Special Issue: Making Cities through Migration Industries
Urban Studies
2022, Vol. 59(11) 2294–2312
ÓUrban Studies Journal Limited 2022
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DOI: 10.1177/00420980221087048
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Moving nurses to cities:
On how migration industries
feed into glocal urban
assemblages in the care sector
Felicitas Hillmann
Technical University Berlin, Germany
Margaret Walton-Roberts
Wilfrid Laurier-University, Canada
Brenda S.A. Yeoh
National University of Singapore, Singapore
Abstract
Migration industries include a diverse array of migration-related services provided by the state,
commercial agents, humanitarian organisations and migrant social networks. The work performed
by this array of providers, both non-state and state actors, includes facilitating, filtering/channelling
and constraining migration. As a powerful example of how migration industries work in general,
we examine their dynamics in the care sector as part of glocal (care) chains involved in the migra-
tion of nurses. The article provides a conceptualisation of the role of the ‘migration industry’ as
part of a changing global business in the field of care work. We direct our attention to the drivers
and institutions that facilitate and shape the arrangements of international care mobility and the
constitution of glocal urban assemblages. Drawing on three models of nurse migration – bus stop
(Philippines–Singapore), two-step (India–Canada) and triple-win (Vietnam–Germany) – we show
how the socio-spatial configurations of glocal urban assemblages linked to the three models yield
different social integration outcomes for migrant nurses.
Corresponding author:
Felicitas Hillmann, Institute of Urban and Regional Planning,
networking unit Pardigm Shift,Technical University Berlin,
Straße des 17. Juni 135, Berlin 10623, Germany.
Email: hillmann@tu-berlin.de
Keywords
care, gender, glocal urban assemblages, governance, infrastructure, migration, nurses
Received October 2020; accepted February 2022
Introduction
The mobility of healthcare personnel as a
key feature of global migratory flows has
often been analysed using the global care
chains (GCC) approach that shows how
care deficits are filled through the migration
of predominantly poorer women from
less developed to higher income regions
(Hillmann, 2005; Hochschild and
Ehrenreich, 2002). Leveraging on ‘the inter-
national division of reproductive labour’
(Parren
˜as, 2003), ‘nurse production indus-
tries’ operate through what Yeates (2009)
calls ‘global nursing care chains’ (GNCCs)
that demonstrate how a hierarchy of nurse
recruitment and migration flows develops in
response to wage and non-wage differences,
professional status, opportunities for career
development and potential return remit-
tances to the family. Despite the uptake of
the GCC concept and the wealth of studies
highlighting the spatialities of the chains and
networks involved in GNCCs, limited atten-
tion has been given to the nodes along these
‘chains’, beyond identifying general Global
South–North directionality. Relatedly, anal-
ysis of migration industries organising the
circulation of care workers within urban cen-
tres is scarce in both GCC and urban
research (Fudge, 2011; McCann, 2004). This
article is thus motivated by the desire to fill
this gap at the intersection of care chain and
urban research. In arguing that care migra-
tion industries are an essential part of urban
assemblages, we show that these industries
are at the service of all kinds of interests and
reproduce power-laden practices between
people and places in terms of care migration,
thereby illustrating one example of how ‘the
introduction of market-type mechanisms
seems to have extended cities’ repertoire of
structural coordination’ (Leixnering et al.,
2021: 2948).
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Hillmann et al. 2295
Our article first outlines the theoretical
groundwork for understanding GNCCs’
spatial organisation, or as we term it, how
migration industries operate within glocal
urban assemblages in shaping nurse migra-
tion. Following a critical review of key con-
cepts that frame our arguments, and a
discussion of methodology, we illustrate our
arguments through an international compar-
ison of three pairs of regional dependencies
between providers from developing countries
to industrialised places: from the Philippines
to Singapore, from India to Canada and
from Vietnam to Germany. Through these
case studies, we show how glocal urban
assemblages operate as infrastructure shap-
ing, facilitating, directing and perpetuating
international flows under different modal-
ities of control and regulation. We fore-
ground the significance of the ‘urban’ and
links with transurban networks while draw-
ing out the kinds of mobility infrastructure
generated by the migration industry under
each model. We also consider the conse-
quences of these arrangements for the inte-
gration of migrant nurses in host cities.
Extending the global care chain
concept
Transnational migration researchers have
argued for the importance of institutions
and infrastructures in enabling or hindering
migrant mobility (Xiang and Lindquist,
2014); for example, in terms of how ‘nested
jurisdictional boundaries’ complicate achiev-
ing decent work (Fudge, 2011). In the case
of the GNCC, exporting nations frame poli-
cies to increase the value of labour, such as
developing language programmes to address
the needs of bilateral labour agreements,
which in turn determines the nursing migra-
tion circuits that nationals can become
embedded within (e.g. lower value regional
markets or higher value core English-speak-
ing service centres). Variations in the
formation of GNCCs are further influenced
by receiving countries’ social welfare models
(Pfau-Effinger and Geissler, 2005). In many
developed nations, austerity measures have
diminished the numbers of domestic nurses
and accorded low priority to retention and
retraining policies, thereby expanding space
for ‘flexible’ internationally trained nurses
(Schwiter and Steiner, 2020). Governance,
and more specifically credentialing, is
another pivotal issue demarcating mobility
within the GNCC. Mutual recognition and
bilateral agreements frame some regional
networks, although such framework utilisa-
tion and application has been limited (Te
et al., 2018). Moreover, immigration regimes
structure the process of settlement, length of
stay and rights nurses can secure (Walton-
Roberts, 2020). Additionally, if costs
increase and rewards are harder to secure,
this has implications for how effectively
migrant nurses can be integrated into the
workplace and the level of success experi-
enced (Ortiga and Macabasag, 2021).
While many of the essential activities that
are integral to producing, governing and
moving nursing labour across international
borders take place in cities, the significance
of the ‘urban’ is often elided. To address this
lacuna in the literature, we bring GNCC
analysis and studies of urban assemblage
together by focusing on how urban struc-
tures inform the migration and integration
of nursing labour through different config-
urations of the migration industry. It is
urban stakeholders – administrators, regula-
tors and financiers – that (re)form the migra-
tion industries through their practices,
connecting individuals to institutions within
migration regimes.
Moving towards glocal urban assemblages
We consider the processes of training,
recruiting, stratifying and integrating
migrant nurses as embedded in various
2296 Urban Studies 59(11)
urban nodes along diverse and complex tra-
jectories of migration of the GNCC. As the
place where educational resources are
located and designed, the city not only plays
a functional role in the organisation of care
labour’s distribution, but also serves as an
aspirational magnet for migrants, becoming
an important staging ground for achieving
goals, including those that entail onwards
and upward migration (Paul and Yeoh,
2021). Research that is explicit about how
care processes operate at different urban
scales has also identified important, but
nuanced, differences for urban and subur-
ban places (Pratt, 2002). The formation of
these by no means random distributions and
linkages within the care sector consolidates
urban hierarchies. In short, not only does
the city itself exert an important cultural,
social and economic gravitational pull on
migrants, the ‘urban’ assembles migration
institutions and industries that are integral
to regulatory control as well as to the filter-
ing and distribution of migrants.
The ‘urban’ consists of a dense, heteroge-
neous and often contradictory field of insti-
tutions and players that process migrants
and migration routes. In (re)arranging the
global flows of nurses, these urban assem-
blages must rely on and operate through
their relations to other places and scales and
perform within distinct sociotechnical geo-
metries of power (Wang, 2019: 4). Urban
assemblage approaches invite multiscalar
thinking, and thus analytically address the
contemporary city in relation to the global
condition (Kamalipour and Peimani, 2015:
405). Brenner et al. (2011: 225) explore how
assemblage theory is applied to critical urban
studies and argue for its use as an ‘explana-
tory tool for understanding the sociospatial
‘‘context of contexts’’ in which urban spaces
and locally embedded social forces are posi-
tioned’. Brenner et al. (2011: 237) argue for
assemblage analysis as empirical or metho-
dological extension of urban political
economy in the drive to explore ‘ongoing
market-driven regulatory experimentation
and intense sociopolitical contestation at all
spatial scales’. Precisely because it exposes
researchers to the complexity of actors,
objectives and means of action in producing
the urban fabric within the capitalist market
economy, urban assemblage thinking sheds
light on the hierarchical nexus between the
urban, where migrant care workers are
located, and migration industries, spurring
the mechanisms that direct migrant workers
to either the urban or beyond.
Viewing the city as an urban assemblage
not only alerts us to the machinery for
extracting labour and organising care chains
through hierarchy, market and network gov-
ernance modes (Leixnering et al., 2021); it
also foregrounds the city as an important
node in urban fields of imaginary and mate-
rial power between two places, but not
necessarily two states. The urban also deeply
shapes migrant experiences, since it is the
convergence point for multiple factors that
comprise the GNCC; travel hubs, education
sites, language training centres, credential
agencies, immigration offices, migration
intermediaries and employment brokers etc.
Even if the city is not the final port of call,
migrants must negotiate with services, func-
tions and power grids assembled at urban
sites. In other words, the urban context
frames the sites where the GNCC’s forma-
tions of inputs and outputs, territoriality
and structures of governance combine, come
to ground and relate to other more remote
places. Cities are often the sites where
migrants may stall or stay while paperwork
is processed and employment secured, and
the experience of living in the city may deter-
mine their subsequent trajectory to stay,
return, move onwards or engage in ‘multina-
tional migrations’ (Paul and Yeoh, 2021).
The heuristic concept of assemblage is of
value here, because it does not refer to a city
as a simple output or resultant formation,
Hillmann et al. 2297
but as being produced through uneven,
power-laden practices (McFarlane, 2011:
221), which we see in the centre of action
within the internationally competitive field
of nurse recruitment. Cities are complex
ensembles of different actors with different
resources and options, which form new insti-
tutional alliances in ‘market-driven regula-
tory experimentation’ (Brenner et al., 2011:
237).
It is hence at the scale of the glocal urban
assemblage where the matrix of opportuni-
ties that migrants engage and negotiate with
is situated. Glocalisation refers to being
recast both above and below the nation in
ways that alter power geometries and expose
tensions between hierarchy, markets and net-
works. This can be seen in ‘the strategies of
global localisation of key forms of industrial,
service and financial capital’ (Swyngedouw,
2004: 37), in the outcomes of exclusion
(Sassen, 2015: 99) and in the way processes
become structured (McFarlane, 2011: 222).
Rescaling and shifts in power geometries are
occurring in the GNCC, a global service that
sources, deploys and places migrant care
workers across places and networks rather
than between states. We speak of ‘glocal’ to
underline the way national regulations are
undercut by local actors and practices oper-
ating at the urban or inter-urban scale. The
politics of scale and territoriality is registered
in relations between actors within the assem-
blage, and in how migrants face multiple tip-
ping points between the intensity of
occupational stratification on the one hand,
and the relative urban opportunities and
resources they can access on the other.
Migrant responses to these matrixes of
opportunity can encourage them to stick and
commit to the urban, depending on the
degree to which they are attracted to the
quality of urban life, their own intersectional
positioning and other cosmopolitan advan-
tages. We thus prefer thinking of cities as
spatial assemblages produced by practices
that are constantly re-established, held
together, maintained and repaired by multi-
ple forces (Farı´as, 2011: 370). This approach
is warranted to map more closely the inputs,
outputs and territorial and distributional
effects of the GNCC. We see an important
role for glocal assemblages in orchestrating
this mobility, but also understand the impor-
tance of contextual difference that compara-
tive analysis reveals (see the fourth section).
Migration industries: Linking GNCC to
glocal urban assemblages
To understand better the emergence of glo-
cal urban assemblages, we make use of the
concept of migration industries that allows
us to analyse the underlying dynamics of this
process. Nyberg-Sørensen and Gammeltoft-
Hansen (2013: 6f) define the ‘migration
industry as the array of non-state actors
who provide services that facilitate, con-
strain or assist international migration’ with
the adherent subcategories of facilitation,
control and rescue. Migration industries are
about control, selection and management on
behalf of employers and state institutions,
comprising policies and practices of govern-
ments to regulate and manage migration
(Herna
´ndez-Leo
´n, 2013: 25).
The migration industry, as it pertains to
the mobility of nursing care labour, involves
a wide array of non-state and market actors,
often working in collaboration with state
agencies. Spaan and Hillmann (2013) point
to networks consisting of recruitment and
travel agencies, government training centres,
educational institutions, medical services,
advertisers and migration brokers, amongst
others, connecting countries of origin, desti-
nation and transit and supporting the perpe-
tuation of care-sector flows. The growth of
the migration industry in this sector aligns
with a general withdrawal of the state from
public welfare provision and coincides with
the increased participation of women in the
2298 Urban Studies 59(11)
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