The term “brain drain” has been applied to the Philippines since the 1960s and continues to be relevant to their economic situation today. In particular, the term has been used to describe the Filipino nursing sector. Although the economic situation has changed in the last several decades, academics have tended to discuss the brain drain phenomenon in the Philippines as a historical progression from colonial and international ties. Post-colonial Philippines In 1946, colonialism in the Philippines ended with the election Manuel Roxas. 77] The Philippines’ infrastructure and conomies had been devastated by WWII contributing to serious national health problems and uneven wealth distribution. [78] As part of reconstruction efforts to the newly independent state, education of nurses was encouraged to combat the low 1 nurse per 12 000 Filipinos ratio[79] and to help raise national health care standards. However Roxas having spent his prior 3 years as the secretary of finance and chairman of the National Economic Council and a number of other Filipino companies, was particularly concerned with the countrys financial (rather than health) problems. 8] The lack of government funding for rural community clinics and hospitals as well as low wages continued to perpetuate low nurse retention rates in rural areas and slow economic recovery. When the United States relaxed their Immigration Act laws in 1965, labor export emerged as a possible solution for the Philippines. Labour export from the 1960s on Since the 1960s and 1970s, the Philippines has been the largest supplier of nurses to the United States, in addition to export labour supplied to the I-JK and Saudi Arabia. 80] In 1965, with a recovering ost-WWII economy and facing labor shortages, the United States introduced a new occupational clause to the Immigration Act. [81] The clause encouraged migration of skilled labour into sectors experiencing a shortage,[81] particularly nursing, as well relaxing restrictions on race and origin. [82] This was seen as an opportunity for mass Filipino labour exportation by the Filipino government, and was followed by a boom in public and private nursing educational programs.
Seeking access through the U. S. government sponsored Exchange Visitors Program (EVP), workers were encouraged to o abroad to learn more skills and earn higher pay, sending remittance payments back home. [83] Regarded as a highly feminized profession, most labour migrants have been predominantly female and young (25-30 years of age). [84] Pursuing economic gains through labour migration over infrastructural financing and improvement, the Philippines still faced slow economic growth during the 1970s and 1980s. 85] With continuously rising demand for nurses in the international service sector and overseas, the Filipino government aggressively furthered their educational rograms under the now elected President Ferdinande Marcos. Although complete statistical data can be difficult to collect, studies done in the 1970s show 13 500 nurses (or 85% of all Filipino nurses) had left the country to pursue work elsewhere. [86] Additionally, public and private nursing school programs multiplied from a reported 17 nursing schools in 1950, to 140 nursing schools in 1970. [87] Remittances – An economic boost for the home country?
Studies show wage discrepancies between the Philippines and developed countries such as the U. S. and the I-JK as ay be seen as more economically valuable than pursuit of local work. Around the turn of the 20th century, the average monthly wage of Filipino nurses who remain in their home country was between 550 – 1000 pesos per month (roughly 70 – 140 USD at that time). [88] Comparatively the average nurse working in the U. S. was receiving 800 – 1400 USD per month. [88] However scholars have noted that economic disparities in the Philippines have not been eased in the past decades.
Although remittance payments account for a large portion of Filipino GDP (290. 5 Million USD in 1978, increased to 10. Billion USD in and are therefore regarded as a large economic boost to the state, Filipino unemployment has continued to rise (8. 4% in 1990, increased to 12. 7% in Here scholars have begun to look at the culture of nurse migration endorsed by the Filipino state as a contributing factor the countrys economic and health problems. Migration Culture of Nursing The Philippines spent only 3. 6% of their GDP on health care and facilities in 2011, ranking them 170th by the World Health Organization on health spending. 90]Their health system, particularly in rural areas has been underfunded, understaffed and lacking dvancements in health technologies causing retention difficulties and poor access to services. [91]However with reported fgures of Filipino nursing graduates reaching 27 000 between 1999 and 2003, and Jumping to a total of 26 000 in 2005 alone, there are clear discrepancies between skilled Filipino nurses and availability to health services in the country. [92] Scholars have pointed to the increasing privatization and commercialization of the nursing industry as a major reason for this loss of skill, i. . brain drain. Migration has arguably become a “taken-for-granted” aspect of a nursing areer particularly with regards to the culture of migration that has been institutionally perpetuated in the health sector. [93]Most nursing schools have been built since the turn of the century and are concentrated primarily in metro Manila and other provincial cities. Of approximately 460 schools providing bachelors of nursing,[94] the majority are privately controlled, in part due to the inability of the Filipino government to keep up with rising education demand.
However the private schooling has also been a lucrative business, playing on the desperation of Philippine labour looking for potential access to higher income. Education Industry In addition to the Philippine Overseas Employment Administration (POEA) run by the government as a source of overseas recruitment agreements, and a marketer of Filipino labour overseas, private nursing schools have acted as migration funnels expanding enrollment, asserting control over licensure process, and entering into business agreements with other overseas recruitment agencies. 95] However retaining qualified instructors and staff has been reported to be as problematic as retaining actual nurses, contributing to low exam pass rates (only 12 of 175 reporting schools ad pass rates of 90% or higher in with an average pass rate of 42% across the country in Private schools have also begun to control licensure exam review centers, providing extra preparation for international qualification exams at extra cost and with no guarantee of success. 98] It is estimated that between 1999 and 2006, 700 million USD was spent on nursing education and licensure review courses by individuals who never even took the licensing exams or were able to complete the programming. [99] With migrant nursing pushed as the most desirable brain drain in the health sector of not only nurses and physicians as well.
Discrepancies in wages between Filipino nurses working at home and those working abroad, as noted above, provide clear economic incentives for nurses to leave the country however physicians have also been lured into these promises of wealth through the creation of “Second Course” nursing programs. [100] Studies compare wages of at-home and abroad Filipino nurses from 2005-2010, with at-home nurses receiving 170 USD per month, or 2040 USD per annum, compared to a 3-4000 USD salary per month in the U.
S. , or 36-48 000 USD per annum. [101] Filipino Physician salaries of those working at home are not much more competitive, earning on verage 300-800 USD per month or 3600-9600 USD per annum. [102] Although it is important to note with such discrepancies that the costs of living are also higher in the U. S. , and remittance payment transfers back home are not free, there is still evidently a large economic pull to studying as a nurse and migrating overseas.
Brain Drain – The Push and Pull, and the lasting effects The Philippines’ colonial and post- WWII history contribute an understanding of the process by which nurses have increasingly turned to migration for greater economic benefits. Discussed in terms of umbers and financial gains, export labour migration has been suggested as a solution to the struggling Filipino economy with labour transfers and remittances payments seen as beneficial for both countries. 103] However noting that in 2004, 80% of all Filipino physicians had taken ‘second courses’ to retrain as nurses, it is suggested that export labour migration is undermining the national health sector of the country. [104] With physicians and nurses leaving en mass for greater financial promise abroad, the ratio of nurse to patients in the Philippines has worsened from 1 urse per 15-20 patients in 1990 to 1 nurse per 40-60 patients in 2007. 105] Additionally, the increase in private institution recruitment has evaded government oversight, and arguably has led to lower standards and working conditions for nurses actually working abroad. Once abroad, Filipino nurses have identified discriminatory workplace practices, receiving more night and holiday shifts, as well as more mundane tasks than non-Filipino counterparts. [106] Nurses also discuss the lack of opportunity to train and learn new skills, an enticement that is promoted by the Filipino export labour migration system. 07]Homesickness and lack of community integration can also cause great emotional duress on migrants, and with the majority of migrants female, family separation can cause negative impacts on both the migrant and the families. Further critical inquiries into the success of export labour migration for the Philippines are needed. As noted, financial and economic statistics can not fully describe the complexity of en-mass migration of nurses and physicians. It is important to understand the multitude of elements which combine to encourage a culture of migration.
Brain-drain as a phenomenon an be currently applied to the Filipino situation however it is important to note, this does not suggest export labour migration as the primary causal factor of the countrys current economic situation. Lack of government funding for health care systems in addition to the export labour migration culture, as well as other local factors, all contribute to what is described as the current brain-drain phenomenon occurring in the Philippines. It is important to understand the complexity of the determine benefits, costs, and perpetuated problems within the societys infrastructure.
