Back in 2014, when I first mentioned to a Keralite that I wanted to speak with older people like Alice whose adult children had migrated abroad, he laughed and said, “Impossible, they will never talk to you.” Parents of migrating nurses were often lonely and isolated, yet they would never admit to it, he opined. Acknowledging such feelings, he argued, would be seen as a sign of weakness, an admission that their children were “bad children” who had abandoned them—or worse, that they themselves were “bad parents” who had raised individuals more oriented toward cash than care.
Among India’s 28 states, Kerala stands out for its exceptionally high literacy, female empowerment, and advanced health care. It is also home to a distinct Syrian Christian minority, many of whom—especially women—pursue careers in nursing. Historically, professional employment for women was rare and often met with criticism. This has been especially true within Hindu communities, where nursing tends to carry a lower status than in Christian communities, who tend to view nursing as a noble profession.
Since the 1960s, thousands of Keralite nurses have migrated to the United States, the Middle East, Europe, Australia, and beyond. Migrating for work became accepted among Syrian Christian families, largely due to church sponsorship. Nursing is often seen as highly lucrative because it offers opportunities for labor migration and the ability to support extended families through remittances. Over time, nursing migration became the norm, creating not only a gap in Kerala’s health care workforce but also in family structures. Adult children, most often daughters, are typically the primary caregivers for aging parents. I wondered what happens to elder care in this context of mass migration.
I was worried at first about the impossibility of finding people who were willing to speak openly about their experiences. But during my fieldwork, nurses and their families all conveyed a common theme: calling is not just about picking up the phone and dialing a number. Many of us do this without a second thought—these kinds of connections have been possible for decades with the help of landlines, calling cards, and laptop videos. But newer and more accessible digital technologies like smartphones, combined with decreased costs of international communication, have transformed calling across borders into a complex and deeply meaningful way of caring.
“I think care is the understanding, it’s trust, it’s not touching … it’s not giving money,” as Anthony, a nurse who had been working in Britain and Australia for several years explained to me in an interview while visiting family in Kerala. “I call my parents every time, but I don’t tell them, ‘Mommy I love you, Daddy, I love you,’ but I call them daily. That’s a gesture. That’s how I show my love.”
THE POWER OF A PHONE CALL
Caring through phone and video calls, nationally or internationally, has become a regular part of life for many families around the world. In my research with over 30 transnational families, I conducted over eight months of intensive fieldwork in India and Oman (a major migration destination for Keralite nurses) followed by several years of remote data collection with Keralite nurses around the world.
I found that most children in these families called their parents every day, sometimes multiple times a day—and none of them complained about it. Once calling became established as a new care practice for them, made necessary through geographic distance, the children fulfilled it dutifully, in an effort to remain good children even across continents. It became a new filial responsibility—a way to reciprocate the care they had received from their parents as young children.
At the same time, calling was also a form of self-care for those who lived abroad alone. Sara, a nurse I visited in Oman, had a structured daily routine of calls to her family in Kerala. She called her husband, daughters, and both parents multiple times each day—carefully scheduling calls around her children’s school hours, her parents’ prayer time, and their favorite soap operas. Unlike her brothers, who also lived in Ireland and the United States, she had no immediate family around her, so calling was also a way to soothe her own feelings of loneliness and make sure she stayed connected to her family: “They are all busy with their own families. But I’m free, no?” she explained to me. “After work, I have no other obligations, I’m free and I can call. That’s why my parents know I am always calling. What else is there for me to do?”
