Danny Chan

Ferdinand Salcedo, a trained physician, is well aware of the dearth of qualified health care workers afflicting the US and Canada. With North America’s aging baby boomers in dire need of professional caregivers, Dr Salcedo is among the burgeoning ranks of Philippine doctors who are training to work as nurses overseas.

The Jose Reyes Medical Center, situated next to Dr Salcedo’s Manila office, offers a fast-track degree in a specialized nursing program. The current enrolment of 350 physicians includes government-employed doctors, officials from the country’s Department of Health, private practitioners and chiefs of staff from leading hospitals.

“Before, I did not want to go abroad, because I thought people who left were failures here,” Dr Salcedo said. “But I know I could earn $40 an hour as a nurse abroad. There’s no place for Filipino doctors, but nurses—yes.”

Dr Salcedo, chief of planning and programming for the Philippine Department of Health, cites money as his incentive for pursuing a nursing degree. A doctor working in the Philippines can earn on average $500 a month, while a nurse can make on average $108 monthly. Salaries for nurses working in western nations, however, can dwarf what a Philippine physician can earn.

As baby boomers approach their golden years, health care workers are in growing demand. Coupled with growing career options for women—who were previously steered to such service industries as nursing—as well as increased life spans in western societies, the demand for trained nurses far outpaces supply.

Phyllis Hansell, dean of Seton Hall’s University College of Nursing, forecasts that the United States will experience a severe nursing shortage by 2010.

“The greatest shortage is among registered nurses, which comprise the largest segment of all health professionals,” Ms Hansell said. The National Institute of Health Policy and Development estimates approximately 3,000 doctors within the Philippines are studying nursing. According to a study the institute is conducting for the International Labor Organization, a chance for a better quality of life in the developed world is the primary reason why physicians are training for nursing careers in western countries.

Garreth and Girlie Tiu, married doctors studying at the Jose Reyes Medical Center, plan to apply for US immigrant visas that allows them to live permanently in the US along with their child. Failing that, they said they plan to apply for three-year labor contracts and then attempt to upgrade their visa status while in the country.

The American embassy in Manila estimates upwards of 2,300 visas have been issued in 2003 to Filipinos planning to work as health workers in the United States. Embassy officials acknowledge the actual figure is far greater due to the number of Filipino health care workers employed illegally in America.

David Donahue, the US embassy’s consul general, said the hidden cost of migration has yet to be assessed.

“It’s a real human issue,” Mr Dohanue said. “Because once you come to the United States, your children are involved in local schools, you’ve spent three years here, you’re earning five to six times what you’re earning back in your home country—and, every year you are there, you miss your family a little bit less.”

Another hidden toll of the exodus is the decrease in the number of health professionals in the Philippines. Marilyn E. Lorenzo, director of the National Institute of Health Policy and Development, said the Philippines needs to stem the flow of doctors leaving the country. She added that in real terms, the country has an adequate number of health care workers. The real issue lies with poor distribution of those workers. Dr Maria Soledad Antonio of the Department of Health added that recent graduates are hesitant about locating to poorer country areas and remote villages. Government hospitals, for instance, offer only 1,000 new positions for the 10,000 nurses that graduate annually.

Copyright ©2002 Danny Chan. About the author