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Gender, Migration, and Work

Filipina Health Care Professionals to the United States
Yen Le Espiritu
p. 55-75


Sexe, migration et travail : les professionnels Philippins de la santé aux Etats-Unis.
Depuis les années 1960, les Philippins ont envoyé un grand nombre d’immigrants professionnels vers les États-unis, la majorité d’entre eux étant des praticiens de la santé. En liant l’impérialisme américain et la migration aux États-Unis, cet article avance que la sur-représentation des infirmières parmi les immigrants philippins actuels est le résultat d’influences imbriquées : le néo-colonialisme américain aux Philippines, l’établissement de centres de formation d’infirmières aux Philippines, le manque récurrent d’infirmières aux États-Unis et le recrutement « accrocheur » des infirmières par l’État Philippin et les agences américaines. Les liens historiques qui sont à l’origine du contexte de la migration des infirmières philippines ont des ramifications dans les vies personnelles et familiales des professionnelles de la santé. Par conséquent, la deuxième partie de l’article traite de la façon dont les relations familiales et matrimoniales se reconstituent aux États-unis lorsque les épouses étaient les premières à partir en migration.

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  • 1 International migration is so prevalent in the Philippines that in 1997, the Philippine Secretary o (...)
  • 2 Filipinos comprised the second largest immigrant group, behind Mexicans. According to the 2000 cens (...)

1The ferocity of U.S. (neo)colonial exploitation, the mismanagement of the Philippines by the country’s coamprador elite, and the violence of globalized capitalism have flung Filipinos “to the ends of the earth” as contract workers, sojourners, expatriates, refugees, exiles, and immigrants (San Juan Jr., 1998: 190)1. Although Filipinos can be found in more than 130 countries and territories by the early 1990s, with most earning a living as short-term contract workers, the vast majority of the Filipinos who migrated to the United States have resettled there as “permanent”immigrants (Tyner, 1999). According to the 2000 U.S. census, Filipinos totaled 1,8 million, comprising the second largest immigrant group as well as the second largest Asian American group in the United States2. Filipino migration to the United States differs in many respects from that to other labor-importing states. The history of U.S. colonialism in the Philippines, combined with a relatively liberal U.S. immigration policy and the proximity to alternative “cheapened” labor supplies, particularly from Central America and the Caribbean, means that a larger proportion of Filipino immigrants in the United States than elsewhere find employment in higher status and higher skilled occupations (Tyner, 1999).

  • 3 Beginning in the early 1960s, as the demand for nursing education exceeded the enrollment slots ava (...)

2Since 1960, women have dominated Philippine labor flows to the United States. In 2000, of the roughly 43 000 Filipinos who immigrated to the United States that year, 61 percent were women (U.S. Immigration and Naturalization Service, 2000). Unlike their counterparts in Europe, the Middle East, and East Asia, the majority of whom are contract domestic workers, Filipina immigrants in the United States are decidedly more concentrated within professional sectors, a phenomenon that can be largely accounted for by the migration of Filipina health care professionals, especially nurses (Tyner, 1999). Since the 1970s, the Philippines has been the largest supplier of health care professionals to the United States, sending nearly 25 000 nurses to this country between 1966 and 1985 and another 10 000 between 1989 and 1991. In 1989, Filipino nurses comprised close to 7rs coof a gemen enService,"tocSecenomenon tzable dedritua nam ligura inloseir">o the8coof a gem(Oand we Azs ho999).4; Adg aarly000).4)n 198f do,ny resen (U.S imminatorgle woreen) the Philippines thadies(Oand we Azs ho999).4 class="footnotecall" id="bodyftn1" 3"ef="#ftn3">(..3>. Fi>

2The fera artithidecidcru thsumon val— the Phischoly froe, arralie well as thethe Phipoprly ge.ction">pl— t in 1grants inspecially nurughto m Cendey lop chantries anombine the United States thasedrie lif by nd lnatc torg (Tysuch theobting in agher skiinaine we ndard.orsen ing ashe hito nd lnatc loitanons are recl as ument< le mr recruitment andcticantinab migcoyment in d hains fore resetd hliguraigder rol family relations are Filipino nealth ca-e professionals to.p> A ="tocfron1" idcritical transnational perspective to migration studies
2The snational perration studies< l ur rolobsiceon stu(Por, thiGuarz, ChratheLo ellt999). ; Glick Sched o1999).7SinF Cenelseporiemniag trandarcuhiIgd empnsnational pe, l thelaralue="e "> centrples lboxf tntat thedisrupshe demnaedmarcoy beint dtpermodof U.Sinairary n. " as rgericaetine"ceen ruch sin formieldaU.S. (neigration poldiescical tr lsnational perspective to migl" i att hi to theyartiher 10waesen ening U.Sbeyothe Carlty tf the earional -tes. : tntat thess de to tglobal hisations that set the context for Filigration and Natigrant groe2F thatii, espathe Carderl U.Slicatieoftwnpresentaciening. itiosewintthelardecil Uteciennvidumieeration.themanrch.op the earperlathetheortunité y. as F that erspective to U.Sigration andentes on"> er 10ortingaciening. itiosewin:S. colonializ, Filialey o ,d higcorary n. "hat in 19vadi for nuceltexymdrpletee Phind lnatc nhigcrlaliza ultce" ceeen ode -powerfclastries and(Lipsitz998: 19054)n G tohe Unmigr ofipligm aceeen ning. itiosernea phetical tracpfesaapatoeigration poldies2erneuaom anca99talado occan. co-lesheucation exhissyriem, nhigricanized pror resipinos wlue="hif migarituons (Tyniritu, Yentua : C . 2)n Etohel conaftwio Philippines tharegad infl coiidrper rdce man1946he majted States diftempinueo theexerhesigncatioin hiences o ohe Phia.opiptiogol— t ghly ansnde99omenon t="plndarcuhi migraley o baseIn 20fed">F h a r. colonialismgcrlaliel Natigagof U.S. (neabur arcuhi migsae Ead the migtiovhind lnatc nhigicy al tratexains forthe Philippines, ther resipinos whorated to the United States thatoass=imr the pemselvto tproximmises the earperlathetheortunité y as (iritu, Yentua : C . 2)n> U.="tocfron1" U.S. colonialism, labor recruitment and the production of filipina nurse migrants
  • 3The/ his1965migration andAdo,nwhich tboher" de earional al-gine4...)
  • 2Emitue sine Pr the resft mignhigonlyesiesesene demietuction of filsing eduthe PhiP href="#ftn3">5...)
  • 2 Interstors1936ee" raingly o poprly oSubbraphy">B, Virs, Heiserhe majprimissers. nurlth prothe PhiP href="#ftn3">6...)

2 Inhough Filr resscholy ore rescentrples d pro context rary Filipino iarse migration hasthe United States dif rtitti t-1965mnomenon thclass="footnotecall" id="bodyftn1" 4"ef="#ftn3">4..4>, 5..5>, F hh nut ultins htombtaU "> globuang to agad ste majieeri "> omenon tanume6..6>. Fil hisfears the earperined P196unhygs hic as Fpinos “lto thenhigjusuiatto h,use-to-h,usenidady o d spion"> 2 InL thevalei,usmricanizejoa=" trsernatv hi toshe majietuction of filsing eduthe PhiPippines tharfo">Prceigr resen enSeifndol,stefunon"> gloself-rulin 198er 10ws" c, enSeifndol,stestiturion of fil Philippines thaahaalteyy-aldcruyediseaseerjusuiatto Phieefor by e conricanizejoa=" trsernatv hi tobthe Phimati filsing ed. View edutearteach in thesing traio Fpinos “ rtitpermoiza obltion 2F,e Unmigedinals thtthee womt erpippnrin profesy nesloipinos tilialewho pisos iyh phe countialismjregmhih, to thew e (Lawcock999)75; Posadand terGuyotte999)F,e Unmigey froexngingeufestioms,nwhich bghly tlipinos totale Phited States whe theperadvarcud ining in as,nonstiturionoccanbal hi,gcrlalizand immirtwlted"uolghel U.opesiU.which . impeituted s ar />Destolcation exhi,gicy al tr,joa=" trstole womsuiod">rtale Pose sin forlippines, t /Artexngingeueris, a pipino iarse mieen aane lippine labcrlaliza amb="pr eln the United States, and the. impsing eduamb="pr eln upene deiecrualinatoe Philippines th / hisfoe iités" l U.Sgo traio rica and rtexngingeu iess" h nombe mieediomaal trfroinatorg/drsing eds coapoprly sy.oEtohtumifr,e ieseiand we wing at fbro s the United States aren aane alform wootrem> trirequie 2&he establishment of Ame estExngingeuVeris, ofestiom (EVP) man1948,nwhich tllowedueris, apsee iay the United States are the woar, 6re the ning in,cmadis eardtorm U.Sgo trafbro s the United States dif sfoe iitésye-ot onlyefelite, aomd (U, nut the perority of whoses in the Unilippines th / hisfric wgee="pandoteF h a r ieses we wingafbro s pertyo occipino nurses comthe raatmatie estEVP i de tnec lnue the perft migwato U.Sm="pgration of Filses to this nited States, andevthedeciitheighlbernearetunil U.Sloitation, tathe. colPosalisms,nwhich gely accregar the enroxngingeuses amonrtitperapened” labwing>Prce. Bygtlarget960s, the80oof a gemen exngingeueris, a the United States when find that erlippines, then a rnes comprised edutearority of the Filticulaspa (TynAcil illa999)76) / hisl co-ablishmeneerctntacof gloAmerican grd professional nursing training in syriem the PhiPippines thantepleF h a r enroxoriecof gloAansnational perprimté y Filipino nurses by ctorted the couEVPaborihe producsional nu,coandol, nhigcrlalismggrd inwinga theitperfey nd pr,eher fr-cationed higloiinga "> or force or forcemigr="pe lbe United States whinkik> er 10orratio inspipina hearatioin ses by e resh s theess ptSinequiga "> paes we wingafruanants" / manexngingeu the perpat-0rvely libher skilaly thaathelgration andArtunité " l il :a "> the United States whe(Oand we Azs ho999).4 c>

  • 3 Inters0s, ,can. coeigration and ts"dt in hituctioed UniH-1 t rary Filwingaeraufestiom,nwhich ena ">a href="#ftn2">7...)

1The ferrrepresentation of nurlth professionals. Aong contemporary Filipino immigrants is the. AorenSeiet of intdeeral Utec migaessive recruitment of m Cen. (nelosalisms,nsing trahineand thelth proorgalizon ansendieg at ftperapened” labwing>Prce oriecri "urinsatspento 7rsestic worrtage oforthe rad infses (TynOand we Azs ho999).4; Cging000). Unlce the 197p="prof nurenSe1965migration andAdo,n. (nelth proorgalizon anseniejonior foay andh a rlippine lab raveluncies. T, ive">Faccreitmenoccipino nurses cospecially nurmatiexplongingeuses am, migrationigale Phited States whe themanent”ployment in higir couituted s ar. M reslosalisms nombe m trahineacreitmenocckers, Faea UniH-1 be m traeraufestiom,nwhich ena ">dat emesee pentnursingeho thafbro s ene rary Filwingaerao thifillemanent”ptusin anlclass="footnotecall" id="bodyftn1" 7"ef="#ftn2">7..7>. FilRuitment and dreptient denombinsalcuousfrodlacin the Uniority locdeo-cwser exso Natin tdemlippine labJnals.o nurNe m tr99ximmiseigict hi s

3.="tocfron1" Gender and migration: the formation of a gendered labor force
2The feroieldaU.Sder rol famigration andentch.op beemovocc that erperigrant gromd (U.only as cpfesaapat yeacoy beizse rexffers ies imbrnrration studyriemo thitntat theexly neow marder rol rtitoandolrsyriem text foes d psrration poliros">< lr theber eld (U. migr(U.SHexaagneu-Sct lo999). ; er, 1999). SinInrticularly hes artscholy ohip beeernatesta to sheiteyy iU.which stiturion ofs U.Sm="arlié " l ifor ey ndé " l orgalizigration has migration to outaines.SHexaagneu-Sct lo999).4)n hough Fil contexs ptSU.Sder rolinterue="e "> the perur rondardrneaen ration. " loies bdcesomen hava goniaree resues td t the oveder roliros"> 2Theder andbeerefs, thttheeing at higi foomen a rathe Cth Filrfndolgbeerefs, af ed">F context and thesc, t sin. colonialism, tlicy a and tercticantin the forlippines, t /Art ey ndste maotineore resetmifooccushe majpriturion of filperer 10 thc as the.opi vocc-ot onlye Cth Filrfndolgbute. Aorenth Filrexuolr higdered labmodof U.Sfers iesting lsr(Mohinty999).1;ateo o1999).1;aYederoglYen9).8)ccott hi vigale Phirutumifr stituted recacts frowhorocer higdered ,ghericalclaKtine"nnHogalnstu(9).8)s sent manw marenSeifndol, on of nurFpinos “ rtbraiag trfrounfitr Filiidrper rdce drewolsrtdorgrnboutedered / hth Filarencifclarer" U. sinaeuananeU.SAhatii, nhigcrlalismgdiscoe mis the eartime,cohajprig aale wordemonatéges t the ovesesy neslo arreoe="ss the earipinos “tol l uraivi d pse hav ana praperiespFilpippnrin tol llusentatiehe proipinos “ l lend edutear anly rgericaetndiend "o-cciona1es theself-grrepnt slnlcearaddo this couldste mao arreoe="s the earfey nd pr ipinos he fordrpion of fil Philippines thaahamd anilipino nurmend "oeffey na and theipino nurld (U. seher fromey nde we nexuold pr (Hogalnst998: 190)37) / hish="srfey nd on of nurFpinos (U. migld (U.misresentatied higdericataigder rolruions thathe Philippines, thealit eduteartwee txthaagad steeach er 10 / hiye. Aorbol arredrenSeifndol, edjprig cns fat yeaFpinos (U.lendedrenSe anly rgericaetn theself-grrepnt slenhigjusuiatto Phieefor by . impeinatv hi tos thirion"fye Philippines, lperunnraliza as der roling. i(iritu, Yentua ) / hise" dre rec. impraley o ctntacof the PhiPippines tha(9898-1992)s sen. Aorductioed arreoe="ss theipina hehode lasi U "> nut s l pr,usmpermrotuted is as cni/supplbmisse“chemail-gide s brides.SHe="elani998: 5; Egat998: 6) /M resipinos wlional pe, eore resrger cd t the ovepermrotuted poliro ">m as the Philippines thadiesF trolsrle resthe forlippines, t /Den edutearVietnamoWarhe majPippines tha theknown the demperremignhigruite n. " as rertwieAmern A,slost educpfesximd P196tohe U,us the. impsice, 2 (U.da lif(Cnto"e nhigRosca999)<3; Warret998: 3)n 198m text fo,r ll ipina heho finifndol, edjsent xuolrprimod i I, us blig migloiend blihe hito nblishmeneerigagof U.tin to nivel labw a ripina hehorrepsorgr terctescribheir couifndol, on of te fin FtheexlypauhiChtine"nabChitu(9).890)44-46)lretunil t year resmle Ealos="p/M leyylclaloymene orregar eir couipina heaestic workers, Fjsent xuolfroducmiscuouFd the puhatheeeforintertwnto me U,of thenuceeillancer higtractolp> 2The. colonialismgsing eduthe PhiPippines thaher lts" co perpat-lexfiine oeon ofs U.Sder rolideniag andh a r eose sinrocer higos="p/in phap U.S. imponialismgader and tercticantinin. colonialismaining in Filipino nurses by,creitmenoccfedrie lif thaperremts f bli as lialewhhehivolvto Phiorti in andAmerican gs coabered labS imm. Aorifndol, edjshigos="ped) thsumon vagrnbouteor fo,nwhich,f rt ey ndstescholy Louise Newr ru(9).9: 34)eici in out,ptusincd t theto nSe concivi d psrenSeifnthe Mide than e (U. migld (U.fil Ptherocerh s thefers if thaoe wer 10 as ce thericanizermd (U.ntialism, tsgk reedSfers iestingaigder rolrs: tdh a rrfndolgfestithc, thiyeview>F contexturion of filanre-0rveao pe as Filipino nurmd (U.singeo thelarnd inon exhisale Phiuplift the earipinos erocehe huse oveder roocc-ot ofs U.Ssing eduaoamd (Us co kers />Destolhideaccounepain theey froen mpieca-e mpurhehhFacch s theresectioe as the Philippines tha(Choentua : 26) /. colonialismggrrepnt slodeeral Utefroec-0rvead higloclugoccipino nur (U. that eror forU.Ssing ed; was. Aoratt mpoeo the egslotee Phiite n. " filanfle-fijsing eduor force2The fermd (U-inated Phiration has Filipino nurses byp. Aoriefted" md (Us corsngt
  • 3 In  ‑ording to the 200lippines, lOrepsorgrEoyment in Ady ndstion anspween 1989 and 1991. 3ilipino nurA href="#ftn2">8...)

1The fer. colohthntc or supptage of nurses in,tt earacuteciecie, 1-c yd Natrlismgm wtés" l,s beelto the 200ave">Fcruitment and thetempinueo cteentestismaine nt of Filomenon - rad infses (TyiU.. coligration andlawsn 198atspento,nglethe 1970s, the Philippines hggrrepnt slo">Faccsesyonocc enroxtunirinte coses (TyiU.exngingeu the peiecrumer:ancerdniorrs,nwhich contical trlyesed the mmdo ovdotee Phin n. " aeemoung stanxnatiol debtt the sndeonefic lclass="footnotecall" id="bodyftn1" 8"ef="#ftn2">8..8>. FilOncerdenated to theib thon edutearlth carsed s the eaiecown peoplig the perots" yrdniorrilipino nurses comwing at fbro s n aane Philippines the,"vnewaional per 10owho pisosning a slhteldahelp therevlism zee Phin n. " aeend lnays(Choentua : 116)n 198a99)73raddithcaio Fpinos aratioin ses by,ilippine Secretary o

1 Inlippines hggrrepnt slothatii, egnhigruitment and cies. TSloitatitdered labdrpion ofs theipina hehomigraek -e earipinos eses co /Artexped">F,e Unmigthatii, egnhig cies. TSlotole Phieingehe,"vlishrdpanli>rma iniand wérepsnrf the Fillippines hgDc-0rnt of Filimenon tAffai y,ilippine SecVntinPreenotand theimenon tAffai ycretary o i in and the perdered labnersgU.Ssing ed: per198Canadahehigricaniz,vEurope, tnd immir er 10dlacispipino iarse miee proin cemani. Why? B aausenthiyedoe peir jobth a relsmiauhik a rogermhik a rgifntheh a r enrne l ourarse sinhelp to theorg/ tproxon.e toe,"vpingheh a outeooog at fam pronlock99h a outemifo the secrreptime,cne lry try to thecliel Unixon.e td thetemfing stahim the timeea goed o /And t theiho pylipino nurses byp.proin cemani.s 198adains fatordered edutearton.e td r lro the prosingec rt eyaauhiGu edl nsdrpionehe proipinos arse miee eetheerfclanboute higlvthee lcom in the eair hy ohemdng at texains forsuch thel conhoe mt thel re phypl traor sun 198m enidmeitey,/Annabyo o ReyieeBoresyeo,rma iniandpreenotand theCEO theSTIis ferM990).4)n > 4.="tocfron1" Female-first migration and changing gender relations
2The frh Fil coniros">i in andinte ele dl theeratorg/drticulaspan is s ew andnoyment in,re concenctolarrep ning a sab migdtorterrticulaspan is s eily rel iciss a-mag at (Piona1999)84)n houative ly, ration. "smay le resder rol rymmees andgely accunngingeiglvtheugh Filceptingedit is ofs U.Sder rolinequmi ibyp.promodfiinf(iritu, Yen9).7/p>
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    1 International migration is so prevalent in the Philippines that in 1997, the Philippine Secretary of Foreign Affairs called for “international migration” to be made a subject for elementary and high school students to prepare them for what he termed the “reality of immigration” (Okamura, 1998: 5).

    2 Filipinos comprised the second largest immigrant group, behind Mexicans. According to the 2000 census, Chinese Americans, at more than 2,4 millions, constituted the largest Asian American group in the United States. In California, Chinese Americans, who neared the 1 million mark also pushed past Filipinos (918 678) to become the state’s largest Asian group. Though the Filipino population rose by 31,5 % nationwide and 25,6 % statewide, it fell well short of predictions that the 2000 census would crown Filipinos as the largest Asian group in the nation and in California.

    3 Beginning in the early 1960s, as the demand for nursing education exceeded the enrollment slots available in Philippine colleges and schools of nursing, Filipino businessmen and health educators opened new schools of nursing in the provinces as well as in urban areas. Between 1950 and 1970, the number of nursing schools in the Philippines increased from just seventeen to 140 (Choy, 2003).

    4 The 1965 Immigration Act, which abolished the national-origins quotas and permitted entry based primarily on family reunification or occupational characteristics, dramatically increased the number of Asian immigrants to the United States.

    5 Catherine Choy’s Empire of Care is the first and only study on the introduction of nursing in the Philippines during U.S. colonial rule and on the impact of the U.S. Exchange Visitor Program of the 1950s and 1960s on Filipino migration to the United States. Therefore, this section of my paper necessarily relies on Choy’s pioneering research.

    6 In his 1936 extraordinary popular autobiography, Victor Heiser, the commissioner of health in the Philippines, described Filipinos in the following terms: “grown-up children, dirty, unsanitary, diseased, ignorant, unscrupulous, superstitious, born actors, resigned to death, untrustworthy, cowards, a nation of invalids, incubators of leprosy, unhygienic”(cited in Anderson, 1995: 100).

    7 In 1970, a U.S. immigration amendment introduced the H-1 temporary work visa program, which enables a hospital or nursing home to sponsor or bring a nurse with a professional license from abroad to work in the United States for two years. However, under this program, applicants must pass the U.S. nurses’ licensing exam. If she passes, she can gain permanent residency after two years. If she fails the exam, she loses her temporary work visa status and faces the threat of deportation (Chang, 2000). The majority of foreign-trained nurses (between 75 to 90 percent) who took the exam failed (Ong and Azores, 1994). In 1989, the Filipina Nurses Organization fought for passage of the Immigration Nursing Relief Act, which enabled H-1 visa nurses who were present in the United States on September 1, 1989, and had worked for three years as a registered nurse in the United States, to adjust their status to permanent resident (Ong and Azores, 1994).

    8  ‑According to the Philippine Overseas Employment Administration, between 1989 and 1993, Filipino Americans remitted approximately five billion dollars, averaging well over one billion dollars each year (Okamura, 1998: 126). By 1989, consumer goods sent via balikbayan (returnee or homecomer) boxes contributed 4.2 billion pesos (or one hundred and ninety million dollars) annually to the Philippine economy (Basch, Glick Schiller, and Szanton Blanc, 1994: 257-58). These numbers are rising. In the first half of 1994, overseas Filipinos remitted almost eight hundred million dollars through official bank transfers — a likely underestimate (Okamura, 1998: 44, 126). In 2001, over seven million overseas Filipino workers sent over six billion dollars in remittances to the Philippines (U.S. Treasury Department, 2003).

    9 Over the course of eight years (1992-2000), I interviewed just over one hundred Filipinos in San Diego County. The majority of the interviewees were Filipino Navy men, Filipino nurses and their families.

    10 During the ninety-four years of U.S. military presence in the Philippines, U.S. bases served as recruiting stations for the U.S. Navy. Filipinos were the only foreign nationals who were allowed to enlist in the U.S. armed forces; and the Navy was the only military branch they could join. As a result, Filipino sailors have always formed a significant segment of the Filipino community in the United States, especially in San Diego, the home of the largest U.S. naval base and the Navy’s primary West Coast training facility until 1998.

    11 Data from the 1984 National Sample Survey of Registered Nurses indicate that Filipinas had the highest earnings among all groups, averaging almost five thousand dollars more annually than white nurses (Moses, 1984). Ong and Azores (1994) report that Filipina nurses use various strategies to increase their earnings: working double shifts or in the higher-paying evening and night shifts, and in inner-city hospitals which offer higher salaries than the national average. In other words, they earn more because they are more likely to work under the least desirable conditions.

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    Yen Le Espiritu, « Gender, Migration, and Work », Revue européenne des migrations internationales [En ligne], vol. 21 - n°1 | 2005, mis en ligne le 02 septembre 2008, consulté le 14 décembre 2017. URL :

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    Yen Le Espiritu

    Ethnic Studies, University of California, San Diego,

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