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Brown Skin in White Coats: The Filipino diaspora at the frontlines of the pandemic

By Romina Eloisa M. Abuan, Elora Mae G. Atos, and Katrina R. Guanio | Issue #22

The Philippines has been one of the major migrant origin countries of human resources for health (HRH) to Western high-income and ageing countries since the last century, thereby forming a significant Filipino diaspora. The Filipino HRH diaspora played a substantial role in the provision of care, especially in the COVID-19 response of many destination countries. This article critically analyses the role of Filipino diasporas in the health sector and how diasporas facilitate cooperation, social protection and knowledge-sharing in healthcare. It provides policy recommendations for diaspora engagement, healthcare provision and sustainable development in both the countries of origin and destination.

In May, the Philippines unveiled its new brand, 'We give the world our best', in an attempt to give tribute to Overseas Filipino Workers (OFWs). This branding was spotted in a UK advertisement featuring May Richell Cestina-Parsons, the Filipino nurse who administered the world’s first approved COVID-19 vaccine. It came under scrutiny as it seemingly promotes the Philippines as a “labour exporter” despite grappling with labour shortages within its own health system. Globally, one out of every eight, or 3.7 million, nurses are foreign-born or foreign-trained. In a 2022 news report, the Filipino Nurses United (FNU) said 35% or four out of 10 registered nurses in the Philippines chose to work abroad.

Filipino HRH, including Filipino-born and Philippine-educated HRH and those with Filipino immigrant backgrounds, have been at the frontlines of the COVID-19 pandemic in many major destination countries. In 2021, Edmund Tabay became the first Filipino nurse to hold a top nursing directorship role at the National Health Service (NHS) in the UK. Charito Leonardo-Romano, a staff nurse at a private care home in Surrey, England, was awarded the British Empire Medal (BEM) for her service during the COVID-19 pandemic. During the pandemic, migrant HRH proved to have significantly contributed to the labour supply and quality of care in destination countries. Meanwhile, origin countries like the Philippines had insufficient healthcare workforce leading to a burned-out HRH with an endless number of patients and generally, an overwhelmed healthcare system.

Migration of skilled workers such as HRH is attributed to ‘brain drain’ in origin countries. Healthcare workers who migrate internationally are often younger, skilled and economically active thus contributing to reducing dependency ratio, supplementing the stock of human capital and increasing gross domestic product (GDP) and overall economic productivity in destination countries, especially those with ageing populations. It is easy to haphazardly fault migration for the insufficient healthcare workforce in origin countries. However, the migration-development nexus is complex for origin and destination countries alike. In origin countries, migration contributes to increased GDP and broader social and economic development through remittances. Similarly, migrants and diasporas contribute to origin countries through the flow of social remittances or the transfer of knowledge, skills, values, beliefs and productivity.

Migrants and diasporas contribute to the flow of knowledge, ideas and social capital through civic engagements promoting poverty reduction and health in their home countries. For instance, the Filipino Nurses Diaspora Network (FIND) in Australia, Filipino Nurses Association UK (FNAUK) and Philippines Nurses Association UK contributed to supporting not only Filipinos nurses abroad but also communities and healthcare workers in the Philippines through fundraisers, capacity-building activities, inter-organisational collaborations, and social, economic and legal assistance.

The Philippines has strong networks of migration health practitioners, advocates and scholars. The Philippine Migrant Health Network (PMHN) is the country’s leading network for the promotion and protection of the health of migrants and overseas Filipinos. Meanwhile, the Human Resources for Health (HRH) Network is responsible for the implementation of the 2020-2040 Human Resources for Health (HRH) Masterplan, and aims to enhance an 'adequate, globally competent, and sustainable health workforce'. These networks will play a critical role in creating spaces for empowerment and collaboration between the diaspora and the origin country towards quality care provision as aligned with universal health care.

As such, it is imperative to adopt migration health policy and partnerships that would:

  • Foster brain circulation by strengthening health networks that create spaces for knowledge-sharing of best practices between the Philippines and Filipino diasporas;

  • Engage Filipino HRH diaspora and other diasporas to lobby for improved working conditions, increased wages, comprehensive employee benefits and regular capacity development in destination countries;

  • Forge a working relationship between the Filipino HRH diaspora and the local HRH to influence programme planning and policymaking in the country’s healthcare system; and

  • Harness return-of-talent programmes such as the Balik Scientist Program to ensure opportunities for growth and local employment for OFWs who intend to return and reintegrate into the country.

Ultimately, the Philippines can mobilise its HRH diaspora by starting with a roadmap for diaspora engagement. This requires knowing the diaspora, their needs, their goals as well as their capacities and relationship with the countries of origin and destination. Similarly, the Philippines has to build trust and a mutualistic relationship with the diaspora through active consular networks, provision and promotion of services, interactions with host governments and privileges to expatriates and descendants among others.

'I have the best of both worlds as a British-Filipino,' Charito said in a webinar about migrants as transnational actors. The Filipino HRH diaspora, with their brown skin in white coats, are the lifeline of health systems, the vehicle for brain circulation and the future of care. There is a need to harness the best of both worlds to create and give the best in those worlds.

Romina Eloisa M. Abuan is currently pursuing her Masters of Arts in Asian Studies concentrating on Southeast Asia at the Asian Center, University of the Philippines Diliman. Her lived and observed experiences as a second-generation (returnee) and migrant has allowed her to view migration from an insider’s and outsider's perspective. Her research interests include Southeast Asia, Migration, Diaspora, and Southeast Asian International Relations.

Katrina R. Guanio is a development practitioner specialising in population and development with a focus on migration, gender, ageing, and the environment. She is a Senior Project Officer at the University of the Philippines - Centre International de Formation des Autorités et Leaders in the Philippines (UP-CIFAL Philippines). She is also a graduate student at the University of the Philippines Population Institute (UPPI).

Elora Mae G. Atos is a Junior Project Associate at the University of the Philippines - Centre International de Formation des Autorités et Leaders in the Philippines (UP-CIFAL Philippines). She is currently spearheading programme initiatives and capacity-building activities on the interwoven themes of the 2030 Agenda for Sustainable Development, migration, gender equality, and transformational business. She completed her Bachelor of Arts in Anthropology at the University of the Philippines, Diliman where she graduated magna cum laude.


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