Angelite Nurses

For many Canadians, the image of a Filipino worker is one of a nanny pushing a baby carriage. But the reality is quickly changing. Lawrence Santiago, a Trudeau scholar doing his doctorate at the University of B.C., wants to dispel some stereotypes about Filipino workers in Canada.
As he puts it, only about 12 per cent of the total Filipino population in Canada arrives via the Live-In Caregiver program.
To make his case, Santiago chose to study health care workers from the Philippines.
B.C. has not recruited nurses en masse from the Philippines the way the Prairie provinces have in recent years. But they apply to come anyway. The province's College of Registered Nurses gets more applications for licences to practise nursing from the Philippines than it does from any other country.
Santiago set out to hear the voices of these workers, understand what happens when they leave the Philippines, and see how they eventually fit into Canadian hospitals and clinics.
His project started in a small Saskatoon house, returned to his native Philippines, and this month looped back to B.C.
His research has illuminated the many challenges involved with widespread migration, both here and in the Philippines.
On a personal level, nurses who emigrate for a brighter economic future are often wracked with homesickness and guilt for leaving their families.
Globally, the large-scale exodus of health care workers also takes a toll. The country they leave loses some of its best and brightest nurses and doctors, harming both the quality of health care and training for the next generation.
Last summer, Santiago camped out for several months with five nurses from the Philippines. They were all on temporary work visas, living in Saskatoon, the first batch of recruits hired by the Saskatoon Health Authority in 2008. His initial source was a childhood friend.
"Before he left for Canada, we met regularly in our town and at the community church," said Santiago.
From there, Santiago fanned out to meet and do in-depth interviews with other Filipino nurse migrants in Saskatoon.
"I lived with them in the same household, so I cooked, cleaned, played and did anything that a typical housemate would do," he explained.
His ability to speak to the nurses in Tagalog - and as the son of a middle-class, migrant construction worker himself - allowed him to "jell very quickly" with his subjects. Still, at times it wasn't easy to draw the line: when to be an objective observer and when to be a fellow Filipino.
One day while helping one of the migrant nurses Skype with an ailing father, Santiago wondered how exactly he should handle himself.
"I can eavesdrop in their private family conversation like an ethnographer who takes advantage or exploits his subjects' emotional circumstances, or I can simply stay away from the scene," wrote Santiago. "I decided to do what a friend would do instead. I cooked him sopas or milk macaroni soup, which he has been requesting from me to cook for the last few days because of the rainy weather here in Saskatoon.
"Managing one's emotions is one of the most difficult things migrants face while they're abroad. In situations [such as] when one's loved ones are sick, or worse, just died, the migrant feels a strong sense of fate's betrayal," he noted.
This April, Santiago moved his research to the Philippines to learn what happens on that end when nurses leave in large numbers.
"There is a huge strain on health care delivery in Philippine hospitals. The boom of nursing colleges in the Philippines has become a major business opportunity for many private entrepreneurs and institutions, enabling further migration," said Santiago. "But it has led to a deterioration of the quality of nursing education, since most of the best trained nursing faculty and clinical instructors are leaving the Philippines as well."
Over the next few weeks, Santiago will conduct focus groups with Filipino nurses who are working in B.C. (Some come on temporary work visas to take hard-to-fill positions, often in more remote locations. Some work first in other countries, such as the U.K., the U.S. or in the Middle East, before coming to Canada on temporary work visas or as immigrants under federal skilled worker programs. Still others come first via the live-in caregiver program and then go through many qualifying hoops to work as nurses again once they are permanent residents.)
Eva Mendez, a consultant at Health Match B.C., which places doctors and nurses throughout the province, hopes Santiago will focus on how these Philippine-trained nurses are doing at work.
"Do your peers relate to you as a member of the team as opposed to [being] a temporary foreign worker? If it's a matter of 'You're an RN, but you're not really one of us,' it can lead to a total breakdown of work dynamics. Satisfaction at work is the linchpin."
To promote his research, Santiago is organizing conferences and collaborating on a multimedia, documentary film project. His great hope is that all the players in this story of migration from the Philippines to Canada will somehow "meet" via his project and think of ways to improve education, health, labour and migration policies.
jlee-young@vancouversun.com