The potent lever toil: Nursing development and exportation in the postcolonial Philippines

American Journal of Public Health

Volumn 100, Issue 9, 2010, Pages 1572-1581

  Brush, Barbara L ^a  

^a UNIVERSITY OF MICHIGAN   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; DEVELOPED COUNTRY; DEVELOPING COUNTRY; FOREIGN WORKER; HISTORY; HUMAN; MIGRATION; NURSING STAFF; PHILIPPINES; UNITED STATES;

DEVELOPED COUNTRIES; DEVELOPING COUNTRIES; EMIGRATION AND IMMIGRATION; FOREIGN PROFESSIONAL PERSONNEL; HISTORY, 20TH CENTURY; HISTORY, 21ST CENTURY; HUMANS; NURSING STAFF; PHILIPPINES; UNITED STATES;

EID: 77956249986     PISSN: 00900036     EISSN: 15410048     Source Type: Journal    
DOI: 10.2105/AJPH.2009.181222     Document Type: Article

References (93)

1. Mireille Kingma, Nurses on the Move: Migration and the Global Health Care Economy (Ithaca, NY: IRS Press, 2006).
2. Most of these efforts target the health workforce in developing countries. See International Migration of Health Personnel: A Challenge for Health Systems in Developing Countries (Geneva: World Health Organization, 2008).
3. Also see Kwadwo Mensah, Maureen Mackintosh, and Leroi Henry, The 'Skills Drain' of Health Professionals from the Developing World: A Framework for Policy Formulation (London: Medact, 2005);
4. Annie Willens and Tim Martineau, Ethical International Recruitment of Health Professionals: Will Codes of Practice Protect Developing Country Health Systems? (Liverpool, England: Liverpool School of Tropical Medicine, 2004);
5. James Buchan and Lynn Caiman, The Global Shortage of Registered Nurses: An Overview of Issues and Actions (Geneva: International Council of Nurses, 2004);
6. and An Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa (Boston: Physicians for Human Rights, 2004).
7. The international movement of Filipino nurses over time has been chronicled by Catherine Ceniza Choy in Empire of Care: Nursing and Migration in Filipino American History (Durham, NC: Duke University Press, 2003)
8. and Barbara L. Brash, Julie Sochalski, and Arm M. Berger, "Imported Care: Recruiting Foreign Nurses to U.S. Health Care Facilities," Health Affairs 23 (2004): 78-87.
9. Nicola Yeates, "Production for Export: The Role of the State in the Development and Operation of Global Care Chains," Population, Space and Place 15 (2009): 175-187.
10. Vicente B. Valdẽpeňas, "The Economic Challenge in the Philippines," Philippine Studies 16 (1968): 278-296.
11. Marcial P. Lichauco's Roxas: The Story of a Great Filipino and of the Political Era in Which He Lived (Manila: Kiko Printing Press, 1952) provides an excellent account of Roxas' life from, childhood to death.
12. Lichauco, Roxas: The Story of a Great Filipino, 124.
13. Manuel Roxas, The Problems of Philippine Rehabilitation and Trade Relations (Manila: Bureau of Printing, 1947).
14. Roxas, The Problems of Philippine Rehabilitation, 7. These funds were allocated through the Philippines Trade Act and the Philippine War Damage Act passed by the US Senate in 1946.
15. Stanley Karnow, In Our Image: America's Empire in the Philippines (New York: Ballantine Books, 1989), 333.
16. See Victor G. Heiser, "Sanitation in the Philippine Islands Since American Occupations, With Particular Reference to Reduction in Mortality by Elimination of Intestinal Parasites, Especially Uncinaria," Journal of the American Medical Association, 52 (1909): 97-99;
17. H. Lara, "The Cause of the Unusually High Rate of Prevalence of Typhoid Fever in the City of Manila," Rockefeller Archives Collection, Tarrytown, NY, R.G. 1.1, 242 C, Box 20, Folder 123;
18. R.G. Padua and W. D. Tiedeman, "Preliminary Report on the Malaria Situation in the Province of Laguna," Rockefeller Archives Collection, Tarrytown, NY, R.G. 1.1, Series 242, Box 20, Folder 124.
19. Roxas' administration accomplishments are highlighted in great detail in a 36-page pamphlet titled "A Brief Record of the Accomplishments of President Roxas from the lime He Took Office on May 28, 1946 to October 4, 1947," University of Michigan, Buhr Shelving Facility, Ann Arbor, MI. The pamphlet, whose author is unknown, was probably published in Manila in late 1947 or 1948. The administration's health agenda is itemized on page 32.
20. Unknown author, "A Brief Record of the Accomplishments of President Roxas," University of Michigan, Buhr Shelving Facility, Ann Arbor, MI.
21. Antonio J. A. Pido, The Filipinos in America: Macro/Micro Dimensions of Immigration and Integration (New York: Center for Migration Studies, 1986), 62. Pido notes that by the early 1960s, the Philippines was ranked second in the world, behind the United States, in the number of college students per population.
22. Julita V. Sotejo, "The Nursing Profession in the Philippines," International Nursing Bulletin (Winter 1948): 6-7.
23. Julita V. Sotejo, "Professional and Educational Objectives of the Philippine University School of Nursing," International Nursing Review 5 (1958): 16-21.
24. Julita V. Sotejo, "Status of Nursing in the Philippines," The Filipino Nurse 20 (1951): 52-55.
25. According to alumni files at the University of Michigan, Lorena Jane Murray was born on August 21, 1901, in Ash Grove, MO; she earned a nursing certificate from the University of Michigan in 1923, a BS in public health nursing from Wayne State University in Detroit in 1934, and an MS in public health nursing from the University of Michigan in 1937. Her master's thesis focused on appraising nurse programs in Michigan, particularly those run solely by nurses in community settings. See Lorena J. Murray, "Means of Appraisal for Lone County Nurses: Presented as Results of a Study of Activities Common to Lone Nurse Programs in Michigan," University of Michigan, Buhr Shelving Facility, Ann Arbor, MI.
26. Sotejo, "Status of Nursing," 53, 55. Sotejo was the president of the Filipino Nurses Association at the time of the survey.
27. Sotejo, "Status of Nursing," 55. Public health, nurses in the country's mountain communities were deemed critical.
28. Sotejo, "Status of Nursing," 54. The population figure was estimated on the basis of a population census that recorded 19234182 people living in the Philippines in 1948.
29. Conchita Ruiz, "Is There a Real Shortage of Nurses?" International Nursing Review 5 (1958): 18-19.
30. American Nurses Association, "Are You Intending to Go Abroad?" The Filipino Nurse 17 (1948): 141-147.
31. Soledad A. Buenate, "Highlights of the FNA Activities during 1963," Philippine Journal of Nursing 33 (1964): 41.
32. In "'Brain Drain' from the Philippines?" Philippine Journal of Nursing 36 (1967), 248,
33. Conchita B. Ruiz noted that nurses "remit part of their earnings to their families at home; this in turn brings in dollars or pounds to the Philippines and improves the financial conditions of Filipino families."
34. Patria G. Alinea and Gloria B. Senador, "Leaving for Abroad? Here's a Word of Caution," Philippine Journal of Nursing 42 (1973): 92-94.
35. Eufrosina P. Balanon, "My Experiences in U.S.A.," Philippine Journal of Nursing 33 (1964): 90-91.
36. Ironically, Unite was runner-up "employee of the year" during his 2-year exchange rotation at Chicago's St. Mary of Nazareth Hospital in 1968. Clearly, the lines between exchangee and employee remained blurry throughout the program's 20 years. See "Personalities Abroad," Philippine Journal of Nursing 46 (1977): 35.
37. Barbara L. Brash, and Anne M. Berger, "Sending for Nurses: Foreign Nurse Migration, 1965-2002," Nursing and Health Policy Review 1 (2002): 103-115.
38. Catherine Ceniza Choy, Empire of Care: Nursing and Migration in Filipino American History (Durham, NC: Duke University Press, 2004).
39. Physicians, Dentists, and Nurses: Medical, Dental and Nursing Schools 1810-1970 (Washington, DC: US Bureau of the Census, 1975).
40. .See Conchita B. Ruiz, "Editorial: lhe Exchange Visitor's Program for Nurses," Philippine Journal of Nursing 35 (1966): 4.
41. Frank C. Tui, "The Nursing Profession in a Changing World," Philippine Journal of Nursing 34 (1965): 293.
42. Some, as noted by Pido in The Filipinos in America, 85, were "fly-by-night operators" who victimized individuals with false claims, stealing paid advances or failing to live up to promises made.
43. Manila Educational Exchange Placement and Travel Service advertisement published in the Philippine Journal of Nursing 35 (1966).
44. Both airlines placed advertisements in Philippine Journal of Nursing in 1964 and 1965. Pan Am's "fly now, pay later" plan was quite popular, allowing emigrating nurses to take advantage of flights and make monthly payments after securing employment, often with interest attached.
45. Advertisement published in the Philippine Journal of Nursing 37 (1968).
46. Pura S. Castrence, "Challenge to the Filipino Nurses," Philippine Journal of Nursing 35 (1966): 206.
47. Epifanio B. Castillejos, "The Exchange Visitors Program: Report and Recommendation," Philippine Journal of Nursing 35 (1966): 306.
48. Responding to the concerns of Castrence, Castillejos, and others, the Philippines Nurses Association, the Department of Foreign Affairs, and the Philippines Department of Labor joined forces against exploitation of Filipino exchange visitor nurses and developed a processing mechanism to screen and validate requests for nurses from, overseas recruiting agencies and hospitals. See "Processing Requests for the Recruitment of Nurses for Employment in Foreign Countries," Philippine Journal of Nursing 37 (1967): 127-128, and
49. Rosario S. Diamante, "Our Filipino Nurses in the United States," Philippine Journal of Nursing 36 (1967): 319.
50. Alfonso Mejia, Helena Pizurski, and Erica Royston, Physician and Nurse Migration: Analysis and Policy Implications (Geneva: World Health Organization, 1979).
51. Figures based on a 1961 study of the Philippines Bureau of the Census and Statistics reported by Vincente B. Valdẽpeňas, "The Economic Challenge in the Philippines," Philippine Studies 16 (1968): 278-296.
52. Karnow, In Our Image.
53. Karnow, In Our Image, 382. Three years later, however, on September 22, 1972, Marcos imposed martial law, arguing that social reform demanded such action. With this, Marcos assumed all powers of government and suspended or denied previously held rights to peaceful assembly, free speech, and labor organization. See Ruby R. Paredes, ed., Philippine Colonial Democracy (New Haven, CT: Yale Center for International and Area Studies, 1988),
54. and David Joel Steinberg, The Philippines: A Singular and a Plural Place, 2nd ed. (Boulder, CO: Westview Press, 1990).
55. "Address of His Excellency, President Ferdinand E. Marcos," Philippine Journal of Nursing 43 (1974): 18-23.
56. Choy, Empire of Care, 98.
57. "Address of His Excellency," 23.
58. Adlai J. Amor, "Philippine Nurses: Bust After a Boom," Philippine Journal of Nursing 47 (1978): 6.
59. Nurses were among the more than 300 000 Filipinos who emigrated to the United States during the Marcos era. As a result of their sending remittances home, some of the national debt was onset. Steinberg, The Philippines- A Singular and a Plural Place, 129.
60. Ernesto M. Pernia, "lhe Question of the Brain Drain from the Philippines. International Migration Review 10 (1976): 63-73.
61. Pura Santillan-Castrenci, "There Is Nothing Like a Filipino Nurse," Philippine Journal of Nursing 36 (1967): 3.
62. Fe Isaac-Sano, "Filipino Nurses Still Seeking Identity, Recognition," Philippine Journal of Nursing 45 (1976): 95.
63. Adelaida G. Makabali, "Nursing in the New Society," Philippine Journal of Nursing 43 (1974)27-31.
64. "Letter to President Ferdinand E. Marcos from Winnie W. Luzon, President PNA," Philippine Journal of Nursing 42 (1973): 240-242.
65. Maria R. Pablico, "A Survey on Attitudes of Filipino Nurses Toward the Nursing Profession in the Philippines," Philippine Journal of Nursing 41 (1972): 107-114.
66. These findings mirrored those of Radcliffe Rodehaver in an earlier study of brain drain ("A Study of Brain Drain," Graphic, February 25, 1970: 56)
67. cited by Asperilla Purita Falgui in her doctoral dissertation, The Mobility of Filipino Nurses (Teachers College, Columbia University, 1971), 74.
68. Clarita Go Miraflor, The Philippine Nurse: Implications for Orientation and In-Service Education for Foreign Nurses in the United States (PhD dissertation, Loyola University of Chicago, 1976).
69. Meg McSherry Breslin, "A Prosperous Life, and Love, Awaited." Available at: http://www.chicagotribune. com/news/local/chi-borders-6story,0, 7951838.story. Accessed April 22, 2010. Dumlao immigrated in 1980 and remained in the United States.
70. Lolita Campos, interview by Barbara L. Brash, August 19, 1993, Cabrini Medical Center, New York City.
71. Campos, interview by Brush. Campos noted that "the reason why so many Filipinos gravitated to Cabrini Medical Center from the very beginning was because it is a Catholic institution, and because the majority of Filipino nurses ... 90% are Catholic." Campos remained at Cabrini Medical Center her entire career, retiring in 2008 when the hospital closed owing to New York City hospital reform efforts (correspondence with author, 2008).
72. L.A., interview by Barbara L. Brush, August 19, 1993, Cabrini Medical Center, New York City.
73. L.A., interview by Brash.
74. Nary Lopez, The Acculturation of Selected Filipino Nurses to Nursing Practice in the United States (PhD dissertation, University of Pennsylvania, 1990).
75. Miraflor, The Philippine Nurse, 87.
76. "News from Abroad," Philippine Journal of Nursing 45 (1976): 58.
77. "News from Abroad," 58.
78. "PNA Chapter News from Abroad: Philippine Nurses Association of New Jersey," Philippine Journal of Nursing 45 (1976): 203.
79. Georgiana Rose Tutay, "The Philippine Nurse Association of Michigan: A Dream Come True," Philippine Journal of Nursing 43 (1974): 203.
80. Choy provides an excellent and detailed analysis of the trials of Filipina Narciso and Leonora Perez in Empire of Care, 139-165.
81. Georgiana Rose Tutay, 'The Dilemma of Some of Our Colleagues Abroad," Philippine Journal of Nursing 44 (1975): 150.
82. Tutay, then president of the Michigan chapter of the Philippine Nurses Association, informed readers of the group's efforts to collaborate with 3 other local Filipino organizations in an appeal to Michigan governor Milliken, asking him to provide legislation providing newly emigrating Filipino nurses "time to acclimate to their new environment and culture" before being subjected to examination.
83. "From News and Views: NarcisoPerez Legal Defense Fund Established in Michigan," Philippine Journal of Nursing Volume 45(1976): 147.
84. James A. Tyner, The Philippines: Mobilities, Identities, Globalization (New York: Routledge, 2009). Tyner discusses the Philippine Overseas Employment Administraticm and its role in managing migration and helping to create the country's status as the world's largest exporter of government-sponsored labor.
85. The Philippine Nurses Association Nurse Manpower Survey of 1987 was detailed in a subsequent report by the Philippines .Senate Committee on Health., chaired by Senator Edgardo J. Angara. See Where the Nurses Are: Report of the Senate Committee on Health (Manila: Philippines Senate Committee on Health, 1989).
86. Doyle Velasco, "The Working Nurse." Available at: http://skylinecollege.edu/library/oralhist/Velasco/essay. htm. Accessed April 22, 2010. A student writing a paper for his class, Velasco interviewed his mother, who immigrated to the United States with her family in 1985.
87. Philippine Overseas Employment Administration, "Statistics 1992-2003." Available at: http://www.poea.gov.ph/ html/statistics.html. Accessed April 22, 2010.
88. Philip Martin, Manolo Abella, and Elizabeth Midgley, "Best Practices to Manage Migration: The Philippines," International Migration Review 38 (2004): 1544-1559.
89. Atenodoro R. Ruiz, "Why Doctora Become Overseas Nurses," The Manila Times. Available at: http://www.valuemd.com/relaxing-lounge/17066-manila- times-article-why-doctors-becomeoverseas-nurses.html. Accessed April 22, 2010.
90. Carlos H. Conde, "A Sick Health Care System," Bulatlat. Available at: http://carlosconde.com/2004/08/17/asick-health-care-system/. Accessed April 22, 2010.
91. Jaime Z. Galvez-Tan, Fernando S. Sanchez, and Virginia L. Balanon, "The Brain Drain Phenomenon and Its Implication for Health." Available at: http://www.up.edu.ph/oldforum/2005/Jul-Aug05/brain-drain.htm. Accessed April 22, 2010.
92. Chit Estella, "Lack of Nurses Burdens an Ailing Healthcare System." Available at: http://www.pcij.org/stories/print/2005/nurses.html. Accessed April 22, 2010.
93. Dula F. Pacquiao, "Recruitment of Philippine Nurses to the United States: Implications for Policy Development," Nursing and Health Policy Review 3 (2004): 167-178.