NewsOnce around the globe to the hospital bed

Once around the globe to the hospital bed

The western health systems can no longer do without nurses from abroad – which is an opportunity for young people, but also tears families apart around the world

For two years, Reeba Kumar was delighted every day that the FaceTime app was available on her smartphone. 7500 kilometers as the crow flies lie between the old people’s and nursing home in the east of Frankfurt and the southern Indian province of Kerala, and until recently the oceans and land masses were also between Reeba Kumar and her little son John, her husband Kamlesh and her parents. Ever since she got off the plane in Frankfurt on a rainy December day in 2019, she has only seen John, who is now four years old, get taller and taller and learned to speak better and better on the screen of her cell phone. “I missed him so much,” says the 31-year-old as she sits in the foyer of the large, bright facility for an interview, in her red uniform and with an FFP2 mask over her mouth and nose.

The hard time is now over: John and Kamlesh also recently landed at the airport, and after two weeks of quarantine, the Kumars are finally able to move into their apartment together as a family. Jake Tom got a place in the nursing home’s company day care center, Kamlesh is a self-trained nurse and will soon start working. He was last employed in Dubai.

Globalization is happening in real time in the east of Frankfurt: a new chapter in life begins for an Indian family on a foreign continent, while coffee cups rattle behind the open terrace door, a quiet murmur penetrates inside and a few sparrows chirp.

There is a lack of care in Germany

The world is on the move. There are more and more old people in Europe. With age, the risk of certain diseases also increases, and the need for care increases. In order to provide good care for everyone, many carers are needed. But there are too few in Germany. That is why employment agencies have been recruiting specifically trained nurses from other regions of the world for several years to look after those in need of care – with eating and personal hygiene, with daily exercise and creating a daily structure. What is a great relief for Western European families, of course, has profound social consequences in the countries of origin of Reeba Kumar and the other migrants from Bosnia, Serbia, India, Ghana, Spain or the Philippines.

Like Kumar, many young women and men have to leave their sons and daughters in the care of their grandparents, knowing that they may not be able to see them for years – in order to be able to earn a family income over the long term. Internet services such as Skype or FaceTime are vital for millions of children and their parents in order to stay close to one another for thousands of kilometers. If you can no longer eat together live or do schoolwork, then it is at least a small consolation to be there in front of the screen.

A bright spot at the end of a working day in the distance, and yet also very sad. What makes mothers and fathers in Germany a lump in their throats just at the thought is so common in many parts of the world that the term “cellphone moms” has long been used, which was first coined in the Philippines. Novels and scientific papers have been written about the phenomenon.

Women abandon their children

Around eleven percent of the Filipino population works abroad, two thirds of the migrants are women. Sociologists coined the term migrant orphans for their children. Because when women work as urgently needed caregivers in Western Europe, far from their families, what the American sociologist Arlie Russell Hochschild calls “global care chain” emerges: a rich country recruits people from a poorer country with it they care for the sick or the elderly. A sister or grandmother then has to step in to look after their own children. Or someone is hired, mostly a woman from an even poorer country, who leaves her family. According to Hochschild, the global care chain does not result in a redistribution of care tasks between the sexes. The tasks that arise will be redistributed globally among women. The care chain in the country of origin consists almost exclusively of female carers. The mother remains primarily responsible for her children in her home country and provides a substitute there, who can either be her own eldest daughter or her own mother.

But everything turned out well for Reeba Kumar. The search for nursing staff has long been a problem nationwide. In 2020 alone, according to the Federal Working Group for Foreign Nursing Workers, an average of around 36,000 positions in nursing remained vacant.

The number of foreign nurses has increased rapidly in recent years. In 2013 there were still around 74,000 employees without a German passport, in 2020 with 208,000 almost three times as many. More than half of them now come from countries outside the EU such as Bosnia, Serbia or the Philippines, but also from Latin America or India, such as Reeba Kumar. Most recruiting is done through private recruitment agencies, but there are also government programs such as “Triple Win”.

In many countries around the world there is no such thing as a “classic” nursing home

What is easy and fluid to read is actually quite complicated – on different levels. “Successful recruitment alone is not enough,” says Heike Blumenauer from the Offenbach Institute for Vocational Training, Labor Market and Social Policy (Inbas). There she works for the “IQ Service Point – International Skilled Workers in Nursing”, funded by the Federal Ministry of Labor and Social Affairs. “The employers have to take care of a company integration management on site, and that includes much more than the organization of language courses.”

It is important to prepare your colleagues for the new addition to the team. “You should explain that someone will soon be coming from the Philippines or India, for example – and ideally also what cultural differences in the approach to care there are in both countries in order to prevent misunderstandings.”

In many countries, the courses for nursing professions are more medically oriented: “Personal hygiene, the provision of food and help with daily exercise are tasks that relatives in the Philippines or India, but also in many southern European countries, usually take on.” The concept a nursing home for the elderly is at most a marginal phenomenon in many parts of the world. The new employees have to get to know it first. Some even feel under-challenged at first because they can hardly apply their extensive medical expertise. “Nevertheless, being able to come here is simply a huge opportunity for most of them.” Still experiencing diversity in old age

Experience diversity even in old age

“There are old people’s homes in India, but not many,” reports Reeba Kumar. She graduated from Kerala with a degree in nursing, an academic degree with a lot of theory. She learned German in India and then deepened it in Frankfurt. Reeba Kumar now speaks fluently and verbatim, and gets into conversation well. “Talking to people is important,” she says. “I think most of them are happy when they see me. ‘You have beautiful eyes,’ said a man who otherwise spoke little. “

Your gaze wanders to the terrace. “Wait a minute, I’ll be right back,” she says, “there is a woman from my ward who is not well oriented”. Reeba Kumar gets up quickly and walks to the open door, through which a woman with a walker is walking, a steep staircase in view. Reeba Kumar gently moves her to turn around again. “You’d better stay in here now,” she tells her and smiles encouragingly. Such seemingly casual situations also show how well she has arrived at her workplace.

Markus Förner is the managing director of the Frankfurt Hufeland House, which, as one of the large retirement and nursing homes in Frankfurt, has long employed numerous employees from other countries. But he also knows that getting used to and integrating is not a sure-fire success. “We do a lot to make it work,” he says. “And I really have to say that I see the diversity of cultures on the wards as an enrichment. I can’t remember a single racist incident or anything like that. “

Many foreign nurses initially feel that they are underutilized

He experiences the newcomers as “extremely motivated”. However, the employers must always be willing to really deal with the people, otherwise the integration could not succeed. “For example, some develop allergies because of their new eating habits, or they have to get used to the fact that dinner is served at 6 p.m.”

However, he also notices how disappointed the well-trained recruits are sometimes that they are unable to apply their medical expertise to the extent that they are used to. “The image of the nursing professions in this country is not good, something needs to be changed urgently. Nurses always sit at the cat table in the hospitals, behind the doctors. The hierarchies in Germany are particularly strict. Nursing staff are often seen as assistants who are not trusted to solve significant problems; a doctor always has to come for this. And geriatric care is seen by many as a second-class profession. “

If the family is allowed to come, everyone is happy

The problem became particularly apparent a few years ago when a program enticed young skilled workers from Spain, where unemployment was high. “The Spaniards were downright appalled by their role here. At home they had studied at a university and carried out tasks that are reserved for women doctors. Most of them returned quickly. ”Taking care of the migrants’ concerns is therefore a high priority in the Hufeland House. “We are also working on training employees to become integration officers.” Markus Förner is also conducting Skype interviews more and more frequently when the future carers are still in their countries of origin. “I always experience that they are well informed about the Hufeland-Haus, some even know exactly what the rooms look like and what the station abbreviations are called.” The apparently good atmosphere in the Hufeland-Haus has got around as far as Madagascar , for which the social networks are of course also responsible. “A very committed young man from Madagascar, who did a voluntary social year here, was so enthusiastic about his time here that he really advertised us. We now get inquiries from the island quite often. “

Reeba Kumar has gained a foothold in Frankfurt and is now looking forward to John’s acclimatization in kindergarten. Because, like many people in South India, she is a Catholic, she was able to quickly find a connection in an Indian parish in Frankfurt. “That helped me a lot to establish contacts.” Then she has to say goodbye again. The early German lunch is about to start.

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