By Carlos H. Conde
International Herald Tribune
THURSDAY, MAY 25, 2006
MANILA — The Philippine health care system, already compromised by the massive migration of Filipino medical workers to other countries, could worsen if the United States ends its cap on the number of foreign nurses it can hire, health experts warn.
The Philippines sends more nurses to the United States than any other country.
While health experts said the increase of migration could benefit the Philippine economy, which relies heavily on the billions of dollars of remittances from Filipinos overseas, the health care system could collapse.
“Filipino nurses will definitely be ecstatic if the bill is passed,” said George Cordero, the president of the Philippine Nurses Association. But, he said, “the Filipino people will suffer because the U.S. will get all our trained nurses.”
Modesto Llamas, the president of the Philippine Medical Association, said health care “is deteriorating in many areas, where there is lack of professionals and lack of facilities.” He warned that this could result in “the medical crisis that we dread.”
Government records show that, in the last three years, more than 50,000 nurses have left the Philippines, mainly for Asia, the Middle East, Europe and the United States.
The demand for Filipino nurses is such that some doctors, most of them from government hospitals, enroll in nursing courses so that they, too, can work abroad as nurses.
As a result, several hospitals have closed or are scaling down their operations. According to the Private Hospital Association of the Philippines, 687 private hospitals have stopped operating since 1998, mainly because of a lack of personnel. Four years from now, this number is projected to increase to 1,000, said Antonio Almonte Chang, the group’s president.
Chang said there were only 1,071 private hospitals in the country and 682 government hospitals, several of which have closed sections and departments because they lacked medical workers.
These closures, Chang said, already had a severe impact on health care.
“All that are left now, especially in the provinces, are government hospitals, which are overloaded and overcrowded but are staffed inadequately,” he said.
The lack of personnel and funds have forced many government hospitals to demand payments from patients, Chang said. In some cases, he said, some government hospitals practically detain patients who cannot pay.
“This is an outrage,” Chang said. “Government hospitals should give free services.”
The turnover of nurses in government hospitals is frequent. Beatriz Sawal, a nurse who runs a nursing training program at the government-run Jose Reyes Memorial Hospital, said that up to 90 percent of the nurses there did not last longer than six months.
“The problem is that the competent ones are immediately hired,” said Alicia Salamanca, a nursing instructor at the hospital. “Once they get their training, they get out of the country,” she said. “We are left with the worst of them.”
The government plays a role in the exodus by actively promoting and facilitating it. At the Jose Reyes Memorial Hospital, nurses from other schools get hands-on training at the wards, which is a requirement for employment abroad. Its facilities are also used to train hundreds of doctors, most of them from government hospitals, to become nurses.
“Many of these doctors are ashamed of what they are doing,” said Sawal, the nursing instructor.
But according to Sawal, they have a difficult financial choice: A physician in a government hospital here earns less than $300 a month, while a nurse earns around $150 or less.
