India's caregivers in Israel: the Keralites at the bedside of a nation
For two decades, Israel's elderly have been cared for by Malayalis from Kerala — India's oldest foothold in the Israeli workforce. Now a post-war labour deal is turning that quiet community of a few thousand into a pipeline of tens of thousands.
Before dawn in a Tel Aviv apartment, a woman from Kerala helps an elderly Israeli out of bed, measures out the morning's medicines, and starts the day she has started a thousand times. She is India's oldest and quietest presence in Israel — not a soldier of a diaspora, not a founder, but a caregiver, one of several thousand Malayalis who have spent two decades at the bedsides of a fast-ageing nation.
Long before headlines about construction workers, this was the shape of the modern Indian community in Israel. As of early 2023 the Ministry of External Affairs counted about 12,500 Indian nationals in the country; the majority were from Kerala, and most of those were caregivers. Kerala's own expatriate agency, NORKA Roots, estimates more than 7,000 Malayalis are engaged in caregiving in Israel. Alongside them sit two smaller, older strands: the diamond traders of Ramat Gan and the tech workers of the Tel Aviv suburbs.
Why Kerala, why caregiving
The match is almost demographic destiny. Israel's population is ageing and its long-term-care system leans heavily on live-in foreign caregivers — metaplot, in Hebrew — hired on dedicated work permits. Kerala, meanwhile, has exported trained nurses and carers for half a century, from the Gulf to the West, backed by a culture of nursing education and a long habit of migration. Israeli wages dwarf what the same work pays in India, and the live-in arrangement means a carer can save and send almost everything home. Israeli demand, for its part, is not a passing thing: Israel is one of the developed world's fastest-ageing societies, and its shortage of hands to care for the elderly is structural rather than temporary — which is why demand for foreign caregivers has held for two decades and shows no sign of easing. Those remittances rebuild houses and fund educations across central Kerala; the mechanics of moving that money are the same ones we lay out in our guide to sending money home.
The work is intimate and hard. A live-in caregiver's day has no clock; the job is as much companionship as nursing, often in a language learned on the job. Many stay for years with a single family, becoming, in effect, part of it.
Inside the permit system
Caregivers do not simply arrive. Israel's long-term-care sector runs on a tightly regulated permit: a foreign worker is matched to a specific elderly or disabled Israeli, and the visa is tied to that care relationship. For years the placements ran through private manpower agencies on both sides — a system that too often loaded workers with heavy recruitment fees before they had earned a single shekel. Cutting out those middlemen was much of the point of the government-to-government channel the two countries later built: transparent contracts, capped fees and legal recourse, at least on paper. For a nurse from Kottayam weighing the move, the difference between an honest agency and a predatory one could decide whether years abroad ended in savings or in debt.
The war, and the pipeline
Then the ground shifted. After the Hamas attack of October 2023 and the war in Gaza that followed, Israel revoked the permits of tens of thousands of Palestinian workers who had underpinned its construction and care sectors. It turned to India to fill the gap — and India, with a framework already in place, was ready.
The two countries had initiated a Framework Agreement on temporary employment in May 2023, formalised as a government-to-government arrangement that November, covering tens of thousands of workers in construction and caregiving. After the war, recruitment accelerated sharply: Israel ran drives in India for 10,000 construction workers and 5,000 caregivers at a stretch. By mid-2025, at least 20,000 Indian workers had arrived since the war began, and the two governments have spoken of raising the number of Indians in Israel toward 50,000 by 2030.
Two decades in
The caregivers did not come alone, and they did not come yesterday. Around them, over twenty years, a small Malayali world has taken root in Israel: Sunday congregations in Kerala's Christian traditions, Onam meals cooked far from home, and Malayalam WhatsApp groups that pass news of permits, employers and flights back to Kochi. It is not a showy diaspora — no grand cultural centres, no festivals that make the newspapers — but it is a real one, held together by shared work and a shared home state.
Its footprint is felt most back in Kerala. A caregiver's salary, saved hard across years of live-in work, comes home as a new house in Kottayam or Thrissur, a daughter's college fees, a loan finally cleared. Kerala's economy has long run on remittances from the Gulf; Israel is a smaller, newer tributary of the same river of money. Many caregivers spend the better part of a decade there, learning Hebrew at the bedside, before returning to the lives their wages built.
Opportunity, and its price
For a worker from Kerala or Uttar Pradesh, the arithmetic is powerful — Israeli pay can be several times an Indian wage, on legal, contracted terms designed, both governments say, to prevent the exploitation that dogs irregular migration. But the same numbers carry an uncomfortable context. Critics, including some rights groups, have questioned the ethics of sending Indian labour to replace Palestinian workers amid the Gaza war, and of placing them in an active conflict zone. The danger is not abstract: earlier in the war, a caregiver from Kerala was among those killed by rocket fire in southern Israel. New Delhi has pointed to safety protocols and evacuation readiness; workers, for the most part, have weighed the risk and gone anyway.
That is the tension at the heart of India's newest community in Israel. For the Keralite at the bedside, it is a job that pays for a house and a future back home. For two governments, it is geopolitics conducted through work permits. Both things are true at once — and the numbers, still climbing, suggest the pipeline is only widening. The policy behind it is set out in our brief on the India–Israel labour deal; the far older Indian presence in the country — the 85,000 Jews of Indian origin — is a different story entirely.
