Postcolonial Perspectives

Nursing Care-work and Feminism in India: Dissonances and Consonance + Opening Lecture

by Kanchana Mahadevan

With its public feminised care-work, nursing has struggled for recognition both from feminism and mainstream society.  The origins of nursing practices in the colonial context have invoked idealized womanhood embodying care, sacrifice and compassion.  For instance, nurses from Britain came to colonies such as India to fulfil its civilization mission.  They looked after English soldiers, controlled disease, trained other nurses and created sanitary awareness.  This led to nursing emerging as a modern science linked to training and skills in opposition to traditional care-work of  birth attendants or the dai.  Nurses were considered to be self-sufficient professionals with technical skills to impart, unlike dais who were regarded as untrained.  Thus, modern nursing both endorsed subordinate feminine roles and exercised sympathetic power over colonial subjects.  This offset feminist apprehensions towards nursing.  Feminists have tended to construe nursing as instilling norms of subordination, given its emphasis on service.  This critique is relevant in the context of professionalising nursing in what following Jürgen Habermas can be characterised as the “system worlds” of empires, pharmacies and hospitals.

Yet one could think of nursing in ways that do not follow the British Empire in  severing its relationship to the Husserlian or Habermasian “life-worlds” of everyday practices of nurses rooted in empathy. As Dan Zahavi and Anthony Fernandez argue, a phenomenological engagement with contemporary nursing as practical work leads to centrality of empathy with cognitive and emotive overtones. One could add the dimension of care to their phenomenological perspective; nursing practices emblematize the very idea of a caring encounter, which along with empathy addresses the vulnerability inherent in the human condition of birth and injury.  Although caring empathy gets buried in the system world of professional nursing, everyday nursing life-worlds that exceed institutional requirements do gesture towards such care.  More so because of the devaluation of nursing, especially it is typically practiced by the socially vulnerable. Integrating the phenomenological description of nursing practice with care can open prospects for normatively reclaiming philosophical concepts of nursing- such as empathy and care- in socially critical ways to resonate with feminism.   

Empathetic care has consonances with feminism following Eva Kittay and Joan Tronto for whom the nurse is a part of the web of human plurality, both vulnerable and interdependent.  Emerging equally thorough the materiality and experientiality of nurses, mothers and midwives, empathetic care foregrounds the vulnerability of the care-giver. It, therefore, has the resources to contest and decolonizing the patriarchal underpinnings of nursing.  By integrating the cognitive and emotive, while moving beyond a theoretical “system world” notion of science and technical skills, such empathetic care establishes a common ground in the life-worlds of nurses, dais and feminists. Eva Kittay’s notion of doulia as the care-giver’s right to receive care, alongside the duty of giving care is an important point of departure for decolonizing nursing and relating it to feminism. Kittay’s doulia reverses colonial and patriarchal exploitative underpinnings of care, as well as, as the alienation of the traditional figure of the dai.  It establishes the space between nurses and dais/doulias  as one of mutual interdependence and exchangeability of care-givers and care-receivers, rather than expert control of nurses over dais.  On this note, nursing practices can offer an alternative to neo-liberal notions of self-sufficiency in the care-giver’s capacity to receive care as well.  

This session argues that the prospects for decolonizing care lie in simultaneously invoking care theory’s notion of vulnerability and the postcolonial shifts in nursing practices.  It notes that transnational contexts of care open up the larger domains of responsibilities and tensions to care givers performing care work for strangers across the globe, so that the notion of doulia would have to be understood ways that surpass the entitlement framework of neo-liberalism.