Three months ago, nurse Leane Bulaong walked slowly along corridors of metal frames and white curtains at the Baltimore Convention Center, which had been converted into a field hospital for COVID-19. Instead of wearing her usual nursing scrubs, she had donned a patient gown; a pair of non-skid socks; a pulse oximeter, measuring her blood oxygen saturation; and a nasal cannula delivering oxygen from a tank she pulled alongside.
Despite the fatigue and shortness of breath, Leane pushed herself to keep moving. As the sole provider of her family, “I had to get better,” she recounts. “I have responsibilities to take care of my family, but I was the one who was sick in the hospital. So, I had to get better.”
Bulaong has since transitioned back to working 40-60 hours per week at a Maryland hospital after contracting the virus, which took her down for a month. Although she feels like she will never be back to feeling 100 percent, she is determined to continue to work to support her intergenerational family.
For many Filipino nurses like Bulaong, the call to care and to provide is strong. The 51-year-old is among the more than 150,000 Filipino nurses who have migrated to the United States since the 1960s, making them the largest group of immigrant nurses in the country. It is estimated that 500,000 healthcare workers are of Filipino descent.
Nursing and the American dream
As the healthcare industry contends with dispersing vaccines across the nation, the coronavirus has hit Filipino nurses particularly hard. Nearly 32 percent of the 213 registered nurses who have died of COVID and related complications are of Filipino descent, according to a National Nurses United union report. ("I feel defeated." A nurse details the unrelenting pressures of the frontlines.)
While the battle against the pandemic remains far from over, these caregivers forge ahead.
“We moved to the United States because it was a good opportunity for our family,” says Marc Bontogon, a 30-year-old telemetry nurse at Doctors Community Medical Center, in Maryland. He emigrated 13 years ago and says that becoming a nurse felt natural. “I knew that nursing would be a stepping stone to fulfilling the American dream.”
For many, working in the United States feels familiar. Healthcare in the Phillippines was largely modeled after the American system during the U.S. occupation, which lasted 48 years. Those entering the nursing profession could pursue better socioeconomic opportunities if they emigrated to the United States. The first large wave of Filipino immigrants began after World War II when the U.S. created the Exchange Visitor Program (EVP), which facilitated the entry of foreign nationals to help ease labor shortages.
In 1948, the Philippines and the U.S. entered into an agreement for the financing of bi-national centers to coordinate educational exchange programs in various fields, including healthcare. By the 1960s, the demand for nurses increased dramatically following the passage of Medicare and Medicaid and a spike in illnesses such as the AIDS epidemic in the 1980s.
An estimated 10 million Filipinos now work overseas in a variety of sectors and they send back more than $30 billion per year in remittances—about 10 percent of the Philippines’ gross domestic product. (Related: My mother's journey as an overseas Filipino worker.)
As the main provider of his family, Mark Abordo, a registered nurse at a Maryland trauma orthopedic unit, has been sending money to the Philippines every month for the past 11 years. Before the pandemic, he worked an additional 12-hour shift every week to send extra cash home to help a cousin get through school and pay for his mother’s expenses, such as food and utilities. “This kind of responsibility is a normal part of my life,” says Abordo.
The appeal of America as a land of promise remains strong, despite hardships for some.
Bulaong left the Philippines 12 years ago with her mother, husband, and a young daughter (her spouse and daughter are now nursing students). Her eldest daughter, Jennifer, stayed behind but later also joined the industry through a recruiting agency that facilitates the visa process. She moved to Missouri in 2017 and is completing a three-year commitment to work 5,200 hours. During this time, half of her salary is collected by the recruitment company.
Still, Jennifer carries on. With the monetary exchange rate of about 48.67 Philippine pesos to $1, a month’s pay is more money than what nurses in the Philippines make in a year. “Being away from my family has been hard,” says Jennifer. She hopes to fulfill her work commitment by April and join her family in Maryland.
Others have found what they were seeking.
Ernest Capadngan, 30, who has been working in the Biocontainment unit since the start of the pandemic, met his wife, Elizabeth Grace, 30, in college shortly after moving to Maryland with his parents in 2009. “We were very poor in the Philippines,” he says. “We lived paycheck to paycheck and struggled to put food on the table.”
The couple, both nurses, has settled in their new home with their newborn, Eliana Grace. For them, nursing has provided a sturdy lifeline even in the midst of the pandemic.