibility test in English language, a must for a nursing job in the US, Britain and Australia.
Jaisama John, who hails from Ernakulam district, said: 'I could manage only 6.5 score for IELTS. If I had got seven, my papers for higher studies in the UK could have gone for processing.'
Her friend cleared the test in the last attempt and she is now studying in Britain. She can also work for 20 hours a week, John said despairing at her own fate. 'In four months, she will complete her studies and will join a hospital there, drawing a good salary. I have to write again,' she said.