The migration of Filipino nurses across the West

Tens of thousands of new nurses graduate every year in Philippines, and many of them move to the United States, Europe, Australia, and New Zealand. AMC uncovers the history behind this migration and looks at the contribution Filipino nurses have made to the front lines of the Covid-19 pandemic.  

How did this all begin? The Philippines became a United States colony in 1898. In the early 1900s, it set up nursing schools in the Philippines that taught an American curriculum in English. It was an effort by Americans to “civilise” - according to Vox, it was a “new kind of colonisation” that was marketed as bringing “public health benefits” to the Philippines.

These schools inadvertently prepared nurses to work in the US, too. During World War II there was a shortage of nurses Stateside, so the US set up a “non-migration” programme to get them there as inexpensive labour. They were only given temporary rights to be in the US, but many stayed, and built Filipino communities. This transformed the demographics of the US healthcare industry.

However, there was a major political event that also encouraged Filipinos out of their homeland well after the war. In 1972, under Ferdinand Marcos’s dictatorship, the Philippines experienced more than 3000 extrajudicial killings and tens of thousands of incarcerations and tortures under martial law. As a result, the economy fell into recession, unemployment skyrocketed, but instead of trying to manage this crisis nationally, the Filipino government actively promoted export of its labour to the West. This is because Filipino expats were already sending hundreds of millions of dollars back home to support their families, and the government wanted to keep that cashflow going (and increase it). This push led to global migration across Europe and Australia as well as North America.

According to Monina Hernandez, nurse, Massey university lecturer, and head of the Filipino Nurses Association of New Zealand, this journey made her home nation the number one producer of healthcare workers in the world. They’re internationally lauded as the best, too. “We have a four-year Bachelor of Science in Nursing (BSN) degree in the Philippines, as opposed to the three-year Bachelor of Nursing programme in New Zealand. The [BSN] includes science, maths and statistics courses not taught [elsewhere]. We learn microbiology, parasitology, obstetrics, gynaecology, and mental health is not a speciality, but a required course. Research is also taught from years 1-4 … in my time, we were even required to deliver five babies and provide neonatal care to these babies before we graduated. We are prepared to take on any task.”

Monina A Hernandez

Monina Hernandez | Photo: Supplied

Hernandez notes that Filipino nurses began to trickle into New Zealand in the 2000s. In 2006, the US began to close its doors to migrant nurses and they began to look to other English-speaking nations en masse, including New Zealand. Today, more than 5000 Filipino nurses in our nation gained their qualifications in the Philippines, making up more than nine percent of the workforce. Before the pandemic, immigration to New Zealand was easy as different nursing specialities were always on the essential skill shortage list, though Covid-19 has obviously thrown a spanner into the works for all migration routes.

Over in the US, Filipino nurses are concentrated in bedside and critical care, making them the most essential healthcare workers in the face of Covid-19. According to CNN, nearly a third of the nurses who've died of coronavirus in the US are Filipino, even though they make up just four percent of the nursing population nationwide. "I think Filipino nurses in the US are in specialised areas of care like critical and emergency nursing because of their willingness to upskill," says Hernandez. "Upskilling also leads to a higher pay. It's part of Filipino values - hard work and willingness to grow or progress in one's career. That's how we ended up in the US front lines."

While deaths for healthcare workers have thankfully been avoided in New Zealand, Filipino nurses here are putting themselves at risk every day too. Hernandez is one of them. “We will go wherever there is work to be done. I’m a clinical nurse specialist who covers six of the 18 Auckland-based Managed Isolation and Quarantine facilities/hotels. When my colleagues are away, I cover all 18 [hotels] on an advisory, consultancy, policy and clinical management basis,” she says. “As a nurse specialist for infection control, it’s a way of me showing gratitude to New Zealand, the country that has adopted me. A way to give back.”

Naturally, Filipinos remain dedicated to their families and the habit of sending money home continues today. “When Marcos imposed the export of labour in the 1970s, it wasn’t just nurses, it was construction workers, artists, doctors…” she says. “All sending USD back. Filipinos are a family-orientated people. We look after our elderly, and if you’re the oldest child, you’re expected to look after your younger siblings. Making sure their basic needs are always met by sending money home is an unwritten rule in our culture.”

- Asia Media Centre 

Banner photo courtesy of University of Southern California Libraries