Caring From Afar

Young Filipinos work as nurses abroad to send money back home.

When April Quirante graduated as the valedictorian of her high school in the small town of Sison in the Philippines, she planned to pursue her dream of becoming an accountant. But after a year of accounting, her family expected her to study something else. When classes resume in June, she will not be learning about economics, finance, or mathematics. Instead, she will enroll in nursing school and soon be expected to enter the demanding environment of an American hospital. Hers is a common story: Quirante is one of thousands of young Filipinos who study nursing with the intention to work abroad. 


According to U.S. Bureau of labor statistics, there are about 100,000 unfilled nursing positions in the United States today. The Bureau estimates that by 2020, there will be close to 800,000 more nurses needed than employed in the United States. As Western populations age and technological advances make more treatment options available, many developed nations are facing a similar problem and have begun looking to the developing world to fill the gap in nursing labor. 

According to the Philippine Overseas Employment Administration, over 13,000 Filipinos leave the country each year to pursue nursing as an economic opportunity abroad. A former U.S. territory, the Philippines has maintained an admiration for and a mutual friendship with the United States since the country’s independence in 1946. Mary lui, an associate professor of history and American studies at Yale who focuses on Asian- American history, told the Globalist that this relationship has existed since the Colonial Period. While immigrants from other Asian countries faced exclusion, Filipinos had far fewer limitations. Americans helped develop higher education in the Philippines, and nursing in particular became popular as it became associated with modern hygiene. lui explained that after the removal of country- based quotas in 1965, the Filipino migration to nursing in the United States “really took off.” Additionally, English has long been an official language of the Philippines, making Filipinos more attractive employees in the United States than comparable workers without English language skills. 

However, there has been some resistance to Filipino nurses, led in particular by the American Nursing Association, which views immigrants as being in competition with American nurses. Filipino nurses are often paid less than domestic ones: Many hospitals and universities bring in Filipino nurses under the title of “intern” or “nurse-in-training,” paying them less than full wages even though they work full shifts and bear full responsibilities. 

But dedication to the profession does not go unnoticed. Employers quickly detect which nurses are passionate about their work. “It’s a job that you have to really enjoy to be successful in,” said Maryknoll Quiachon, a Filipino nurse who left her apartment in Pandacan, Manila, seven years ago to work abroad in London. 

Originally a political science student, Quiachon pursued nursing after her family helped her realize that it would be her chance to join her relatives already in the United States. despite her stable income, Quiachon, a mother of two, lives in a cramped house with two other families and two single women. She sends a sizable portion of her income back to her mother and siblings in the Philippines. 

What is left is saved for her journey to the United States, for which she has been waiting since she left the Philippines. When asked about the decision to pursue nursing, Quiachon said, “There’s more than just coming to America on my mind.” Quiachon was only able to begin studying nursing with financial support from family abroad. Now with a sustainable income, she views it as her duty to help her remaining relatives go to school in pursuit of better employment. “My aunt and uncle helped me, and now it is my turn,” she said. 

Due to emigration of doctors and nurses, the Philippines has only one medical professional for every 15,000 citizens, according to the World Health Organization. Brain drain continues, leaving few to care for the country from within. Remittances to families make up a significant portion of the GdP, reinforcing the dependency on overseas workers. 

Paired with a foreign-focused education, this attachment to the American economy raises the question: How independent has the Philippines really become over the last 60 years? Meanwhile, with the lack of nurses in the United States only growing, American citizens may be increasingly dependent on Filipinos in return. 

Joe Bolognese is a freshman in Pierson College.

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