My Mommy gone over de ocean
My Mommy gone over de sea
she gawn dere to work for some money
an den she gawn sen back for me

one year
two year
three year gawn

four year
five year
six year come

The Arrival of Brighteye – Jean ‘Binta’ Breeze

The increase in migration and particularly female migration – half of the world’s 190 million migrants are women – means that care has become a global issue. Caring for children or ageing parents may stretch across continents. At the same time, many women who migrate from poorer regions go into paid care or domestic work, looking after children, older people and households in richer nations. In parallel to these ‘global care chains’ is the increased transnational recruitment of nurses and doctors from developing countries to work in the care homes and hospitals of the health services in the developed world. The care industry has become big international business, as providers move their operations across the globe and, in a countermovement, financial organisations transfer an annual US$500 billion of migrants’ remittances back home. How is it that care has become a transnational commodity? And what are the consequences?

The connection between migration and care work is linked to two aspects of social change. First is the global increase in women’s involvement in the labour market. In developed countries, this is marked by a shift away from the ‘malebreadwinner’ model of family life to one which assumes that all adults, men and women, are in paid work – out of necessity as much as women’s emancipation. In poorer regions of the world, the destruction of local economies, unemployment and poverty have pressed women into assuming a greater breadwinning role.

Second, this means that care has become a central social, political, and economic concern. How can responsibilities for care be reconciled when women are employed? How can support for care be paid for? In the richer regions an ageing society and declining fertility have made these questions critical, along with greater political and financial pressure to cut back on social expenditure costs. These issues of a ‘care crisis’ are no less pressing in developing countries, where at its extreme, in Africa, AIDS, chronic illness, natural disasters and a high child dependency ratio, place enormous burdens on women, who are expected to care and earn with very little infrastructural support. Migration, often into domestic and care work, is one way that women can find earning opportunities, even though this intensifies the caring responsibilities of those left behind.

Increasingly, the employment of migrant care and health workers has become, directly or indirectly, one way in which richer nation states and their citizens can meet their needs for care and work/life balance at lower cost. While this might look like a symbiotic relationship, in effect it reproduces profound problems.

To begin with, care work has traditionally been devalued and considered to be more of a female ‘attribute’ than a skill (in spite of the fact that it often demands considerable people skills and physical strength), and where it involves paid work within private households, it is less open to collective bargaining. This, combined with their relative lack of citizenship rights, means that migrant workers usually command low wages and poor conditions.

This is accentuated by the ways in which, across most developed welfare states, the private market has become a central feature of care provision through contracting out state or local authority services to the private sector, and by providing families with vouchers, cash benefits, or tax credits to meet their household, children’s and older relatives’ care needs through the private or voluntary sector. Care is labour-intensive work, but companies and agencies seek to make a profit through cutting labour costs, often compromising on the quality of care.

In addition, while the immediate problem women face in trying to combine paid work with household and care responsibilities can be resolved by paying women from poorer classes or countries to do that work, this detracts from the wider issue of men’s responsibility to share domestic and care work.

Furthermore, when we consider the fact that states have become global employers recruiting their health care staff from poorer countries, the geopolitical inequalities then become apparent in the draining of care resources from poorer countries. In Norway, almost a quarter of workers in health and community services come from abroad – from places like Poland, Latvia and the Philippines. In the Philippines, structural adjustment policies have increased foreign debt and reduced the state’s capacity to improve its own health, care and education infrastructures. This instability drives migration, along with an export-oriented economy in which nursing and care labor provide, through remittances, the largest source of foreign currency. Yet overall, this situation perpetuates geopolitical inequalities and the gendered inequalities associated with care responsibilities, as well as the devaluation of care as an activity.

Is there an alternative? Global strategies include in 2010 the International Labour Organisation’s convention for the rights of domestic workers and the World Health Organisation’s endorsement of an ethical code for countries to follow in the recruitment of migrant health workers. These are important, but there is a bigger challenge. Common to both developed and developing countries is a logic of policy-making that focuses on productivism, the facilitation of markets, and on drawing women into the labour market on ‘male’ terms, where care needs have to be organized around paid work. Although care is central to national and global economies, and to wellbeing and human sustainability, its activities are subsumed under economic competitiveness and are often invisible in calculations of gross domestic product. Recognising care as a collective social good means prioritizing the needs of care providers and care receivers in political and economic strategies. This would be a start to tackling a global care crisis in which the care needs of households and countries are being resolved through a hidden dependence on the unequal gendered and geopolitical relations of care work.

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