Filipino senior carers on last November’s NHSTogether march
Filipino senior carers on last November’s NHSTogether march

‘Gloria Macapagal-Arroyo is like a poster girl promoting migration of Filipinos in the name of dollar remittances, at the expense of the poor’, the Secretary-General, of the Alliance of Health Workers (AHW), Philippines said yesterday.

‘The Arroyo Government and the first world treat the Filipino families and the Overseas Filipino Workers (OFWs) and migrants as simply collateral damages’.

At the International Assembly of Migrants & Refugees, Jossel I Ebesate, RN, MAN Candidate and Secretary-General, Alliance of Health Workers (AHW), produced the report ‘Migration of Health Workers & Professionals: The Philippine Experience.

The AHW issued a lengthy statement which is reported in an abridged form below. The report exposes the conditions of Phillipine export labour and condemns the Arroyo government for their complicity.

Ebesate said that migration affects the lives of around 90 million Filipinos, with 9 to 10 million officially coined as Overseas Filipino Workers or OFWs.

He said that the Assembly is therefore significant because it is being held at almost the same time as the 2nd Global Forum on Migration & Development (GFMD).

Ebesate wrote: ‘We, migrants, refugees and concerned organisations and individuals are strengthening our unity to fight for our rights in the face of a worsening global financial crisis affecting all countries.

‘The Philippines is the number one exporter of nurses worldwide with 85% of Filipino nurses working in some 50 countries.

‘Every month more than 2,000 nurses leave the Philippines to work abroad. More than 9,000 doctors left to work as nurses from 2002 to 2005. Other professionals like dentists, physical therapists, medical technologists, lawyers and engineers, are taking up nursing courses to work as nurses abroad. An estimated 15,000 health professionals leave the country annually for employment abroad.

‘Over the last five years, 50% of nurses employed in specialty hospitals like the Philippine Health Center, National Kidney & Transplant Institute, Lung Center of the Philippines & Philippine Children’s Medical Center, went abroad.

‘Doctors becoming nurses – a new phenomenon – has resulted in a 90% depletion of Municipal Health Officers, (doctors working in rural health centres) as well as anesthesiologists, obstetricians, paediatricians and surgeons. The demand for nurses is expected to increase by 600,000 between now and the year 2010.

‘Developed countries want skilled labour to take care of their sick and old population. Under imperialist globalisation countries like the USA, UK and others, thrive on the cheap labour of third world countries like the Philippines – 10 million Filipinos live and work in 197 countries.

‘The World Trade Organisation’s, General Agreement on Trade in Services (GATS) pursues the liberalisation of trade in services to encourage industrialised countries to poach the brightest and the best from poor countries while protecting their own.

‘Unemployment, low salaries, rising cost of commodities and services push many Filipinos abroad.

‘Health workers are among the most overworked workers in the world, yet, salaries remain at starvation level. A nurse should take care of 15 patients for an 8-hour shift, but nurses in the Philippines take care of up to 150 patients per shift.

‘Nurses receive a monthly salary of P6,000 (US$130) in private hospitals and P12,026 (US$261) in government hospitals.

‘A resident physician in a government hospital earns P19,168 (US$417) a month, way below the monthly cost of living of P27,100 (US $565) for a family of 6.

‘Health workers are deprived of overtime pay, night shift differential, housing allowance and holiday pay. Meager amounts are given for subsistence, clothing and laundry allowances. Health workers have to struggle earnestly for those benefits, despite all these benefits being mandated by law.

‘The Phillipine government are implementing reorganisation and streamlining programs which result in mass lay-offs. In state hospitals, operations and maintenance are being privatised.

‘As well as nurses, security services, dietary, pharmacy, laundry, engineering and maintenance workers become contractual workers.

‘Government agencies say that we have an ‘oversupply of nurses’. But aside from understaffing in the hospitals, there are many doctorless and nurse-less barangays (village districts) throughout the country, because there are no plantilla positions available or no takers for available positions.

‘The ‘oversupply’ – which is actually unemployment, results in exploitation in hospitals in the private and public sector through “volunteer” work and “trainings” in exchange for exorbitant fees but in most cases are made to cover for the understaffing in hospitals.

‘Freedom of expression is suppressed. Contractual health workers are prevented from joining unions or organisations while legitimate workers’ unions are being busted. Management refuse to negotiate with accredited workers unions. Union leaders are harassed. Pro-management & yellow unions are promoted.

‘The Philippine government’s Department of Health’s response is not to stop the brain drain. Government agencies do nothing to stop the sprouting of substandard profit-oriented nursing schools. A western-oriented and commercialised curriculum is being modified to further ‘prepare’ nurse graduates to work abroad.

‘The Arroyo government has a labour export policy to trade cheap labour in exchange for dollar remittances. A growing number of health professionals end up working as nanny’s, health care givers in home care institutions or live-in care givers.

‘In Canada, Filipino Nurses are recruited to work as registered nurses through the Live-in Caregiver Program that forces them to work as 24-hour domestic workers for the middle and upper class Canadian families.

‘In the UK, foreign nurses are made to pay their employer or recruitment agency for the opportunity to work. They are made to work as health care assistants, while they are processing their registration as professional nurses.

‘In the USA, some health professionals become victims of illegal recruitment. Like the 27 victims of the Sentosa Recruitment Agency in New York who were duped to work as agency nurses, rather than staff nurses.

‘Their wages were lowered and withheld as well as their green card. When they resigned they were charged with criminal and administrative charges by the hospitals and nursing homes together with Sentosa.

‘The case of illegal recruitment filed against Sentosa in the Philippine Overseas Employment Administration was dismissed after a government official intervened.

‘In the Middle East, nurses complained contract substitution is the norm. The free airfare promised by the agency is deducted from their salaries. There are reports of bullying.

‘Because of the continuing out-migration of health workers, health groups have predicted an impending health crisis at home unless the ‘exodus’ of health personnel is mitigated.

‘50% of the population has no access to health care. The Philippines is the record holder in tuberculosis but only 60% of the population has access to essential drugs. An average hospitalisation bill is three times average monthly income.

‘Fast turn-over of nurses further lowers the standard of care, because they are replaced with new inexperienced nurses.

‘Operating rooms are staffed with novice nurses, and experienced ones often work double shifts.

‘Due to the shortage of doctors and nurses in the hospitals and in rural areas, some 200 hospitals were completely closed, 800 partially closed in 2003 to 2005.

‘It is ironic that in a country exporting tens of thousands of nurses, seven out of 10 Filipinos are dying without being seen by health personnel.

‘The social cost is devastating. Those leaving the country suffer extreme loneliness and long for home. Family members suffer from the separation. Children of OFWs become victims of drug addiction, alcoholism, early pregnancy due to lack of parental guidance. Cases of infidelity and separation among married couples are increasing.

‘The Philippine government is callous and insensitive to cost-cutting measures dictated by the International Monetary Fund-World Bank in exchange for fresh loans.

‘The Arroyo government is more concerned in staying in power. It prioritises debt servicing and military expenditures in the national budget.

‘Forced migration is used to deflect social revolt due to the people’s discontent and it is used as a deception tool employed by the government to enable the daily survival of the of majority Filipinos.

‘The Philippines ranks 4th worldwide in terms of remittances earned with US $17 billion remittances in 2007 and constitutes the bulk of dollar reserves, used not for social services, but as a guarantee for foreign loans, payment for foreign debt and to cover for trade deficit.

‘If not for the remittances of the OFWs, the Philippine economy would have collapsed long ago.

‘As long as the Philippines remain as semi-colonial and semi-feudal society, it will be a steady source of cheap labour to exploit’ the document concluded.