After four centuries of Spanish colonial rule, the United States acquired the Philippine archipelago as part of the 1898 Treaty of Paris that ended the Spanish-American War. President William McKinley framed this military conquest as “benevolent assimilation” with the justification that Filipinos were an “uncivilized” people.[1] The U.S. would hold sovereignty over the Philippines for the next five decades. With the U.S. occupation of the Philippines came the development of a new healthcare system. While hospitals and nursing schools provided professional opportunities for Filipino women, it was contingent upon the enforcement of American social beliefs and practices regarding class and gender, i.e., the racial inferiority of Filipinos.[2] Filipino nursing students were taught the English language among other nursing competencies.

Even after the Philippines gained independence in 1946, state policies encouraged the immigration of nurses and others deemed skilled labor to the U.S. The first mass wave of Filipino nurse immigration to the U.S. took place in the 1960s under the Immigration and Nationality Act.[3] Hospital recruiters targeted the Philippines in particular because Filipino nurses were already familiarized with American culture. Dictator Ferdinand Marcos in particular was a key figure in the construction of the Philippine labor export economy.[4] Moving overseas as a Filipino nurse was touted as a heroic act of nationalism.[5] 

To this day, the U.S. and Philippines have an enmeshed political relationship, in which the U.S. has continually relied on Filipino nurses to fill their shortage of medical personnel, and the Philippines has become increasingly dependent on remittances from Filipino nurses abroad. There are not enough employment opportunities in the Philippines for its growing population, so Filipino nurses continue to immigrate to the U.S. seeking to support their families.[6] Approximately 16% of nurses in the United States are foreign-born, and nearly one-third of those are Filipinos.[7] Filipino nurses continue to face inequities in the form of lower wages compared to their white counterparts, less desirable working conditions, casual racism, and even a disproportionate number of COVID-related deaths.

Prior to entering undergrad, I had planned to study nursing. It was what was expected of me, it was what I was prepared for, and at the time, I had not been exposed to other options. It felt like the safest way to secure a future for myself and my family. It felt like a respectable vocation, and I did not think to show any resistance. Maybe it was divine intervention, and maybe it was luck, but I ended up at the one university I applied to without a pre-nursing program, and now here I am, working in a Medical Humanities lab. I am grateful to be able to formulate these inquiries, to dig into tensions that have been purposefully obscured from my people, to investigate my personal trajectory and its entanglement with the Philippine global economy at large. 

I did not have the privilege of learning about comprehensive Filipino history in primary or secondary school textbooks. Being aware of that gap in collective knowledge and entering into this project, I intended to shine a light on America’s imperial past and challenge generational amnesia, but this project has proliferated in ways I could not foresee. My work has become less a formally-postcolonial critique of U.S. modernity and more so documentation of the flourishing of diasporic pinay communities. This research brings back into the light submerged historical experiences manifesting in everyday life struggles. Communicating with an accent. Ethnic food cravings. Professional credibility.

This project has allowed me to grapple with what it means to be a Filipino abroad. In many ways, assimilation has not granted Filipino immigrants the space to make their cultural presence known, in the US and in other nations. Discourses of the traditional and the domestic have invalidated diasporic identities. Occupying the space within these attitudes of unwelcome, these interviews felt like a way of saying, “We are here. We will be acknowledged. We are still Filipino.”  

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References

1. Cachero, P. (2021). How Filipino Nurses Have Propped Up America’s Medical System. Time. https://time.com/6051754/history-filipino-nurses-us/

2. Choy, C. C. (2003). Empire of care. In Empire of care. Duke University Press.

3. Brush, B. L. (2010). The Potent Lever of Toil: Nursing Development and Exportation in the Postcolonial Philippines. American Journal of Public Health, 100(9), 1572–1581.

4. Muir, C. (2020). BIMI-HIFIS Policy Brief Series. Essential Workers or Exports: Filipino Nurses in the Era of COVID-19. Berkeley, CA: Berkeley Interdisciplinary Migration Initiative.

5. Nazareno, J., Yoshioka, E., Adia, A. C., Restar, A., Operario, D., & Choy, C. C. (2021). From imperialism to inpatient care: Work differences of Filipino and White registered nurses in the United States and implications for COVID-19 through an intersectional lens. Gender, Work & Organization, 28(4), 1426–1446. 

6. Lorenzo, F. M. E., Galvez-Tan, J., Icamina, K., & Javier, L. (2007). Nurse Migration from a Source Country Perspective: Philippine Country Case Study. Health Services Research, 42(3), 1406–1418. 

7. Almendral, A. (2020). On Pandemic’s Front Lines, Nurses From Half a World Away. The New York Times. https://www.nytimes.com/2020/04/20/world/asia/coronavirus-philippines-nurses.html