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«Work, care and life among low-paid migrant workers in London: towards a migrant ethic of care November 2006 Kavita Datta, Cathy McIlwaine, Yara ...»

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The construction of care-giving and caring spaces among migrant care workers We now want to turn our attention to considering how such an ethic of care impacts upon the construction of relationships with care recipients and in particular, whether care-giving (characterised by marketised and reproductive labour transactions) or caring (characterised by nurturance) spaces are created with clients. Evident in the accounts of many care workers was a determination to create nurturing relationships with their clients that went beyond the simple provision of care. There was a clear attempt by many to present care recipients as ‘social beings’ (see Dyck et al., 2005) who were not unlike care providers themselves. In turn, the majority of the care workers used familial terms to refer to their clients. In part, this was because the care workers were uncomfortable with the idea of looking after strangers, and partly as a process of valorising their work by emphasising its nurturing dimensions and its importance to life itself. To this end, Addae argued that it was important to treat clients as “your own, you treat them as a family” and it was because she was able to do this that her clients always wanted her to come back to care for them. Eafeu, a male care worker also from Ghana commented that in order to valorize and cope with what, in his view, was poorly paid work, one had to see their clients as family members and had to be: “sympathetic, like maybe you helping your own old dad or your own old mum, to me that’s how I think of it.” In a similar vein, Arfua said of one of her clients who was wheelchair bound, “I go and sit with her, I converse with her I feel she is my sister I go to everything for her, you know.” There was an understanding that even though some clients were ‘difficult’ (see below), you could not, in Addae’s words, “argue with them, you are there to help them. They don’t like the situation they are in. If you had been in that situation you wouldn’t like it. It makes you sad you understand?” Despite this desire, however, various elements of the care systems that the migrant men and women encountered in London were identified as inhibiting the creation of nurturing relationships between care providers and recipients (see also Dyck et al., 2005). The focus of the care systems and care plans was predominantly on the provision of reproductive labour for clients in contrast to the carers themselves who constructed their roles from the perspective of nurture. Care providers such as Brygida, a Polish woman, were highly critical of care plans which detailed all that needed to be done for specific clients and stopped carers from asking clients what they wanted done. She recalled, “But in fact, I remember from induction, we are not supposed to ask client what can I do for you, or other question like this which is very strange.” Other carers like Parvez, a male care worker from Mauritius, told us how agencies failed both care givers and receivers. Thus, for example, they would often not inform clients if their regular care worker was unavailable or introduce replacement carers to them, while also failing to give care providers a full medical history of new clients. In contrast, migrants attempted to create nurturing or caring spaces which revolved around negotiating power, and especially trying to empower the clients. Ajua described this in terms of choice. Detailing her work routine, she told us how she asked clients if they wanted to have a wash, what clothes they wanted to wear and so on. Critically, she said that she did this because, “sometimes it’s about choice and respecting them as individuals you understand, so what do you want to wear? Care for the patient. Do you want me to help you have a wash? Some of them will say yes but with that, it’s for you to say oh, you do what you can do yourself and I’ll help you with what you can’t, because if you’re going to help people, you don’t have to do everything for them, you are taking their power off them, so you ask them what do you want me to do for you?” As well as the strictly delimited care plans imposed on carers, high work loads also prohibited the creation of caring spaces. Rushing from one job to the next meant that care workers could not see to all of the needs of one care recipient before having to move on to their next client. Again, Addae

commented that:

“But it just something that you have to handle it with care, have to handle it with care.

And when you’re thinking of, oh you’re working so you rushing to go to another job you know. When you are--, some people rush you know and you need to take time to do these jobs you know, you need to take time. You can’t rush people… No, no, no, you can’t move them about, no. They’re not toys are they, [laughs], they’re not toys, they are human.

Everybody have to be treated nicely. Yeah, everybody have to be treated nicely. What you don’t like to be done unto you, you don’t do it to others. You know. Don’t do it to others.” As such, care workers often assumed responsibility for doing more work then specified in the care plans. Arfua, for example, did her clients’ shopping, collected her money from the Post Office and took her to hospital. This was further illustrated by Brygida who spoke about the loneliness that clients endured and said: “it happens quite often, these people feel very lonely and in fact they need my help a bit of lunch, they want me to stay and talk, one lady says, “Can you hold my hand and talk to me, please?” “Yes, no problem, yes.” Yes, it’s not only provide personal care, it’s not only do lunch and domestic, it’s only like, just to support them, give advice as well, you know.” Indeed, she went on to suggest that a good care worker had to be part nurse, psychiatrist, support worker, friend and even sometimes a GP. Yet, doing extra work for some clients meant that they were late for other appointments and had to face other potentially irate and distressed clients. Long working hours as well as lack of training could also potentially lead to mistakes in the provision of care which the care worker from Mauritius, Parvez, was very concerned about. It is important to draw explicit attention to the fact that there is a clear tension between migrants’ attempts to create nurturing spaces and the marketised provision of care which delimits caring activities to reproductive tasks such as cleaning and washing which in turn are set out in care plans. Not only are care workers only paid for contact time (such that even travelling between jobs is unpaid), they do not receive any financial compensation for deviating from the care plans (Wills, 2003).

At the same time, it is important to acknowledge that care providers were not critical of all aspects of care and caring in London. There was an appreciation among some of our respondents that they had learnt new skills in the process of becoming care workers. For care workers such as Ajua, the lack of theoretical knowledge in care had been addressed by her NVQ training which had taught her a lot about the care of older people, the importance of communication, as well as being tactful.

Indeed, for her, qualifications such as the NVQ valorised care work. Abina said: “When I started I realise that I was making certain mistakes and because of that, like, I didn’t blame nurses whom would be shouting at you and all that, but when I decided to do the NVQ 1 and 3, I learnt a lot then.

I stopped making those mistakes and now that I enjoying my work. ‘Cause knowledge is power, knowledge is good, it’s good to learn, to know what we are doing”. Indeed, when compared to workers in other sectors, care providers were more likely to be able to identify features that they liked about their jobs (47 per cent), with 14 percent of these saying that they enjoyed the social contact that it encompassed. Such differences suggest, perhaps, that in contrast to other low paid workers, care workers can have a stronger and more positive attachment to their vocation and the clients they serve and view care work as a career rather than a job with opportunities for progression and career development.

One final point is that the migrant ethic of care elaborated upon above is clearly informed by a concern for others. Yet, evident in the accounts of some migrants was a perception that care ought to also be informed by a sense of oneself and be a reciprocal process and activity. For example, Parvez, the male carer from Mauritius, argued that: “But if you’re working with someone who has some history with the family then the family should have some responsibility towards you, that if the carer came sick or have an accident, he may have any problem while doing the job and he’s the responsibility of the--, of anyone who is in the house.” Yet, as others like Gladys, from Ghana, observed care receivers could be oblivious of the needs of their care workers. She said, “some clients are very, very greedy, one hour they want you to do a whole lot of things, and you tell them you can’t do it all. They don’t understand why you tell them you can’t do this before you go, “Make breakfast, make me the bed, do this, clean this.”’ This is important not least because it illustrates the vulnerability of migrant care providers themselves and counters a trend in wider research which focuses on the (physical) vulnerability of recipients but not workers (Dyck et al., 2005). Yet, ultimately, as noted above an ethics of care should consider both the recipients and the providers of care (Dyck, 2005).

The gendering and racialisation of care values and nurturing spaces The relationships that existed between care providers and recipients were strongly mediated through gender, ethnic and racial differences. As we noted above, most of our care providers were women and the majority were also Black Africans. Again, the workers emphasised the nurturing elements of their work, often justifying this on gender grounds. Several women care workers noted that their work was a ‘natural’ extension of their gendered roles. Ajua said, “what I mean, as a woman, there’s a saying that as a woman, you have to care for somebody, it was in me.” Yet, having said that, the few men who did work in the care sector also stressed their capacity to care on the basis of their familial loyalties and nurturing culture (see also McIlwaine et al., 2006). For instance, Joshua, a care worker from Ghana pointed out: “For the care work, I had a passion, that passion is with them, because when I was back home I was looking for my granddad and the like,

so I had a passion, that was fine”. Another male carer from Mauritius, Parvez, highlighted that:

“I personally think the work is more about loving people. If you really love human beings it’s easier for you than doing things only for yourself … the minute you go into care only for money, but then it’s difficult because then you find case of abuse, case of negligence, you know, those kind of things”.

While gender was discussed in a positive light as facilitating care work especially among women, ethnic and racial differences between providers and recipients had a largely negative effect on the creation of nurturing relationships and linked mainly with discrimination on the part of clients. The respondents commented that not only were they ‘looked down upon’ as carers in general, but also that their clients typically responded to them with racist insults. Eafeu, a male care worker from Ghana, recalled how, “One client for the first time, I go there, I mention the name, “Oh hello, how are you doing?” and I mentioned the name, “Oh, I’m Eafeu”, “What do you want?” He ask me what do I want? I said, “Oh, I’m a care worker and I’ve been sent to come and help, to give you meal.” He stood up and had a look at me, “Oh, I’m tired of black people, everyday, black, black, black, black.” Zelu, from Bangladesh, highlighted more subtle ethnic differences when he recalled his experience

with an Indian man from Whitechapel for whom he did housework two hours a week:

“The very first time I met with him, he asked me, “You’re from Bangladesh?” “Yes.” “What did you do? What did you do back to your country?“ And I told him, “To be very honest, I am a doctor in my country.” “Oh, you bloody doctor, what are you doing here? You are doing my kitchen, my hovering,” and what he did last of all, he underestimate me very much, you can’t imagine it, and I did work with him for that day only and I told the office that I don’t feel comfortable with that man”.

However, other care providers felt more able to negotiate such discrimination than others, again with recourse to the nurturing skills required for the job. Kofi for instance, spoke at great depth about the racist reactions from some of his clients and their ensuing conversations, yet he also stressed that with patience the problem was surmountable. He summarised the trajectory of one


“When I went there for the first time, he was making some comments about my colour, I didn’t mind, one, I saw that he was quite old and he can’t help himself, so now when he’s making a comment, making comment about my colour, whatever, I’m there to help him, so I help him. He is now used to me, let me put it that way. Every time that I go there, he is now happy, he allows himself for me to help him. That’s how it is”.

Patricia, from Jamaica shared this evaluation. When asked to describe her experiences of care work she claimed: ‘Honestly it’s really, really quite challenging, very, very challenging. Some of the clients are like oh--, you know, as soon as some of them when they see the skin, they don’t even want you to attend to them at all. And sometimes I do understand them cause they’re like, ‘‘oh where’s this one--, where is she from yeah?’’ ’ However, she concluded: ‘It’s quite difficult with humans, but with time authority shifts.’ Patricia’s last comment is quite telling in that she details how, at the end of the day, as care providers, they retain more power than the care recipients.

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