KERALA, India (WOMENSENEWS)–Nurses here have begun speaking out against a "bonding" process they see as systematic exploitation by hospitals and a reason to leave the country.

"We swallow the abuse and break our backs doing tough 16-hour shifts just to obtain that one-year experience certificate from the hospital," says 27-year-old Tiju Mathew. "We do it because it’s our only ticket to leave the country forever."

Most private nursing colleges are attached to a hospital where fresh graduates are required to work for a year, or 365 days, to gain practical experience and a "certificate of experience."

It sounds like a good arrangement, unless you are a nurse who has studied or suffered the down side.

"This is nothing short of a trap," says Beena Bhasan, president of Kerala Trained Nurses Association (East Zone) and principal of a private nursing college in central Kerala. "Overnight, these graduates become the manual-work force of the hospital. Their original certificates are withheld. If a student chooses to discontinue, she has to not just forego her experience certificate but pay the compensation amount, fixed at will by individual institutes."

One nurse from north Kerala said she worked for the mandatory one-year term after completing her course, only to be told that it was not a certificate of experience that she would be getting, but a certificate of internship. She had to work another full year to obtain the certificate of experience.

In her agreement, the hospital management said it would pay a salary stipulated by Calicut University, but in fact it paid one-quarter less.

Going on Strike

"Six months into the internship, we went on a strike," the nurse said.

That brought in full payment for the second year but there were more problems. In her second year as staff nurse, the hospital once again tried to undercut the payment stipulation set by Calicut. She and other nurses went on strike again and won again.

But the experience did nothing to make her stay in India. She quit the same month she got all her certificates and is now training to work in Canada.

In Maharashtra, almost all private hospitals that work on the "bond" system charge a contract-breaking penalty of about $950.

One woman’s case has brought these abuses to national headlines. Beena Baby worked in a prominent cardiac care hospital in Mumbai and was charged with misplacing a patient’s electronic chart. Hospital administrators ordered her to pay the cost of replacing the chart or work without pay for the rest of the year. Either way, she stood to lose her experience certificate. Rather than face her parents, still toiling hard to pay off her educational loan, the 22-year-old nurse chose suicide in October, according to those who knew her.

In Kerala, private nursing colleges charge around $1,370 a year for the four-year bachelor of science nursing degree. Ninety percent of students here take out loans to meet these costs, says Bhasan.

"My students come from the poorest of families in Kerala. I can only plead for their sake to the management," she says.

The Trained Nurses Association in Kerala is tackling the system in court.

"We want absolute abolition of the bond system," says Kochu Thressiamma, president of the group’s Kerala chapter. "We are also asking for a salary revision and leave allowances."

Bhasan says enrollment in private nursing colleges has dropped sharply in recent years and those who are still lining up to take these courses are looking for a way to make a living in the West.

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This article is adapted from one that was released by the Women’s Feature Service. For more articles on women’s issues log on to:

Shwetha E. George is a correspondent for the Women’s Feature Service, based in Mumbai, India.

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250 Nurses Go on Strike Over Bond, Harassment, Mid Day: