Photo by SJ Objio on Unsplash
By Kathy Dimaya
When I was in hospital in New York City in 2015, I noticed a handful of Filipino nurses taking turns monitoring the patients in the emergency room. Each time a nurse carted me to another test, I counted even more Filipinos in the other practice areas, and eventually, I lost count. The prevalence of Filipinos in healthcare is no secret – nearly 20,000 people emigrate from the Philippines every year to work in nursing and other healthcare professions abroad.
The COVID-19 pandemic may have brought global health to the forefront of our social consciousness, but despite the rhetoric around heroic healthcare providers and first responders, very few of us have stopped to know who exactly has been working, and dying, on the frontline against the virus for the last year and a half. Alarmingly, Filipinos compose 26% of nurses who have died from COVID-19, while only constituting 4% of nurses in the U.S., a small fraction of all nurses. In addition, Filipinos account for almost half of nurses of colour who have died, disproportionately larger than any other ethnic background.
Why have Filipinos come to be the most devastated ethnic group in healthcare in the pandemic?
A colonialist history
For decades, the Philippines has exported hundreds of thousands of nurses across the globe. The U.K. currently has one of the highest levels of foreign-born nurses in the EU, with an estimated 40,000 Filipino staff employed by the NHS, while the U.S. at present hosts 150,000 Filipino nurses.
To understand how this came to be, we look to the turn of the 20th century, which saw the implementation of a new U.S. policy of “Benevolent Assimilation” towards a newly colonised Philippines. Americans built nursing schools across the country and taught Western medical practices in English to Filipino nursing students with the intention of “civilising” local healthcare. Directly after Philippine independence in 1946 and again in the 1960s, the U.S. experienced nursing shortages and twice turned to recruiting Filipino nurses who, by their own colonial enterprise, were already educated by American standards. Amidst a recession in the Philippines during the 1980s, the Philippine government recognised the economic potential of overseas Filipino healthcare workers sending their earnings home, so they encouraged further mass emigration, resulting in a newfound boom in the export of nurses to countries other than the U.S. that endures today.
Exploitation during the pandemic
As a welcoming and obliging people, many Filipinos have long felt at home in nursing and healthcare professions. This considerate nature has caused many Filipino healthcare workers to forgo their own wellbeing, either in favour of the wellbeing of others or to avoid conflict during the difficulty of the pandemic. WNYC reported circumstances in the U.S. where Filipino nurses expressed a “cultural thing of not wanting to rock the boat or speak up for themselves” regarding a shortage of PPE and reusing masks. Similarly, the Philippines Nurses Association of United Kingdom had raised concerns about a “lack of personal protective equipment” as well as possible “higher risk environments” that British-Filipino nurses were asked to work in. Workers in the U.K. also feared that turning down additional shifts would jeopardise their jobs. These reports feel most distressing when we consider that Filipinos are concentrated in bedside or critical care, where stress levels are high, social distancing is impossible, and exposure to COVID-19 is so certain it has become a death sentence.
Furthermore, nurses who emigrated with the intention of remitting money worried more for the livelihood of their families back home. The pandemic crushed the Philippines commercially as enhanced community quarantines caused businesses to fully shut down and the economy to stagnate, so the earnings of family abroad were more valuable than ever. Thus, driven by necessity and undeterred by the possibility of contracting the virus, Filipino nurses worked extra shifts to send much needed money home.
All but forgotten
The number of hospitalisations today pales in comparison to the astronomical levels of 2020, and half of the global population has received at least one dose of a COVID-19 vaccine. With hospitalisations reduced and much of the Western world becoming double vaccinated earlier this year, many people have returned to a semi-normal life. However, on this path back to normalcy, we must not forget the thousands of nurses, doctors, hospice staff, healthcare providers, and hospital workers who fought against the virus and died before they could see the world as it is today. We must not forget the families who could not be with their loved ones in their last moments and still carry a profound trauma from the pandemic.
Most importantly, the pandemic is not over. Lower income countries battle the pandemic as valiantly as ever. Bangladesh, Malaysia, Thailand, and Vietnam are experiencing far more cases in August 2021 than in March 2020, burdening health infrastructures which have yet to recover from the previous 15 months. The more contagious Delta variant has become the dominant strain, causing thousands of new infections every day, and for the unvaccinated, is more likely to cause hospitalisation.
As hospitalisations remain relatively high in the U.S. and U.K., the nurses and healthcare workers who survived working overtime during the first 19 months of the pandemic are the same nurses and healthcare workers we continue to rely on to tend to our sick. If our vaccines lose efficacy or new variants become vaccine-resistant, these same nurses and healthcare workers will once again be our champions. I hope that we finally begin to recognise the contribution of these nurses and healthcare workers, specifically Filipinos, to the pandemic effort, and honour them as true heroes.
Please take a moment to pay tribute to the Filipinos lost to the pandemic at the Kanlungan Tribute Gallery.