I love Filipino nurses.
As my father lay dying with Alzheimer’s and a host of other ailments in 1980s California, we hired one to guide him through his last days. And years earlier, growing up there, those dark-haired angels were ubiquitously present in healthcare establishments throughout the state.
They still are.
Because everyone knows — in California and elsewhere — that you can’t do any better than with a Filipino nurse. Which poses a haunting dilemma for thousands of them: here or there? Specifically, whether to serve in the homeland that gave them birth, emotionally sustains them, and desperately needs them. Or flee to a foreign country that also desperately needs them but can pay much more?
“The quality of life that I could have abroad is going to be better than staying here in the Philippines,” 24-year-old Ralph Garcia, who recently passed the Philippine Nurse Licensing Examination, told Singapore-based news channel CNA.
Added John Lorena, dean of St. Luke’s College of Nursing at Quezon City’s Trinity University of Asia: “When I interview students...they usually say they want to help their family and helping their family means [leaving] the country. I cannot do anything about it because that’s the sad reality.”
The consequences for the Philippines are drastic. With 300,000 to 350,000 of its nurses working overseas, CNA reports, the country is roughly 160,000 short. Which is obvious to anyone who’s ever been — or visited a patient — hospitalized in the Philippines. A recent two-month stay in a Northern Mindanao intensive care unit by my critically injured sister-in-law, for instance, required the constant presence of friends and relatives to assure around-the-clock care. The family literally drew up a 24/7 schedule and took volunteers. Most Philippine hospital rooms, in fact, are equipped with extra couches to bed those much-needed “watchers.”
And the problem is likely to get worse.
In 2023, the world employed nearly 30 million nurses, according to the State of the World’s Nursing 2025 report by the World Health Organization and International Council of Nurses; a number likely to increase by 10 million in just the next four years.
But that still won’t be enough to handle the then-expected global population of 8.5 billion, much of it elderly. And a large portion of that swollen demand will be met by OFWs from the Philippines, where entry-level nurses earn around 40,000 pesos monthly, far less than in many other countries.
“That salary is barely enough to cover daily living expenses,” says one 20-year-old nursing student in Surigao City. “So the only way I can help my struggling family is to go abroad.”
And here’s where it gets personal: that student is a much-loved niece living with us while attending school. “Leaving my family will be hard,” she admits, “but I will just keep reminding myself to be strong. Everything I do will be to give my family the better life that they want and deserve.”
Another niece, now 23 and working full-time at a local hospital, admits to having mixed feelings regarding her profession. “Working in healthcare,” she says, presents the “enormous challenge” of assuming responsibility for the wellbeing of sufferers amid sometimes-dangerous nursing/patient ratios.
It can also be toxic, she adds, involving long hours, back-to-back shifts, and patients’ families that can be demanding, unappreciative, and disrespectful. Still, she concludes, “I’m grateful to [be able to] witness, learn, and experience [wonderful things].”
And yet she too would like to go abroad because, she explains, “Their technologies are more advanced and, more importantly, our services are well paid. I want to challenge myself to see how far this dream will go. Leaving will not be easy, but I’m better off missing my parents than thinking that the future holds no promise.”
Those farewells will be difficult. And yet I can only wish them fruitful and productive partings. Somehow we will manage to continue without them. As must the rest of the Philippines.
kkk
David Haldane is an award-winning American journalist and author with homes in Southern California and Northern Mindanao. His latest book is Dark Skies: Tales of Turbulence in Paradise.