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Gender Inequality in Production and Reproduction

Sarah Dyer,

Linda McDowell, Adina Batnitzky,

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Emotional work/body work: the caring labours of migrants in the

UK’s National Health Service

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Case study

• West Central Hospital (NHS)

• 60 interviews with employees born and school-educated outside the UK

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Why ask about migration?

• Numbers/complexity• Migrants and service

sector work• Gender and migration

http://www.statistics.gov.uk/cci/nugget.asp?id=260

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Twofold characterisation of ‘caring work’

• Emotional labour (Hochschild 1983)

• Body work (Gubrium, 1975, Wolkowitz, 2002, 2006)

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Emotional labour

• ‘Customer orientated bureaucracy’ (Kerfoot and Korczynski, 2005, Korczynski, 2001)

• Patients to ‘customers’

• Neo-liberal and managerial organization of care

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Body work

Wolkowitz (2002: 501) argues “the worker is employed as much to carry dirt’s stigma as to labour”

Need to be explicit in “recognizing, and therefore attempting to deal with, the centrality of body work to post industrial national and global economies”. Wolkowitz (2002: 499)

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Migrants’ ‘caring labour’ at WCH

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Intense emotional labour

Still it’s hard work and there is a lot, because the first time I see, you know, someone… I saw someone die with the civil war. I haven’t seen someone dying naturally and that was hardest. Before they left I was heartbroken because the home, the nursing home the old people were dying a lot, you could see two or three people dying in one day and so [I was] heartbroken, you know. Sometimes you’re so attached with someone and then you know and it was so hard for me, that’s why. (Habiba, HCA, female, Somalia)

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Oh dear, like for example, if the patient, like patient’s progress or patient’s deterioration, sometimes they panic and they're more aggressive than the patient most of the time, and the patient is okay but they are panicking and like insulting, verbal insults (Joy, nurse, female, Philippines)

We can stay calm…if we raise our voice, that again going to…you know, going to agitate the family and they will be more anxious and they will get more angry so I think it is better to stay calm (Parnal, nurse, female, India)

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‘Cultures’ of emotional labour

Attitude is how you approach the patient, how you feel you're working. But here (in the UK) it is only skills and knowledge. Attitude (is) how you interact with the patient or like when you communicate to the patient, how is your facial expression? How is your body language? (Joy, nurse, female, Philippines)

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Caring as non-routine

Oh dear, if you have to thoroughly wash, it takes about 15 to 30 minutes, it depends on how, you know, how dirty they are; how difficult (they are) to move. Because sometimes when, after washing them, they poo again. I have to go back again and wash them. (Joy, nurse, female, Philippines)

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Prisoners of ‘love’ (Folbre and Nelson 2000)

A lot of Polish will come to the hospital, it is growing, so I can’t see that I’m useful, some of them don’t speak English at all, they are really distressed and a new place, everything is new, different. (Krzysztof, Porter, male, Poland)

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If they're short of staff, they will ask me if I can go on the ward to help the patients but I don’t like it because the ward is too big [laughing] … I really love old people. I love to help old people as well. Yeah, I have a pity for old people, so I go there and I’ll make them breakfast and tidy the ward, like mop and clean the sink and going in their room, clean anything, check toilets, soap and stuff, so I’m used to it…I like caring, sometimes I go there and I sing for them. (Amber, cleaner, female, Jamaica)

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‘Cultures’ of body work

I didn't realise that you have to wash the body and everything. Back home we don’t do it, washing patients. We don’t really do it. It's a relative doing it. (Catherine, nurse, female, Philippines)

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In Morocco they said “listen, if you go to Europe, like a domestic or sweeping the roads or what ever, you will find a job quickly [snaps his fingers] because the English people, they don’t want to do this type of job”. So they give them to foreigners. (Hafid, cleaning supervisor, male, Moroccan)

Jobs for migrants?

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Because they throw me in South side where the old building is, because they’re changing the building and they would shuffle the staff, and they put me to [elderly] Ward which is like… it's not permanent and they’re throwing patients, mostly like having mental problems or really waiting for a nursing home and everything, and it's really, for one, it's not really good conditions of where it is, it's an old building down there, it's not happy to work with because all patients are complaining, “what is this style of work”. (Catherine, nurse, female, Philippines)

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Conclusions

• ‘Care = organisation + physical labour + emotional labour’ (James 1992)

• Caring work gendered and devalued as both ‘emotional labour’ and ‘body work’

• Migration shapes these mechanisms in important ways

• Valuable to not presuppose who does caring work