All Girls’ Best Friends?

2011–2012

ERSTE Foundation Fellowship for Social Research Should we stay or should we go?

Migration and its effects on demographic and economic development in Central Eastern Europe

All Girls’ Best Friend?: Care Diamond in Ukraine in the Context of Population Aging Alissa V. Tolstokorova

1 All Girls’ Best Friends?: Care Migration and Care Diamond in Ukraine in the Context of Population Aging1 Alissa Tolstokorova PhD, Associate Professor Kyiv, Ukraine Abstract Current research focuses on the dynamics of “care economy” in Ukraine in conditions of demographic change and feminization of migration fluxes. The key analytical concept used to study operation of Ukrainian care economy is “care diamond” understood following S. Razavi as the architecture which explains the relationship between the state, market, family and community in care provision. The argument of the paper is that increasing out-migration of women from Ukraine entails “care deficit” in society and alters the operation of the care diamond for the account of increasing role of the family in its structure. In turn, the family tends to outsource its care functions to the market, but preserves the responsibility for the organizational and financial backing of paid home care. The paper shows that the emerging “care crises” in Ukraine results from the strategy of “crisis transfer” employed by postindustrial nations to shift the burden of multiple crises, care crises among them, from the nucleus of the word system to its periphery. In conclusion the paper offers policy proposals for the development of coherent policy strategies aimed to cover key sectors of care diamond, with special focus on the market and non-profit sectors.

Key words: Care diamond in Ukraine, elder-care, Ukrainian care migration, population aging, gender implications of care drain Introduction All postindustrial societies are ageing and the share of the population over age 65 is augmenting rapidly. Europe is increasingly ageing too, the age pyramid being turned on its head as birth rates fall and life expectancy rises. Eurostat warns of possible “demographic deficit”2 in the EU once deaths outnumber births3. The demographic change combined with the transformation in household structures due to the decline of extended families, the increasing participation of women in the labour market and the decline of welfare state 1

My sincere appreciation goes to anonymous reviewers of my paper for insightful comments and to ERSTE foundation for financial support to this project.

2 MGI (2004). The Coming Demographic Deficit: How aging populations will reduce global savings? McKinsey Global Institute.

3 Economic Migrant Workers: Is migration an answer to the Member States ageing problem and working-age population decline?

2 entailed grave “care challenges”4 in postindustrial societies. The key of them are “care deficit” and “care gap” caused by the disparity between a growing demand in care services on the one hand, and the decreasing capacities of families to provide care on the other hand. This disparity lead to the emergence of large informal labour market of paid care services, referred to as „care economy“, which rests mainly on the shoulders of migrant women from economically disadvantaged societies, Ukraine among others. My earlier research6,7 showed that social costs of out-migration of women are often too high and can outscore economic benefits. At the same time economic mobility of women’s has positive outcomes as well.

These are financial empowerment of women, the increase of wellbeing and economic security of translational households and most importantly accumulation of social remittances, “gender equality remittances”8 among them.

The increased mobility of women has raised concerns about the resultant rearrangements of care in sending contexts9. In Ukraine, however, a new gender dynamics of care economy and its impact on care arrangements in the society is not yet an object of focused study. This explains the research novelty of the paper, aimed at studying the emerging “care gap” in Ukraine, while locating the analysis within the broader context of interplay between the care regime in Ukraine and global care economy.

Conceptual framework: Current research is focused on the dynamics of “care economy” in Ukraine in conditions of demographic change and feminization of migration fluxes. Care economy is understood here as the allocation of scarce resources (mostly work) 4

Razavi, S. (2011). Caring for the Care Workers: State Must Play a Role. ILO, Geneva.

Online UR at: 5 Hochcshild, A. R. (1997). The Time Bind: When Work Becomes Home and Home Becomes Work. N.Y: Metropolitan Books.

6 Tolstokorova, A. (2008). Locally Neglected, Globally Engaged: Ukrainian Women on the Move. In: Technologies of Globalization. International Conference Proceedings (Eds. Anderl, Reiner, Arich-Gerz, Brund, Schmiede, Rudi), Technical University Darmstadt. pp. 44-61 7 Tolstokorova, A. (2009a). Costs and Benefits of Labour Migration for Ukrainian Transnational Families: Connection or Consumption?, In: Les cahiers de l’URMIS. Circulation migratoire et insertions économiques précaires en Europe, 12. Online URL at : http://urmis.revues.org/index868.html 8 Tolstokorova, A. (2010). Where Have All the Mothers Gone? The Gendered Effect of Labour Migration and Transnationalism on the Institution of Parenthood in Ukraine. In: The Anthropology of East Europe Review (AEER), “Gender in Postsocialist Eastern Europe and the former Soviet Union”, 28 (1), pp. 184-214.

9 Kofman, E., Raghuram, P. (2009). The Implications of Migration for Gender and Care Regimes in the South. Social Policy and Development Programme Paper Number 41. United Nations Research Institute for Social Development.

10 Hochschild, A. R. (2000). Global Care Chains and Emotional Surplus. In: On the Edge.

Living with Global Capitalism. Hutton, W., Giddens, A. (Eds.). London: Jonathan Cape, pp. pp.130-146.

3 contributing to the welfare of others, within and outside household11,12. It rests on such specific activities as care work, implying the provision for others’ needs without expected reciprocation and without remuneration. In this paper “care” is defined following G. Standing13 as the work of looking after the physical, psychological, emotional and developmental needs of one or more people. Amongst the most important caring jobs is paid domestic work, viewed here as household activities with practical and social dimensions, which may be aimed at “caring for”, i.e. cooking, cleaning and nursing, and “caring about” (caring and loving as emotional work and social support)14.

The key analytical concept used to study the operation of Ukrainian care economy in this paper is “care diamond”, introduced by S. Razavi15 to outline “the architecture through which care is provided, especially for those with intense care needs such as young children, the frail elderly, the chronically ill and people with physical and mental disabilities”. This architecture embraces human services that have a particularly strong personal and emotional dimension, such as childcare, health care, eldercare, social work and even education16. It explains the relationship between the state, market, family and community through the “care diamond diagram”: State (federal/local)

Families/households

Market

Public and not-for-profit sectors

11

Folbre, N. (1995). Holding Hands at Midnight: the Paradox of Caring Labour. Feminist Economics, 1 (1), pp.73-92.

12 Himmelweit, S. (1999). Caring Labour. Annals of the American Academy of Political and Social Science, 561 (0), pp. 27-38.

13 Standing, G. (2001). Care work: overcoming insecurity and neglect. In Daly, M. (Ed.) Care Work: The Quest for Security. International Labour Office, Geneva, pp. 15-32 (17).

14 Lutz, H., Palenga-Mollenbeck, E. (2010). Care Work Migration in Germany: SemiCompliance and Complicity. In: Social Policy & Society, 9 (3), pp. 419–430.

15 Razavi, S. (2007). The Political and Social Economy of Care in a Development Context: Conceptual Issues, Research Questions and Policy Options. United Nations Research Institute for Social Development.

16 Folbre, N. (2006). Measuring Care: Gender, empowerment, and the care economy. In: Journal of Human Development, 7 (2), pp. 183–199.

4 The key components of the care diamond interact with each other in complex ways, and the boundaries between them are neither clear-cut nor static17. Current research departs from the observation18 that out-migration of females is likely to alter the operation of care diamond to the extent that remittances inject finances which may expand recourse to paid labour and commodification in the families left behind at home and represent some recognition or compensation for caring activities, especially by family members and extended kin. In other words, earnings made abroad may be used for paying an extended kin or a hired domestic worker for the outsourced care giving. In this way the care diamond operation is being reshaped due to increasing role of the market in its structure.

Drawing from the above, the main goal of current research is to identify the impact of outmigration from Ukraine of females as first-line care providers on the structure and operation of “care diamond” and analyze its gender implications for the society.

Research methodology: The project draws from the results of a multidimensional field research which included non-participant and participant observation, semi-structured interviewing and focus group discussions. Results of non-participant and participant observation represent a generalization of the author’s experience of socialization among the target groups of responders: families requiring care services for the elderly, particularly longterm care, older care users, personnel of public and private agencies, social services for the elderly and medical institutions, offering care provision in Kherson oblast of Ukraine, care workers and migrant care providers.

Interviewing covered 39 Ukrainian labour migrantsr, members of their families and extended migrants’ networks mainly in urban communities (neighbors, relatives, co-workers).

Among our responders were returnees and current migrants: both those who came home visiting from countries of work and circular migrants who temporarily stayed in Ukraine inbetween voyages for employment abroad. The group of responders included women working as aux-pairs in Austria and Germany19. Additionally, two focus groups were organized with

17

UNRISD (2010). Why Care Matters for Social Development. Research and Policy Brief 9.

Geneva.

18 Kofman, E., Raghuram, P. (2009). Op. cit., p. 6.

19 Although aux-pair program was designed as a language and culture training program for young professionals requiring a first-hand experience in the country of work for career purposes, there are grounds to contend that throughout the last decade it changed its initial goal and acquired a character of a low-cost care service rather than a cultural training. Thus, some of our aux-pair responders reported doing all kinds of household work including cleaning, cooking, pet care, and even gardening. More importantly, a recent trend of hiring retired women to do aux-pair work in Germany confirms the claim that it lost its initial educational character (See: “Aux-pair” dlya nemetskih babushek [“Aux-pair” for German

5 members of transnational families, including both migrants who came home for visiting and their home-staying relatives.

The group of responders consisted of 27 females of various age groups and 12 males, mainly middle aged. Initially, the field research included only females as it was aimed to study care migration, which is allegedly a mainly female preserve. Yet, during the focus group discussions with extended families it became clear that men should be also interviewed, insofar as it turned out that migrant males are often involved in care services, although mainly as a part-time and temporary/occasional supplement to their principle employment20.

Additionally, males are invisible in the research on care economy, given that they take a different niche on the labor market than females, involving minimal inter-personal contacts and less emotional work. For instance, men, especially at the initial stage of migratory experience, may agree to work in pet care, gardening, yacht and car care, body care (as massagers and barbers), house care (small repairs, walls/windows painting, etc), dish-washing at cafes and restaurants, cleaning at public places and institutions. Some responders were employed in cleaning train carriages, as was the case in Poland.

Interviewing was based on a semi-structured questionnaire with open-ended questions, aimed to cover different stages of migration cycle and to reflect on gendered experiences of migrants. The interviewing process started with existing contacts with migrants and their families and in many cases followed with a snowball sampling method whereby new respondents were contacted through preceding respondents. However, occasional meetings with migrants or members of their social networks were also welcome, for instance in embassy lines, on board of a plane, at the airports lounges or in the airport shuttle buses during the author’s international travels. In Ukraine, interviews were taken in Kherson, Kirovograd, Kyiv and small towns of Kherson oblast. Others were interviewed in the countries of work (Italy, Germany, Austria).

Additionally, the interviews were supplemented by the analysis of secondary sources covering the subject-matter of the study and by an overview of employment advertisements in Ukrainian media on the recruitment of domestics workers for family care.

The ethic principles of current field research depart from an observation that the research in such fields as nursing and caring requires to conflate the highest standards of research ethics and professional surveillance with altruism, compassion and affection, given

grannies]. Online URL at: http://www.newsland.ru/news/detail/id/739012/ [Stand November 5, 2011].

20 This is also confirmed in the study by Lutz, H. (2004). Migration, Transnationality, Gender in the Private Household. In: Journal of Contemporary European Studies, 12 (1), pp. 47 -55.

6 that suffering and vulnerability of the subjects are associated with situational circumstances which may diminish their ability to give their informed consent and take part in the inquiry21.

With this in mind, the interviews were made under the condition that real identities of the responders would not be disclosed in order to maintain their privacy. It was necessary because earlier experience showed that many migrants were reluctant to discuss personal issues in the fair that their confidential information might be disclosed to outsiders. Therefore, in search for adequate methodology, sensitive to confidentiality requirements of responders, this study extensively resorted to ICT as an innovative tool of field research, enabling respect to ethical considerations of information gathering. For instance, field work was conducted via telephone interviewing, SKYPE connection, e-mail messaging. These techniques provided to responders a greater freedom for expressing personal opinions and sharing intimate experiences, while at the same time enabling them to preserve relative anonymity.

As various studies have demonstrated22,23,24,25, care migration, in responding to new needs created by globalization, is transforming welfare systems in both hosting and sending societies. Migration enables them to respond to a growing number of needs, but also brings them face-to-face with a greater precariousness and fluidity of care services and with the emergence of a parallel market built on a direct and little-institutionalized relationship between migrants and families. As shown elsewhere26, as in many countries across the globe, it became a kind of “symbolic capital”27 in the houses of “new Ukrainians” to employ domestic workers and careers for children and the elderly “as a way to exhibit the economic superiority of the household in position to employ” them28. Throughout last years, domestics

21

Duvell, F., Triandafyllidou, A., Vollmer, B. (2008). Ethical issues in irregular migration research. CLANDESTINO, p. 6.

22 Parreňas, R. (2001). Servants of Globalization: Women, Migration, and Domestic Work.

Stanford, CA: Stanford University Press.

23 Lutz, H. (2004). Life in the Twilight Zone: Migration, Transnationality and Gender in the Private Household. Journal of Contemporary European Studies, 12(1), April, pp. 47-55.

24 Folbre, N. (1995). Op. cit.

25 Yeates, N. (2005). Global Care Chains: A Critical Introduction. In: Global Migration Perspectives, 44.

26 Tolstokorova, A. (2011a). From Ukrainian Freken Bokk to Filipina Mary Poppins: Care Migration in Ukraine Collection of essays on migration “Migration problems in the countries of Western Europe, Russian Federation and other CIS republics. AWO Heimatgarten Foundation “Bridges of Good Neighbourhood” Project. Odessa, pp. 5-14.

27 Bourdieu, P. (1979). Distinction. A Social Critique of the Judgment of the Taste.

28 Zervidou, M. (2008). National Report: The Case of Cyprus, Integration of Female Migrant Domestic Workers: Strategies for Employment and Civic Participation. Nicosia: University of Nicosia Press, MIGS, pp. 33-62 (37).

7 from “exotic” countries, like Philippines, are being preferred to native carers29. An important factor boosting the demand for foreign domestic workers in Ukraine is that it has the function of “consolidating the identity and life-style images of middle-class families”, a tendency observed in the neighbor country of Turkey too30.

The causality behind the growth of the demand for paid domestic services in Ukraine is the sharp socio-economic polarization of the hitherto homogeneous society, nuclearization of the family, transformation of social policy, as well as the emergence of a new conception of privacy and mode of life among the new middle class. The rationale of this conception is the emancipation of middle class women from domestic labour for the account of an emerging class of “new servants”31. Additionally, the rise of the demand in home carers, child-minders in particular, owes to the growth of birth-rates in Ukraine throughout last years, which was not accompanied by the expansion of the network of pre-school public institutions, most of which were destroyed during the years of transition to market economy.

The demand in long-term care for the elderly is also on the rise, considering that the share of retired seniors among the general stock of Ukrainian population is augmenting throughout the last decades. Thus, according to the UN world aging rate, which considers the share of seniors aged over 65, Ukrainian population reached the threshold of aging yet in 1959 when people of this age group amounted 6,9% of the population. In 1989, when their share reached 11.7%,Ukraine could already be categorized as an old-aged society. According to the census of 2001 this age group increased till 14.4%, in 2005 it made 16%32, in 2007 –

29

Sagula, T. (2008). V poslednee vremya v Ukraine rastyot spros na personal iz ekzoticheskih stran [Lately, Ukraine has been facing an increasing demand in exotic service workers]. In: Fakty [Facts], August, 7. Online URL at: http://www.facts.kiev.ua/archive/2008-0807/27057/index.html 30 Toksöz, G., Ulutaş, C. Ü. (2012). Is Migration Feminized? A Gender- and Ethnicity-Based Review of the Literature on Irregular Migration to Turkey. In: Turkey, Migration and the EU: Potentials, Challenges and Opportunities. Elitok, S. P., Straubhaar, Th. (Eds.). HWWI Publications, pp. 85-111 (93).

31 Tkach, O. (2009). Uborschitsa ili pomoschnitsa?: Varianty gendernogo kontrakta v uslovijah kommercializacii byta [A cleaner or a helper?: Variants of gender contract in conditions of commercialization of daily life]. In: Noby byt v sovremennoy Rossii: gendernye issledovania povsednevnosti. Kollektivnaja monografia [New Mode of Life in Contemporary Russia: Gendered Research of Daily Life. Collective Monograph] (Eds). Zdravomyslova, Elena, Rotkrich, Anna, Tyomkina, Anna. St. Petersburg: Publishing House of St. Petersburg University, pp. 137-186 (182).

32 Stelmakh, L. (2006). Statevo-vikovy sklad naselennya: uzagal’nene vidobrazhennya pryrodnogho ta mighracijnogho ruhu lyudej [Gender and age composition of the population: a generalized reflection of natural and migratory movement of people] , In: Dialogues. Online URL at: http://dialogs.org.ua/ua/dialog.php?id=23&op_id=621 [Stand 20.09.2011].

8 23.9%. Currently the share of seniors tantamounts 24.7% of the total population33, while by mid-century this index is expected to raise up till 38.1% 34. At present Ukraine ranks 11th in the world aging rate and is expected to move to the 9-th place by 2025. At the same time experts want that a unified system of state-governed long-term care (LTC), particularly for the elderly, is nearly non-existent and there is no overarching policy or programme specifically addressing LTC35,36. Hence, the groups of the population requiring care steadily augment, while the pull of available carers shrinks as aresult of increasing feminization of international economic mobility. This process evidences the emergence of a new challenge in the system of domestic care arrangements in Ukraine, caused by a mismatch between the growing demand in paid care-giving services, and the increasing out-flow of potential careers from Ukraine, leaving it “care drained” and bereft of care labour.

An overview of advertisements of employment agencies in Kyiv, carried out for this project, showed that the wage offered for domestic/care work in a private house in the Ukrainian capital tangibly exceeds the expected job remuneration for such skilled laborers as interpreters/translators, sales mangers, leave alone teachers, nurses at public nurseries or kindergartens or even University professors. Furthermore, the content analysis of available commercials evidences that throughout last 2-3 years the cost of domestic work increased nearly by half. The requirements to potential employees, however, have also increased and the job acquired a very competitive character37. A potential high-paid domestic worker is expected to be 45-50 years of age, a professional teacher or a doctor, preferably married and with children, skilled in cooking, especially dietary cuisine, and capable to get along well with children. Additional requirements include foreign language skills, computer literacy, knowledge of methods of early age teaching and readiness to provide elementary training to employers’ children. Last but not least, is the career’s personal qualities: she is expected to be tactful, patient, sociable and easy-going. However, recruiters contend that currently the key

33

Srendij vozrast naselenia Ukrainy – 40 let [Median Age of the Ukrainian population is 40 years old]. (2011). UA Club, July 12, 2011. Online URL at: http://news.uaclub.net/10_469165.html [Stand 12.07.2011].

34 Chajkovska, V. (2010). Geryatrychna dopomogha naselennyu: vyklyky ta perspektyvy [Geriatric Support to Population: Challenges and Prospects]. In: Biblioyteka semejnogo doktora [Family Doctor Library]. Online URL at: http://family-doctor.com.ua/ [Stand 20.06.2011].

35 Bezrukov, V. (2002). Case Study Ukraine. The Cross-Cluster Initiative on Long-Term Care. Geneva: World Health Organization.

36 FISCO (2011). Who Cares? The Institutional Framework for Long term Social Care Benefits. A Survey by the Local Government and Public Service Reform Initiative of the Open Society Institute and the Council of Europe. Observations for Ukraine.

37 Tolstokorova, A. (2011a). Op. cit.

9 challenge is the qualifications of domestic employees, as long as there are educational institutions offering training to potential personnel in this newly emerging sector of the labor market. It is argued that native careers, who are mostly former school teachers or medical workers, although well qualified professionally, are often not in command of psychological skills indispensable for employment in private houses, unlike in public institutions, wherefore most of them worked hitherto. For this and other reasons, native careers are increasingly preferred to “global nannies”38 from such exotic countries, as for instance, Philippines. These “disposable domestics”39 are imported into Ukraine for the most part illegally to do “the dirty work”40 in the houses of Ukrainian nouveau rich, and for that matter are considerably less costly than native employees. Furthermore, due to illegality, they lack any access to the system of social protection and judiciary and therefore, human rights. Additionally, largely with no linguistic skills, they simply are not in position to protect themselves and therefore are exposed to exploitation and overexploitation. The language of media confirms this opinion, because often in advertisements they are referred to not even as “servants and slaves”41, but actually as animals, like, of example, dogs, whose value for the owner consist in the capability to understand and fulfill commands42.

Hence, there are grounds to contend that in the context of global care economy Ukraine is no more “the end of the chain”, but “just another loop” in a vicious circle of endless “global care chains”, wherein “global women”43 are captured “between the Scylla of unemployment and Charybdis of care migration”44. For that matter the research on the resultant “care gap”45 and the concurrent process of its filling in Ukraine is critical at the moment.

38

Ehrenreich, B., Hochschild, A.R. (Eds.) (2003). Global Woman: Nannies, Maids, and Sex Workers in the New Economy. New York: Metropolitan Books.

39 Chang, G. (2000). Disposable Domestics: Immigrant Women Workers in the Global Economy. Boston: South End Press.

40 Anderson, B. (2000). Doing the Dirty Work? The Global Politics of Domestic Labor. New York: Zed Books.

41 Anderson, B. (1997). Servants and Slaves: Europe’s Domestic Workers. Race+ Class 39(1): 37-49.

42 Sagula, T. (2008).Op. cit.

43 Ehrenreich, B., Hochschild, A.R. (2003). Op. cit.

44 Tolstokorova, A. (2009 b). From “Bonds of Love” to “Chains of Care”: Ukrainian rural women between the Scylla of unemployment and Charybdis of care migration, In: Materials of the XXIV National Conference of Labour Economics, University of Sassari, Italy, 24-25 September 2009 http://www.aiel.it/bacheca/SASSARI/papers/tolstokorova.pdf 45 Himmelweit, S. (2002). Economic Theory, Norms and the Care Gap. In: Analyzing Families: Morality and Rationalities in Policy and Practice. Carling, A., Duncan, S., Edwards, R. (Eds.) London: Routledge, pp. 231–249.

10 Discussion of field research findings. Impact of the outmigration of care labour on eldercare diamond structure in Ukraine State sector: Polishing the ‘pretty pebble’ of care Under state socialism every soviet citizen was guaranteed free basic health care, medical assistance and medical insurance from birth to death. Although the public system of elderly care shelters existed, its infrastructure was insufficient to meet the requirements of the population. The quality of care provision was so low that it was not widely used by the population. Additionally, traditional culture and public opinion did not welcome families who outsourced the responsibilities of elderly care to public institutions. For that matter elder-care shelters were mainly used by single frail people who were not in position to provide for themselves. In those conditions, families requiring elder care developed a tradition of informal home care as a coping strategy. It relied on “inter-family migration”46, through which the older generation, mainly single or widowed senior women, after retirement moved to live in families of their adult children. In this way dual earner working families could solve three care challenges at a time. Due to this arrangement grandmothers (less often grandfathers) took care of their grandchildren and assumed responsibilities for daily domestic chores in the household of their working children. On top of that, they themselves were taken care of by their off-springs and could count on their support in case of emergency or health disability. Such an informal “kinfare”47 did not require hired care givers for the young, disabled or older family members. Yet, on the flip side, it relied heavily on informal and therefore unpaid reproductive labour of women, both of retired grandmothers and their working daughters or daughters-in-law. While in big industrial centres this tradition gradually declines, in small towns it still persists. In conditions when women as “main reproductive workers”48 are increasingly departing for earnings abroad, this creates “care gap” in families, relying on this care arrangement.

46

Tolstokorova, A. (2011b). Novye zolushki v staroj Evrope: formirovanie rynka domashnego obsluzhivajuschego truda v Ukraine v kontekste global’noy ekonomiki zaboty i uhoda [New Cinderellas in Old Europe: The emergence of the Ukrainian labour market of domestic care work in the context of global care economy]. In: Antropologia professij ili postoronnim vhov razreshen [Anthropology of Professions or Entrance Welcome]. YarskayaSmirnova, E, Romanov, P. (Eds.). Moscow: ООО «Variant», pp. 334-351 (in Russian).

47 Deneva, N. (2012). Transnational Aging Carers: On Transformation of Kinship and Citizenship in the Context of Migration among Bulgarian Muslims in Spain. In: Social Politics (forthcoming).

48 Bastia, T., Busse, E. (2011). Transnational migration and changing gender relations in Peruvian and Bolivian cities. Diversities, 13 (1), pp. 19 – 33.

11 The Constitution of independent Ukraine preserved the rights for free health care, medical treatment and insurance intact49. However, in reality the quality of institutional care provided is dependent on the financial resources of the patient. There is no clear distinction between social and medical care. Social care is generally the responsibility of the Ministry of Labour and Social Policy, with nursing centres as the main residential facilities for those requiring external assistance for daily living. Institutional social care is provided mainly in public institutions for dependent groups, including seniors, war and labour veterans and other cohorts with special needs, such as people with disabilities, but in practice community services are poorly developed. After the demise of the USSR, state expenditures on health care have tangibly decreased. At present, per capita expenditures is around $16 or 2.7% of the GDP, compared to $4,093 or 14.1% in the United States50. This level of expenses can meet only the minimal health care requirements of the population. In terms of elder care it is especially dramatic. The state fails to meet the demands of the elderly population in therapeutic and specialized consultative services by around 47.0%, in rehabilitation facilities by 81%, in intensive institutional health-care by 26.2 %, in home care by 71.1% and in ambulance services by 32.5%51,52. The share of the elderly who have access to medical home care varies from 3% to 40% depending on the region53, in rural areas being tangibly lower than in urban settlements. In 2000, the total of 905 units provided home social care services to 394,200 people; additional 750 territorial centres provided domestic and medico-social care services to disabled citizens in daycare settings or at home54,55. The demand for institutional elderly care exceeds available possibilities by far, with waiting lists increasing while available beds decrease (Table 1).

49

Constitution of Ukraine (1997). Clasue 49. Adopted at the 5th session of Verkhovna Rada of Ukraine on June 28, 1996. Kyiv: Ukrain’ska pravnycha fundacia.

50 Ivanov, L.L. (2009). Nursing and Health Care Crisis in Ukraine. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 12 (1), pp. 98-103 (99).

51 Chajkovska, V. (2010). Op. cit.

52 Bezrukov, V.V., Voronenko, Yu. V. (2004). Shlyakhy vdoskonalennya medyko-social’noji dopomogy lyuduam litn’ogo viku v Ukrajini. [Ways of perfection of medico-social support to elderly people in Ukraine]. In: Problemy stareniya I dolgoletija [Problems of aging and longevity], 13 (3), pp. 221-224.

53 Amjadeen, L. (2008). Gender equality, social justice and elderly care: problems and transformations in Ukraine. Draft paper for the conference “Transforming elderly care at local, national and transnational levels” Danish National Centre for Social Research (SFI), Copenhagen, 26-28 June 2008, p.11.

54 Lekhan, V., Rudiy, V., Nolte, E. (2004). Health care systems in transition: Ukraine.

Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies, p. 80.

55 The total population in Ukraine in 2000 was around 47 bn.

12 Table 1. Allocation of elderly and disabled adults in elder care centers (per 100 persons)56 1985

1990

1995

1996

1997

1998

1999

2000

7.6

7.6

7.9

6.3

5.0

4.2

4.0

3.8

Recently, some municipalities introduced palliative care facilities (hospices) for frail patients and the oldest old. They are usually backed up by local governments, public and religious institutions and are incorporated into the system of the Ministry of Health Care, which allocated them quotas for personnel. However, the network of hospices is only in its infancy and can meet but a small share of current demand in palliative care, which is growing rapidly. Experts contend that the quality of services there leaves much to be desired, especially in what concerns emotional and spiritual support to clients57. In addition to institutional LTC services that were emphasized in the past, Ukraine developed home-based care services including health and personal care, as well as home-making service. As underscored by WHO58, this development may be understood as responding to the needs of the ageing society.

A serious challenge to the operation of the state component of the care diamond is in the embedded nepotism, structural erosion and absence of transparency. This was evidenced by the story of our responder whose bed-ridden mother required services of a qualified nurse who could come to her place to make injections at home. She offered an extra out-of-pocket remuneration for these services, despite they are a part of professional responsibilities of institutionally employed nurses. “I asked in the local clinic if they have a nurse who could provide paid home care. Yet, my request was turned down. The argument was bad lack of nurses among medical personnel. Soon after that, quite incidentally, I met my exschoolsmate, a skilled nurse with tangible professional experience. It turned out that she was unemployed and her financial situation was rather poor. So, I brought her to the head of the outpatient department at our clinic and told her: “Here you go. Now you have a qualified nurse in your staff and I have a person to

56

State Statistics Committee of Ukraine, Statistical yearbook of Ukraine for 2000. (2001).

State Statistics Committee of Ukraine: Kyiv.

57 Navchannya organizacij, jaki opikujut’sya paliatyvnymy hvorymy [Training for organizations, taking care of with palliative patients]. Civic space portal, September 9, 2011.

Online URL at: http://www.civicua.org/news/view.html?q=1683159 [Stand 09.09.2011].

58 WHO (2002). Lessons for long-term care policy. Geneva.

13 make injections to my Mom at home”. Yet, the reply was that it was hardly possible, because the administration of the clinic received an unofficial prescription from top health-care officials to avoid employing nurses with official residence permit in Kyiv, and instead to give priority to those who reside in Kyiv clandestine. As you understand, the former are usually better educated, know their rights well and are in position to defend them, while the latter are more vulnerable and more prone to manipulation and exploitation and for that matter more convenient for administration. So, my ex-classmate did not get this job, despite her qualifications and work experience. Soon after that I learned that she had found employment abroad and left Ukraine”.

This interview shows how mercenary motifs of top-level state officials create conditions which push off from the national system of health care its best, most skilled and experienced personnel. With few possibilities to find a place for themselves at home, they are forced to seek means of survival abroad, whereby their works is more required. Due to this, the collapsing care systems of affluent northern economies receive cheap skilled care and nursing labour. It enables tangible budget savings both on wages pay-outs and on the investments into human capital (training of qualified care and nursing personnel), necessary to meet the demands of their aging population. In other words, the so-called “golden billion” benefits by dysfunctions of care economies in “bottom billion” through dividends received from them.

This process evidences the emergence of globalized institutional and economic contexts that facilitate corrupt practices and other forms of institutional misconduct among top decisionmakers in labor exporting societies such as Ukraine. At the same time, it demonstrates that the strategy of “crisis transfer”59, employed by post-industrial nations to shift the burden of multiple crises in the nucleus of the word system to periphery, is applicable to care economy as well. In particular, it confirms the claim that the absorption of unprotected intellectual products and resources from the source counties is one of major tools in the use of these strategies60.

In reference to Ukraine, the stance of “crisis transfer strategy” is instrumental in explaining how the emerging care gap and the enveloping care crisis result from the care crisis in postindustrial societies, and how the latter translates into “care drain” from lowincome nations via global care chains. As demonstrated by the theory, developed by a

59

Souhorukov, A. I. (2004). Transfer ekonomichnykh cryz jak prychina nedoskonalyh tzykliv [Transfer of economic crises as a root cause of incomplete cycles]. In: Strategychna panorama [Strategic Panorama], 2, pp. 68-84.

60 Ibidem.

14 Ukrainian researcher A. Souhorukov61, crisis transfer represents “conscious actions of one country with regard to another country (generally less developed), entailing disastrous consequences for the latter, such as profound multiple crises, decrease of competitiveness of the national economy, diminishing exposure to the world market, deterioration of entrepreneurial and investment climate, degradation of social and ecological situation”.

Within this framework, the chain transfer of crisis is defined as a consecutive (chain-driven) transfer of crises from better developed societies onto less developed ones, involving more than one country. An illustrative example of this strategy is the so-called “global care chains”, which represent networks, aiming to maintain daily life in the so-called “transnational households”62 by transferring care provision from one to another based on power structures, such as gender, ethnicity, social class, and place of origin. In the framework of feminist economics a near-global trend of massive entrance into the paid labour and acquisition of financial independence by middle-class women in industrialized nations is interpreted as the cost of freedom of their domestic and care workers. The latter have to sacrifice their own family life and responsibilities to enable their female employers to reconcile career and family life, while their own families are left bereft of care. By this sort of “gendered and racialized international division of caring labor”63 the global capitalism and neoliberal economic restructuring have enforced a “new world domestic order”64 that requires the emigration of the so-called “new servants”65, i.e. poor women from the periphery of the world system, to provide low-cost care in wealthier “core countries”.

The claim of “crisis transfer strategy” as a tool by which “care drain” is crafted may be supported by observations, highlighting a discernable link between two concomitant processes: a growing demand in female labor in post-industrialized economies, and a concurrent increase in female labor supply from transitional societies after the demise of the USSR66,67,68. As was highlighted in the UNIFEM report for 200669, the connection between

61

Souhorukov, A. I. (2004). Antykryzova polityka rozvynutyh krajin [ Anti-crisis Policy of Developed Countries. In: Ekonomika Ukrajiny [Economics of Ukraine], 8, pp. 16- 27.

62 UN-INSTRAW (2007). Feminization of Migration. Working Paper 1. Dominican Republic.

63 Ally, Sh. (2005). Caring about Care Workers: Organising in the Female Shadow of Globalisation http://www.globaljusticecenter.org/papers2005/ally_eng.htm.

64 Hondagneu-Sotelo, P. (2001). Domestica: Immigrant Workers Cleaning and Caring in the Shadows of Affluence. Berkeley CA: University of California Press.

65 Lutz, H. (2004). Op. cit.

66 Lyberaki, A. (2008). “Deae ex Machina”: migrant women, care work and women’s employment in Greece. GreeSE Paper No 20. Hellenic Observatory Papers on Greece and Southeast Europe.

67 Lutz, H. (2008). Introduction. Migrant Domestic Workers in Europe. In: Lutz, H. (Ed.) Migration and Domestic Work. Ashgate, pp. 1-10.

15 these two processes explains the supply of cheap migrant care-workers to the West. Thus, it was noticed that the process of paid jobs acquisition and demand of equal treatment inside and outside the labor force by women from most developed Western capitalist societies in 1980-s ‘strikingly’ coincided with a reverse tendency in countries of state socialism, where women were granted long maternity leaves and started to drop out of paid work for lengthy periods early in their careers. These simultaneous trends converged more pronouncedly in the 1990-s after the collapse of state socialism and the related escalation in economic globalization. Even more strikingly, East European women were forced out of labor force in unprecedented numbers, exactly at the time when their Western counterparts started to take up paid employment at the encouragement of national and transitional governments as well as corporate employers. This enabled “the sudden supply of –relatively cheap and flexible– immigrant labour”70 that has accelerated female paid economic activity in migrant recipient societies. The obvious connection between these two processes points to the “Deae ex Machina effect” of the so-called “just-in-time- women’s migration71 as well as to a “prêt-aporté character” of the emerging “care gap” in care exporting societies.

The dysfunctions of care systems in care drained sending societies, resultant from “crisis transfer strategy”, enhance changes in the architecture of the care diamond by relocating the functions of the state and the family onto the market, thus contributing to “global commodification of care”. A bright illustration to this trend was secured due to personal experience of one of interviewers in this project, who tried to obtain the official status of a paid home care-giver to a bed-ridden family member with functional dependency. This document officially verifies that a frail patient is not in position to serve his/her daily living and requires personal home-based care. Officially, a status of personal home carer may be secured by a family member or a close relative who is entitled for a home care allowance, although negligible in terms of remuneration (currently less than €10 per month). More importantly, it enables a home care-giver to reserve his/her job placement while staying home, retain an un-interrupted labour history and have the time spend in the care for a frail relative recorded as a paid work. Additionally, a carer may be entitled to some social welfare subsidies available for low-income groups, such as reduced rent, etc. Although not highly Karjanen, D. (2008). “Just-in-time” Migration. In: Migration and Mobility in an Enlarged Europe. A gender perspective. (Eds.) Metz-Gockell, S., Morokvasic, M, Munst, A.S. Opladen and Framingto Hills: Barbara Budrich Publishers, pp. 159-178.

69 UNIFEM (2006). The Story Behind the Numbers: Women and Employment in Central and Eastern Europe and the Western Commonwealth of Independent States. Bratislava, p. 6.

70 Lyberaki, A. (2008). Op. cit, p. 1.

71 Karjanen, D. (2008). Op. cit.

68

16 wide-spread due to minuscule financial provisions, this care arrangement was required and used by many families. Yet, it turned out that due to recent legislative amendments, obtaining a status of a formal home carer for an elderly relative became an intricate venture. In the first place, the category of patients who are entitled to formal home care provision was tangibly reduced due to the scaling-up of the age limit for them by 80 years and over. Therefore, the relatives who could afford scarifying their careers and incomes to provide decent care to their dear ones aged below 80 had to resign from jobs and interrupt their employment histories, which can have salient implications for their own financial security in old age. Secondly, the district physician in charge for the relative’s medical treatment was reluctant to confirm that her frail bed-ridden patient required informal home care. In a private conversation she intimated that yet five years ago the personnel of her clinic received an unofficial prescription to avoid by all possible means issuing such permits to clients as long as they required state provisions. In this condition the remaining option for care-dependent families was to employ a paid care-giver to provide home-based services to their frail relative, i.e. to refer either to the informal market of domestic services or to a commercial sector of state social services.

Interestingly, when the required papers were gleaned to apply for the latter, the medical confirmation of the frailty and care dependence of the care receiver was issued by a district physician without delay. In these conditions the “care burden” was forcefully shifted from the family to the commercial sector due to structural pressure of the health-care system on the family, despite its willingness to shoulder this care challenge by means of internal human resources. In this way it was deprived of its “right to provide care”72.

Family sector: A Ukrainian “orange river”73 of care As observed by WHO, informal care is by far the dominant form of care throughout the world, while paid services - either at home or in institutions - play a relatively small role, except in a few countries74. The results of current field research confirmed our earlier finding75 that in the situation when women as principle careers depart abroad, the caring roles are redistributed among members of extended families, being mainly assumed by grandmothers and less often among the community. Yet, it is more likely to happen in rural 72

Daly, M. (Ed.) (2001). Care Work. The quest for security. Geneva: International Labour Office.

73 Orange River is a the location of the first working diamond mines on the of the NamibiaSouth Africa border (1888), where the DeBeers diamond mining and trading company was born.

74 WHO (2002). Op. cit., p. 19.

75 Tolstokorova, A. (2009 c). Who Cares for Carers?: Feminization of Labor Migration from Ukraine and its Impact on Social Welfare. In: International Issues & Slovak Foreign Policy Affairs Vol. XVIII, No. 1, pp. 62-84.

17 areas and in small towns, whereby family and community connections are stronger, rather than in highly alienated urban settlements which currently face a challenge of emerging “care deficit”, exacerbated by the demographic change in the Ukrainian society.

In urban “mother-away migrant families”76, and less often in rural families, absence of women for work abroad often entails redistribution of gender role models among transnationals. As was shown elsewhere77, the males left behind may assume household duties and often cope well with their new roles of “househusbands”78. This was intimnated by our interviewee: “I decided that it is me who has to go [for earnings abroad], because I knew that although my man was not the best possible husband, he was a good dad and my boys loved and obeyed him. Now, I see that although I am away from home, my boys are taken care of well, and all my guys get along well with each other. Now that I am going home for a short leave, I am busy with present-hunting for my ex, to thank him for being a good father to our sons.”

(Anastasia, 38, working in services business in Monaco).

Another responder commented that such instances are quite common in transnational families and the new “gender contract” with wives as breadwinners is gaining currency: “Here, in small towns in the South of Ukraine, around 40% of men live on remittances snet by their migrant wives and take care of the household. In the West of Ukraine their share is even higher, probably over 50% and since my sister lives in Moldova and I know that there such men make no less than 70% of the total male population” (Varvara, 76, a mother of a man working in Russia).

One more responder expressed an opinion that the share of “househusbands” might be even higher than that. These interviews confirmed the observation that spouses/partners may provide a critical safety net for care dependent family members79. However, in our research the caring roles of males, if any, were limited mainly to the care for their off-springs, but seldom extended that far as to assume responsibility for their own elderly parents, leave alone

76

Parreňas, R. S. (2005). Long Distance Intimacy: Class, Gender and Intergenerational Relations Between Mothers and Children in Filipino Transnational Families. In: Global Networks, 5 (4): 317–336 (318).

77 Tolstokorova, A. (2010). Op. cit.

78 Parreňas, R. S. (2005). Op. cit, p. 331.

79 Hoffmann, F., Rodrigues, R. (2010). Informal Carers: Who Takes Care of Them? Policy Brief. Vienna: European Centre for Social Welfare Policy and Research, p. 3.

18 for the parents of their migrant wives. In the best cases men contributed to elder-care through fiscal support, but not so much through daily care-giving and emotional work.

Current research confirmed that the reconstitution of gender role models in “motheraway families” with fathers left behind occurs mainly while women are absent from home.

After they come back, however, they are expected to re-assume their traditional gender role models of home-makers, while their husbands return to their roles of heads of families, although not necessarily main breadwinners.

Non-profit sector: a rough side of the diamond As noted above, during state socialism the national health-care system was heavily biased towards institutional care, while transition to a free market economy enhanced a shift towards services that are more community centered80. In Ukraine, the network of NGOs involved in care provision is a fairly new development that operates on the national, regional and municipal levels. The Red Cross is an asset in providing informational services and training to families of long-term carers, yet overall, the system of such training in Ukraine is practically non-existent81. The operation of this sector of care diamond lacks state involvement, especially in terms of scarcity of financial provision and insufficient legislative backing. This was evidenced by a responder in an earlier research82: Unfortunately, in this country social services exist only on the state level. This is a monopoly of the state. NGOs have no right to provide social services. Charity activity or support to those who need it is allowed, but it is not qualified as social services. There is no law which stipulates which social services can be provided

by NGOs. …. Therefore people who really need care services can not buy them.

They can hire a person in a private way, but then they do it unofficially. In this case no one can guarantee professional care-service. If there was a labor market of these services at least partly covered by the state, then women would not go to make money abroad. Because currently there is a huge demand in care services in Ukraine (Director of an NGO providing care-services).

Experts’ data were confirmed by the information received through participant observation, drawing on informal communication with members of families seeking paid care services for elderly and physically disabled members83. Thus, one of our informants reported that for quite a while she could not find a qualified nurse to provide home care for her elderly

80

WHO (2002). Op. cit.

Bezrukov, V. (2002). Op. cit.

82 Tolstokorova, A. (2009 c). Op.cit., p.75.

83 See more at: Tolstokorova, A. (2011 b). Op. cit.

81

19 mother, suffering from Alzheimer’s disease. All the proposals for this paid home care offer came from people who had no experience of work with frail patients, especially of this profile. Her experience with families of patients suffering from the same disease suggested that all of them had the same care challenge. Being a PhD holder with considerable experience in Social Sciences, teaching and entrepreneurship, she decided to organize training courses aimed to provide skills in home elderly care. She succeeded in finding premises for her classes and invited highly qualified professionals of this profile who supported her idea and were ready to share their expertise to make her venture work. However, it soon became clear that this goal was a hard nut to crack, because all her enthusiastic attempts encountered indifference if not resistance on the part of decision-makers. As a result, despite her efforts, this project has never been put into place, although the demand in such a kind of professional activity was obvious.

This is another example of how bureaucracy and reluctance of decision-making bodies in health-care sector create constraints to progressive developments in the non-profit component of care diamond. Due to this, national system of care provision forfeits not only perspectives initiated by enthusiasts, but most importantly health and lives of numerous patients, who can not receive home care when necessary.

Market: the “Diamond Empowerment Fund”?84 The results of expert interviews for this project carried out in 200885 did not confirm an observation of international scholars that in Ukrainian transnational families “care is reorganized through the acquisition of new care services on the private market, especially by resorting to the services of domestic helpers, babysitters, surrogate carers who perform the role of guardians or basic child-minders, lodgers also entrusted with a caring role or by making renewed use of religious institutions”86. At that stage my argument was that the high demand for care-givers in Ukraine due to care drain from the country and absence of a regulated labor market of care services entailed their high costs (from €1000 to €1500 per month) which is hardly affordable for Ukrainian women carers, whose average monthly

84

Diamond Empowerment Fund is a women-led, celebrity-endorsed organization, which pushed the government in Botswana to use the tax revenue from diamond mining -more than $3.3 billion or a third of the country’s GDP - to subsidize primary education (see: Judith Imel Van Allen. Free Women: Kinship, Capitalism, Gender and The State. Dissertation for D. Phil University of California, Berkeley. Fall 2002. UMI Number: 3082442 at 239.

85 Тolstokorova, A. (2009 c). Op. cit.

86 Piperno, F. (2007). Welfare for Whom? The impact of care drain in Romania and Ukraine and the rise of transnational welfare. Online URL at: http://www.cespi.it/Curricula/PDF/piperno-welfare.pdf [Stand 30.08.2008].

20 income, for instance in Italy, was from €700 to €1000 per month87. The conclusion was that although it is true that paid care services to children and the elderly exist and are practiced by migrants’ families, as a result of inadequate remuneration they are but symbolic both in scale and in efficiency. This goes in line with the Razavi’s argument that in low- and middleincome countries, commercial paid care services providing quality care tend to be underdeveloped and are too expensive for most households88.

The field research for current project carried out in 2011 showed that throughout last years the process of commodification of caring labour in migrants’ households somewhat increased. Some of our responders reported using paid care for either child- or elder-care in their families left behind, as it was in the case of Marina, who worked as a domestic carer in Italy: When I worked in Italy, my two sons were left behind for the care of my elderly mother. But the boys did not get along well with each other, while my Mom was too old to cope with them. Their frequent collisions exhausted her and had a salient effect on her health, so that she developed a serious disease and became bedridden. For that matter I had to hire a woman to take care of her, because she could not serve herself any more. Meanwhile my boys had to take care of themselves.

Although it is still not very prominent, anyway, this process per se is significant as long as it evidences the changes in the operation of care diamond through its market component enforcement. The tendency of outsourcing care from the family to hired caregivers, i.e. to the irregular market, was confirmed by experts in the earlier stage of this project89: The situation is that care services have never been developed here at the level as they are in Western Europe. It’s only recently, as I noticed, that care giving started to involve people who are being hired and paid for that. It has not been so before. Traditionally, it was the responsibility of the family. These functions were assumed by family members” (Expert in migration issues).

It is noteworthy that because the delegation of care provision to the market is a new and unconventional phenomenon in post-socialist Ukrainian families, often associated with lack 87

According to a research by K. Dalgas in 2006 it was around € 850 [Dalgas, K. (2010). Love and Money: Changing Family Ties Among Ukrainian Domestic Workers in Italy. Paper presented at the seminar "Migration and domestic care work", February 11, University of Copenhagen, Denmark (unpublished manuscript)].

88 Razavi, S. (2007). Op. cit.

89 Тolstokorova, A. (2009 c). Op. cit.

21 of emotional connections between generations, it may acquire the form of “concealed care”, which is why it is neither clearly visualized nor perceived as a market-based activity. Our interviews intimated that there is a tendency among affluent families that adult children of senior people hire care-givers or companions for them, recruiting them from close friends or neighbors of their elderly parents. In this arrangement the clients themselves are unaware that their careers are paid for, and perceive them as volunteers driven by altruism. This enables them to cherish the illusion that they are required by members of their habitual social networks, to believe that they are cared because they deserve love, affection and devotion, but not because commercial interests are involved.

Over the last years in Ukraine there is an increase of people ready to work in private homes, for one hand, and the expansion of the network of employment agencies offering jobs in home care, including services for child and elder-care, cleaning, etc. The fact that employment agencies have moved into providing domestic services signals both that a global labour market has emerged in this area and that there is an effort to standardize these services deliver. Additionally, as field research showed, the job offer is practiced through informal networks and informal recruiters from amongst those who had an earlier experience of work in this labour market. Thus, our responders related a common practice of “job selling” by more experienced women-domestics to new entrants into this labour market.

“Very often if, say, a woman seeks a temporal leave from her work, and wants to resume working at the same family upon return, she finds a candidate to take her place for the time of her absence from work. You see, on the one hand, she insures that her job placement is preserved for her, and on the other hand, she usually takes a fee for offering a job placement to a beginner, who does not yet have connections in the new place and for who it is a lucky chance to get this job” (Inna, a domestic worker in Moscow).

The job may also be ”sold” in this way if a woman found a better place and wants to move there as a short notice to her employee, who she does not want to leave without a career. In this case again, she makes a favour to both the employer and a new candidate and might expect a remuneration for her services from both sides. Sometimes, after having experience of selling her jobs a few times, a woman may acquire sufficient marketing skills to decide to make it her informal occupation.

The rise in the pool of available careers owes to a magnitude of determinants, some of them were mentioned above. However, our interviews showed that one of the reasons why high-skilled women might agree to enter the precarious labour market of low status care

22 services upon returning home is the experience they acquired abroad. Before they became involved in foreign employment many of our responders held high-ranking, and even managerial positions at home, e.g. working as civil servants in municipalities, lectures at colleges and Universities, etc. However, they decided to take a risk of de-skilling and “brain waist” by temporarily working in low-status jobs abroad insofar as their goal was to financially back up their high social status at home. Most of them regarded their “downward social mobility” as no more than a short-term occasional project necessary to sustain the reputation of middle class belonging. For example, Lilia, a civil servant at a municipality, despite her administrative position of high social standing, had a low salary below the level of poverty, combined with frequent suspensions of its payouts. This entailed a gap between her high social standing and low economic status which she managed to bridge by developing a strategy of circular migration to domestic work in Germany. Once in two or three years she secured an unpaid sabbatical at her institution to work for a few months as a cleaner in Germany. Her earnings there enabled her to purchase a new flat for herself, to renovate the apartment of her retired mother, to buy new furniture and other modern appliances for both households as well as to earn for subsistence, sufficient to enable her to resume working in her low-paid, but high status job in local administration at home.

The fieldwork showed that this “win-win strategy” is followed by many middle-class women, at least in the South of Ukraine. However, after a while some of them become accustomed to their low-status, but well-paid jobs and do not conceive them as precarious any more given that they enable financial empowerment. Often, upon returning to Ukraine, women are ready to accept similar positions at home if they promise decent supplementary income to their wages or retirement allowances. It is crucial that by that time they have already been well established on the labour market of domestic care services and have both necessary experience, skills, credentials and social capital which enable better employment opportunities than those they could afford when leaving for earnings abroad for the first time.

For instance, a responder Mila, a former civil servant in the department of culture in a municipality, had been employed for two years as a home carer in Moscow. During her employment there she stayed in a few families consecutively. Each transition to a new place family was preconditioned by an opportunity to receive a higher remuneration for her work, so that her income over two years nearly doubled. When she decided that she had earned enough to be able to terminate commuting for earnings to Moscow, Mila settled back home and resumed working in her native town as a deputy head at a local library. Soon, her former recruiter from an employment agency in Moscow called her to offer a well-paid job of a child minder in Odessa (Southern Ukraine) which she agreed to take only for the time-being, until a

23 permanent career will be found for this position. Another responder, Valentina, after a few years of commuting to care sector in Moscow and having secured extensive experience of “selling” her job to other colleagues, realized that she should reinvest her social capital into financial capital. Using her social networks among potential employers and landlords in Moscow, she organized an informal recruitment business, offering a job placement in care services and accompanying accommodation possibility in Moscow to beginners.

The above examples evidence that through such “carers’ carees”90 the Ukrainian market of care services is gradually institualizing itself. At the same time, this new trend generates new gender challenges in their own right. In the first place, the market of domestic care services is not “just another labour market”, but has its own specific conditions, derived from social construction of household chores and care giving as “women’s work”91. Second, care workers, whether native or immigrant, are mainly females who are in the lowest echelons of the social ladder. Even when care services are decently paid, the work remains culturally undervalued primarily due to the said association with “women’s work”92,93. This evinces the emergence of a new category of gender inequalities in the Ukrainian labour market which must be addressed in policy-making.

Conclusions and policy proposals The findings of current research showed that in the context of demographic change in Ukraine due to population aging and growing birth-rates, the pull of available carers shrinks as a result of increasing outmigration of women as prime-line “reproductive workers” in the family. This leads to “care gap” and creates high demand in care givers. In these conditions the structure of care diamond is being reshaped for the account of increasing role of the extended family, which is in full compliance with an all-European trend of the relocation of the (unpaid) care work from the public sector to the family94. This puts more care pressure on the latter which in turn starts outsourcing its caring responsibilities to the market, while preserving the responsibility for the organization and financial backing of paid home care.

Tolstokorova, A. (2012). One Way Ticket?: International Labour Mobility of Ukrainian Women, In: Tracing the New Mobilities Regimes. Vogl, G., Kesselring, S., Witzgall, S. (Eds.). Ashgater (forthcoming).

91 Lutz, H. (2008): When Home Becomes a Workplace: Domestic Work as an Ordinary Job in Germany. In: (Ed.) Lutz, H. Migration and Domestic Work. Hampshire, Burlington: Ashgate.

92 Esplen, E. (2009). Gender and Care. Overview report. BRIDGE. 93 Saraceno, Ch. (2008). Gender and Care: Old solutions, new developments. EUI, RSCAS distinguished lectures.

94 EAF (2011). EAF best practice workshop on social experimentation to develop innovative home care solutions. Website of the European Alliance for Families. Online URL at: http://ec.europa.eu/employment_social/emplweb/families/index.cfm?langId=en&id=3&news_ id=2321&news_det=yes [Stand 10.11.2011].

90

24 Meanwhile, as elsewhere, “public responsibility for care is not widely recognized or accepted”95 due to which the contribution of both the state and the public (non-profit) sectors to care provision, especially in elder-care, remains minuscule.

Ukrainian experts contend that in the context of demographic shifts, the role of the family in caring for the elderly will hardly become the dominant mode of care provision, especially in LTC. Therefore, the key role in its organization should be assumed by the state96. However, in current conditions of chronic budget constrains in Ukraine, exacerbated by the global financial downturn, there are no grounds to expect that the state will be willing to assume these responsibilities. This increases the pressure on the market and the non-profit sectors of the care diamond, and respectively requires more attention of the society to the process of institualization of home care. Meantime, it was observed that when care giving moves from the private world of the family to the public sphere, tensions emerge in such areas as the technical-professional competencies, relational and emotional skills, etc.97. In this regard IOM underscores that the care labour market is in need of increased attention related to recruitment, skill requirements, admissions, mobility, and residency issues, the attitudes and expectations of employers and clients, the training for care workers, and the discrimination that pervades some of the sectors98. Hence, these challenges should be addressed in the first place. For that matter it is necessary to develop coherent policy strategies aiming to cover all sectors of care diamond, yet with special focus on the market and non-profit sectors as potential successors to bear home care burden. Above all, it is critical to enhance strategic linkages between the key stakeholders in the care diamond and to ensure their policy coordination both on the national and local levels. This is necessary to construct a balance of care provision and enhance the “continuum of care” with an optimal interplay of public, home-based and community-based care grounded on the needs of the population.

Secondly, it is imperative to provide a legislative framework for the efficient functioning of the market and non-for-profit sectors of care diamond, the lack thereof creates great constraints to institualization of non-state care provision in Ukraine. This will enable the creation of public organizations of carers, empowered to lobby their interests, advocate their rights and speaks on their behalf.

95

Hankivsky, O. (2004). Social Policy and the Ethics of Care. UBC Press: University of British Columbia, p. 1.

96 Bezrukov, V. (2002). Op. cit.

97 Tobío, C., Tomás, S.A., Gómez, V., Palomo, T.M. (2010). Caring for Others: A challenge for the 21st century. In: Social Studiers Collection, No 28. The ”la Caixa” Foundation, p. 147.

98 IOM (2010). The Role of Migrant Care Workers in Ageing Societies: Report on Research Findings in the United Kingdom, Ireland, Canada and the United States. Geneva: International Organization for Migration, p. 63.

25 Thirdly, of paramount importance is to attract the attention of the academic community to the formation of Ukrainian care economy in the context of new global division of reproductive labour and the emergence of global care. In that, the accent should be placed on the feminization of migratory flows from Ukraine and gender implications of this process for care arrangements and care regime in the society. To this end the launch of longitudinal projects is required, drawing on the accumulation of statistics sensitive to gender, age and other social parameters of migrant populace.

At the same time, the family sector should not be neglected either. Thus, at the moment the size of financial benefits for care provision is negligible and insufficient to stimulate stronger participation of individuals and families in taking care of themselves or their elderly99. Meanwhile, it is argued that putting more public money into providing home care services for elderly and disabled might free up more unpaid carers to remain in or return to the labour market and that those carers would be contributing economically to the economy via taxation and social insurance contributions100. Therefore, it is important to address the formation of care labour market in Ukraine in terms of consideration of interrelationship between paid work and care giving and cost of the care for both care workers and client families.

Experts of World Health Organization (WHO) suggested that a necessary contribution into the development of family care are awareness-raising, counseling, education, training and support. This may include the provision of specific skills, emotional counseling through support groups, a “respite care” aiming to provide caregivers with temporary relief and regulation of labour initiatives that may cover laws guaranteeing workers unpaid leave if they have to care for sick relatives. Very importantly, support should incorporate “pension credits” for informal carers, meaning that the level of pension benefits depends on years of paid work, including home care101.

Most importantly, as noted by IOM102, it is necessary to attract and retain natives in the care sector, that is to minimize care migration and therefore, limit the effects of care drain.

To this end, public policy should be aimed at the enhancement of women-friendly labour market and creation of working places and decent working conditions for women, especially single mothers, enabling them to reconcile work and family life at home, without seeking employment abroad and leaving their children behind unattended. Additionally, emphasis

99

FISCO (2011). Op. cit., p. 49.

EAF (2011). Op. cit.

101 WHO (2003). Key Policy Issues in Long-Term Care. Geneva: World Health Organization.

102 IOM (2010). Op. cit.

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26 must be placed on policies aimed to enhance men’s caring roles in ways that break down gender stereotyping and open up possibilities for males to be more actively involved in family care.

It should also be considered that care work is an international market and, therefore, it is important for Ukraine to comply with international standards of policy-making on care provision and migration. Thus, it is necessary to join a recently released by WHO “Global Code of Practice on the International Recruitment of Health Personnel”. Another important international document to consider is the “Convention on Decent Work for Domestic Workers”, adopted in June 2011 by the International Labour Organization’s (ILO), which requires governments to protect the human and labour rights of domestic workers and defines minimum standards for decent working conditions. These documents have to be incorporated into national legislative practices if Ukraine wants to be reputed as the state respectful to human rights of its people.

And finally, to reach these goals it is critical to make the dynamics of care more central to public concerns and efforts while practices of care should receive increasing attention from activists, researchers, and policy-makers in terms of recognition of the practical, moral, and political importance of care and generating normative commitments to guide thinking, practices, and public policies through “care lens”.