In Thiruvananthapuram on April 21, 2026, government officials, labour advocates, and recruitment experts gathered to confront an invisible crisis: the exploitation of care workers from Kerala who staff hospitals, care homes, and households across the world. The dialogue, convened by the International Labour Organization and NORKA Roots, focused on a hard truth: while Kerala's nurses, caregivers, and domestic workers have become essential to global care systems, they often migrate through unsafe pathways with minimal protections and no reliable way to report abuse.
The care economy has become increasingly dependent on migrant workers, particularly women, yet Kerala's contribution to this global infrastructure remains largely unrecognized and unprotected. Workers from the state risk recruitment fraud, occupational downgrading, unpaid fees, and limited access to grievance redressal mechanisms or social protection at their destinations. These challenges are not abstract—they shape the daily lives of tens of thousands of Keralites working abroad.
Research presented at the dialogue, commissioned by the ILO and conducted by CDS Trivandrum, revealed the staggering scale of Kerala's role in global care: the state accounts for almost 75 percent of emigration clearances granted to nurses from India. The study also documented persistent patterns of recruitment malpractice, inadequate language training, and the near-total absence of protections for domestic workers and caregivers migrating through informal channels. Mr. Ajit Kolassery, CEO of NORKA Roots, emphasized the urgency of addressing unsafe migration pathways, irregular recruitment, high costs, and uneven working conditions that undermine the dignity and security of care workers.
The dialogue brought together representatives from government bodies including the Kerala Social Welfare Development Council and the Kerala Nursing Council, alongside private recruitment agencies and employer networks like Triple Win Germany. Their collective task: to translate research findings into concrete policy recommendations. Ms. Michiko Miyamoto, Director of ILO India and the Decent Work Team for South Asia, delivered the keynote address with a clear call to action: "Migrant care workers from Kerala are at the heart of global care systems and deserve governance frameworks that match their contribution."
Mr. P. Sreeramakrishnan, Resident Vice-Chairman of NORKA-ROOTS and former Speaker of the Kerala Legislative Assembly, reframed the question as one of reciprocity and obligation. He noted that Kerala's care workers have sustained the economies of Gulf nations, staffed care homes in Germany, and filled hospital positions in Ireland—all while sending remittances that educated children and strengthened their home state. "The question before us," he said, "is whether our institutions have given back in equal measure."
Ms. Sindhu S, Additional Secretary of the NORKA Department, highlighted state government initiatives already underway while calling for actionable recommendations that fit within existing mandates. Discussions centered on skill development and fair recruitment practices, with emphasis on learning from both origin and destination countries that have successfully implemented protections. The consensus emerging from the dialogue pointed toward continued collaboration between the ILO and Kerala government to ensure that migration for care work becomes safer, more ethical, and aligned with fundamental labour rights. For the thousands of Keralites working in the world's care systems, this dialogue represents a potential turning point—recognition that their contribution deserves protection proportional to its value.