Notes on the Nursing Crisis in the Philippines and U.S.

Overview

• Philippines faces a nursing shortage of over 20,000 nurses.
• Tens of thousands of nurses graduate yearly.
• The paradox: high graduation rate vs. significant shortage.

Historical Context

American Colonization (1898)

• U.S. colonization led to over 200,000 Filipino deaths.
• Introduced 'benevolent assimilation' policy to justify colonization.
• U.S. focused on education, infrastructure, and public health.

Nursing Education Development

• More than 10 nursing schools established in the Philippines in a decade.
• Filipino nurses trained in Western medical practices and English.
• Graduates prepared to work in the U.S.

Post World War II (1941 onwards)

• U.S. nursing shortage during the war led to programs like the Cadet Nurse Corps.
• Nearly 200,000 American women became nurses, but many left post-war.
• U.S. turned to Filipino nurses to fill vacancies.

Economic Factors

• Filipino nurses faced low wages (often less than janitors) in the Philippines.
• Many sought better opportunities abroad.
• Upon arriving in the U.S., many faced exploitation and minimal pay.

Changes in U.S. Immigration Policy (1960s)

• 1965 Immigration and Nationality Act changed the immigration landscape.
• Increased demand for nursing services due to Medicare/Medicaid and civil rights movements.
• Filipino nurses marketed with enticing ads promising bright futures.

Continued Discrimination and Challenges

• Discrimination faced by Filipino nurses in the U.S.
• Added licensing requirements limited entry into nursing.
• Many still ended up in lower-paid positions despite qualifications.

Migration Dynamics

• Philippine government promoted labor export, benefiting economically from remittances.
• Global migration led the Philippines to become the largest exporter of nurses.
• Around 20,000 nurses annually migrate to various countries.

Current Situation

• Roughly one-third of foreign-born nurses in the U.S. are Filipino.
• Exploitation issues persist, although some advocacy for better conditions exists.
• Filipino nurses disproportionately on the front lines, especially during COVID-19.

COVID-19 Impact

• 30 out of 318 healthcare workers lost to COVID-19 were Filipino.
• Temporary ban on healthcare workers leaving the Philippines during the pandemic.
• Long-standing overseas migration patterns conflict with local needs.

Conclusion

• Filipino nurses face ongoing challenges in both the Philippines and the U.S.
• They remain critical to healthcare, especially in crisis situations.