Home > India > An expat/repat’s guide: moving with kids to India

An expat/repat’s guide: moving with kids to India

As India continues to thrive despite the global recession, the movement/return of skilled folks of all stripes into India has picked up.  A major consideration however is the impact on migrant families and several have asked me about our experiences.  To break down a broad topic, this post will focus on issues relating to young children who are otherwise happy in an OECD locale but  daddy/mommy would like to move to Mumbai/Delhi/Bangalore.

Kids younger than 3:

Your worries will be less about education and more about health care and early childhood development.

  • Pediatricians are decent and plentiful but to find one with the bedside manner your kids are comfortable with is nearly impossible.   We have settled for competence rather than comfort.
  • Beyond basic care, the country lacks pediatric specialists.  In Boston we were spoilt by easy access to pediatric cardiologists, orthopedists, ophthalmologists, dentists, etc. etc.    Their expertise was world class but more importantly they had infrastructure and training to take a two year old through complex procedures playfully.    Doctors in India are great but the in-clinic experience is not the same.
  • Pediatric grade tools (think endoscopes) are rare.  As are early childhood diagnostics: hearing tests, vision tests, behavioral analysis, etc. are not easy to find.   Same goes for speech therapy and other remedial development measures.
  • Most of the time, you are using pretty good adult grade facilities re-purposed for children.  It works but it is not optimal.
  • After you have found the doctor you like  you still need to watch out for aggressive medication.   Drugs, especially antibiotics and anti-depressants are over prescribed and professionals here are not used to having their opinions and procedures questioned.   Please do insist on knowing what is going on!
  • And last but not least, nobody maintains health records in their practice.    Patients maintain their records themselves but these are not routinely referred to and people switch doctors frequently so continuity in care is frequently lost.   So stay alert for drug interactions, allergy awareness etc.
  • And maintain the customary wariness when it comes to water uncooked food outside the home, and mosquitoes.

Older toddlers and young children

The same concerns about infant facilities  (above) are also relevant to older toddlers and children of all ages.    As the little ones get past 3, other issues creep up, prime among them are those related to education and recreation.

  • Gross motor development / physical activities:  Most cities are devoid of usable parks.  Swings, slides, climbing gyms, monkey-bars, swimming pools  are sub-standard even in premium/non-public settings.    Most cities do not have walkable sidewalks so going for a walk, or riding a bicycle is a “destination” activity – you have to find a place to do it and such places are not easy to find.   Clubs are a good place to find some facilities but no single club can meet all your needs.  A good school (see below) can also help.
  • As the kids get older getting some hiking/trekking in is a real option but you will have to travel some distance from the city to get serious.
  • Expat kids can find local kids aggressive in social situations.  Adapting to this has been challenging for some.


Every expat has a different perspective on this, but here are mine.

  • Traditional Indian schools have been known to be good for their academic rigor, focus on math/science, etc.   Almost all of them feature education in English, class sizes in excess of 50 students (for one teacher), and compulsory language education in regional languages of marginal utility.  Academics reign supreme over all other aspects of development and teaching is generally by the so-called “rote method.”  This generally involves being taught facts and figures which children need to “know” to get through periodic tests.  Contrast this with the experiential methods of the Montessori method or the IB PYP program.   These schools are generally semi-private but very affordable since they enjoy government subsidies.    Schools are run by non-profits of local repute or in a lot of cases by local church parishes.  Some are private but fees are still quite low compared to other countries (less than $1000 per year).   Generally speaking, extra-curricular facilities are minimalistic if at all.
  • International schools are popping up all over Indian cities and this is the newest trend in education here.  They usually follow IB or IGCSE curricula and correspondingly have low (13:1) student to teacher ratios and more modern teaching methods focused on experiential learning.   However, there is an acute shortage of trained teachers.  We have been appalled by what passes for a qualified teacher in some of these schools.   As schools proliferate, they are poaching talent from each other and the constant turnover is causing some angst in young kids who see teachers come and go.   Attrition rates are reportedly approaching the IT industry’s unenviable figures.  Facilities in these schools are hit-or-miss.
  • Expat schools are your best option if you have a short-term (few years at most) assignment in India.  These schools are usually staffed by expat teachers, follow native curricula of US, UK, German and French systems which makes it easy for kids to transfer in and out of.    Facilities are hit-or-miss here as well.  The in-class experience for our kids has been exactly what they experienced in the US including the diversity in the student body.   The downside is that most of these schools do not scale if you plan on being in India for long periods of time or indefinitely.   They are more expensive than private schooling in your home country.    Further, the school community including the teaching staff and management can be transient.

For the record, our twin daughters have been in an expat school but we are experimenting with an International school this summer.   The first impressions have not been favorable :-(  Getting into schools is not easy: few spots and tremendous demand make it hypercompetitive and a function of luck.   Hence, people tend to put up with underperformance.

All said, India is a great place to be despite the hardship – and to be fair a lot of expats do not see it as hardship at all – your mileage may vary.   Education and health care are challenging but as long as you are aware of them you can make informed decisions before and after you arrive.   The kids will learn from their travels and from the cultural mash up that this place is.   Springboard travel to other parts of Asia is also tantalizingly easy.    But there is an opportunity cost that the family incurs even as you take advantage of the business and career opportunities that exist here.

Categories: India
  1. Aamit Joshi
    September 4, 2009 at 2:19 pm

    Agree about the infrastructure, general lack of facilities and the blind acceptance to status-quo. There are many like you who are attracted to the India story but the story on-the-ground is far from satisfactory.

    The only positive is that things have improved tremendously over the last 5 and hopefully I will say this in 2013 again!

  2. Wendi
    October 5, 2015 at 5:53 pm

    Hi there! I appreciate that you have given some information here in regard to Pediatricians… I am also an expat that just relocated from Boston via Munich.. I have a 3 month year old infant and I need a pediatrician that is competent. Specifically we have to keep up with the current vaccination schedule… so I would really appreciate a recommendation if you have one! With Kind Thanks!!!\

    • Shyam Kamadolli
      October 5, 2015 at 10:07 pm

      Wendi – we are back in Boston for a few years, but my recollection is that there are a couple of pediatricians in South Mumbai who came highly recommended by other expats so I would ask around among the kids friends at school etc. We ended up using Dr Balsekar in Opera House who was pretty good and was well versed with western vaccination schedules. Just be aware that there are local vaccination regimes which are slightly different (oral vs injected), local infectious diseases etc.

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