The Strike That Hurts

From postponed transplants to turned-away emergencies, Kerala's nursing strike is leaving ordinary patients with nowhere to goOutside the neonatal intensive care unit of a super-specialty hospital in Kozhikode, Shahid Jamal cannot bring himself to sit down.

The waiting area chairs are mostly empty, but the trader from Valiyangadi keeps pacing the corridor, eyes fixed on the closed ICU doors. Inside lies his newborn son, on a ventilator. Jamal's wife Gazala Tabassum had delivered the baby prematurely through a C-section following amniotic fluid rupture — before she had even completed seven months of pregnancy. For four days now, the infant has remained in critical care, dependent on ventilator support.

On any other day, the NICU would hum with nurses working in coordinated shifts. But the ongoing strike at private hospitals across Kerala has disrupted routine care and the hospital administration has admitted to “difficulties in continuing care due to the non-availability of adequate nurses.” Doctors are providing care, but the hospital is unsure how long this arrangement can continue. "I have been pleading with the authorities to somehow keep him here," Jamal said, his voice tense.

Jamal’s anxiety reflects a wider disruption unfolding across hospitals in the state as the nurses’ strike entered its sixth day. Planned surgeries have been postponed, new admissions curtailed, and emergency departments stretched thin as hospital managements scramble to maintain essential services with limited staff. Some hospital managements have turned to technicians and other staff with nursing backgrounds to keep services running.

None of it has been enough. The strike, called by the United Nurses Association, centres on a demand for a minimum monthly salary of Rs 40,000, significantly higher than the revised pay recommended by the state govt. It follows closely on the heels of a separate strike by govt doctors over payment delays, which was only recently called off. Each time healthcare workers— whether doctors or nurses—go on strike, it is often patients who bear the brunt. Kerala has approximately 3.29 lakh registered nurses and roughly 60% of nurses working across India are Keralites. As international demand for Malayali nurses has grown, many now work in the state for a few years before moving to the Gulf or Europe. Despite over 8,500 nursing graduates entering the workforce each year from 268 institutions in the state, hospitals have faced a sustained shortage, driven directly by low wages and poor working conditions in the private sector.

Vijoy B, a nurse at Aster MIMS Hospital, says: “Salary revisions happened long ago and are no longer adequate. Even daily labourers earn Rs 1,000 to Rs 1,200 a day. Nurses do not." The hospital managements, for their part, have condemned the strike on procedural grounds, arguing it was called without the mandatory 14-day notice period. With neither side willing to move, the standoff continues, and the human cost mounts by the hour. Among those caught in the middle is 54-year-old Vinod KP (name changed on request), from Kannur, who had spent months preparing for a liver transplant scheduled at a Kozhikode hospital on March 9. The strike forced a postponement. Rather than return home and risk missing a rescheduled slot, he and his wife checked into a nearby hotel. Each day, he visits the hospital to ask about a new date. “I am not alone,” he said. “There are many more innocent patients who have been left in limbo.

”Beena, from Karuvarakundu in Malappuram, arrived at a Kozhikode hospital after her husband Joji began struggling to breathe. Joji has been receiving long-term treatment for chronic obstructive pulmonary disease at the facility, and the couple trusted its respiratory care. Doctors stabilised him at the emergency wing, but could not admit him for further treatment. “He has been taking treatment here for a long time, that is why we came,” Beena said.

“But since we cannot be admitted, we have to go back and find another hospital if his condition worsens.”Even for Kozhikode resident Shemina, who was injured after falling off a two-wheeler when a stray dog crossed her path, it was a rude realization that immediate medical attention is not always guaranteed, even in a private hospital that charges high fees. She was rushed to the casualty department of a super specialty hospital, where a CT scan suggested she required observation after admission.

But with new admissions suspended, the hospital advised the family to seek treatment elsewhere.

For the next two and a half hours, her relatives scrambled for a hospital willing to admit her. “We went from one hospital to another. At least three hospitals refused due to the ongoing strike. Nurses have the right to demand better salaries, but this should be done without disrupting emergency and critical care services,” said Asfa, Shemina’s sister.For Jamal, Vinod, Beena, Shemina, and countless others unwittingly caught between the nurses and hospital managements, the strike has ceased to be a labour dispute. It is now a long, anxious wait, measured in hours outside closed ward doors.