Immigrant careworkers and Norwegian gender equality - SAGE Journals

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Immigrant careworkers and Norwegian gender equality: Institutions, identities, intersections

EJ WS European Journal of Women’s Studies 19(2) 173–185 © The Author(s) 2012 Reprints and permission: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1350506811434665 ejw.sagepub.com

Marie Louise Seeberg NOVA (Norwegian Social Research Institute), Norway

Abstract This article examines how immigrant careworkers relate dynamically with the Norwegian gender regime. While the importation of careworkers contributes both to the practical maintenance and to the undermining on a more ideological level of the Norwegian gender regime, it also brings in new constellations and possibilities. In this article examples from two studies are discussed in the light of institutional and intersectional perspectives. It describes features of the Norwegian gender regime that are especially relevant to carework, and the highly gendered distribution and sharing of carework across the public and private domains. One central Norwegian form of care institution, the nursing home, then comes into focus. Making use of empirical examples from fieldwork and interviews, the article discusses how, as immigrant careworkers increasingly staff these institutions, new light is thrown on existing power structures, while at the same time these structures may be challenged through the fluidity of situational and relational gendering processes. Keywords Carework institutions, global careworkers, intersectionality, Norway

Introduction Careworkers inhabit feminized occupations that recruit far more women than men worldwide. Norway represents an intriguing case for a combination of reasons: its strong public welfare apparatus where carework plays a central role, its oil-based affluence and its alleged state feminism (Hernes, 1987; but see also Borchorst and Siim, 2008).

Corresponding author: Marie Louise Seeberg, NOVA, PB 3223, Elisenberg, N-0208 Oslo, Norway Email: [email protected]

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European Journal of Women’s Studies 19(2)

Based on studies of immigrant nursing personnel in Norway, my main question here is: How does the presence of immigrant careworkers relate dynamically with structures of the Norwegian gender regime? More specifically, the article aims to show that while the importation of careworkers paradoxically contributes both to the practical maintenance and to the undermining on a more ideological level of the Norwegian gender regime, it also brings in new constellations and possibilities. After a brief presentation of the studies which constitute the empirical basis for this article, I describe some features of the Norwegian gender regime that are especially relevant to carework across different kinds of caregiving institutions. The highly gendered distribution and sharing of carework across the public and private domains are presented. One central Norwegian form of care institution, the nursing home, then comes into focus. Making use of empirical examples from my fieldwork and interviews, I discuss how, as immigrant careworkers increasingly staff these institutions, new light is thrown on existing power structures, while at the same time these structures may be challenged through the fluidity of situational and relational gendering processes (Ryan and Webster, 2008: 5).

Methods and theoretical approach This article is based on two qualitative studies of immigrant nursing personnel in Norway, the first between 2003 and 2006 and the second between 2006 and 2009 (Seeberg and Dahle, 2005, 2006; Seeberg and Sollund, 2009). The first study, on gender, class and ethnicity in the healthcare workplace, included fieldwork and interviews in a nursing home unit and in a hospital unit. Up to 35 careworkers – of which four nurses – were employed at the nursing home unit, approximately one-third of them full-time and the remaining two-thirds on different part-time contracts. The nursing home was the workplace of some of the nurses also included in the second project, which focused on the immigration of nurses. Combining these two studies has provided me with empirical knowledge of these healthcare workers’ positions in relation to residents and other staff in their workplaces and in other parts of the health workplace hierarchy. As part of the second study, I interviewed 17 female and three male nurses. Ten of the nurses, including two of the three men, came from the Philippines, while the others came from different countries across Asia, America and Eastern Europe. Theoretically, I am inspired by complexity and systems theory, which I find make it easier to grasp connections, flux and dynamics within and between different levels of interaction and organization (see esp. Walby, 2007, 2009). In similar ways, intersectional approaches viewing gender, class and ethnicity as closely interconnected regimes of inequality have been critically examined, discussed and applauded as one answer to fundamental methodological questions (Collins, 1998; Crenshaw, 1990; Lewis, 2009; McCall, 2005; Phoenix and Pattynama, 2006; Walby, 2007; Yuval-Davis, 2006). Intersectional approaches introduce new challenges and ambiguities but, as Davis (2008: 79) points out, intersectionality ‘initiates a process of discovery, alerting us to the fact that the world around us is always more complicated and contradictory than we ever could have anticipated. It compels us to grapple with this complexity in our scholarship.’ I use this perspective as an entry into the tensions, paradoxes and ambiguities of and

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between Norwegian feminism and gender scripts and the immigration of careworkers into the egalitarian welfare state. My concept of institution transgresses the private/public distinction, and implies viewing each institution as ‘located in the nexus of . . . structural relations of inequality within and across all other institutions’ (Ferree, 2010: 425). I explore the gendered connections between carework institutions and the Norwegian welfare state, arguably a ‘woman-friendly welfare state’ (Borchorst and Siim, 2008). Local carework practices link to larger, national and global processes. A critical view of the nation-state as the basic unit of analysis in the social sciences (Wimmer and Schiller, 2003) helps expose the relevance of such larger connections. This perspective brings into view the contours of a Norwegian gender equality based on the exploitation of women, men and children in Norway and around the globe, similar to the findings of Williams and Gavanas in Sweden (2008), and parallel to the conclusions of several international studies (e.g. Glenn, 1992; Hochschild, 2000; Parreñas, 2006; Peterson, 2007; Yeates, 2004).

The Norwegian gender regime and the gendered distribution of carework Gender in/equality in Norway, as elsewhere, is a topic ridden with disparity. In many respects, not least in official self-representations, the country is viewed as leading in the emancipation of women. For instance, in 2009, Norway ranked as number two of 109 countries on the UNDP’s gender empowerment measure of women’s active participation in economic and political life (UNDP, 2009). Women’s participation in the labour force has steadily increased in a process closely intertwined with the development of family policies (Ellingsaeter and Leira, 2006) and is now nearly as high as men’s, around 70%. Compared to most other countries, this is a high proportion. However, gender segregation in the labour market is also high. While family life is increasingly gender equal, paid employment outside the family shows a 20-year time lag in this respect (Holter et al., 2008). A large proportion of women work part-time (43% of women; 13% of men), there is a gender pay gap of 15% and over 90% of employees within carework and cleaning services are women (Norway, 2009). In all, 25% of the workforce work part-time, while 75% of these are women (Aune, 2009). In female-dominated sectors salaries are lower, and part-time and temporary employment are structural features. Whereas gender equality policies both ideologically and in practice, explicitly and with some success deal with inequality structures in the family, corresponding structures in working life outside the family have not been subject to similarly effective interventions. Three main sets of measures have been tested: campaigns aimed at changing young people’s career choices, affirmative action in the form of women’s quotas and equality pools in wage negotiations, yet none of these measures have so far proved effective (Likelønnskommisjonen, 2008). The proportion of girls who choose traditionally male careers has grown somewhat, but boys have not shown corresponding changes in their career choices. Women’s quotas have caused more controversy than change. Different versions of equality pools have been tried out, without the intended effects.

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Of all employed males in 2007, only 7% were registered under ‘work in the health and social sector’, while 34% of all employed women were found here (SSB, 2010). The labour market remains segregated in terms of salary and power gaps, and in terms of separate, gender-coded professions and sectors, where carework remains a female occupation. In the private domain, the Norwegian ideal as presented by and supported through policies and in government-run campaigns (see Danielsen and Mühleisen, 2009) is the egalitarian, monogamous, democratic heterosexual couple with children. This family is formed by a man and a woman who together and without gender differences through unpaid labour care for their children and through paid work contribute to the economy of family and society, in a climate of egalitarian sameness. In practice, it does not work quite like that, as indicated by the fact that campaigns and policies are necessary in the first place. Upper- and middle-class families are the main carriers of the gender-neutral ideal (Skilbrei, 2003), while practices here, too, render an ambiguous picture (Aarseth, 2008; Egge-Hoveid, 2008; Lilleås, 2005). Yet the model is dominant in the sense that it is the moral norm against which practices are measured, in the workplace as well as the family. In a recent gender script theory informed study, Oftung (2009) identifies three alternative scripts for Norwegian fatherhood across class divisions: the breadwinner, mother’s helper and the equal spouse. For the breadwinner, carework is mother’s territory; for mother’s helper, mother is responsible for carework while father carries out what she defines as his share; for the equal spouse, carework is shared equally. Fathers, Oftung found, shift between scripts as circumstances change. Such Norwegian versions of gender scripts are useful in understanding links between ideology and practice, and I return to the concept of scripts in the discussion of careworkers’ negotiations around task sharing and its gendered implications.

Caring for the elderly: Between family and nursing home Care, defined as ‘the activities and relations involved in meeting the physical and emotional requirements of dependent adults and children, and the normative, economic and social frameworks within which these are assigned and carried out’ (Daly and Lewis, 2000: 285), includes aspects of labour and moral obligation, and of being an activity that crosses the private/public boundary and entails financial as well as emotional costs (Daly and Lewis, 2000). This wide definition includes the serving of food, cleaning and other ‘housework’, considerable components in the carework that takes place in nursing homes, and is thus similar to Glenn’s concept of ‘reproductive labor’ (Glenn, 1992). In Norway, childcare as a collective responsibility overarches the public/private boundary through nearly universal public childcare coverage, cash-for-care, father quotas, additional rights to sick leave for parents, tax deduction for childcare expenses and other measures. In comparison, care for the elderly is a much less integrated responsiblity. There is no corresponding low-threshold public acknowledgement of time spent on ageing parents. With a steadily climbing proportion of elderly in the total population, this constitutes a growing care receiving group, while the proportion of young people as potential caregivers is decreasing. An expansion of the home care services in recent years

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has been intended to make it possible for old people with care needs to live in their own homes, while nursing homes are still the solution for many. In this context, neoliberal user-oriented models create grey zones where old people become dependent on their adult children either caring for them or administering different sources of care, or both. This also creates a new double time bind problem for some, who find themselves in a situation where ageing parents and young children both need their care at the same time (Daatland et al., 2009). Historically, nursing homes for the elderly were exclusively run by municipalities. They are now increasingly contracted out to private entrepreneurs, following a series of legal changes in the 1990s and 2000s that have made this possible. The outsourcing of carework is part of an international trend with strongly gendered implications, especially for vulnerable groups such as immigrant and working-class women (Armstrong and Armstrong, 2008). This larger trend, a ‘neoliberal economic restructuring, in the guise of structural adjustment policies, welfare state restructuring, and immigration and emigration policies, has helped give shape to the “international division of reproductive labor” ’ (Misra et al., 2006). In this perspective, some of the women and men who place their capacity for carework on the global market take bids from Norwegian carework institutions. National supply has lagged behind the rocketing demand for personnel in health and care institutions. International recruitment has become one part of the solution to this perceived shortage. Au pair regulations have become a way of obtaining an entry visa and work permit as a domestic worker (Sollund, 2010), while nurses may enter the country through needed specialists’ regulations comprising entry visas and work permits. There are no reliable statistics on the gender distribution of the imported careworkers. Based on the global feminization of such professions, and on my own observations, it is likely that the vast majority are women, although the proportion of immigrant men especially among careworkers for the elderly is significantly higher than the general male proportion in this group. Another solution to the recruitment problem targets immigrants already living in the country. A range of measures and incentives along with much higher unemployment rates among people from immigrant background have resulted in a growing proportion of women and men from such backgrounds working in this sector. In my studies, I met people of both categories who were working together. Some were nurses recruited from abroad – for instance Poland, the Philippines, or India – who were either working as unskilled or semi-skilled careworkers while awaiting Norwegian nurse authorization. Others had lived in Norway for many years before entering this sector either through Norwegian nurse or auxiliary nurse education or, in many cases, because they had not succeeded in finding employment in their preferred fields of work.

Nursing homes: Old inequality structures, new careworkers In nursing homes, female careworkers are historically and at present an overwhelming majority. Not only are over 80% of employees in healthcare women (Håland and Daugstad, 2003), but the hierarchy of professions is gendered as well as classed. For all

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professions, hospitals are higher status workplaces than are nursing homes. The lowest paid and lowest status jobs in nursing homes are most closely associated with workingclass women, while male doctors occupy the summit. Like the institutions in which they are embedded, carework practices are also gendered and classed. While carework is coded as feminine, dirty carework – defined as the removal of dirt from the bodies of others – is coded as feminine and working-class (Dahle, 2005). In a recent study of male careworkers in a Norwegian nursing home, recruiting male nurses as part of the research project, Svare (2009) found that where female careworkers spent much of their time at work organizing and creating order, their newer male colleagues sat down with the residents and talked to them. Svare attributes this difference to a ‘housewife’ identity on the part of the women, who presented themselves as industrious and hard working, while the men faced no similar danger of being viewed as lazy if they sat down and ‘just chatted’. The old gendered and classed inequality regime prevails, while inequalities that are conceptualized as more recent – national, ethnic and racial inequalities – complicate the picture. Ethnic Norwegian-ness is assumed in most studies of workplaces and gender. In my initial study, I found that ethnic differences generally led to the exacerbation of existing inequalities, while some individual men and women might use such differences strategically (Seeberg and Dahle, 2005). Ethnic differences are conceptualized as new, although such and other silenced differences have long been an implicit premise for welfare and normalcy within the Norwegian state as in the other Nordic countries (Froestad and Ravneberg, 2006; Gullestad, 2007; Keskinen et al., 2009). Nurses have long distanced themselves from dirty carework through the academization and technologization of their middle-class profession (Dahle, 2005). Norwegian working-class women, traditionally the largest group of auxiliary nurses, are less and less willing to do dirty carework and, with the general prosperity from oil revenues, increasingly able to avoid it through finding work elsewhere. With the technologization of hospitals, auxiliary nurses and nursing assistants have been pushed lower down the hierarchy: out of hospitals and into nursing homes. Increasingly, these positions are filled by immigrant careworkers. While their bodies are perceived as the right kind of bodies for this sort of work and the wrong kind for many other sorts of work (Cox, 2007; Puwar, 2004), they see the nursing home as an opportunity to find employment in a labour market that otherwise excludes and marginalizes many who have an immigrant background. Several of the nurses who participated in my research projects reported that the status of nurses in Norway was higher than in their countries of origin. This supported them in the belief that they were indeed better off than before – even if their contracts were part-time or temporary, or both, even if their qualifications were not fully recognized, and even if they did not get the more prestigious hospital jobs. Zytka, who was an experienced nurse from Poland, said: Many nurses have left Poland. It has to do with the salaries, nurses’ salaries are very low there. But there is something else too, something about their status. There, the status of nurses isn’t just lower than that of the doctors, but lower than others’, too. Patients may shout and command and do not need to be polite, it is not a good situation. Here, at the nursing home, the nurses are

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very independent. There are doctors here, but just once a week, and they depend completely on the things I observe and know about their patients. They need us, and I cooperate very well with them.

Throughout my research, status and hierarchy came across as relative phenomena, depending on the context each informant found to be, or was able to define as, relevant. In the nursing home, I frequently observed how femininities and masculinities were negotiated, reorganized and evaluated in the light of different scripts, experiences and ideals of which the dominant middle-class Norwegian ideal of egalitarian gender equality was only one. The following is a typical example of such negotiations: At the nursing home unit, care assistant Arvin is in charge of this morning’s task distribution. He asks: ‘Who wants to be in charge of the kitchen today?’ Yasmin smiles and says: ‘Why me, of course!’ Arvin: ‘What do you mean?’ Yasmin: ‘I’ll do the kitchen; I’m a woman after all!’ She looks taken aback when Arvin retorts: ‘Exactly. And that’s why you shouldn’t do the kitchen. That’s just it.’ Kari: ‘I agree with you, Arvin. I think what she said there was a bit insinuating.’ Arvin: ‘The wash room then. And your break?’ Yasmin: ‘I’ll take it at noon.’ Later, I asked Arvin whether he thought Yasmin had been sarcastic, as Kari seemed to think, but he rejected the idea: ‘No, she really meant it the way she said it. That’s why it was so important not to let her do it.’

Caring for the elderly residents was what Arvin, Yasmin and Kari had in common. Arvin was an Iranian man in his late thirties, a refugee who had left behind a half-finished graduate degree in languages. Care assistant Yasmin was a woman in her early twenties from Pakistani background, educated in Norway as a computer engineer but so far with no success in getting a relevant job. Kari was a Norwegian working-class woman in her fifties, who worked as an activity therapist. Arvin’s decision to educate Yasmin in modern gender equality was, paradoxically, quite paternalistic, while on the other hand, Yasmin’s apparently reactionary gender model contrasted sharply with her choice of male-dominated computer engineering as a profession. Kari was a self-confident veteran who often expressed her opinions in terms of being the most experienced careworker present as well as being one of the few ethnic Norwegians. In keeping with her working-class identity, she did not usually come across as typically feminist, but was often critical of what she viewed as immigrant backwardness – in more nationalist than feminist ways. This is consistent with the findings of other studies of Norwegian working-class positions (Hagelund, 2003; Skilbrei, 2003). Knowing that the residents were waiting for their breakfasts or for help in getting up, the staff at the morning meeting probably felt that they had already spent enough time on this issue, and no one commented on Yasmin’s ending up being responsible for the wash room. Whether the wash room or the kitchen was the more feminized of the two is hard to tell, although the wash room clearly had the lower status of dirty carework. Whether or not Yasmin was being ironic is less important in this example than the many ways in which gender was up for negotiation. They all crossed boundaries, while using and abandoning different gender scripts. Arvin was at once paternalistic and keen on changing stereotypic gender scripts; Yasmin had defied gendered labour segregation by choosing to become a computer engineer, a sector of the labour market with approximately 70%

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male employees (SSB, 2010), yet she confused the others by giving gender-stereotypical answers. Above all, the example demonstrates the openness of a situation where inequality structures could not be taken for granted. From day to day, the negotiated distribution of tasks held the potential of shaping new inequality structures through the constellations of old ones. While all their tasks were coded as feminine and low-status, many of the staff identified themselves in contrast to this status. They related to it in different ways, often drawing on sources outside their workplace to negotiate and recodify their professional and personal identities. The Asian head nurse, Ajaya, phrased the dilemma like this: I hope they will all eventually find the kind of job that they would really like, I am not going to try to keep them here. Just think how humiliating it must be for many of them. For instance for many of the male carers, look at Arvin for instance, with his university studies. How humiliating to have to work here, they are not used to washing people’s private parts, this is not what they wanted. But they have to. That’s life – you have bills to pay, a family to support, then you have no choice.

Arvin had a temporary 75% contract, and filled the remaining 25% of his working time by working extra shifts, a situation otherwise typical for female employees in nursing homes. His everyday role was that of a household philosopher, as he was constantly analysing situations and intellectualizing his and the other careworkers’ activities. He defined his work in terms of honouring and helping people who had contributed to society but were now no longer able to do so. He further expressed that in his view, his and his colleagues’ jobs were important to society and therefore deserved a much higher status – although, he admitted, he would himself much rather have worked as a teacher had he had the choice. He also told me that he had long tried to continue his university education, but was about to give up and take an auxiliary nurse course, offered for free through his workplace, instead. Washing the private parts of other people’s bodies is indeed part of the job for many careworkers. Not all the carers I spoke to found this part of the job humiliating. Nurse Pat from Canada, for instance, had found a job as an auxiliary nurse in a nursing home while awaiting Norwegian nurse authorization. In the process, she had discovered that she much preferred this job to hospital work: Pat: I just don’t like working with sick people! Now I have a job I really love. Everything at the nursing home just suits me. I work with demented people so it’s challenging in many ways but really interesting. I have just eight residents. And because I really know them, I do so enjoy working with them. Even if they don’t always recognize me, that’s ok. ML: But earlier you talked about changing bandages and sick people and feeling disgusted – I mean, some of the work at the nursing home is like that too, washing people for instance? Pat: Yes, but I know them! That makes all the difference. I just want them to feel good! It’s like I give a softer care now.

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Pat had chosen the lower-status position in a nursing home rather than hospital work, while Arvin used every occasion to try to infuse his – to him as well as to others – humiliating role with dignity. This reversal can only be understood in terms of their different positions in Norwegian society at large, which bring into view the extreme heterogeneity of the category ‘immigrant careworkers’ in terms of gender and ethnicity as well as other dimensions of identity and inequality. Although they both came from middle-class background, Pat was a ‘white’ Canadian, female, western and qualified nurse, while Arvin was male, Muslim, ‘dark’, from the Middle East and unskilled within a healthcare context. All of these descriptive terms are highly loaded with connotations that link in complex ways to each other and to social status in Norway as well as in other places. Pat had the higher status here in social as well as in professional terms and had been able to choose, while Arvin found himself at the bottom of a hierarchy in spite of his own preferences. Head nurse Ajaya expressed sympathy with her immigrant male subordinates: You know; I think women adapt better here than men do. Men from other countries have a much harder time of it here. It is easier for us, in a way. It’s to do with society. It’s Norway. It’s equality and women: women [from other countries] are lifted up and men are pushed out. And they can’t handle that. Their pride can’t take it. It’s worse for them. I’ve had grown men crying in my office, they can’t get work and their wives manage and so they become dependent on them instead of the other way round. Women are better treated by this society, while at the same time they can cope with being dependent on their spouse. We are more used to that, aren’t we, it doesn’t harm our dignity in the same way.

It is commonly held that being an immigrant to Norway is generally easier for women than it is for men. There is, indeed, some evidence that male immigrants do experience, or report that they experience, more discrimination in Norway than do their female counterparts (Andersson, 2000; Blom and Henriksen, 2008; Engebrigtsen, 2007). Processes of othering and orientalization, where immigrant men, and Muslim men in particular, are constructed in terms of what majority men do not want to be, are likely to be part of the explanation (Walle, 2010). What ‘being a man’ means is contested at the intersection of gender, class and ethnicity, and Arvin’s position is clear: his form of masculinity is an enlightened, modern version where taking responsibility for others is compatible with recognizing their agency. That his own position is less than recognized outside his immediate environment may at best serve to confirm the nobility of his stance and his dignity as a man.

Exploitation, mobilities and identities The presence of immigrant careworkers has become a necessity to uphold a Norwegian gender regime where Norwegian women increasingly distance themselves from the lower status carework occupations. Immigrant nurses and other job seekers from immigrant background willing to take on the less attractive work are welcomed as cheap, often highly qualified careworkers. Many of these have left behind societies and families where their carework is badly missed. In practice, this means that the continuation of the

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Norwegian gender equality project is based on the exploitation of others, clearly at odds with the egalitarian ideology underpinning the project. The presence of such workers brings into view established and taken-for-granted inequality structures of gender and class, shaking the Norwegian egalitarian system at its moral foundations. It becomes increasingly clear that this strongly ideological egalitarian welfare state has based the services to its inhabitants on the exploitation of working-class women, much like it now continues to exploit women and men from immigrant background. In contrast to this negative assessment, careworkers who migrate to Norway from economically poorer countries tend to understand their situation as one of upwards social mobility (Seeberg and Sollund, 2009; Sollund, 2010). A range of compensations make up for the losses they and their families experience. Zytka’s statement, quoted earlier, serves as an example of this, when she highlights how not only nurses’ salaries, but their general status is higher after migration. In many cases, migrants from poorer countries experience an upward social mobility as seen from their countries of origin simply through the fact of having migrated, regardless of their social position in the country of immigration. Social mobility, usually understood in terms of class, also has a strongly gendered aspect. Arvin’s struggle with the careworker status illustrates this point very well: he not only finds this feminine-coded job a ‘challenge to being a man’ but negotiates the terms of his own gendered downward social mobility (Ryan and Webster, 2008: 9). Immigrant women in Norway may experience the opposite of this gendered effect, as Ajaya argues, through processes that reflect and engage with men’s experiences, and where dominant images of immigrant femininity interact with images of immigrant masculinity. The recruitment of immigrant careworkers involves ever new constellations of people, identities and structures in kaleidoscopic processes. Gender and ethnicity are shaped by the migration experience: ‘[gendered] relationships . . . in families, workplaces, in the host and native society are important to an understanding of how identities are formed and developed over time’ (Ryan and Webster, 2008: 5). The new constellations imply that old inequality structures may be up for negotiation. Funding The author wishes to thank the Norwegian Research Council for funding this research through the projects ‘Work places in the health care sector: gender, class, ethnicity’ and ‘Global Care Workers in the Norwegian Welfare State’.

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