By Karen Lema and Clare Baldwin
MANILA, Sept 16 (Reuters) - From across the Philippines,
they gathered to pray by Zoom.
They were praying to be allowed to leave: To be allowed to
take up nursing jobs in countries where the coronavirus is
killing thousands in hospitals and care homes. In recent months,
these care workers have taken to calling themselves
"priso-nurses."
With infections also surging in the Philippines, the
government in April banned healthcare workers from leaving the
country. They were needed, it said, to fight the pandemic at
home.
But many of the nurses on the two-hour Zoom call on Aug. 20,
organised by a union and attended by nearly 200 health workers
both in the Philippines and abroad, were unwilling to work at
home. They said they felt underpaid, unappreciated and
unprotected.
Nurses have been leaving the Philippines for decades,
encouraged by the government to join other workers who send back
billions of dollars each year.
With COVID-19 sweeping the globalised economy, the
Philippine ban squeezed a supply line that has sent hundreds of
thousands of staff to hospitals in the United States, the Gulf
and Britain, where some commentators have called the nurses
"unsung heroes" of the pandemic.
The Philippines' healthcare system is already short-handed.
In Germany there are 430 doctors and nurses per 10,000 people,
in the United States 337 and in Britain 254, International
Labour Organization data shows.
The Philippines - where the coronavirus death rate is one of
the highest in Southeast Asia - has 65.
The April ban has stopped more than 1,000 nurses from
leaving the country. Of those, only 25 have applied to work in
local hospitals, Health Secretary Francisco Duque III told
journalists late last month. The Department of Health did not
reply to a request for an updated figure.
The government has since partially eased the restrictions,
but sometimes also tightens them, so nurses are still clamouring
to get out.
On the Zoom call in August, someone played a recording of
the Philippine national anthem. A Catholic priest prayed and a
man with a soft voice crooned a song about passing off your
burdens to God.
One nurse, 34-year-old April Glory, had already spent years
away from her young son and had been about to leave again when
the ban kicked in. Even before the pandemic, she told Reuters
separately, she was better off in a war zone in the Middle East
than at home.
Soon after she arrived in Yemen in 2011, a bullet pierced
the wall of her private hospital, she said. Staff moved patients
to safety.
Still, she said, "we were insured, we had free lodging so my
salary was intact and I could send more to my family." Abroad,
there was no need to do any work outside her job description:
"You are not expected to sweep the floor."
SIMPLE MATH
It's mainly money that drives the Filipinos abroad.
A nurse in the United States can earn as much as $5,000 per
month; in the Middle East it's $2,000 per month, tax free. In
Germany, nurses can earn up to $2,800 per month, and get
language training, labour organizers, recruiters and the
Philippine government's overseas employment agency say.
Even with its emergency hiring efforts, the Philippine
Department of Health is only offering nurses a starting salary
of $650 per month. It says it will pay another $10 per day as
COVID-19 hazard allowance.
Private nurses sometimes make just $100 per month.
"I felt that I was not earning enough," said Glory,
explaining why she left. Her son, now 11, was a year and a half
old at the time. "My mother told me: Better to leave now because
my child will not really remember."
Abroad, Glory's shifts were a standard eight hours and she
only looked after one or two patients at a time in intensive
care. Working in Yemen and then Saudi Arabia, she said she
bought a house and a car.
Nurses have recently left faster than they are trained. Last
year, 12,083 new nurses graduated in the Philippines. That same
year, 16,711 signed contracts to go abroad, data from the
Commission on Higher Education and the Philippine Overseas
Employment Administration shows. Those renewing foreign
contracts are counted separately. So far this year there have
been 46,000 such renewals.
The Philippine government wasn't able to provide figures for
the total number of nurses overseas, or say which countries they
are working in.
Filipinos are the biggest group of foreign nurses in the
United States. In 2018, there were 348,000, an analysis of U.S.
government data by Washington D.C.-based think tank Migration
Policy Institute showed. Even with the pandemic, another 3,260
Filipinos have passed the U.S. nurse licensing exam this year.
A report to Britain's House of Commons Library in May said
more than 15,000 of the National Health Service nursing jobs
held by foreigners went to Filipinos - nearly a third of the
total and more than any other nationality. The NHS employs a
further 6,600 Filipinos in other healthcare jobs.
Labour brokers say that, besides the UK and US, Filipino
nurses are sought-after in Germany, Saudi Arabia, the United
Arab Emirates and Singapore.
36-HOUR SHIFTS
Nine months into the pandemic in the Philippines, reported
coronavirus infections in the Philippines have soared to around
270,000. Not all hospitals allow family members to visit, so
nurses must feed and clean patients as well as giving health
care, said Filipino Nurses United President Maristela Abenojar.
Some nurses are working up to 36-hour shifts because relief
staff are calling in sick or not reporting for duty, she said,
and sometimes nurses are issued just one set of protective gear
per shift. Nurses can't get tested regularly and if they get
sick, there aren't always hospital beds reserved for them, she
said.
At least 56 healthcare workers have died in the Philippines,
Department of Health data shows.
"It seems they don't really value our contributions," said
Jordan Jugo, who works at a private hospital in the
Philippines. "It hurts." He had a contract to work in Britain,
but the ban prevented him from leaving.
He said he could sometimes only eat two meals a day and
could no longer support his siblings.
The Philippine Department of Health said its healthcare
workers work long hours and "it is natural for them to feel
tired and overwhelmed with their immense responsibilities." It
said it had arranged for "substitution teams" in some areas.
It said hospitals should provide sufficient protective gear
and that healthcare workers should not go on duty without it.
Healthcare workers should be prioritized for regular COVID-19
testing, it said, and the Department would ensure there are
enough beds for everyone.
Health Secretary Duque has said previously that the
government was appealing to the nurses' "sense of nation, sense
of people and sense of service."
"I DON'T WANT TO BE A HERO"
Foreign countries have gone all-out to show Filipino nurses
they are valued.
Saudi Arabia sent chartered planes to help them return to
work, and only partly filled them so the nurses could maintain
social distance.
British ambassador to the Philippines Daniel Pruce went on
an 11-minute segment on Philippine television to praise the
"incredible commitment and dedication" of Filipino healthcare
workers in Britain.
When nurse Aileen Amoncio, 36, got trapped by a lockdown and
then the travel ban during a vacation to the Philippines in
March, Britain's NHS granted her a special "COVID leave" and
kept paying her, she said. The NHS said staff stuck abroad due
to COVID-19 could qualify for such leave.
Amoncio got out of the Philippines in June, after the
government eased the ban slightly.
Working at an NHS neurological rehabilitation hospital in
the UK, she said she sympathized with the nurses back home,
where she once handled as many as 80 patients on a surgical ward
at a small hospital. Now she looks after no more than 10 at a
time.
Not only are the pay and conditions better in Britain, she
said, but she also hopes her daughter will one day be able to
join her and get free treatment on the NHS. The hearing implant
she needs would cost $20,000 in the Philippines.
"I've served my country already," said Amoncio. "I don't
want to be a hero again. I am looking out for the future of my
children."
On the Zoom call, Labour Secretary Silvestre Bello III
dialed in with an update: Some of those who had existing
contracts could leave, he announced. Cheers went up.
Nurse Glory was one of them. She wept.
"I hope the government will not take it against us that we
are leaving," she said. "We are looking forward to helping the
government with this fight in other ways. When we are able, when
we've risen out of poverty, we will."
Hours later, on the pavement outside the airport, she
quickly hugged her son, then raced to board her flight in case
the government changed its mind.