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Why nurses leave the Philippines
Stories by Mike Comerford
Most of the graduates are Filipinos. Many were living in the Philippines just months ago. Jonathan Gueco, 16, stands next to his brother Jonel, 18, at the Meridian Banquet Hall. Both immigrated last year and live with their father and two sisters in Hoffman Estates. Yet, as happy as he is at the applause, Jonathan Gueco's thoughts flash back to his mother, Adelina, in Manila. "I think of her all the time," he says. About 8,000 miles and 22 hours away, in Tacloban City on the central Philippine island of Leyte, another group of teenagers hangs out at a McDonald's in checkered nurse uniforms. They shriek with laughter after being asked if anyone at their nursing school wants to work abroad. Stepping forward with her textbook in hand is Candice Maecinco, an extroverted 19-year-old. "I think about 99.9 percent of us do," she says. As difficult as immigration might be, it isn't slowing the number of young Filipinos in the health-care industry who want to be sent abroad. In fact, there is evidence expatriation is rising. Because they speak English and are educated in an American-based school system, Filipinos are a highly recruited nationality. For them, it's a ticket out of an economically struggling country and into a field that some say fits well with a culture that prizes nurturing, especially in women. The number of nursing schools in the Philippines will double next year, according to a recent University of the Philippines study. It's a sure bet it's not the $120 to $220 a month many nurses make in the Philippines that's attracting students. Nurses are leaving the country three times faster than they are entering the Philippine work force, according to a Philippine study. A 2001 survey by the U.S.-based Commission on Graduates of Foreign Nursing Schools found 41 percent of the 789 respondents received their nursing education in the Philippines. And because the job demand in industrialized countries is for nurses, not doctors, the same study estimates that 4,000 Philippine doctors are enrolled in nursing schools. Tailored nursing classes speed the process for doctors who would have a tougher time gaining U.S. entry as physicians. Given that an entry-level doctor will make less than $4,000 a year in the Philippines, nursing in America for $40,000 a year becomes the proverbial carrot at the end of a long stick. Elmer Reyes Jacinto is symbolic of this trend. Last year, when he topped the national medical board exams, he promptly announced he would not be going to medical school in the Philippines. Instead, he took a nursing job in Florida. The recruiters South Barrington physician Nela Cordero's trip to provide health care in Puerto Princesa is swamped with patients. The exodus of nurses and doctors to foreign lands is part of the reason the need for care is so great. Still, when Des Plaines resident and Philippine immigrant Wilma Tougas finishes with this mission health-care work, she's going to Mindanao and Manila to recruit nurses for the Chicago-area market. Chicago-area nursing homes and hospitals want nurses "yesterday," she says. The Philippines already is the largest exporter of nurses in the world, according to the National Institutes of Health in Manila. It is the second-largest exporter of doctors, after India. There are nearly 300,000 Philippine-born nurses working abroad, according to World Health Organization estimates. The lack of health-care workers in the Philippines is so acute the Philippine Medical Association is trying to get physicians and nurses to sign pledges to stay in the country. But Tougas' KC Placement Services offers to smooth the way for nurses with passport services, a free flight and a place to stay in Chicago. It doesn't sound all bad to one Manila nurse taking a break at the Puerto Princesa medical mission site. "I'm curious about the place," says Jun Consad. "I'd do it for the experience." Tougas is a Realtor with a background as a bank examiner, auditor and Catholic school math teacher. She says she wouldn't be in the nurse recruiting business if she didn't think the numbers were there. "There is a market out there, and I know I have access to a large supply of nurses," Tougas says. She started her business early last year. She's already placed six nurses with Community Nursing and Rehabilitation Center, a nursing home in Naperville. She has 12 "coordinators," recruiting nurses in the Philippines and the resumes of 16 nurses looking for work in the Chicago area. Charging hospitals and nursing homes $5,000 a nurse, she doesn't collect anything upfront from the nurse recruits. After employment in America for a few months, they begin payments toward a $2,500 fee. In return, she'll guarantee at least $21-an-hour pay along with full benefits. Legal expenses, air travel and 30 days' room and board also are part of the deal. One kink in the flow of nurses to the United States could be new regulations enacted Jan. 1, putting on hold fast-track work visas, which had made it possible to get a visa within 60 days. Tougas said it won't affect her business because she's applying for permanent residence status for her applicants. Streamwood entrepreneurs Jhun Mangalindan and his wife, Alesa, opened JCM III in Schaumburg last summer. The scene at the Meridian Banquet hall graduation was his school's first graduating class. Although he also travels to the Philippines to recruit, his school is thriving because many hospitals prefer to find nurses already in America. "I know hospitals that are cutting down on recruitment agencies," he says. Still, be it from domestic or Philippine sources, more nurses and nurse aides are needed. The United States is going to need 100,000 doctors and 100,000 nurses annually for the next 10 years, according to one study by Jaime Galvez-Tan, executive director of the University of the Philippines' National Institutes of Health. U.S. authorities have said the country could have a shortage of 275,000 nurses in five years. Tougas uses those figures to tell nurses if they don't like their first job, there will be choices after their contract ends. "You need them. They need you," is on Tougas' fliers at Philippine job fairs. A traditional role But money isn't the only motivator. Some Filipinos say health care is a natural fit for them. "There is that family culture of caring that is innate for me," says Gloria Simmons, head of the Filipino Nurses Association in the Chicago area. Traditionally, health care was a way for women to become professionals. "So many women around me, all my aunts, were nurses," Simmons says. "For educated women, it was teaching or nursing. You end up thinking, ‘What is there for me but teaching or nursing?'" And one reason many Filipinos come to America — and are highly valued — has to do with the colonial past of the Philippines. The Philippines was a U.S. territory from 1898 to 1946, except when it was under Japanese domination during World War II. When the United States took control of the Philippines after the Spanish-American War, it made the entire educational system English-based. Nursing schools also were based on the U.S. model. And in post-World War II America, a shortage of nurses invited a wave of migration that is producing a second generation of Filipino-American nurses. Whatever the causes of the health-care migration to America, many Filipinos like 16-year-old Gueco are highly motivated. "I want to help people," he says, "especially old people." And as much as Gueco misses his mother, he has his own long-range plan. "It's easy to get work and make money here," he says. "And in five years, I'll be an American."
IN PART 2:
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| © 2005 Daily Herald, Paddock Publications, Inc. |