MANILA, Philippines -- After decades of exporting its nurses to other countries, the Philippines is now pressuring them to stay home to fight the coronavirus.
The country, which is experiencing the second-most-deadly outbreak of the disease in Southeast Asia after Indonesia, has barred health workers with new contracts from overseas jobs and launched an emergency hiring program to shore up a medical system that was failing even before the pandemic began.
The changes mark one more twist in the complex history of Philippine nurses, whose professional origins date back to American colonial rule more than a century ago when they were trained to care for U.S. soldiers.
Often tapped to fill shortages in other nations, Philippine nurses are the backbone of many health care facilities across the world and disproportionately planted on the front lines against covid-19. In California, nearly one-fifth of registered nurses are ethnic Filipinos in a state where less than 4% of the population is Filipino.
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"If our nurses were to come back from overseas, the health care systems of those countries would collapse," said Ted Herbosa, former Philippine Health Department undersecretary and an adviser to the nation's covid-10 task force.
Nurses were once criticized for leaving the Philippines. But in the 1970s the country began promoting the export of caregivers and other Philippine workers whose remittances lifted the economy. Those who went abroad were portrayed as national heroes. Today, money sent home by Philippine workers accounts for 10% of the nation's gross domestic product, roughly equal to the role exports play in the U.S. economy.
The pandemic threatens that economic model. Philippine domestic workers can't reach employers in places like Hong Kong and Saudi Arabia, and the lull in maritime transportation, particularly cruise ships, threatens the livelihoods of hundreds of thousands of Philippine seafarers.
Nurses, on the other hand, are being told that jobs await them at home. But a tradition of exploitation marked by grueling work hours and little to no pay has left many skeptical to answer the call.
Safety concerns are high given the dearth of protective gear. At least 21 doctors and six nurses have died of the virus in the Philippines. President Rodrigo Duterte angered the medical community when he said in March that health workers were "lucky to die" in service of their country. Critics say the veneration of workers is designed to justify their sacrifice and obscure the government's failings.
"Filipino nurses have long been treated as products for export -- produced and marketed to wealthier countries looking to buy cheaper labor for their own understaffed hospitals," said Yasmin Ortiga, a sociologist at Singapore Management University and an expert on Philippine nurses. "The pandemic changes the dynamic in that now. ... But in the end, the nurses are still treated like commodities to use, and not as people who deserve proper compensation and support."
The government initially sought volunteers to plug the shortage of health workers with a $10 daily stipend. That was met with public anger, resulting in the introduction of the emergency hiring program that offers potential full-time employment, hazard pay and a lump sum of about $20,000 in case of death.
It is unclear if the country will find enough takers, especially among nurses angry about being barred from taking positions waiting for them in other countries. At least 1,700 applications have been received in the past two weeks, according to the health department, which is seeking 15,700 workers to staff its covid-19 facilities.
Nurse advocates say applicants are wary because the poor conditions and low wages that drive thousands of nurses to seek work overseas persist. Nurses are still waiting for the salary increase set by the Supreme Court in October that would triple wages in public hospitals to at least $600 a month.
A Section on 05/07/2020