History of Filipino nurses in the United States

Last updated

Since the 1890s, the United States has periodically relied upon Filipino nurses to help meet the needs of the healthcare system. [1] This collaboration has been a significant contributor to the migration of Filipinos to the U.S., as Filipino citizens increasingly had personal connections in America. Since 1960, more than 150,000 nurses have migrated from the Philippines. [2]

Contents

Early history (1898–1930)

After the Spanish–American War (1898), the U.S. acquired control over the Philippines and conferred U.S. national status upon the islands' population. The U.S. Army trained and recruited Filipinos as Volunteer Auxiliary and Contract Nurses to serve in the Philippines, focusing on tropical diseases. [3] The hospitals founded served two U.S. interests: treating their soldiers and exporting Western "civilized" culture to the Philippines. [2] Several nurses were sent to San Francisco and New York City for further training and employment. In 1907, formalized nursing education patterned on the U.S. curriculum was established in the Philippines to train nurses there. A shortage of nurses was increasingly urgent due to the epidemics of tuberculosis, typhoid and other communicable disease and the start of World War I. The Pensionado Act (1903) established and legislated a formalized framework to send Filipino pensionados (government subsidized scholars) to the United States for further education and training. Some stayed in the U.S. for employment. A continuous influx of Filipino nurses worked in New York City, and helped to meet to the demands of healthcare at that time. The Philippine Nurses Association – New York was established in 1928 by the Filipino nurses with the goals of promoting cultural understanding and streamlining professional guidance to other Filipino nurses. The first president was Marta Ubana, who completed her Bachelor of Science in Teachers College, Columbia University. [4] [ citation needed ]

1940s-1970s

Exchange Visitor Program

In 1948, Congress passed the Smith-Mundt Act, which created the Exchange Visitor Program. [5] The program allowed students and skilled workers to stay in the U.S. for a two-year period to promote cultural exchange. [6] While the program was largely intended to counteract propaganda disseminated by the Soviet Union at the outset of the Cold War, it came at a time when the U.S. had again found itself in the midst of a postwar nursing shortage. Hospitals quickly began sponsoring Filipino women who had been trained in U.S.-style nursing programs abroad. [2] [7] For this reason, despite being open to all countries, the EVP induced a wave of Filipino migration. [7] By the late 1960s, Filipino applicants, the vast majority of whom were nurses, made up 80% of participants in the program. [8]

Immigration and Nationality Act

In 1965, Congress passed the Immigration and Nationality Act, which made it easier for Filipino nurses to petition to stay in the U.S. permanently. In addition, hospitals had caught on to the fact that many of their nurses came from the Philippines and started actively recruiting women to come. [7] The Act had a provision which created a visa for skilled laborers. As a result, nurses could now not only come permanently, but bring their families as well. This brought a wave of immigrants from the Philippines, some of whom may have been taking advantage of the program. In the years immediately after the passage of the INA, board exam passing rates for nurses from the Philippines were very low, leading to the establishment of the Commission on Graduates of Foreign Nursing Schools. [9]

The same year that the INA was passed, Medicare and Medicaid were also created, making healthcare more accessible for millions of Americans who had limited access. Nineteen million Americans enrolled in the programs' first year. [10] The demand for healthcare workers in the U.S. once more outpaced its supply.

Ferdinand Marcos, the president of the Philippines from 1966-1986, saw the emigration of nurses as a potential solution to a domestic economic crisis. The country was struggling with high rates of unemployment. Nurses living abroad decreased the amount of competition within the job market. [11] Further, many nurses continued to send money home to family overseas, which Marcos hoped might stimulate the economy. Marcos actively encouraged the emigration of nurses as a means to stabilize the economy. This temporary effort became formalized as a program to encourage the export of nurses. [8] While the program was intended to be a temporary, it became deeply embedded in the nation's economy and did not end until 2022. In 2005, 85% of the Philippine's nurses were employed internationally. [12]

AIDS Crisis

During the 1980s, HIV/AIDS was discovered, first becoming apparent in the metropolitan centers and then widening to a nationwide crisis. The disease was initially thought to be unique to men who have sex with men, with the earliest reports of AIDS-related Kaposi's Sarcoma being described as a "gay cancer." [13] While this was quickly proven untrue, the idea of HIV/AIDS as a "gay disease" remained prominent. This contributed to the stigma against the disease and people affected by it. This association, combined with the initial lack of understanding as to how the virus was transmitted and the fear that that caused, led to the refusal by many medical professionals to treat people with AIDS. [14] In 1986, the American Medical Association released guidelines allowing physicians who were "emotionally unable" to care for AIDS patients to refer them to another clinician. [15]

The shortage of willing medical staff led to another influx of migration from the Philippines. In fact, the Filipino population of the United States doubled between 1980 and 1990. [16]

Nursing Relief Act of 1989

In 1989, in recognition of the large wave of Filipino nurses throughout the AIDS crisis, Congress passed the Nursing Relief Act of 1989. The Act granted special immigrant status to nurses, which allowed them to apply for green cards, and did not set a limit on the number of visas that could be issued under the program. This allowed many nurses who may have had to leave their families behind to bring them to the U.S. This bill had strong backing from the government of the Philippines, which hoped that nurses might send money back home and stimulate the economy. [16]

See also

Related Research Articles

<span class="mw-page-title-main">HIV/AIDS in the United States</span> HIV/AIDS epidemic in the United States

The AIDS epidemic, caused by HIV, found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.

<span class="mw-page-title-main">Human capital flight</span> Emigration of highly skilled or well-educated individuals

Human capital flight is the emigration or immigration of individuals who have received advanced training at home. The net benefits of human capital flight for the receiving country are sometimes referred to as a "brain gain" whereas the net costs for the sending country are sometimes referred to as a "brain drain". In occupations with a surplus of graduates, immigration of foreign-trained professionals can aggravate the underemployment of domestic graduates, whereas emigration from an area with a surplus of trained people leads to better opportunities for those remaining. But emigration may cause problems for the home country if the trained people are in short supply there.

The H-1B is a visa in the United States under the Immigration and Nationality Act, section 101(a)(15)(H), that allows U.S. employers to employ foreign workers in specialty occupations. A specialty occupation requires the application of specialized knowledge and a bachelor's degree or the equivalent of work experience. The duration of stay is three years, extendable to six years, after which the visa holder can reapply. Laws limit the number of H-1B visas that are issued each year. There exist congressionally mandated caps limiting the number of H-1B visas that can be issued each fiscal year, which is 65,000 visas, and an additional 20,000 set aside for those graduating with master’s degrees or higher from a U.S. college or university. An employer must sponsor individuals for the visa. USCIS estimates there are 583,420 foreign nationals on H-1B visas as of September 30, 2019. The number of issued H-1B visas have quadrupled since the first year these visas were issued in 1991. There were 206,002 initial and continuing H-1B visas issued in 2022.

<span class="mw-page-title-main">Tropical medicine</span> Interdisciplinary branch of medicine

Tropical medicine is an interdisciplinary branch of medicine that deals with health issues that occur uniquely, are more widespread, or are more difficult to control in tropical and subtropical regions.

<span class="mw-page-title-main">SUNY Downstate Medical Center</span> Hospital in New York City, United States

SUNY Downstate Health Sciences University is a public medical school and hospital in Brooklyn, New York. It is the southernmost member of the State University of New York (SUNY) system and the only academic medical center for health education, research, and patient care serving Brooklyn's 2.5 million residents. It is the only state-run hospital in New York City. As of Fall 2018, it had a total student body of 1,846 and approximately 8,000 faculty and staff.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.

<span class="mw-page-title-main">Nursing shortage</span> Overview of global nursing shortages

A nursing shortage occurs when the demand for nursing professionals, such as Registered Nurses (RNs), exceeds the supply locally—within a healthcare facility—nationally or globally. It can be measured, for instance, when the nurse-to-patient ratio, the nurse-to-population ratio, the number of job openings necessitates a higher number of nurses than currently available, or the current number of nurses is above a certain age where retirement becomes an option and plays a factor in staffing making the workforce in a higher need of nurses. The nursing shortage is global according to 2022 World Health Organization fact sheet.

Filipino Austrians are Austrians of full or partial Filipino descent and are part of the so-called Overseas Filipinos. When excluding Afghan, Iraqi and Syrian refugees, Filipinos make up the fourth largest group of Asians within Austria, behind Iranian, Chinese and Indian people and form the largest Southeast-Asian community in the country. The majority of them live in Vienna, the capital of Austria.

<span class="mw-page-title-main">Health in the Philippines</span> Overview of health in the Philippines

Access to healthcare services in the Philippines is marked by significant inequities, particularly affecting poor communities. These disparities are reflected in both access to services, health outcomes, and the effects of climate change which exacerbate the incidences of infectious diseases. One major challenge is the varying financing for local government units, leading to differences in the benefits packages of insurance plans and difficulties in accessing public health services. The decentralization of healthcare responsibilities from the federal government to local governments has, in some cases, increased local authority but has also made certain communities vulnerable to a lack of access to basic services.

Nursing in the Philippines is provided by professionally trained nurses, who also provide a quarter of the world's overseas nurses. Every year, some 20,000 nurses work in other countries. Nurses in the Philippines are licensed by the Professional Regulatory Commission. The advance of nursing in the Philippines as a career was pioneered by a culture of care that is intrinsic in the Filipino people. This began before Spanish colonization.

In South Africa, private and public health systems exist in parallel. The public system serves the vast majority of the population. Authority and service delivery are divided between the national Department of Health, provincial health departments, and municipal health departments.

Discrimination against people with HIV/AIDS or serophobia is the prejudice, fear, rejection, and stigmatization of people with HIV/AIDS. Marginalized, at-risk groups such as members of the LGBTQ+ community, intravenous drug users, and sex workers are most vulnerable to facing HIV/AIDS discrimination. The consequences of societal stigma against PLHIV are quite severe, as HIV/AIDS discrimination actively hinders access to HIV/AIDS screening and care around the world. Moreover, these negative stigmas become used against members of the LGBTQ+ community in the form of stereotypes held by physicians.

The labor migration policy of the Philippine government allows and encourages emigration. The Department of Foreign Affairs, which is one of the government's arms of emigration, grants Filipinos passports that allow entry to foreign countries. In 1952, the Philippine government formed the Philippine Overseas Employment Administration (POEA) as the agency responsible for opening the benefits of the overseas employment program. In 1995, it enacted the Migrant Workers and Overseas Filipino Act in order to "institute the policies of overseas employment and establish a higher standard of protection and promotion of the welfare of migrant workers and their families and overseas Filipinos in distress." In 2022, the Department of Migrant Workers was formed, incorporating the POEA with its functions and mandate becoming the backbone of the new executive department.

Nursing in Kenya began in 1908 and was conducted without a formal framework until 1950. Over the decades, with demand for healthcare providers increasing due to marked growth in the population of Kenya, training programs were implemented.

<span class="mw-page-title-main">Demographics of Filipino Americans</span> Overview of the demographics of Filipino Americans

The demographics of Filipino Americans describe a heterogeneous group of people in the United States who trace their ancestry to the Philippines. As of the 2020 Census, there were 4.4 million Filipino Americans, including Multiracial Americans who were part Filipino living in the US. Filipino Americans constitute the third-largest population of Asian Americans, and the largest population of Overseas Filipinos.

<span class="mw-page-title-main">Alliance of Young Nurse Leaders and Advocates</span>

The Alliance of Young Nurse Leaders and Advocates, also known as AYNLA, is a professional organization in the Philippines advocating for the achievement of the United Nations Millennium Development Goals (now Sustainable Development Goals), Universal Health Care, and advancement of nurses' rights and welfare. It was established in the year 2009 and registered with the Philippine Securities and Exchange Commission in 2010. The headquarters of the organization is currently located at Villaruel Street, in Pasay.

The H-1A visa was a visa that was previously available to foreign nationals seeking temporary employment in the United States. These visas were made available to foreign nurses coming into the United States to perform services as a registered nurse in areas with a shortage of health professionals as determined by the Department of Labor. The creation of this visa was prompted by a nursing shortage.

<span class="mw-page-title-main">Sylvia Trent-Adams</span> American public health official

Sylvia Trent-Adams is a retired U.S. Public Health Service Commissioned Corps rear admiral, who last served as the principal deputy assistant secretary for health from January 2, 2019 to August 31, 2020. She previously served as the deputy surgeon general of the United States from October 25, 2015 to January 2, 2019. Trent-Adams also served as the acting surgeon general of the United States from April 21, 2017 to September 5, 2017. She retired from the U.S. Public Health Service on September 30, 2020 after over 33 years of combined uniformed service. On October 5, 2020, Trent-Adams was named to the board of directors for AMN Healthcare.

The Pensionado Act is Act Number 854 of the Philippine Commission, which passed on 26 August 1903. Passed by the United States Congress, it established a scholarship program for Filipinos to attend school in the United States. The program has roots in pacification efforts following the Philippine–American War. It hoped to prepare the Philippines for self-governance and present a positive image of Filipinos to the rest of the United States. Students of this scholarship program were known as pensionados.

Mary Goretti Boland, MSN, RN, FAAN is a Pediatric Nurse and Doctor of Public Health, and a Fellow of the American Academy of Nursing. She is nationally known for her work developing innovative healthcare programs for underserved children with HIV/AIDS and other chronic diseases. In 1978, Boland staffed an innovative mobile health screening van for the Ironbound Community Health Project in Newark, New Jersey. She became director of the AIDS program at Children's Hospital of New Jersey and served as the coordinator for the Children's AIDS program (CHAP) at United Hospitals Medical Center in Newark. She served on the AIDS Advisory Committee in New Jersey and the National AIDS Advisory Committee. The United States Department of Health and Human Services gave her an award for her work in pediatric AIDS/HIV treatment.

References

  1. ↑ "Filipino and Filipino American Nurses in the United States | School of Nursing" . Retrieved 2024-03-07.
  2. 1 2 3 "How Filipino Nurses Have Propped Up America's Medical System". TIME. 2021-05-30. Retrieved 2024-03-07.
  3. ↑ "Filipino Nurses in the U.S."
  4. ↑ "US nursing shortage may again spur recruitment from PH". 2 November 2017.
  5. ↑ "Background of Exchange Vistor Program in the Philippines - Exchange Visitors Program of the Philippines". www.evpcommittee.ph. Retrieved 2024-03-07.
  6. ↑ "Chapter 1 - Purpose and Background | USCIS". www.uscis.gov. 2023-06-08. Retrieved 2024-03-07.
  7. 1 2 3 "Why are there so many Filipino nurses in the U.S.?". Berkeley. 2022. Retrieved 2024-03-07.
  8. 1 2 Masselink, Leah E.; Shoou-Yih, Daniel Lee (March 21, 2012). "Government officials' representation of nurses and migration in the Philippines". Health Policy and Planning. 28 (1): 90–99. doi:10.1093/heapol/czs028. PMID   22437505 . Retrieved 2024-03-08.
  9. ↑ "Filipino Nurses Working in the U.S." www.conexusmedstaff.com. Retrieved 2024-03-08.
  10. ↑ "A brief history of Medicare in America". medicareresources.org. 2022-12-01. Retrieved 2024-03-08.
  11. ↑ O'Neil, Kevin (2004-01-01). "Labor Export as Government Policy: The Case of the Philippines".
  12. ↑ Masselink, Leah E.; Shoou-Yih, Daniel Lee (2010-07-01). "Nurses, Inc.: Expansion and commercialization of nursing education in the Philippines". Social Science & Medicine. 71 (1): 166–172. doi:10.1016/j.socscimed.2009.11.043. PMID   20399550.
  13. ↑ Wright, Joe (8 May 2006). "Remembering the Early Days of 'Gay Cancer'". NPR. Retrieved 7 June 2024.
  14. ↑ "Immigrant Nurses".
  15. ↑ Freedman, B. (1988). "Health professions, codes, and the right to refuse HIV-infectious patients". The Hastings Center Report. 18 (2): S20-5. doi:10.2307/3562422. JSTOR   3562422. PMID   11650067.
  16. 1 2 Women & the American Story (2021). "Immigrant Nurses". New York Historical Society. Retrieved 13 June 2024.{{cite web}}: CS1 maint: url-status (link)

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.