DoH Also Exports Filipino Nurses Abroad

Can Filipino nurses known all over the world “to do their job with a smile, with charm, with grace, with the real purpose of helping to ease patients’ pain, work without looking at the clock or without minding overtime” be enticed to stay home? Most say, "I love the Philippines. But working as a nurse can barely cover the rent and the electricity.”

BY JOCELYN SANTOS
Reposted by Bulatlat.com

Within October nurses celebrate Nurses’ Week.  It is worthwhile to reflect on an issue affecting the country: the exodus of nurses, whose gain, whose loss. 

There is a worldwide shortage in nurses and Filipino nurses are again very much in demand. In the United States, there are job advertisements that say “preferably Filipinos.” In the Middle East, there was an article that states, if you want a job done, hire a Filipino.

The government, welcomes “job orders” for Filipino nurses. Overworked and underpaid Filipino nurses grab the opportunity in search for greener pastures.

To date there are 300,000 nurses working abroad.  In 2001, POEA reported 13,536 nurses – twice the figure of the previous year-- who have gone to 131 countries. Within January to August of this year alone, 7855 nurses have left.  USA and Canada have projected a need of about 10,000 nurses a year, United Kingdom 15,000, The Netherlands 44,000, Ireland 50,000 medical personnel including nurses, Norway 5,500 and Saudi Arabia 15,000. Japan, Singapore, Taiwan and Korea are expected to open its doors to foreign nurses. The demand for Filipino nurses is expected to increase in the next 10-15 years.

 The outflow of nurses to more affluent countries has weakened the country’s own health care system. According to the Alliance of Health Workers (AHW), in the last two years, 800 or 17 percent of nurses in 11 hospitals went abroad. Operating rooms are staffed with novice nurses, and experienced ones often work double shifts.  Gary Liberal, an OR nurse in Jose R. Reyes Memorial and Medical Center, said that 25 out of 30 of them, or 63 percent, have applied to go abroad.

Doctors who intend to go abroad enroll in nursing. In Bacolod City alone, at least 100 doctors have enrolled in a one-year course offered by a local college that would give them a nursing degree within one year. Even deans of nursing schools all over the country are scrounging for experienced clinical instructors for replacement to those who have migrated.

Measly wages are the primary reason that prods nurses to migrate.  Labor Secretary Patricia Sto. Tomas herself said, “It's not as if we can prevent people from leaving, and it's not like we can raise their salaries to approximate what's being offered." Currently, nurses with two or three years' experience earn only P6,000-10,000 a month, or $120 – $198 per month. US offers salaries of $18-45 per hour, or $144- $360 daily. Nor is the government about to grant the economic benefits to augment nurses’ incomes. There has been no budget allocation for the implementation of workers’ economic benefits won through the Magna Carta for Public Health Workers.  Benefits like subsistence allowance and hazard pay are delayed, cut, or totally not given.

Meanwhile, the Department of Health response to the problem is not to stop the brain drain. . Health Secretary Manuel Dayrit also said, “We can not stop them from leaving. Commission on Higher Education should make sure that the new two-year nursing courses offered in nursing schools adhere to local and international standards.” 

DoH response to the problem is to ensure production of competent nurses appropriate to demands of the world market.  In the process, nursing schools attune their curriculum more and more to western health care system to prepare graduates for jobs abroad. Hospital practice is being emphasized to the detriment of community nursing thus pre-conditioning students’ career in nursing. No wonder nurses, like other health professionals, stay put in urban health facilities rather than in rural communities where majority of Filipinos reside.

The ethical question of developed countries recruiting from poorer countries with problems in their own health care are altogether put aside.  Globalization of labor has been accepted as a solution to the shortage of nurses.  Developed countries want extra skilled labor to take care of their graying population. Their youth population no longer takes interest in the nursing profession due to relatively difficult, long hours and high stress working conditions; and riskier working conditions related to evening duty, care of the chronically ill and exposure to HIV/AIDS.

The globalization of labor has been accepted via the World Trade Organization’s specific provision, General Agreement on Trade in Services (GATS) which sets down disciplines and provides a framework for negotiations on the liberalization of services.  GATS encourages industrialized countries to poach the brightest and the best from poor countries while protecting their own. This translates to a migration policy of persons with high levels of education but are likely to be temporary and are working in leading sectors of the economy.  Under GATS, “human capital” can be imported, but borders are closed to immigrants, who are invariably assumed to be “colored,” resulting in institutionalized and legitimized racism.

While the Philippine government and the world commend the excellent performance and skills of overseas Filipino nurses, stories of their discrimination are kept low key. In Canada, Filipino nurses are recruited to work as registered nurses through the Live-in Caregiver Program (LCP), a Canadian immigration policy that forces Filipino nurses to work as domestic workers who clean, cook and care for the children and elderly of middle and upper class Canadian families.  Nurses become de-skilled and their personal and professional development become tragically stalled.

Nurses in the United Kingdom relayed a series of promises over salaries and accommodation that have been broken. They claim their housing costs have been raised in spite of their contract to include electricity, gas and council tax. The nurses also report that the free airfare promised by the recruitment agency is now being deducted from their salaries. 

In other countries, they encountered problems of being asked to sign new contracts that will commit them to less pay and more work, including some domestic duties. Some have been asked to do their employer’s ironing, or wash their car. There have also been reports of bullying. Nurses were not provided with job descriptions and some employers have asked to be paid if the nurse leaves before the end of three years, even though they had only agreed to work for two.

These hazards do not discourage migration.  The nurse, experienced or a fresh graduate, continues to be lured abroad. Choice for employment is determined by recruitment incentives: salary, free test reviews and registration on required nursing examinations, free airfare and accommodation in taking foreign-based exams, free one-way airfare to destination, one to three months free housing, assistance in securing SSS and driver’s license, free life and health insurance, paid vacation leaves for over two weeks after one year of service and a recruitment bonus of $5,000-$6,000 as sign-in privilege or given at the end of the second year of service. A major consideration is an immigrant visa that allows them to bring their immediate family members with them.

Can Filipino nurses known all over the world “to do their job with a smile, with charm, with grace, with the real purpose of helping to ease patients’ pain, work without looking at the clock or without minding overtime” be enticed to stay home? Most say, "I love the Philippines. But working as a nurse can barely cover the rent and the electricity.”

The solution lies in changing the inherent system of Philippine society. The problem of forced migration will not end unless employment opportunities in the Philippines improve. The country needs national industrialization that is based on developed agriculture to create jobs to meet the needs and aspirations of  Filipinos; and not that of foreign interests. Reposted by Bulatlat.com

*Member,Policy Studies, Health Alliance for Democracy

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