At the age of seven, Maria Katrina Entrampas knew that she wanted to become a teacher. She held on to that dream until she heard the news about the high demand for nurses abroad. When she reached high school, nursing suddenly became a trending course for college students in the Philippines due to the increase in job opportunities available for nurses in countries such as the United States, United Kingdom and the Middle East.
“I gave up my childhood dream of becoming a teacher because I really wanted to work abroad,” Ms Entrampas said.
Her father also worked overseas as a member of a crew ship since she was young.
For most Filipinos, working overseas was seen as the ticket to escaping the poor economic conditions in their country.
It was the 6th of April in 2010 when Ms Entrampas finally received her college diploma in Nursing in the Philippines. She immediately reviewed for the board exam and received her license as a Registered Nurse in March 2011.
She volunteered in a public hospital for one month just to earn a certificate and decided to venture into other jobs while figuring out what country she should work for as a nurse.
Ms Entrampas said at that time, nurses in Philippine public hospitals only received a monthly salary of P 15,000 (A$ 500) while nurses in private hospitals were paid P 8,000 (A$ 266.67) every month.
“Plus you have a lot of deductions so there’s really not much left for your basic needs. Filipino nurses were and still are underpaid. A family can hardly survive with those wages,” she said.
85% of Filipino nurses are working outside the country
A total of 2, 457 Filipino nurse migrants to Australia have been recorded from 2010-2014
By 2025, Australia is expected to have a shortage of 109,000 nurses
Filipino Nurses in the BPO Sector
Ms Entrampas decided to work as a call center agent and as an English tutor for Korean students instead.
“At least as a call center agent, I was able to save a little money for my application abroad,” she narrated.
In 2010, the Philippines became the world’s Business Process Outsourcing (BPO) capital, employing hundreds of thousands of Filipinos, including nursing graduates. As call center agents, nurses could earn twice as much as what they are paid for in hospitals.
Among the Filipino nurses who continues to work in the B.P.O. industry is Pamela Estalilla, who has no plans of going back to working in the country’s healthcare sector.
“In my opinion, given the nature of work, nurses should be paid much more than call center agents. Unless that happens, I have no plans to do that again ever,” she said.
Katrina’s journey to Oz
Ms Entrampas initially planned to apply in the United States, however US demand for Philippine nurses plateaued because of its shrinking market and filling up of visa quotas.
She then heard of Australia’s current demand for nurses in its Skilled Occupations List. Knowing that she had a few relatives who migrated to Australia, she decided to give the land down under a try.
She first applied for a tourist visa in 2012 and worked as a babysitter for her nephews and nieces for three months. Because of her limited approved stay, she had to go back to the Philippines shortly.
“I learned about how much I could possibly earn if I worked as a nurse here in Australia and I told myself that I was definitely coming back,” she said.
For Filipino nurses to apply for work in Australia, they should pass a mandatory Occupational English Test (OET) or International English Language Testing System (IELTS) test. They are also required to pass specific examinations in Australian nursing theory and practice to receive nurse registration, or complete a registered nurse bridging program.
Ms Entrampas learned that the fastest way to go back to Australia was by securing a student visa and working her way towards earning Permanent Residency through points testing. This in fact, is the technique used by most Filipinos today in order to secure a ticket to the land down under.
She came back to Australia in 2013 with her student visa after enrolling in a certificate course in Aged Care. The process was not easy, as she had to borrow P 1.5 million or more than A$45,450 for her bank statement requirement for her visa application. On top of this, she had to pay her tuition and visa processing fee, as well as her airfare expenses.
“My family made such a huge investment for me to be able to get here. This motivated me to work very hard,” she said.
In Sydney, she juggled three jobs at a time. She worked in a nursing home, became a nanny, and cleaned people’s houses just to pay the bills.
“My day was like, study, work, work, work, study. I barely had time to rest,” she said.
As an Assistant in Nursing (AIN), she earned A$21 an hour, which was even bigger than the daily minimum wage of nurses in the Philippines.
“What I earned in a week in the Philippines, I earned in a day in Australia. So I really didn’t mind cleaning after old people or scrubbing dirty toilets,” she said.
She was able to pay her loans after a few months and managed to save enough money so that she could enroll in a Bachelor’s degree in an Australian University and become a Registered Nurse in Australia. She could then gain enough points for permanent residency and would no longer have to pay for tuition fees to remain in the country.
Depending on the state, Australian registered nurses earn at least A$27 per hour. In Queensland for example, they receive an hourly rate of A$35.34.
Next year, Ms Entrampas will earn her second bachelor degree in Nursing, this time in Australia, and she can hardly wait for that day.
Although the compensation is great, Ms Entrampas said living away from home is very difficult. She had to adjust to a lot of things—the lifestyle, culture, even the weather.
She said she battled depression and homesickness especially during the winter when everything felt gloomy.
“After my first two months, I wanted to go home so badly. I missed the Philippines so much,” she narrated.
“It breaks my heart that I was caring for other people in a foreign land but I could not take care of my own family when they were sick.”
Finding fellow Filipino nurses in school and in her workplace helped ease the loneliness she felt. They try to squeeze in fun activities into their schedule every now and then to shake the blues away.
Ms Entrampas says if only working conditions for nurses in the Philippines were desirable, they would not leave at all.
Aside from watching Filipino telenovelas together, Ms Entrampas and her fellow Filipino nurses bond at home by singing acoustic songs. In this video, they sing “Hawak Kamay,” which means “We’re in this journey together”
Nursing Shortage in Australia vis-a-vis Philippine ‘Brain Drain’
Filipino nurses continue to flock to Australia to earn a higher income. Australia’s Department of Immigration and Border Protection has recorded a total of 2,457 Filipino nurse migrants to Australia from 2010-2014, who were either sponsored by employers or gained permanent residency through Points Tested Skilled Migration. These figures do not yet include the number of Filipino nurses who were granted an Australian visa by enrolling as international students like Ms Entrampas.
This might sound favorable to Australian healthcare institutions, especially after a report from Health Workforce Australia in 2012 revealed that the country will face a shortage of 109,000 nurses by 2025. The Australian Nursing and Midwifery Federation (ANMF) stated that short-term shortages in nursing and midwifery positions have been addressed by hiring skilled migrants.
Although Australia can benefit from the influx of Filipino nurses, the Philippines on the other hand has been losing its healthcare workforce. According to a health worker migration case study commissioned by the International Labor Organization, 85% of Filipino nurses are working outside the country. The study cited a report from the Philippine Hospital Association in 2005 stating that 200 hospitals have closed due to shortages of doctors and nurses, while 800 hospitals have partially closed for the same reason.
The Philippine Senate has already approved the Comprehensive Nursing Law of 2015 increasing the salary of nurses in public hospitals to P25, 000 (A$ 758) per month however, this is yet to be implemented.
Nurses in private Philippine hospitals on the other hand, still await government intervention for their salary increase.
Cyrene Toledo, who has been working as a private hospital nurse for more than three years, said nothing has changed since 2011. Until her last month of work in January, she only received P 10, 000 (A$ 303) monthly in exchange for work that demanded a 1:10 nurse-to-patient ratio.
“Had I not ventured into online selling, I would not have survived those three years,” she said.
She is now working as a nurse in Singapore.
“Unless the government makes concrete actions to make us stay, they will continue to lose their health care workers,” she commented.
The challenge for ethical recruitment
With an average nurse age of 50, Australia is challenged to achieve self-sufficiency in nursing in the future, and will continue to depend on inviting and hiring international nursing graduates. However, such recruitment drains human capital from developing countries such as the Philippines. The worldwide thirst for nurses trained in developing countries needs to be turned into a mutually beneficial phenomenon.
According to the WHO Code of Conduct on International Recruitment of Health Personnel, developed countries need to consider sustainable health services planning, training and education in order to reduce dependence on migrant health workers. Developing countries on the other hand, need to improve workers’ compensation to avoid emigration of professionals.
Ms Entrampas, who migrated to Oz to make ends meet, is still waiting for the day where Filipino nurses do not have to leave. Like Dorothy in search for the Wizard of Oz, she too has realized that “There’s no place like home.”