Rachel Brown’s Unsettled Labors: Migrant Care Work in Palestine/Israel (2024) theorizes migrant, home-based eldercare as a critical yet underexamined component of the economic, cultural, biological, and discursive reproduction of settler colonialism in Israel and Palestine, where almost 70,000 migrant caregivers are currently working (3). After the first Intifada in 1987, the Israeli government began granting visas to migrant workers from South and South East Asia and parts of Eastern Europe. Meanwhile, Palestinian workers who had formerly been employed in the home- and health-care sectors faced blockades, checkpoints, and crossing points. In her book, Brown develops the concept of “unsettled labors” to highlight how such reproductive labor carried out by migrant caregivers is positioned within and made indispensable to the settler state (5). She argues for the “the liminal positioning of migrant caregivers as workers whose ‘labor[s] of care’ disrupt the constitution of the Jewish Israeli home and nation as the exclusive realm of Jews, even as their labors ensure its reproduction” (4). Brown’s intervention is especially relevant for it provides a comparative analysis of the racialized positioning and relations of the settler, migrant, and native populations. Her book argues how migrant care labor becomes structurally necessary to the maintenance of settler life, while remaining politically and socially unrecognized, while also happening at the expense and the continued dispossession of Palestinian peoples (Brown, 2024).
This essay takes Brown’s concept of unsettled labor as a starting point, but shifts the analytical focus from labor alone to argue that health itself also operates as a constitutive mechanism of settler colonial governance. While Brown primarily examines labor relations and the political economy of care, I argue that the health of the settler state is not just supported by migrant labor, but is actively produced through the material exploitation and managed debilitation of migrant bodies. I further argue that health functions simultaneously as rationale, infrastructure, and technology that operates through regimes of surveillance and exclusion. This, in turn, organizes care systems and labor regimes and produces differential capacities for life and who gets to live. Unsettled labor then extends itself to be more than a labor relation but also a health relation: health becomes a biopolitical apparatus that organizes differential access to life, vitality, aging, kinship, and care. This analysis, I hope, highlights how migrant caregivers are positioned not only as workers, but as infrastructural supports for settler longevity.
As a case study, this essay will consider how Nepali workers are incorporated into global circuits of home-based care in Israel as racialized and geopolitically positioned bodies whose laboring capacities are mobilized to sustain settler life. I argue that this incorporation is not incidental, but structured through racial capitalism and settler colonialism, which have long relied on the circulation, extraction, and strategic placement of racialized workers, even from countries that have not been formerly colonized, across particular geographies to sustain regimes of accumulation, care, and reproduction. In this configuration, the health of aging, growing, and living Israeli bodies becomes inseparable from the health of the settler state. Eldercare, then, reveals that health is not simply about curing illness, but about governing aging, decline, and death in ways that secure the continuity of settler social worlds, kinship structures, and claims to permanence.
In Israel, neoliberal labor reforms since the mid-1990s facilitated a strategic reconfiguration of labor demographics, enabling the state to reduce its reliance on Palestinian workers and replace them with migrant laborers who are rendered politically disposable and territorially non-claiming. This shift reflects not only economic restructuring, but a settler colonial logic wherein Palestinian labor is framed as a demographic and political threat, while migrant labor is positioned as simultaneously necessary and replaceable (Brown 19). The recent bilateral labor agreements between Israel and Nepal, a context that marks the history of movement and migration of many of my family members, further materialize this dynamic. This settler colonial reorganization and outsourcing of care labor is instantiated in Israel’s bilateral labor agreements with Nepal, which formally institutionalize Nepali workers as “auxiliary workers” in long-term care and related sectors. In 2020, Israel and Nepal signed a framework agreement on the temporary employment of Nepali workers in specific labor market sectors in the State of Israel followed by an implementation protocol in January 2021. These agreements explicitly position Nepali workers within geriatric institutions, long-term care facilities, and home-based caregiving. On January 6, 2026, Nepali media reported that the government approved the deployment of Nepali workers to Israel’s agriculture and home-based caregiving sectors under an expanded bilateral labor framework. This followed Israel’s August 2025 request for approximately 1,000 auxiliary workers in agriculture and care, further institutionalizing the recruitment of Nepali labor into sectors central to the management of health, aging, and social reproduction. These agreements do not merely supply labor; they reorganize the conditions under which settler life is sustained and rendered continuous.
Even before the Nepali worker reaches the occupied lands in Israel to offer their labor, they are required to have been “medically examined, are in good mental and physical health and hold relevant medical certificates”. These medical screenings that Nepali workers must undergo to secure visas for Israel reinforces how health operates as a colonial technology rather than what it is positioned as: administrative requirement. Selected auxiliary workers are required to complete repeated and intensive health examinations prior to departure and at regular intervals, including tests for tuberculosis, hepatitis, kidney function, and other conditions (Nepal Health News, 2025). These screenings function as biopolitical sorting mechanisms that distinguish between bodies deemed fit for extraction and those rendered ineligible for mobility. Far from simply protecting public health, such regimes operate as technologies of selection that produce migrant workers as temporarily valuable, conditionally admissible, and perpetually surveilled biological subjects. In this sense, the bilateral care regime materializes what Neferti Tadiar theorizes as imperialism as a relation of dispossession intrinsic to exploitation: a system in which certain populations are positioned as reservoirs of life-making capacity whose depletion becomes the condition of possibility for other lives to be sustained (Tadiar, 2013). Workers must appear maximally healthy in order to be rendered employable but are also simultaneously inserted into labor regimes that predictably erode their physical and affective capacities.
Health here functions not to secure migrant well-being, but to guarantee their capacity to sustain settler longevity. The process of medical screening becomes a mechanism through which the state governs not only entry, but the temporal horizon of migrant life itself in Israel and Palestine — admitting workers only insofar as their bodies can be rendered useful for the maintenance of settler aging, while disavowing responsibility for the long-term health consequences of the nature of migrant care labor. Once illness, injury, or reproductive attachment threatens their status as auxiliary life, migrant workers become subject to exclusion or deportability. Health, thus, becomes a gatekeeping apparatus that aligns migrant vitality with settler futurity. At the same time, restrictions on family reunification, marriage, and the presence of children among workers makes migrant life structurally temporary and reproductively constrained. There is also a significant, under-explored dimension to this issue in relation to transnational surrogacy arrangements, including documented cases in which Israeli gay men have engaged Nepali women as gestational surrogates. While this article does not undertake a full analysis of these practices, their emergence points to a broader set of questions concerning the outsourcing of reproductive labor, the gendered and racialized political economy of fertility, and the uneven legal and ethical regimes that govern cross-border surrogacy. These policies ensure that migrant workers can sustain settler care, aging, and health while being prevented from establishing durable kinship, care networks, or futurities of their own within the settler state.
Read through Brown’s framework, unsettled labor then takes on an expanded meaning. It is not only unsettled in relation to citizenship, belonging, and political recognition, but also unsettled in relation to health, temporality, and futurity. Migrant caregivers occupy an unsettled position within settler health regimes ,as they are rendered indispensable to the reproduction of settler life yet excluded from the temporal and biological futures those regimes are designed to secure. This asymmetry reveals how unsettled labor is also unsettled reproduction: migrant workers are permitted to reproduce settler life but denied the conditions to reproduce their own social and biological lives within the settler polity.
Works Cited
Brown, Rachel H. Unsettled Labors: Migrant Care Work in Palestine/Israel. Duke University Press, 2024.
Tadiar, Neferti X. M. Remaindered Life. Duke University Press, 2022.
