Rethinking Care from Development and Transnational Perspectives

"Care" means the provision of the necessities to a subject for the well-being of their health, psychology, and other fundamentals of livelihood. The distinction between "caring for someone" and "caring about someone" has always been there and is classified into two different domains in the private and public sectors. According to Standing, “Care can be defined as the work of looking after the physical, psychological, emotional and developmental needs of one or more people” (Standing, 2001, p. 17 as cited by Raghuram, 2012, p. 157). This did not create any problem in the definition until the wave of feminism influenced people to think about it from socioeconomic, intersectionality, transnational migration, and racialization points of view, and the structure of caregiving institutions influenced people to think about "care" as a service that can also be sold, not only served. The divergence between "care" and "caregivers" has been a complex issue due to its multifaceted nature and needs a global approach to redefine it. Non-marketed and marketed care jobs globally are exposed to gender segregation, where females dominate care industries and are often the prey of wage discrimination, stereotyping, and racialization.

In this article, the concept of "care" and how it varies from development and transnational perspectives will be discussed. Countries like India and the Philippines will be addressed to shed light on the marginalization of care workers through care jobs from the Global South to the Global North.

Gender dynamics in "Care Jobs"

“Caring, however defined, is a predominantly female activity and its study appears both to demand an analysis rooted in the gender order and to facilitate the development of knowledge on the oppression of women” (Thomas, 1993, p. 4)

The provision of "care" is essential to social and human well-being. In addition to ordinary household chores like cooking, cleaning, washing, mending, and fetching water, it also involves caring for children, the elderly, and people with physical and mental illnesses and impairments. Three out of four people in care jobs are women (OECD, 2019). The research by Hilary Graham (1991) indicated very clearly that the sector of "care" is dominated by women, and thus it is a matter of gender order and role. The women working as caregivers in the health sector as nurses, in houses as house-helps, and in the cleaning sector as cleaning women also indicate gender dominance in the care industry. On the other hand, as females are taking space in the labor markets not only in paid care jobs but also in other industries, how families are fulfilling their "care" demand in the absence of them has become a matter of core discussion. If the point of intersectionality comes here, it can be seen that most of the women who migrated from the global south are engaged in jobs such as househelps, babysitters, nurses, and cleaners in the global north. Many of the women who were care workers in their home country have been attracted by better economic prospects elsewhere and thus migrated. The marginalization of women through care jobs in their home country and abroad is a different phenomenon, as the demographic and economic set of factors vary greatly. Thus, the necessity of a Global Chain of Care (GCC) for the development of care services in education, healthcare, and households is to reduce the gender gap, eliminate discrimination, and eradicate transnational migrant exploitation. GCC is a cross-national network in which care work is transmitted from one person to another, generally along economic and geographic lines. GCC research may reinforce care work as women's work (Yeats, 2012). The word "care" has long outgrown the relative simplicity once attached to it; it now encompasses a broad sociological aspect and influences development, politics, and international policy.

Figure 1: 'Portrait of a Lady and a Nurse' (Royal College of Nursing, 20th century)

Variation in the Concept of Care Throughout Regions and Theorists

“The provision of care is differentially embedded in cultural, political and economic formations such as the family, the market, the state and the community sector in different countries” (Raghuram, 2012, p. 156)

Culturally, care is perceived very differently in the Global South than in the Global North. The case studies of India, the Philippines, and other Asian and Latin countries can help to understand that care is not only embedded among the family members or loved ones; the caregivers can also live a transnational life outside their home countries’ borders. For example, women in northern countries are contributing to the different kinds of labor markets, and frequently they need to hire nannies or babysitters for their children or resort to housekeepers for assistance with household chores. It creates labor markets for caregivers, where people from poor families or underprivileged countries are willingly becoming migrants as caregiver laborers. For instance, a Filipino woman is living as a "caregiver" in the USA, being a babysitter for a child in that country. However, such a transfer of labor cannot be seen from the north to the south. If a laborer from the north is migrating to the south, it is basically for any development or technological sector where they can pass on the knowledge and experience of specialized fields.

Different cultural and economic conditions can shape the mobility of caregivers. Thus, the theories related to global care are not limited to migration and transnationalism but also raise concerns about racialization and development. The specific race dominance in a certain field can expose their specialties and could also be a reason for discrimination. Care is being globalized from one place to another as a commodity demanded and a workforce supplied. So, "care" cannot be theorized from one aspect only; it needs a global form. The concept of a global care chain is intended to help people view and understand the global care market not only from an economic or development standpoint but also from racialization, intersectionality, and transnational perspectives. Thus, feminist theories incorporate sex exploitation and wage exploitation in the care market, where development economists see care as a transfer of workers, remittance gain, and care deficit. Politicians and philanthropists admire care as the well-being of a subject, and that is how the theories of care are centered through the policy design related to this market. Hence, it is extremely important to approach global addressing of care holistically. Grandea and Kerr (1998) illustrated in their research how women’s migration as caregivers leads to crucial social consequences in their home country, where women as immigrants are economically well off and play a significant role in the remittance earnings of their countries. On the contrary, their absence creates a negative impact on their families as a "care deficit" occurs. Later, Parreňas (2005) further describes in her book that extending the reach of care discussions globally is supported by empirical grounds, and the most significant one is that mobility has increased the distances between persons who could be participating in affectionate caregiving.

Figure 2: Illustration of Caregivers (SEKISUI Diagnostics, 2024)

Care from a Development Perspective

The concept of care from a development perspective focuses on understanding and supporting the growth and developmental stages of individuals, particularly children and youth. This perspective integrates development theories such as Dependency Theory (Singer & Prebisch, 1949), World System Theory (Wallerstein, 1974) and caregiving into practices to enhance overall well-being from the micro- to macro-level. These theories see "care" as an element of the global economy, and developed countries are better off with the labor provided by developing countries. Caregivers migrating from poorer nations take on important roles in wealthier countries; however, they may remain economically disadvantaged (Fudge, 2012).

There is a link between a country's economic status and how "care" might be defined from a development standpoint. For the countries that are transforming from traditional to industrial advances, or, simply, are chasing economic growth for development, the practice of "care" is of marginal interest there. The "care" in the families as care from a mother to the child or the elder citizen can be noticed there. The concept of babysitting or providing caregiving services to a senior citizen whose family lives away is unreachable in such economies compared to the global north. At the macro level, politicized care is given to the targeted group, which is vulnerable or left out of the development.

To understand "care" from a development perspective, the case study of India can be scrutinized, as Raghuram (2012), Deshpande and Ramachandran (2019), and other scholars have emphasized empirical evidence of India’s marginalized people’s development with various Indian governments’ policy dialogues. For example, women in some selected castes and tribes were taken under governmental policies for development, where "care" came in the sense of development in policies theoretically, but empirical evidence showed the notion of modernization overlooked "care" within the development frame. Deshpande and Ramachandran (2019), in their study, analyzed the effectiveness of government interventions like quota systems or reservations according to caste systems in reducing caste-based employment disparities for marginalized people’s development. However, the policies failed to integrate the concept of "care," which includes social support, community health, and well-being, to reach the level of qualifying in the job market. As a result, there is a continuous flow of impoverishment or marginalization of a specific group of people being exploited in low-paid or unpaid care jobs.

Figure 3: Painting By Manish Vaishnav, Rajasthani Women Fetching Water, (n.d)

The care deficit in the development process of an economy is noticed by non-profitable institutions and social workers. Social workers are one of the earliest groups to identify the well-being of domestic workers, which also included awareness against the violence happening to domestic workers by house owners. The purpose of social workers was limited to modernizing domestic workers with skills who were predominantly drawn from working-class, lower-caste, and tribal groups, as well as the institution of domestic service itself, i.e., private households (Raghuram, 2012). If we look at the history of India, like other countries in the south, India was colonized by Europeans, and the dominance of churches in the caregiving sector is strong because historically, care and compassion were inputs in colonial projects by the churches. That is why the first survey of domestic workers was carried out by the Catholic Bishops Conference of India in the 1970s (Nilaya 1983, as cited by Raghuram 2012, p. 169). As a result, the existing framework did not question the caste-based classification of people and their socioeconomic status for which they wanted to continue the care jobs; rather, it emphasized the modernization of labor, like eliminating minimum wages and better holiday allowances. The quantity of care work throughout India also varies with the geographical locations. In the dry states, like Rajasthan and Gujrat, women walk mile after mile to fetch a few liters of water, and it is considered a "women's job," which is ungratefully unpaid. A study by Kookana et al. (2016) explained that female students are more likely to miss or drop out of school due to the groundwater scarcity problem as they have to invest a significant amount of time of the day in fetching water from miles away than their male counterparts in Gujarat and Rajasthan (Kookana et al. 2016 as cited by Ghosh & Sarker, 2023, p. 360). So, the development projects for water supplies there are crucial, as they have geographical barriers that are exploiting women who invest many hours a day in unpaid care jobs. Furthermore, various care traditions persist in India, each with its own set of qualifications, certification procedures, honors, and awards. There were notable disparities in the experiences of various health caregivers in the context of healthcare providers at the time of independence (early 1960s). In India, there were additional distinctions between ayurvedic and allopathic medical practitioners, as well as between the public and private sectors and the military and civilian health services. The Indian Medical Service (IMS) occupied the highest position in the medical hierarchy, and its practitioners offered unique types of care not seen in other traditional hospitals (Raghuram, 2012).

 Figure 4: Photo of Domestic help in India (The WIRE, 2023)

This is evidence that throughout India's development process, India's care industry transitioned through numerous frameworks where colonial effects, modernized definitions of INGOs, and institutional hierarchies within the care industry affected the lives of care workers. To politicize this notion, following models of the global north, where the economic and societal history is different, can result in false paradigm models without helping out the targeted group.

Though economic development is necessary to achieve the growth of the country, "care" within development projects can be marginalized. As development has colonial biases, it affects both caregivers and care-receivers. So, "care" from a development perspective is massively criticized by feminist and transnational theorists.

Care from a Transnational Perspective

If care is deconstructed from a transnational perspective, it is mostly female persons who are migrating from one part of the world to other parts of the world to engage themselves in the caregiver market as nurses, nannies, housemaids, domestic workers, or cleaners in factories and offices. This migration directly creates a care deficit in the caregiver’s country because mostly the women from the south are migrating north, and it is not vice versa. According to Arlie Hochschild (2000), the relocation of Filipino nannies to the United States causes a shift in caring roles. While these nannies offer care for American households, the families they leave behind in the Philippines are neglected. In essence, the lack of caregivers is not filled but rather transferred from American homes to those in the Philippines (Raghuram, 2012, p. 158). In contrast, traditionally, where women were seen as migrants for care work, Manalansan (2004) addressed the intersection of gender and sexuality among gay Filipino men working abroad as caregivers and the phenomenon of male doctors in the Philippines retraining as nurses to migrate to the USA and Europe. As a result, migration through carework is shifting occupational preferences as well. This phenomenon is particularly evident in the context of highly skilled professionals who may retrain or accept lower-skilled positions in the care sector to facilitate their migration (Da Roit & Weicht, 2013).

Figure 5: Painting by Rosanne Mckenney, Caregiver Nurse, (n.d)

Labor exploitation, sex exploitation, and human trafficking can be traced when a person is living a transnational life beyond the boundaries. When a person is migrating from south to north, it is mostly because they can have a higher-paying job than that in their country. Here, economic status plays a vital role. For example, in the 1970s, a huge influx of Filipinos was in Italy because Italy did not have any concrete social service programs back then. However, often they would get temporary jobs and not permanent contracts. So, they fall into the global care chain, taking care of babies in Italy or senior citizens, where they are paid low; the jobs are care intensive, but they are able to send remittances in the Philippines and gain their caregiver’s job recognition in the global market (Basa et al., 2012).

In the healthcare sector, the discrimination and narrow opportunities in terms of caregiver work can be seen clearly. In Saudi Arabia, Filipina nurses are hired as general nurses with low wages, compared to the less qualified European nurses. European nurses are paid highly. The migrant nurses in Western countries, according to Bach (2003), face downward occupational mobility (workers move from any high-wage occupation to any low-wage occupational category), thus not being able to end up having nurse jobs no matter how qualified they are and doing jobs such as nannies, cleaning ladies, and housemaids. So, a woman who is living a transnational life as a caregiver can be marginalized based on her race and ethnicity due to stereotypical narratives established in the global north.

Figure 6: International flows of doctors and nurses (Science Direct, 2011)

In care work, race and ethnicity play a vital role. For example, many families in certain countries prefer women from Mexico and Peru as nannies because they believe these women are culturally and behaviorally motherly figures. Maher (2003), in his research, argues that these specific Latin American women fit into care work as "natural mothers" and, at the same time, "very submissive" as a type of worker. On the other hand, Asian women are preferred as domestic workers in America because of their "nimble fingers." So, the care job sectors are being segregated within themselves, according to established perceptions and stereotypes regarding ethnicity.

To conclude, there is explicit segregation in the care industry globally, where it is women who are often engaged in care jobs domestically and internationally. Throughout the development of a country, government policies may not notice the inclusion of "care," resulting in social classifications and the continuation of low-paid care jobs. In many cases, these women immigrate to the global north from the global south to work as caregivers in different sectors, leaving their families behind. This migration is driven by economic necessity, which generates a labor flow to satisfy the developed countries' care demands and creates a deficit in the home countries' care systems. Development theorists often view the migration of care workers as a beneficial transfer of labor that supports economic growth through remittances sent back to their home countries. However, transnational theorists highlight the complex realities faced by these migrants, emphasizing the exploitation and discrimination they often endure both in their home and host countries. This dichotomy reveals that the care industry is multifaceted and requires comprehensive research from various perspectives. Understanding these dynamics is crucial to addressing and mitigating the issues of discrimination and exploitation within the sector.

Bibliographical References

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