Thursday, February 5, 2009

Five Times Freed, Six Times Invisible

An Ethnography of Women’s Liberation on the Neoliberal Times-Table
By Quincy Saul, December 2008 - January 2009

“The tremendous change in woman’s position... is indeed phenomenal when we reflect that it is but a short time since she has entered the industrial arena. Six million women wage-earners; six million women, who have the equal right with men to be exploited, to be robbed, to go on strike; aye, to starve even. Anything more, my lord? Yes, six million wage-workers in every walk of life, from the highest brain work to the most difficult menial labor in the mines and on the railroad tracks; yes, even detectives and policemen. Surely the emancipation is complete.” -Emma Goldman, 1917

Women everywhere are born in chains, but recently they are being freed. This is more or less the discourse of liberal feminism. But the widely diverging conditions in which women find themselves today leave us with many unanswered questions about the liberation of women in the context of capitalism, the nation-state and globalization. Are markets freeing women from patriarchy? How have liberal democratic states contributed towards the emancipation of women? Is globalization leading the world on a path towards feminist revolution? In this paper I will explore some of these questions by looking at the lives of a particular group of women upon whom many narratives of emancipation converge. These women come from all over the world, and are brought together through the particular mechanisms of nation-states and global markets.

The central characters in this study are women of color from the the global South who work in the home health aid industry in the United States. These women are employed to do domestic work and carework for the elderly. It is important to reflect on this specific group of women for two reasons. Firstly, because five narratives of emancipation converge on them: 1)They are women in the labor market, emancipated from the domesticity of the patriarchal family, 2)They are women of color, working in the same labor market as white women and thus emancipated from segregation, 3)They are poor women, working their way towards the promised emancipation of the middle-class, 4)They are migrant women from poor countries, whose income, sent home in remittances, contributes greatly to the economic development and emancipation of the Third World, and finally 5)The home health industry in which they work promises to emancipate the elderly of the First World from the well known horrors of today’s hospitals and the medical industrial complex. Secondly, it is important to reflect on these women because they are six times invisible: 1)They are women in a Man’s World, surviving in the shadows of patriarchy and Western rape culture, 2)They are women of color, doubly invisible in the institutionally male-dominated and white-supremacist United States, 3)They are poor women, fated for the footnotes and graveyards of history by classist ideology and war, 4)They are from the Third World, and they bear the scars and sufferings of a colonization which the liberal First World imagines has ended, 5)They are doing domestic and care work, invisible not only to the patriarchs who rule over it but also to many of the political economists who should account for it, and finally, 6)They care for the elderly, who in all of the First World and especially the United States, are increasingly marginalized, neglected, and forgotten, not only by global markets and nation-states, not only by economists, politicians and revolutionaries, but also by their own families.

I will begin with some preliminary explanations of two of the key terms that will appear in this investigation: domestic labor and carework. Then I will take on the five narratives of emancipation that converge on these women, analyzing them under the categories of class, gender, race, economic development and health. I will then attempt to summarize my findings from a holistic systems perspective. Finally, I will offer what little I can by way of suggestions as to what must be done today to advance the cause of feminist revolution and to build a long-term vision of women’s liberation.

Domestic Labor and Carework:
The Invisible Foundation

“Housework trivial? Not on your life!”
-Redstockings, The Politics of Housework

“If a meal is cooked in a restaurant, it is reflected in GDP; but if cooked at home, it is invisible.” -Bridget Anderson, Doing the Dirty Work (p21)

Every society is built on domestic labor, and every society is kept alive by carework. In the sexual division of labor characteristic of patriarchal societies, domestic labor and carework are performed almost entirely by women. The subordinate position of women within patriarchal societies relegates domestic labor and carework to the margins, misunderstood and undervalued. While the men who control society and write its discourse benefit immensely from the domestic labor and carework performed by women, they consistently degrade this work as more or less petty and inconsequential. As Bridget Anderson writes in her book Doing the Dirty Work, “the notion that domestic work is unproductive downgrades its social and economic contribution and excuses its invisibility.” (p12) In this section I hope to demonstrate convincingly that domestic labor and carework are absolutely foundational to the same societies that neither understand or adequately value them.

Domestic labor is difficult to define and measure because its boundaries are not clear. Anderson explains that “[r]ather than a series of tasks... domestic work is better perceived as a series of processes, of tasks inextricably linked, often operating at the same time.” (p11) Moreover, she continues, “domestic work is highly skilled both in terms of time management and what is actually done”. (p12) Women routinely perform work in the home that is as complex and demanding as the labor done by the most skilled male factory workers. Women have a dual role in the domestic arena as both laborers (doing all the cleaning, cooking, washing, shopping, etc) and managers (of both children and incompetent husbands). Domestic labor is resistant to figures, not necessarily because it is immeasurable but because its contribution is so huge. The UK Office for National Statistics likely underestimated when it wrote in 1997 that “the household industry is probably larger than that of any of the main single digit heading industries within the production boundary. The accounts should be seen more as twin planets rather than earth and moon.” (Anderson, p12) However, such statistics, while enlightening, fail to capture the full extent of just how much work domestic labor really is. This brings us to the porous boundaries between domestic labor and carework. As Anderson writes, “domestic work is more than the sum of these processes, for it is not just physical work...” (p11-12)

Carework is a term used to describe the labor which for which everyone has a need: the need to be cared for, to be nurtured, to be loved, to be healed. Domestic labor, understood as work done within the home, necessarily includes carework. Carework is not just a series of physical tasks; it requires emotional content and commitment. However, it is not quite possible to entirely separate the physical work of domestic labor from the emotional content from carework. Labors of love cannot in the end be separated strictly into distinct spheres of labor and love. Love inspires labor just as love grows from labor. Carework and domestic labor must be understood interdependently, and they produce not only clean houses but healthy homes. And if you step back to see the bigger picture, you recognize that domestic labor and carework reproduce not only families but societies. “[T]he... domestic worker is herself, in her very essence, a means of reproduction,” writes Anderson. (p113)

Women, as domestic laborers and careworkers, collectively produce and reproduce families and communities, local and global. “Through the doing of domestic work,” writes Anderson, “we literally reproduce our communities and our place with them. In the doing of domestic work, particularly in matters involving the care of children and the elderly, we forge our communities.” (p14) Patriarchal societies owe immense debts to the women diminutively defined as ‘housewives’. These debts are concrete and not abstract. Women’s work in literal and material ways produce and reproduce the foundations for every level of human organization up to global markets and nation-states. As Nona Glazer writes in her article Servants to Capital, “domestic labor is integral to capitalism and the capitalist state”.

Mary Zimmerman, Jacquelyn Litt, and Christine Bose, [editors, from now on referred to as ZLB] in the conclusion to their book Global Dimensions of Gender and Carework, write that “[w]e are consistently struck by the contradiction that carework is both vital for society and at the same time overlooked, invisible, and devalued.” (p370) This contradiction is by any measure outrageous and intolerable. The women who every day build and rebuild the foundations of society are not only invisible and unrewarded but quite literally exploited, not only by their husbands, but by their local and global communities. I have begun with this lengthy introduction of domestic labor and carework because it will be integral to our understanding of not only of the individual lives of the women who do this work, but also of the whole system to which their labor contributes.

Class: Commodification, Immigration, Informalization and Neo-indentured Servitude

“Inequality... is the conduit by which the tendency for richer households to substitute commodities for domestic activities is generalized.” -Susan Himmelweit, The Discovery of “Unpaid Work”: The Social Consequences of the Expansion of “Work”, 1995

“There are clear parallels between the servicing of life-styles by contemporary domestic workers and the work of domestic servants in England in Victorian times.”
-Anderson, p18

“Your passport is your life.” -Daniel, a migrant worker from Eritrea in Athens, Greece, (Anderson p179)

The promise of capitalism is that anyone from any class can, through hard work and perseverance, accumulate great wealth and status. This is part of the promise that brings women from the global South to the United States to sell their labor as home health aides for the elderly. Working in the households of middle- and upper-class US citizens, migrant women who often have grown up amongst poverty and structural violence, have an acute class consciousness. In this section I will explore the experience of these women as a class, as shaped by both market and state forces.

A process of commodification occurs in all capitalist marketplaces. Anything that is put on the market is ‘commodified’; turned into a commodity. A commodity is defined by being exchangeable with any other commodity, by means of money. Workers are no exception. When they sell their labor in a marketplace, it too is commodified, in particular ways depending on their occupation. The varying aspects of this commodification in turn determine the experience of the workers as employees. “Specifically,” asks Anderson, “what is being commodified when employers pay domestic workers?” (p108)

The unique qualities of domestic work that I outlined earlier make these women’s experience of commodification different than that of the archetypical male worker. To begin with, it is easier for the archetypical male worker to define how much of his labor is being commodified: Labor in offices or factories is commodified, but at home they have what they call a private sphere. Live-in domestic careworkers have no such luxury; they have little to nothing in the way of a ‘public-private’ distinction in their lives. Furthermore, more is demanded from domestic careworkers than simply labor power. These women are not only employed to perform routine physical tasks; they are expected to care; and so not only their physical labor but also their emotional and psychological labor is also commodified. Ultimately, these women are commodified much more intimately and intensely than any factory worker. Employers peruse and purchase their labor not only by the criteria of their physical capacities but by their personalities. “Employers want more than labor power,” writes Anderson: “They often openly stipulate that they want a particular type of person.” (p114) In other words, in their working lives, these women are commodified not only as labor power but as people.

Just as the commodification of personhood has particular consequences for home health aids, the commodification of carework has particular consequences for the elderly. “Commodification,” write ZLB,

“imposes a bureaucratic, rationalized authority structure over work. When carework is commodified, it is easy for impersonal rules and procedures, rather than personal affection to take precedence over relationships and nurturing... By breaking down care into discrete functions, a more highly differentiated and impersonal division of labor is encouraged, so that care becomes specialized and technical rather than holistic and embedded in human relationships.... in this way an overly commodified arrangement for carework threatens the social bonds and cohesion that are necessary for human well-being. This deepens rather than alleviates social divisions.” (p21)

To reiterate, these home health aides are doubly commodified as both workers and as people. This makes them subject to particularly strict control by their employers, it degrades the quality of care received by their patients, and it widens the class tensions that are already extreme between these women and the households they serve.

Besides their specific experiences of commodification, the legal status of these women as immigrants also determines their working lives. Whether they enter the United States legally (on a permit) or illegally, migrant women are in a highly vulnerable position. Of those women who can obtain a permit, Grace Chang, in her book Disposable Domestics, narrates that

“[m]igrant women enter with their employers’ names stamped on their passports and cannot change employers after entering. Even in the rare case that a woman negotiates a contract with her employer, she has no bargaining power or legal recourse if the employer violates it.”

For this very reason, migrant women are highly desirable as employees. The reason is simple. “Migrants,” writes Anderson, “are far more flexible than citizens.” (p190) These women will work longer, more difficult hours for less, and they are less likely to complain or file grievances, much less form or join any kind of organized resistance. Here again, these home health aids are doubly vulnerable when compared to the archetypical proletarian. Anderson explains:

“The fact that employers are citizens and the workers are not citizens formalizes their unequal power relations -- even outside of the employment relationship, workers and their employers are not equal before the law.” (p193)

In their vulnerability and exploitation as immigrants, these women are challenged and controlled by the same system which millions of immigrants, documented and undocumented, in every imaginable line of work, face daily across the United States and indeed throughout the First World.

This has particular implications for these women as a class. Chang explains how the vulnerability enforced by United States immigration law has historically functioned as a mechanism of preventing class mobility among immigrants. “This system,” she writes, “served to keep nurses in low-wage, temporary positions, forcing them to begin again and again at entry level with no seniority or benefits.” (p131) There is a big picture here. A whole history of scholarship indicates that the immigration policy of the United States is directly designed to serve the interests of the upper-classes and capital accumulation. “Much historical evidence suggests that the INS1 and Border Patrol function to regulate the flow of immigration to ensure a reserve army of labor2,” writes Chang. (p110-1) While a narrative of upward mobility brings many of these women to the United States to work, they potentially risk being trapped into another narrative altogether: “[I]mmigrant women,” writes Chang, “are in danger of becoming the new ‘braceras’ -- a pair of arms to rack the cradle or scrub the floors for their employers, then go home tired and empty-handed to their own children.” (p116) There is more to be said about the political economy of immigration and how it shapes the lives of these women. I will return to this in the section on economic development.

A final phenomenon that confronts the aspirations of migrant home health aids, which promises them freedom but renders them vulnerable, is known as informalization. The promising narrative of informalization is that it will grant workers greater autonomy and freedom in their work, allowing them to easily and efficiently adapt to their specific circumstances, unconstrained by the slow, unwieldy and impersonal qualities characteristic of formal workplaces. Whatever the promises, the reality of informalization today, explain ZLB, is that

“in globalization, paid work, especially work performed by women and migrants, is downgraded to residential areas or informal settings such as worker’s homes. As a result of this... ‘informalization,’ work is less subject to regulation and workers more subject to exploitation.” (p23)

Seizing on a theme that will recur throughout this study, Heidi Hartmann, in her essay The Unhappy Marriage of Marxism and Feminism, writes that “Where capitalists purposely segment the labor force... this clearly derives from the need for social control rather than accumulation needs in a narrow sense.” (p24)

Migrant home health aids in the United States and throughout the first world find themselves in a social position of servitude, which bears many resemblances to the indentured servitude of the 18th and 19th centuries, but which also has new qualities. Where the old indentured servants exclusively served the specific families that they were bound to, these women are bound into a particular relationship with the state, through both taxes and the welfare system. “Poverty policy has been designed and implemented to serve two basic functions,” writes Chang:

“In times of economic contraction, welfare can be expanded to quell or prevent civil unrest by unemployed masses. Or, in times of relative economic and political stability, welfare can be contracted to expel people from the rolls, thus ensuring their availability to perform low-wage labor according to local needs.” (p70)

Whether they are citizens or not, migrant home health workers are bound into this system. If they are recipients of any kind of social services, they are subject to the fluctuations of the welfare state as explained by Chang. And even if they do not receive any services, their labor directly and materially is bound to this system through taxes: most immigrants throughout the United States and the First World (with and without papers) pay social security taxes whether or not they receive services.

The promises of upward mobility offered by the home health aid industry to migrant women from the global South suffered an extreme setback in a 2007 Supreme Court decision. In Long Island Care at Home v. Coke, the court upheld its ruling that domestic workers are not subject to federal regulations regarding the minimum wage or overtime pay. Migrant home health aids today, as a class at the nexus of intimate commodification, immigration, informalization and neo-indentured servitude, are not only six times invisible, but at least as many times vulnerable to exploitation. Along with migrant farm workers and prisoners, these women are probably the most exploited labor force in the United States. The emancipation promised by the narratives of liberal feminism are found wanting, from the perspective of these women as an economic class.

Gender- Transnational Care Deficits and Double Standards: Dividing Mothers and Daughters

“One of the ironies about studying motherhood is that rather than take us to a set of practices that unite women across social divisions, we are confronted with the reality of profound global and local inequalities.” -ZLB p202

“[L]iberation of women from caring seems to require the creation of a new subclass of women workers.”
-Lynet Uttal, 2002 (ZLB p203)

The last 30 years have witnessed unprecedented changes in women’s lives. Increasingly, women are working outside their homes, and competing in the same labor markets as men. Many millions of women are now wage-earners, and their ranks are growing every day. The statistics here can’t fail to raise some eyebrows:

“[A]ccording to the U.S. Department of Labor (2005), 78 percent of mothers of school-age children are in the labor force [p16]... According to U.S. census data in 2000, close to 80 percent of single mothers and just over 70 percent of married mothers were employed in the labor force. This compares to just over 58 percent of single mothers and 40 percent of married mothers employed in 1970.” (p199)

This momentous change in women’s lives, unsurprisingly, has had immense consequences, both local and global. And like much of the discourse around the emancipation of women by capitalism, it leaves us with unanswered questions.

While women have been ‘liberated’ from domesticity, men have not been ‘liberated’ from the patriarchal division of labor. The amount of domestic work done by men has not significantly increased in recent history. In other words, the vast majority of women wage-earners work a double shift; first in the market, and then in the home. Even in stable economic times, this double shift is extremely difficult to manage, for any human being. And in the competitive grind of the rat race, women are daily forced to do wage work instead of carework. “For certain groups of women,” writes Chang, “...full time mothering was sacrificed to the demands of capitalism.” (p.73) And even here Chang is characteristic in seeing only half the picture; not only children but also the elderly are in the vast majority of cases cared for by women. When carework is sacrificed for wage work, a care deficit is created; a vacuum of labor that is necessary and vital to the production and reproduction of society. ZLB explain:

“In most societies, women constitute the backbone of carework provision. Changes in their labor force participation, alterations in resources available for childcare and family maintenance, and changing national and international laws all create potential ‘care deficits’ because women’s traditional carework patters and the underlying gender division of labor are threatened.” (p15)

The sea change in women’s work over the past 30 years, along with the resulting care deficits, has coincided with a global shift towards the adoption of neoliberal economic policies and programs by nation-states. Domestically, this has entailed decreases in all kinds of public social spending. So as care deficits have been growing, social programs (from day care to senior care) have been shrinking. “While women’s participation in the labor force is rising,” writes Anderson, “provisions for childcare and care of the elderly remain extremely limited.” (p109) And it is here, into the gaps created by growing markets and shrinking commons, where the home health aide enters center stage.

Care deficits in the First World have created a demand for paid careworkers which is as large and growing as women’s work outside the home. Anderson writes that “The employment of a domestic worker is often presented as a strategy for enabling middle-class women to enter ‘productive employment’.”(p16) This demand for careworkers to fill in for wage-earning women has simultaneously lead to transnational migration and to urbanization within countries. In both, the demographics of migration are increasingly feminized. ZLB write that

“In 1990, for every 100 men who migrated internationally, 91 women did so, making women about 47 percent of the global international flow of people [p103] ...the demand for women’s labor has resulted in a feminization of migration both among rural and urban migrants within a single country”.

When we put migrant home health aides in center stage, we get another perspective on the narrative of women’s emancipation from housework. The increased participation of middle- and upper-class women in the labor market has allowed them to challenge patriarchy and sexism in real and important ways, but this freedom has been predicated on the domestic labor and carework of poor immigrant women. Migrant women fill the care deficit, which allows middle-class women to not only compete with men, but to do so as as working mothers and daughters. Anderson writes:

“Migrant domestic workers, therefore, enable some middle-class women citizens to participate in the labour force as men’s equals... Migrant domestic workers enable women citizens to fulfill the political duty of motherhood [and daughterhood] at the same time as participating in the labor market.” (p190)

Migrant domestic work promises not only emancipation to employers, but to the migrants themselves. As such, the home health aid industry presents itself as a win-win solution to the problems of employers and employees. Middle- and upper-class women are promised emancipation from domestic labor and carework, and migrant women are promised emancipation from both poverty and the patriarchal societies and families from which they come. Migrant women wage workers thus are promised another version of everything promised to commuting women wage workers. The Globe and Mail, a Toronto newspaper, explains the narrative:

“For the women themselves, improving their economic status helps them challenge the... traditional stereotype of women as submissive homemakers who need to rely on their husbands, fathers, or brothers to survive. The huge exodus of female contract workers... in the past decade has created a generation of women who are more confident and independent about their role in a society that has now been forced to ask some hard questions about many of its traditional paternalistic attitudes.” (cited by Chang, p135)

This, again, is the discourse of liberal feminism. Advanced capitalism emancipates women from backwards patriarchy. But just as we must ask whether wage work really emancipates migrant women as a class, we must also ask if it really emancipates them as women. Once again, poor migrant women are on distinct terrain from their middle- or upper-class employers on their path to emancipation. ZLB begin to explain:

“When women have entered local labor markets in the past, their new status as wage earners has brought them greater independence, which they have used to renegotiate male domination in traditional relationships and institutions. For women migrants today, this process of empowerment -- both individually and in terms of collective action -- is impeded by their physical isolation and invisibility... Women migrate to seek opportunities; however, many end up providing cheap service labor instead.”(p11)

The narrative that First World employers offer poor immigrant women an opportunity to escape from the patriarchy of their native societies is problematic and questionable on several counts. Not only does it recapitulate many unsavory colonial narratives, but it ignores that these women are still doing domestic labor and carework. Migrant women who work as home health aides in fact preserve the patriarchal, gendered division of labor which was challenged by the increasing competition from women wage workers. “[T]hey are being used to maintain patriarchy in the First World,” writes Chang:

“Clearly, if... women’s roles in their society are subservient... then those roles are not overturned but reinforced when migrant women are forced to serve as low-wage workers overseas instead of homemakers. The only difference is that they provide domestic services to employers in the First World, instead of to their own families, while servicing their government’s foreign debt at the same time.” (p136)

While ever increasing numbers of women all over the world begin to work for markets, the resulting consequences can offer women opportunities for freedom, but they can just as easily create new vulnerabilities. One obvious example are the care deficits in the Third World that have been created by the immigration of many hundreds of thousands of mothers and daughters to the First World. I will return to this important subject in the section on economic development. While migrant women are ‘free’ to sell their labor, their career options are almost exclusively in domestic labor and carework. ZLB summarize:

“Women undertake the majority of the world’s carework, even as wider social forces are overturning traditional gender and work practices. New, transnational households hold the possibility of empowering women, but... jobs in some sectors of the global economy are, in reality, exploitative dead ends.” (p374)

It is not so much that the narrative of women’s emancipation doesn’t deliver -- rather, it splits in two. On a global scale, one group of women are freed to compete with men, and another group are freed to work for the first group, allowing for the advancement of their employers, but excluded from the benefits of that advance. “Thus inequality among women,” write ZLB, “according to social class and nationality, becomes institutionalized in the global economy.” (p111) This double standard is perpetuated in two overlapping institutional spheres: state and market. Firstly, the work of Third World women allow First World women to challenge their status as ‘second sex’, but Third World women remain themselves in third place. Anderson writes:

“Migrant domestic workers are enabling female citizens to participate in the public sphere, thereby taking full advantage of the rights attached to their citizenship status, but they themselves are often formally denied citizenship rights.” (p191)

Secondly, the work of Third World women allow First World women to take on professional careers outside the home, but Third World women are kept in the home. Chang writes:

“the advances of many middle-class white women in the workforce have been largely predicated on the exploitation of poor, immigrant women... The employment of undocumented women in dead-end, low-wage, temporary service jobs makes it possible for middle- and upper-class women to pursue salaried jobs and not have to contend with the ‘second shift’ when they come home.” (p58)

This double standard divides mothers and daughters locally and globally. Furthermore, the divide complicates the project of women’s liberation, and it points to an embarrassment in the liberal feminist discourse. This embarrassment is evidenced by the lack of attention (and sympathy) given by liberal feminist organizations to home health aides and other migrant domestic workers. Chang writes that

“Mainstream US feminist responses to the issue of the trade in women have been lukewarm at best... Perhaps the real issue is that privileged women of the First World, even self-avowed feminists, may be some of the prime beneficiaries in this trade.” (p144)

Women’s liberation becomes more complicated when we look at the lives and work of migrant domestic laborers and caregivers from the Third World. It is impossible to miss this double standard, and its implications: First World women exploit Third World women. From this perspective, the project of feminist revolution cannot proceed in any desirable fashion without coming to grips with what Heidi Hartmann wrote sometime ago, that “[w]omen may themselves exercise patriarchal power”. (p18) Furthermore, no long-term vision of such a revolution can see clearly if it doesn’t confront the fact that the double standard which divides mothers and daughters is racial.

Race- Slaves for Liberation: Segregation and Assimilation in the Global Household

Women of color from in global South have many different experiences and perspectives of race, but when they immigrate to the United States, they enter into a society and culture with a long and brutal history of institutionalized white supremacy. However, as wage workers in a nation-state that no longer legally sponsors racial segregation, they theoretically have an opportunity to challenge and overcome racism through hard work. The narrative is familiar; just as capitalism emancipates women from the home, it can emancipate people of color from segregation, and provide them with the financial autonomy to compete on equal footing with whites. While the narrative leaves us with unanswered questions, it does contain some truth. Cecilia Conrad, in her article Changes in the Labor Market Status of Black Women,1960-2000, (2005), records that

“[b]lack women have made enormous economic progress in the last four decades... most of the gains were realized between 1960 and 1980. The median earnings of black women who were year-round, full-time workers increased by 53 percent between 1960 and 1970...”

Without examining in detail the specific conditions which lead to this ‘enormous progress’, (and, as Conrad shows, its subsequent decline) we can say without hesitation that some women of color have indeed been empowered to challenge and overcome discrimination through their participation in the labor market. Nonetheless, this progress has not come to all women of color. The lives of migrant women of color who work as home health aids in the United States present a different, counter-narrative which once again raises uncomfortable questions for the discourse of women’s liberation.

To be clear, the home health aid industry, as comprised of public and private companies and contractors, is not formally segregated. There are some white home health aides. Nonetheless, by default or design, the industry facilitates a racial division of reproductive labor. White home health aides are a small minority. Meanwhile, white women are freed from housework largely by women of color who, for a very low wage, will do the domestic labor and carework that white families have left behind. This is not a new narrative; for centuries poor women of color have been doing domestic labor and carework for upper-class white families. What is new is the demographic, and the scale: not only upper-class, but middle-class white women are increasingly employing women of color to do housework, and the demand for this labor has brought women literally from the other side of the world. ZLB write that

“[t]he transfer of white women’s domestic and reproductive labor to women of color has taken on global proportions... Now... we are faced with an international transfer of reproductive labor and an international system of racial stratification in reproductive carework.” (p26)

Within this segregated division of labor, women of color from the Third World supply carework for white families at the cost of carework for their own families. “Under the current racial division of reproductive labor,” writes Chang, “some women cannot stay at home with their own children while they mother other people’s children and keep other people’s homes.” (p77-8) Chang characteristically neglects to mention the elderly, but the implications are the same: for every woman of color caring for an elderly white person, there is a directly related care deficit for an elderly person of color.

We will not be able to understand or effectively challenge this globalized racial division of reproductive labor if we don’t understand the racist ideologies that underpin it. Racist ideology continues to serve a dual purpose today just as it has in the past; it legitimates segregation and it facilitates the myth of assimilation. “Dominant US ideology,” writes Chang, “identifies women as caretakers and women of color/Third World women especially as servants to nurture and clean up after First World elites.” (p113) The implicit racism in any legitimation of the home health aid industry as it exists today is that care deficits of white families are more important than care deficits of families of color. And even as racist ideologies allow white families to tolerate an industry that privileges them at the expense of families of color, the same ideologies serve to inculcate the myth of assimilation into women of color. This myth tempts women of color to purchase the carrot of upward mobility as individuals in exchange for accepting the stick of society’s structural inequalities.“[T]hese ideologies,” Chang reiterates,

“...are so strong and so prevalent in US society that many people of color and immigrants fall prey to them as well. Ultimately... the effect of these policies and media images is not only to produce workers who are more easily exploitable, but to reproduce the racist, sexist, classist, imperialist ideologies upon which this exploitation is founded... In other words, these [ideologies] ...serve not only to capture immigrant workers as super-exploitable service workers but to recruit immigrants, refugees, and people of color as gatekeepers.” (p207)

Reflecting on a world-wide racial division of domestic labor and carework that privileges white families at the expense of families of color, we can see more clearly how the narrative of women’s liberation splits. White women can participate in a narrative of liberation only because women of color participate in a narrative of slavery. ZLB write that this industry “continues a long legacy of people of color being incorporated into the U.S. economy through coercive systems of labor”. (p205) Chang also picks up on this, reminding us that

“women of color have historically relieved privileged white women of much of the burden of reproductive labor by performing both private household and institutional service work... women of color’s performance of reproductive labor for others frees dominant-group women to pursue leisure or employment, thus making possible the privilege and ‘liberation’ of white women.”

Thus, these home health aides and other women of color from the Third World who do domestic labor and carework for wealthier white families, become slaves for liberation. The emancipation of wealthier white women from housework casts a long shadow: Women of color are exploited in the houses of their white employers as live-in careworkers, and families of color in the Third World struggle and suffer through care deficits, so that white women in the First World can be freed.

Economic Development- Martyrs for Growth: The Hero-Victims of Neoliberal Progress

“The migrant workers are our heroes because they sustain our economy.” - an ambassador from the Philippines to Canada (Chang, p130)

“We see migration as the result of structural adjustment programs -- we give up our lands, our products, and finally our people.”
-Eileen Fernandez, migrant domestic worker from Malaysia (Chang, p123)

While home health aids are torn on personal levels as poor women of color between overlapping narratives of emancipation and slavery, they are also drawn in as characters in a vast global drama of economic development. Symbolically, home health aides live a double life in this drama -- they both invisible and exploited, and simultaneously heroic and revered. “In 1988,” writes Chang, “on a state visit to Hong Kong, President Corazon Aquino declared migrant women the new heroes of the Philippine economy.” (Chang, p136) The Freedom from Debt Coalition, a non-governmental organization based in the Philippines, explain that “[b]ecause of their economic contributions, “migrant workers are hailed by the administration as the new heroes and labor export is elevated into a national policy”. (Chang, p136)

The export of women from poor countries to rich countries, in the grand narrative of economic development, is portrayed as a triple emancipation. Immigrant home health aids emancipate wealthy white women from housework, themselves from backwards patriarchal societies, and their native countries from debt and dependency. “On the one hand,” write ZLB,

“for consumers in affluent countries the availability of care services and workers in the marketplace has increased the ability of high-end workers to pursue work and careers outside the home. At the same time, it has created jobs in carework with the potential for empowering lower-class women and migrants by allowing them to enter the labor force.” (ZLB, p20)

And finally, even as these jobs empower lower-class women, their incomes, at least in part sent home to their families, serve to relieve the debt burden of poor countries. “[E]xporting workers and importing their incomes,” ZLB explain, “is often a coping strategy to inject more financial resources back into the national economy.” (ZLB, p12) Poor women are thus drawn into the export-oriented development strategies of less developed economies. Chang explains that “what the country cannot achieve through export of goods, it compensates for through the export of human resources.” (Chang, p130) Looking at the lives of migrant home health aides from the perspective of economic development, we are struck with the contradiction that while these women are marginalized to the point of invisibility within the societies they serve, they have become absolutely essential to the very functioning of the global economy. Just as much as developing countries depend on a steady flow of remittances from migrant workers abroad, the so-called developed countries depend on a steady supply of flexible female labor. ZLB write that “remittances are the third largest source of foreign currency in the Phillipines and make up one-third of the foreign currency transactions in Bangladesh” (ZLB, p104) These figures are representative of a larger trend. Most developing nations depend on remittances for a large percentage of their foreign currency. And the First World is no less dependent. “In February 1997,” Anderson writes,

“Italy’s General Accountant declared that over the next fifty years Italy would need at least 50,000 immigrants per year to balance the social security budget and support the economy in the face of a stagnant birth rate and an increasingly aging population.” (Anderson, p190)

To better understand just how the First World as well as the Third World depends on migrant home health aids, we must return to the subject of how states themselves thrive in various ways on the life and work of vulnerable immigrant women. Anderson writes that

“the receiving state might be said to profit from migrant workers, since their labour power has been produced without any outlay from this state and, theoretically at least, they are to return to their countries of origin one day, thereby saving the receiving state any expenses associated with their old age. Again, theoretically, they do not bring their children with them, saving the host state associated health and education costs.” (Anderson, p108-9)

As explained briefly in an earlier section, migrant careworkers serve the state indirectly by doing the labor necessary to reproduce the labor force and society at large. But these women also serve the state directly, when a cut out of their pay-check goes to the state. Taxation of migrant workers is an especially good deal for the state because migrant workers are statistically far less likely to call upon any of the public services provided by the state. “In practice,” writes Anderson,

“immigrants are less likely to draw on social programs than citizens, and yet they do pay taxes: a US Federal Department of Labor study of undocumented workers in the early 1980s found that 73 percent had income tax deducted from their pay, 77 per cent paid social security, and 0.5 per cent received benefits”.
(Anderson, p108-109)

Chang explains the human picture behind these statistics:

“[T]hese women earn incomes far below the poverty level; yet they under-utilize public assistance and social services to which they or their children are fully entitled, fearing that they will jeopardize their legalization applications.” (Chang, p67)

By paying for welfare that they don’t receive, migrant workers help to reproduce society not only cheaply, but, again, symbolically. Anderson explains the symbolic implications of preserving the welfare state while being excluded from it:

“By providing welfare, one of the crucial social rights of the citizen, they are helping to give meaning to the notion of citizenship status, while themselves being denied any of its rights.” (Anderson, p191)

Here again we encounter an invisible foundation. These women underwrite the economies of both the Third and the First World, upholding the very meaning of citizenship, all whilst being excluded from the emancipation made possible by their labor. “[T]hese women’s labor,” summarizes Chang, “-- caring for the young, elderly, sick, and disabled -- makes possible the maintenance and reproduction of the American labor force at virtually no cost to the US government.”3 (Chang p13) Thus, in addition to the many agencies, institutions and individuals that these women must contend with to work in the First World, finally these women are in a direct relationship with the state itself. But to understand this relationship, we must look not only at states but at the international institutions that shape the global economy.

“Supranational organizations,” write ZLB, “constitute a powerful force in determining the nature of carework.” (ZLB p24) The supranational organizations relevant to this paper, to which ZLB refer, are the International Monetary Fund (IMF) and the World Bank.4 A great deal has been written about these institutions; their history and their trajectory have been analyzed in much detail, and I will not attempt to do so thoroughly here. For the purposes of this paper, it is sufficient to explain that the IMF and the World Bank offer loans to governments who agree to implement what are commonly known as ‘structural adjustment programs’ (SAPs). SAPs have far reaching effects for borrowing nations and for the global economy, but they also have a particular effect on the lives of women. “[W]hen nations borrow money from the IMF or the World Bank,” write ZLB,

“loan restrictions, known as structural adjustment requirements, are placed on the debtor governments. Among the typical requirements are keeping wages down, cutting social services, reducing health and education budgets, and eliminating food subsidies, all of which make women’s daily carework harder.” (ZLB p108)

Chang echoes: “SAPs strike women in these nations the hardest, and render them most vulnerable to exploitation, both at home and in the global labor market.” (Chang, p124) It is essential for us to understand SAPs and the global economy if we want to understand the immensity of immigration today. Global immigration today has truly reached biblical proportions, with many millions of people living transnational lives, working in every imaginable industry. But running parallel to the narrative of the global village where the world is brought closer together and into greater harmony by global markets, is a counter-narrative of the global work camp, where the world is torn apart as millions migrate in a struggle for basic survival. Chang is succinct: “[M]igration is not a matter of an individual woman’s free choice, but a response to poverty created by imperialism and perpetuated by SAPs.”(Chang, p142)

The narrative of the global work camp takes place in a larger system of re-colonization. Immigrant workers, and women in particular (as the primary reproducers of society) bear the brunt of this exploitation. In an era described by many academics as ‘postcolonial’, it is impossible to really understand the lives and work of migrant home health aides without coming to grips with a very intimate kind of colonization -- the extraction of women as an exploitable resource. ZLB write that “migrant women workers are effectively imported into the United States from the Third World and channeled into service jobs, specifically in care work or paid reproductive labor.” (ZLB p12-3) To understand that Third World women are literally imported into the First World. (as opposed to the narrative that casts them in a role of willingly migrating heroes), it is necessary to have some familiarity with the history of First-Third World relations. “Migration,” Chang begins to explain:

“is rooted in the creation of linkages between sending and receiving countries through foreign investment and military intervention by First World countries in the Third World... First world imperialism and development policy in the Third World have resulted in resource depletion, debt, and poverty for many people in these nations. The extraction of resources by the United States and other First World nations forces many people in the Third World to follow their countries’ wealth... the ‘draw’ of the United States is more accurately described as a calculated pull by the United States and other First World countries on the Third World’s most valuable remaining resource: human labor. (p3)... immigration from the Third World to the United States doesn’t just happen in response to a set of factors but is carefully orchestrated -- that is, desired, planned, compelled, managed, accelerated, slowed, and periodically stopped -- by the direct action of US interests, including the government as state and as employer, private employers, and corporations.” (Chang, p4)

The picture that we are beginning to see is a picture of a world system; a global institutional arrangement that incorporates us all into a particular set of relationships. While each immigrant and each employer certainly has their own unique story, these stories are connected. To paraphrase an adage, when an upper class housewife in the First World flaps her wings, there are storms in the Third World. Not only the actions of individuals, but the policies of governments are interwoven through linkages that have been created through centuries of colonization and imperial expansion.

The world system with which we must all contend today is of a particular kind. Many scholars and social movements characterize today’s global economy as ‘neoliberal’. Briefly, neoliberalism is understood to be a form taken by capitalism in crisis. Faced globally with stagnating profits, neoliberal policy consists of the privatization of public services, the deregulation of financial markets, and the opening of borders to capital transactions. Both the Third and First Worlds are undergoing neoliberal transformations today, and these different changes need to understood as developments within a world system. “[T]he simultaneous dismantling of social service systems in the Third World and the First World,” writes Chang, “is no coincidence.” (Chang, p16) Where social services that provide carework are dismantled, care deficits are created. ZLB explain how

“[c]are deficits in the First World create paid carework opportunities for women to migrate as domestic workers. Some migrant women are themselves nurses, creating another set of deficits when they leave their paid jobs in hospitals and clinics.” (ZLB, p16)

This world system of care deficits is not in any way theoretical. It is transforming lives and livelihoods in immense and intimate ways all over the world, not only for individuals but for entire societies. Chang writes that in the Philippines, for example, “there are 100,000 registered nurses... but almost none actually reside in the country. Similarly, 90 percent of all Filipina/o medical-school graduates do not live in their country.” (Chang, p131). In many parts of Africa, ZLB write, “the care deficit has assumed crisis proportions”. (ZLB, p17) Crises of care contradict what we imagine economic development to look like, but they increasingly characterize what we call globalization. “[M]ultiple crises of care,” write ZLB, “are developing in relation to globalization in locations all over the world: in developing countries, in developed countries, and in response to migration when women leave the former for the latter. Today, hundreds of thousands of women are living transnational lives.” (ZLB, p2) The lives of these women, and consequently the character of entire societies, are undergoing drastic changes, and we have only begun to understand the consequences.

To reiterate, First World women are driven by increasingly competitive neoliberal societies to seek wage-earning employment in the work market. Their dependency on wages for survival increasingly forces them to prioritize wage earning over domestic labor and carework. First World governments under the same neoliberal pressures cut social spending that in the past might have helped families compensate for this deficit. Meanwhile, Third World governments adopt SAPs in exchange for loans from neoliberal transnational institutions, cutting social services, exacerbating poverty and shrinking the opportunities for adequate employment for their citizens, especially women. This drives women of Third World countries to immigrate to the First World, where they are channeled by both immigration law and sexist and racist cultural norms into jobs that fill the care deficits created by the labor market participation of First world women. All of these diverse experiences are mediated by a world system that links the lives of women in the First and Third Worlds, even as it divides and exploits them.

Migrant women from the Third World are the heroes of this system: the labor force participation of First World women would not be sustainable without them, and their willingness to work for low wages directly serves First and Third World capitalists and governments. Regimes around the world would collapse without them. But these women are also the victims of this system: the economic growth associated with ‘development’ is predicated on their exploitation. Home health aides, though by no choice of their own, are martyrs for the progress of a neoliberal world system which grows on a foundation of crisis.

Health- Capitalist Retrenchment: Privatization of the Medical Industrial Complex

“[I]mporting nurses.. is a moneymaking venture for hospitals and the nursing recruiters they contract... US hospitals and the health-care industry would collapse without Filipina nurses.” -Chang, p132

“We take care of everybody else’s weaker members of society, while we let our own society go to hell.”
-Ninotchka Rosca, Gabriela Network USA (Chang, p132-3)

In this section we will turn to the final narrative of emancipation that devolves on the lives of home health aides. The home health aid industry which employs these women is itself projected and perceived by some to be working to liberate patients and caregivers from what has come to be called the medical industrial complex. The medical industrial complex was first described as such in a book called The American Health Empire by Barbara Ehrenreich published in 1971. An online encyclopedia of sociology summarizes:

“The medical-industrial complex... refers to the health industry, which is composed of the multibillion-dollar congeries of enterprises including doctors, hospitals, nursing homes, insurance companies, drug manufacturers, hospital supply and equipment companies, real estate and construction businesses, health systems consulting and accounting firms, and banks.”5

According to some analysts, the medical industrial complex is as large if not larger than the military industrial complex, consuming hundreds of billions of taxpayer dollars every year. The home health industry has developed largely in response to the inadequacies and inefficiencies of health care provided by the medical industrial complex. In their book Unhealthy Times, Pat Armstrong, Hugh Armstrong and David Coburn (from now on referred to as AAC), write that

“The shift from hospitals to home... has long been advocated by consumers and health-care analysts as a means of reforming the health care system and redressing a range of historical problems, including an overreliance on expensive high-tech, bed-based, expert-driven illness care. A shift from hospitals, it has been argued, could provide an effective counter to expert dominance and devolve decision-making to consumers and communities most familiar with their own health needs and the appropriate ways of addressing them. In addition to facilitating the more efficient and rational use of scarce health care resources, this shift would allow individuals, families, and communities to take back control over their own health. Thus, groups and interests disempowered by the rise of medical and hospital dominance could be re-empowered, and cost savings achieved through the more efficient use of health services could be reinvested in new or more appropriate health services, or allocated to the social determinants of health." (AAC, p15)

And so the women who are the subject of this paper, through their participation in the home health aid industry, are drawn into yet another story of liberation. But as with the other narratives of freedom that we have encountered, this one also leaves us with unanswered questions, both about the home health industry itself and about its particular effects upon its employees and patients.

There is certainly no shortage of legitimate grievances with the health care system provided by the medical industrial complex. The United States has the worst health care system of the First World in quantitative and qualitative terms, in spite of spending the most on it. Public health care in the United States today has come to mean subsidizing corporate drug dealers. A transition from hospitals to home could be an important step in reforming the health care system in the best interests of both its patients and its employees. “However,” write AAC,

“it is important to acknowledge that current policy reforms aimed at downsizing the hospital sector and shifting care to home and community have been controlled, for the most part, not by progressive reformers intent on a more equitable society, but by governments intent on curbing public expenditures and introducing a greater reliance on economic market forces.” (AAC, p15)

In the past several decades, movements built to reform a profit-driven health care system have been co-opted to retrench it. “[T]he discourse of health system reform and restructuring,” continue AAC, “supported ironically by legitimate criticisms of hospitals, physicians, and the medical model, is open to assimilation by neo-liberal governments bent on state retrenchment, tax cuts, and economic globalization.” (AAC, p17) Thus, efforts to reorganize the medical industrial complex have been channeled into efforts to privatize it. The state, following neoliberal dictation, spends less on hospitals and (directly or indirectly) subsidizes the growth of the private health sector. It is worth emphasizing that this discussion is not only theoretical, but has changed millions of lives. “An example of a large-scale change,” write ZLB,

“...took place in the early to mid-1980s when the home care needs of sick individuals rapidly escalated due to changes in U.S. federal policy. Medicare began paying hospitals a fixed amount per diagnosis rather than reimbursing for the actual length of stay. Medicare’s policy change created a strong incentive to release hospitalized patients as soon as possible and thereby save money. This signaled a momentous change in hospital lengths of stay and discharge procedures with huge consequences for families and for paid careworkers in the home health-care field... Home health agencies grew, often by providing de-skilled jobs and paying workers minimum wages.” (ZLB p15)

From this perspective, the home health aid industry appears as a direct outgrowth of a neoliberal political and economic system. For both patients and employees, it is an ominous development. For patients, the transition from hospital to home care may provide some conveniences, but it is also risky. While hospitals with centralized bureaucracies can be held accountable both to patients and the state, it is far more difficult to redress or reform a diffuse network of private institutions for neglect or malpractice. And more urgently, it leaves those who cannot afford home care with even less access to health care services. Furthermore, as addressed earlier, the privatization of carework itself has ambiguous consequences for patients. “[C]arework is increasingly being organized into services that can be bought and sold,” write ZLB. (p20) Reducing the holistic process of care into a commodity and the relation between the sick and the caring into a relation between buyer and seller is bound to have consequences on the quality of care. For employees the situation is no better. Working in a private home instead of a public institution makes workers more vulnerable to all manner of abuses, from harassment to overwork to underpay. The diffuse nature of the privatized health system makes it all the more difficult both for workers to get their grievances heard, and to organize into coalitions that can make demands.

On the other hand, it is clear whose interests the home health industry does serve. While hospitals in the hands of capitalists are used as profit generating mechanisms at the expense of patients and employees, Chang writes that “[i]n the private sector, the situation is no better... Home-care agencies, just like hospitals, make huge profits form recruiting and replacing home-care workers”. (Chang, p134) But before citizens of the United States feel any righteous indignation against the corporations who exploit not only patients and workers but the whole movement of health care reform in order to retrench their power and augment their profits, they should recognize that they too, along with the private sector and the state, are beneficiaries of the system. Chang writes that

“[e]mploying an IHSS [In-Home Support Services] worker saves taxpayers approximately $30,000 a year, the difference between the cost of keeping a patient in a nursing home and the typical salary of $7,000 a year earned by an IHSS worker who works 30 hours a week... The IHSS program provides one of the best illustrations of the tremendous savings to governments through the low-wage labor of migrant care workers.” (Chang, p134)

The home health care industry, instead of challenging the medical industrial complex, has been transformed into a mechanism of capitalist retrenchment. The home health care industry represents the privatization and decentralization of the medical industrial complex. The consequences for both patients and employees are at best inauspicious. The narrative that casts migrant home health aides as heroes in health care reform is thus rather perverse: Not only is their work exploited by the same powers that health care reform seeks to challenge, but their work in the United States comes at the expense of the health of the societies they leave behind, who suffer in their absence. What emerges is a global hierarchy of health care -- the Third World heals the First World, even as the First World condemns the Third World, in the words of Ninotchka Rosca, “to hell”.

Summary - Domestic Carework and Imperialism: Realizing and Resisting the World System

“Households, as well as governments... increasingly depend on migrating women workers for survival.” -ZLB p12

The public/private divide, desperate poverty and ostentatious wealth, underpinned by a history of ferocious imperialism and plunder: herein lie the roots of the problems confronted by women who work as migrant domestic workers.” -Anderson, p196

We have extensively examined the lives and work of migrant home health aides through the lenses of class, gender, race, economic development and health. Throughout we have raised questions to challenge the liberal feminist idea that capitalism liberates women. We have also reflected on the nature of domestic carework from all of these perspectives. In the section on economic development, I introduced the framework of a world system. Thinking holistically helps to thoroughly assess the various converging lenses of class, gender, race, development and health as they devolve upon migrant home health aides and the local and global communities they serve. I believe that it also helps us to think about domestic carework itself in terms of systems. At first, this may seem grandiose. Domestic carework at first glance seems highly isolated. ZLB write that “we do carework in individualized terms, making seemingly individual and private decisions”. (ZLB, p208) However, the work that happens in the private home has implications for the world economy. Domestic careworkers through their collective labor produce and reproduce not only households and governments but the foundations for globalization. Therefore, just as we realize that class, race, gender, development and health all play out in systemic terms, we can begin to understand care itself in systemic proportions. ZLB quote Mona Harrington, who leads us in this direction:

“We don’t see a collapsing care system because we don’t see care as a system to begin with. We see individuals making private decisions about who takes care of the children or helps [an] arthritis-plagued elderly patient. We see families using the private market for services they don’t have time to provide themselves -- day care, house cleaning, fast food. We don’t add all of this up and call it a system that is working well or badly.” (ZLB, p197)

Today’s care system, incorporated through commodification into the capitalist economy, is global in reach. And whether badly or well, it functions not out of concern for the intrinsic well-being of humankind but for the accumulation and expansion of capital. In the capitalist care system, public care services shrink, societies splinter into competitive households and families fragment into units of labor dependent on wages for survival. Middle class families face care deficits due to the exigencies of wage work and the global poor must migrate to find wage work, leaving care deficits behind them. “Given a declining welfare state,” writes Anderson,

“families that are increasingly nuclear with no support available from kinship networks, a growth in middle-class female employment outside the home, with a pool of cheap, flexible labor, it is scarcely surprising that employment of a migrant domestic worker is regarded as a suitable strategy for families in need of full time careers.” (Anderson,p16)

The capitalist care system provides care through a market; and just as in any other market, those with the power to purchase are privileged over those who only have the power to sell. This system thus rewards the rich with all the care they can buy. But care is not infinite; wherever and whenever a caregiver moves, whether to a job on Main Street or to a job in the global market, a care deficit is left behind. As carework is bought and sold around the world like any other commodity, a vast constellation of care deficits are created. And as this system becomes more entrenched, the commodification of care and care deficits both multiply. “Polish women working as domestic workers in Berlin, for example,” writes Anderson, “reportedly often employ Ukarainians to care for their children in Poland.” (Anderson, p118)

Finally, I don’t believe that any assessment of the capitalist world system, and especially the role that caregivers have within it, is complete without a frank engagement with imperialism. For the past 500 years, European imperialism has carved up and plundered the majority of the world. While physical conquest has gone out of fashion (if not out of practice), plunder has not. Beaten into vulnerability by centuries of colonization, the Third World today is trapped into economic path dependency, underdevelopment by SAPs and unequal exchange.

Domestic careworkers have a very intimate relationship with imperialism. They understand probably even more than any soldier what horrific havoc it wreaks on societies, families and individuals. Domestic careworkers must carry the burden of healing the unparalleled trauma that is the wake of empire, and they must do it alone in the private grief of each home. Migrant domestic careworkers in the capitalist care system have an even more intense relationship with imperialism. Not only must they do the same undervalued carework that everyone desperately needs in an age of empire, but they must provide it for wealthy white First World employers, whose lifestyle and taxes support the imperialism which impoverishes the societies from which the migrant women come -- the same societies that imperialism forces these women to leave behind. From this perspective, the care system becomes yet another avenue through which imperialism is exercised. “The dynamics of globalization,” writes ZLB,

“create care deficits for sending countries at the same time that it ‘solves’ care deficits in receiving countries by commodifying carework as well as care laborers. Thus, the global care deficits and care chains reflect and help to reproduce radical inequalities among women, between women and men, and between advanced and developing economies”. (ZLB, p208)

As domestic careworkers, these women build the foundations of a society that renders them invisible. As commodified immigrants, they are bound by racial double standards into relations of neo-indentured servitude. As slaves for the liberation of wealthier white women, they are martyrs for the economic growth of governments that exploit them. As heroes and as victims, these women are integral to the international status quo, and yet they remain six times invisible. “No party is willing to admit responsibility for, or to be held accountable for, the rights and protection of these workers,” writes Chang:

“All parties, including both the sending and receiving countries’ governments, employers, and employment agencies, evade or completely disclaim responsibility. Yet all benefit immensely from these workers’ labor, extracting foreign currency, profits, savings, and care services.” (Chang, p142)

To return to a conviction I voiced earlier, all of these contradictions are outrageous and intolerable. No amount of satisfaction with business as usual can justify their continuation. The narratives of freedom and emancipation have been found to be empty and naive, if not outright ridiculous. “[L]ive-in domestic work,” writes Anderson,

“for all the benefits it apparently offers the worker, binds her into a relation of status and dependence mediated by racism. How to organize for rights, justice and equality within that relation -- if it is possible at all -- needs some serious thought.” (Anderson, p196)

In this final section, I will take up Anderson’s challenge and outline the beginning of some of the serious thought about how struggles for rights, justice and equality can be organized. Having realized the world system, now we must begin to resist it.

What Must Be Done? - Burning Questions of Domesticity

“[W]e must not allow ourselves to be talked out of the urgency and importance of our tasks, as we have so many times in the past. We must fight the attempted coercion, both subtle and not so subtle, to abandon feminist objectives.” -Hartmann, p32

“While men have long struggled against capital, women know what to struggle for.” -Hartmann, p33

“We have a dream that one day, all work will be valued equally.”
-Domestic Workers United

Resisting a world system raises an interminable set of questions about organization, strategy, tactics and visions for the future. The theoretical horizon of analysis is limitless and without a doubt many dozens of scholars will bite their nails over domestic carework for generations to come, agonizing over implications and contingencies of resistance. Theory and analysis are important, but they often lack the urgency with which these home health aides deserve to be considered. A 2006 survey conducted by Domestic Workers United (DWU) found that

“26 percent of domestic workers live below the poverty line, 65 percent do not receive overtime pay, and 90 percent don't have employer-paid health benefits, while 36 percent reported having no access to healthcare.” (the study, called Home Is Where the Work Is, is cited by Ari Paul in his article Organizing Domestics in ZMagazine)

Due to their higher than average rates of exploitation and their growth as a workforce, migrant home health aides are increasingly becoming the focus of some union organizers. However, due to problems of immigration and informalization outlined in the section on class and problems of privatization raised in the section on health, there are many obstacles in the way of these women unionizing in any traditional sense. Chang mentions some of “the ongoing challenges for organizing homecare workers”:

"First there is no central workplace, with workers scattered among as many as 6,000 different work sites in a country. Second, some immigrant workers feel indebted to their employers and are not only reluctant to join the union but have reported other workers who do. Third, the union has had to identify an “employer” on which to make their demands, as the state is unwilling to identify as much. The union has had to create an employer, called the “public authority,” made up of disability advocates, clients currently receiving IHSS, and senior citizens.”

In addition to these obstacles, there are reasons to be skeptical of efforts to unionize these domestic workers.. With a few important exceptions, unions have historically been sexist and racist organizations. Unions have consistently marginalized and exploited the concerns and grievances of women and people of color, subordinating them into an organizing strategy conceived by white men. Women of color for centuries have been caught in the paradoxical space between exploitative employers and equally exploitative labor organizers. Hartmann reminds us that unions have long played a role similar to bosses, in undervaluing women’s work and perpetuating male supremacy:

“Union contracts which specify lower wages, lesser benefits, and fewer advancement opportunities for women are not just atavistic hangovers -- a case of sexist attitudes or male supremacist ideology -- they maintain the material base of the patriarchal system.” (Hartmann, p25)

Bearing this in mind, furthermore, migrant home health aides have little to expect from feminist organizers. Just as unions have perpetuated patriarchy, so feminist organizations have perpetuated racist and classist double standards. Anderson reminds us that ““it was only in the 1970s that domestic labor became a key feminist issue”. (Anderson, p9) Migrant home health aides thus find themselves at the nexus of three different sources of oppression, all of which pretend to emancipate them, but which only place obstacles in the way of their organized resistance: a world-wide capitalist care system, patriarchal unions, and classist and racist feminist organizations.

At the end of the day, while the scholars are busy as always in the archives, it will be the women themselves who find a way to navigate through the network of exploitation arrayed against them. The contributions of academics like myself are thus limited, but I can point to some promising developments that may contain the seeds of future change. Domestic Workers United, based out of the Bronx in New York City, is one organization that looks promising. It is not officially a labor union, and there are no membership dues. “Founded in 2000,” their website reads,

“Domestic Workers United is an organization of Caribbean, Latina and African nannies, housekeepers, and elderly caregivers in New York, organizing for power, respect, fair labor standards and to help build a movement to end exploitation and oppression for all.”

In 2008, DWU organized the first National Domestic Workers Congress, which brought domestic careworkers from all over the country together to discuss their common struggles and goals. One product of this Congress was the New York State Domestic Workers’ Bill of Rights, the first of its kind in the nation. Organizations like DWU are doing the pivotal work of establishing communication and collaboration between the many thousands of women who are isolated from each other by societies and systems. It is on the foundation of this communication that a movement can grow.

But even as these women begin to organize, there are still some burning questions about the nature of domestic carework in today’s world that we must endeavor to answer. Faced with a world-wide proliferation of care deficits, it is not enough to call for the least privileged sector of society to organize themselves -- the privileged must play a part in this struggle, or they will impede it at every step. As local and global communities we must grapple with the question of how to fill care deficits when they appear, without resorting to a coping mechanism that will only create another care deficit in another place. We must also incorporate our solutions into a long term vision of the society we want to create. In their essay Fighting the Feminization of Poverty: Socialist-Feminist Analysis and Strategy, Wendy Sarvasy and Judith Van Allen write that

“it is not enough to call for the expansion of social programs of women as long as the present welfare state structure and ideology remain unchanged. The ideology embedded in that structure must be challenged, because it justified the inequalities”.

In other words, calling for the expansion of social programs is problematic for several reasons. For one, it perpetuates dependency on a state structure that is historically sexist, classist, racist and imperialist. While the struggle for social services and state accountability should not be abandoned, especially at a time when these services are under attack from transnational neoliberal institutions, it should not distract us from a more obvious struggle for the accountability of men. As Sarvasy and Van Allen point out in simple terms, “[w]omen’s unjust dual role will not be altered until men do their fair share of domestic labor”. When a houswife gets a job, the care deficit is not only left behind by her, but by her husband. Until men are made accountable to their families for domestic carework, care deficits will be endemic in any society.

Another burning question which we have not discussed until now is the question of the elderly in society. In a culture obsessed with innovation and convinced of its own permanence, the elderly are a reminder of the past and of impermanence -- as such they are physically and psychically marginalized from mainstream society. What little literature there is on carework speaks almost exclusively of care for children. The neglect of the elderly in the post-industrial West is one of the most disturbing episodes of the 21st century. Future, saner generations will weep at how our societies are carelessly discarding our pasts into the landfills of abandoned history. And sentimental concerns aside, the question of the elderly is a burning one because their numbers are growing. The problems facing Japan and Europe -- a declining productive labor force combined with a higher demand for public health care services, known as ‘the age wave’, will soon be upon the United States. The question of the elderly will be solved one way or another -- the prospects are not bright, but the answers are not inevitable.

The evidence is piled high and deep. The current world system is found guilty of immeasurable contradiction and intolerable injustice. The discourse of liberal feminism is a farce. A new system must be fashioned and a new discourse must be launched. But the struggle for women’s liberation has never run smooth. The project of feminist revolution must contend not only with its obvious enemies, but also with other projects of revolution, many of which share some but not all of the same objectives. For example, “[i]t is not clear,” Hartmann writes,

“that the socialism being struggled for is the same for both men and women. For a humane socialism would require not only a consensus on what the new society should look like and what a healthy person should look like, but more concretely, it would require that men relinquish their privilege”. (Hartmann, p32)

A failure to demand the renunciation of male privilege as one of the key programs of revolutionary organizing can and has had serious consequences for women. “A society could undergo transition from capitalism to socialism, for example, and remain patriarchal,” writes Hartmann. (p17) A long term vision for women’s liberation, for home health aides as much as for middle- and upper-class women must be built from a coalition that transcends and redresses the racial and class divisions that have divided feminist revolution for so long. They must refuse to be marginalized by men. Hartmann points to the way forward:

“Women should not trust men to liberate them after the revolution, in part because there is no reason to think they would know how; in part, because there is no necessity for them to do so. In fact their immediate self-interest lies in our continued oppression. Instead, we must have our own organizations and our own power base.” (Hartmann, p32)

On the neoliberal times-table, home health aides have been divided even as they have been multiplied, enslaved in the name of emancipation. A careful and detailed look at their lives shows that the discourse of liberal feminism is full of holes. They have not escaped the frying pan of patriarchy -- the pan has only gotten bigger and hotter on the fire of capitalism. But while these women reveal to us the magnitude of the obstacles we face, their experiences also suggest a direction forward. These women, and their parents and grandparents before them, know how to heal their societies from the agonies of imperialism -- they have been doing it for centuries. They not only know that another world is possible, but they have been hard at work building it for a long time. As men, and as First World women, our first responsibility is to learn from them, and join the movement that they are already leading.


1 Incidentally, since the publication of Chang’s book, the INS (Immigration and Naturalization Service) has been subsumed into the Department of Homeland of Security, and replaced by Immigration and Customs Enforcement (ICE), which represents the administrative nexus of immigration policy and the War on Terror. This has only intensified the direction of the evidence referenced by Chang.

2 The reserve army of labor is a concept introduced by Karl Marx in reference to the tendency of capitalist economies to create a large population of the unemployed. This serves simultaneously to keep wages low by forcing the impoverished ‘reserve army’ to compete for even low-paying jobs, and to weaken the bargaining power of labor by maintaining a ready workforce of strikebreakers.

3 Anderson notes elsewhere that there is one cost that First World nations and peoples pay for this invisible foundation. (Anderson, p109) This is the cost of persecution. The pursuit, detention and deportation of immigrants is the greatest cost associated with their presence in the United States. This grotesque reward for the services rendered by immigrants keeps them in a state of fear and paranoia, thus preserving their vulnerability and willingness to accept the lowest wages, the longest hours, and the dirtiest work.

4 Ironically or not, it is probably relevant to point out that the World Bank and the IMF together employ about 1,000 migrant workers to do domestic work in both offices and the homes of World Bank and IMF employees. (Chang, p140)


Doing the Dirty Work The Global Politics of Domestic Labour by Bridget Anderson, 2000
Disposable Domestics Immigrant Workers in the Global Economy, by Grace Chang, 2000
Global Dimensions of Gender and Carework, edited by by Mary K. Zimmerman, Jacquelyn S. Litt and Christine E. Bose, 2006
Unhealthy Times Political Economy Perspectives on Health and Care in Canada, edited by Pat Armstrong, Hugh Armstrong and David Coburn
The American Health Empire by Barbara Ehrenreich, 1971
The Politics of Housework, by Redstockings, from Liberation Now! Writings from the Women’s Liberation Movement, 1971
On Marriage and Love, by Emma Goldman, 1917
Servants to Capital: Unpaid Domestic Labor and Paid Work by Nona Y. Glazer, 1984
The Discovery of “Unpaid Work”: The Social Consequences of the Expansion of “Work”, by Susan Himmelweit, 1995
Changes in the Labor Market Status of Black Women,1960-2000, by Cecilia A. Conrad, 2005
Fighting the Feminization of Poverty: Socialist-Feminist Analysis and Strategy, by Wendy Sarvasy and Judith Van Allen, 1984
The Unhappy Marriage of Marxism and Feminism: Towards a More Progressive Union, by Heidi Hartmann 1979
Organizing Domestic Workers, by Ari Paul, Z Magazine, December 2007
Domestic Workers United website:
Websites on Coke vs. Long Island Home Care:§ion=newsroom

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