FILIPINO NURSES AT THE HEALTH SYS­TEM’S CORE

Nearly a third of Filipinos in Ire­land work as nurses, send­ing money back to their fam­i­lies. More mind the el­derly and dis­abled. But they haven’t al­ways felt ap­pre­ci­ated

The Irish Times - Weekend Review - - NEWS REVIEW - Sor­cha Pol­lak

The walls of the in­ten­sive- care unit at the Na­tional Ma­ter­nity Hos­pi­tal are lined with scores of tubes that con­nect to the half- dozen in­cu­ba­tors hold­ing tiny ba­bies bat­tling through their first chal­leng­ing days and weeks on earth.

A cou­ple of mothers are dot­ted around the ward, cradling their pre­ma­ture ba­bies. Nurses watch the rest of the new­borns as their par­ents take a break f rom the rhyth­mic beeps that echo through the room.

Vicky Belleza sits by the win­dow, hold­ing a baby who is ea­gerly suck­ing milk from a bot­tle. “This one won’t be with us much longer,” Belleza says with a chuckle as the baby’s eyes dart around the room. “He’s too healthy to be in here. Time to go home with Mammy.”

Belleza del­i­cately lifts the in­fant into his cot be­fore wash­ing her hands and bustling over to a nearby in­cu­ba­tor to check on a much smaller new­born. Af­ter 16 years of car­ing for pre­ma­ture ba­bies at Holles Street she moves with ease and ex­per­tise around the ward.

Belleza had spent a few years work­ing in Saudi Ara­bia. Like many of her peers, she was at­tracted to the Mid­dle East by the prom­ise of a higher salary. But she grew tired of the re­stric­tions on women and re­turned to the Philip­pines. Then she heard about the short­age of nurses in Ire­land.

Belleza hated leav­ing her three sons and daugh­ter be­hind but knew that one par­ent needed to earn a de­cent salary to pay for their ed­u­ca­tion. “My brother told me a mother should be an an­gel to her baby. She must be with her chil­dren. It re­ally was re­ally dif­fi­cult, but we need to ac­cept that life is just like that.”

In Au­gust 2001 she ar­rived in Dublin and worked tem­po­rar­ily at St Michael’s Hos­pi­tal, in Dún Laoghaire, be­fore mov­ing to the Na­tional Ma­ter­nity Hos­pi­tal. “Our unit man­ager and ma­tron were so sup­port­ive, but there were some staff that weren’t as wel­com­ing. There were some Ir­ish peo­ple who could not un­der­stand us, but the man­ager re­minded them that we were nurses, too. That was back in 2001. They weren’t used to us then.”

Af­ter more than 15 years in Ir­ish hos­pi­tals and care homes Filipinos are no longer an un­usual pres­ence. Since their ar­rival, in the late 1990s and early 2000s, they have be­come a fix­ture in our hos­pi­tals and ar­guably, along with In­dian nurses, played a vi­tal role in hold­ing our pre­car­i­ous health sys­tem in place.

They nurse new­borns and feed the el­derly while qui­etly sav­ing up re­mit­tances for loved ones thou­sands of kilo­me­tres away. The lucky ones bring their fam­i­lies to join them here; oth­ers pa­tiently count the days, weeks and years un­til they can fly home to re­tire in the Philip­pines.

Nearly a third of the Filipinos liv­ing in Ire­land to­day work as nurses; 4,265 are reg­is­tered with the Nurs­ing and Mid­wifery Board of I re­land. Given t he l ack of reg­u­la­tion in the home­care sec­tor, it’s im­pos­si­ble to tell how many Filipino women and men are scat­tered across the coun­try look­ing af­ter young, el­derly and dis­abled peo­ple.

Mar­riage strained

Lily De­fi­esta and her hus­band did not just come to Ire­land for work. They heard it was a Catholic coun­try and had strug­gled liv­ing in Libya and Saudi Ara­bia, where they were un­able to openly prac­tise their Chris­tian faith. The cou­ple were work­ing in Rome when they met an Ir­ish priest who sug­gested they try Ire­land. In 2001, eight years af­ter leav­ing their home in the Philip­pines, they ar­rived in Dublin.

De­fi­esta’s youngest son was born in Ire­land, but her el­dest, who is 25, re­mains in the Philip­pines. Her ap­pli­ca­tions for fam­ily re­uni­fi­ca­tion have been re­jected be­cause of his age.

“That is the hard­est thing about be­ing here, be­cause we only get home once a year,” says De­fi­esta, who also works at the Na­tional Ma­ter­nity Hos­pi­tal. “I tried to ap­peal the de­ci­sion, but the an­swer was still neg­a­tive. My mum is here now, too, so he’s the only one left over there.”

Adeliza Ramirez left three chil­dren be­hind when she came to Ire­land in 2004. She never planned to work abroad but bowed to pres­sure from her cousins, who con­vinced her to visit Ire­land.

Her Ir­ish salary was a huge sup­port to fam­ily mem­bers back home. “You would work here for a month and send it back to the Philip­pines. The value was so much more there. When you live and work here, you just send the money. You don’t spend much on your­self.”

Ramirez liked her new job, but the dis­tance placed a strain on her mar­riage. Her hus­band was un­happy she had trav­elled so far for work and asked that she re­turn home. They set­tled on a com­pro­mise, and he and their three sons ar­rived in Ire­land in 2007.

Although the ICU nurses en­joy their work, they say the short­age of nurses and mid­wives means long hours and ex­tra pres­sure. “It’s a mul­ti­task­ing job. You need to work re­ally hard just to com­plete the work­load,” Belleza says. “There is a short­age of staff, but we help each other. Some­times you can­not avoid the pres­sure of work.”

De­fi­esta also dis­likes how so much of her salary ends up in tax pay­ments. “The high tax, that’s my big­gest com­plaint here. It’s a ma­jor thing for me, and it’s so hard to un­der­stand. Even when we want to do an ex­tra shift half of it will go to tax, so it doesn’t re­ally make sense to do over­time.”

Judy San­tos, who is a nurse at Tal­laght Hos­pi­tal, has lived in Ire­land since June 2001. She bought phone cards to speak every day with her son, who was liv­ing with her par­ents in the Philip­pines. She also sent half her salary home for the fam­ily. When he was 12 she ap­plied for him to join her in Europe.

“He started sec­ondary school here, but there were only two other Filipinos in the school, and he was bul­lied. I ig­nored it the first time, but then he came home cry­ing and said his sports bag was be­ing stolen. When we went home for our va­ca­tion he begged me not to take him back to Ire­land. I agreed be­cause he was cry­ing so much.”

San­tos came back alone, re­turn­ing to a lonely ex­is­tence fo­cused solely on work and phone calls home. She felt des­per­ately sad with­out her son, so when he turned 16 she tried to re­new his Ir­ish visa. He was told he could re­turn only on a tourist visa. Nine years on he is still in the Philip­pines, where he works as a chef, in Manila.

San­tos, who has Ir­ish cit­i­zen­ship, con­tin­ues to send half her salary to her par­ents.

“I have to sup­port them. I am the el­dest in the fam­ily. They have no pen­sions, so I send them my salary.”

She en­joys car­ing for pa­tients at Tal­laght Hos­pi­tal but plans to re­turn home as soon as she re­tires. “Philip­pines will al­ways be my home. This i s my se­cond home.”

Gentle­ness and re­spect

Paul Gal­lagher, di­rec­tor of nurs­ing at St James’s Hos­pi­tal in Dublin, says the in­ter­na­tional re­cruit­ment drives that brought nurses such as Belleza and San­tos to Ire­land in the early 2000s have been a vi­tal re­source for Ir­ish hos­pi­tals.

“Pa­tients might have felt chal­lenged in the early days, but they soon re­alised their stan­dard of care was every bit as good as our nurses’. They bring a gentle­ness and have an ap­proach that is very re­spect­ful.”

Gal­lagher trav­elled to Manila last year as part of a re­cruit­ment drive to bring more Filipino nurses to Ire­land and was struck by their com­mit­ment to the in­ter­view process. “You could see the sac­ri­fices they were mak­ing, not only to come to Ire­land but to pre­pare for the in­ter­view. Many trav­elled on buses for 18 hours overnight to get there, went through the rigours of the in­ter­view and then got back on the bus home again.”

With­out the sup­port of Filipino and In­dian nurses – who have also ar­rived in Ir­ish hos­pi­tals over the past decade – many wards would have closed by now, he says. “They are part of our hos­pi­tal com­mu­nit i es. They are part of t he f abric at St James’s, and we are very proud to have them on our staff.”

“The lady be­came very ill”

Tess Mon­tene­gro came to Ire­land 14 years ago af­ter her aunt, who worked in a school can­teen in south Dublin, con­vinced her to move. She and her hus­band left three chil­dren be­hind with their par­ents so they could earn a higher salary and pay for a good ed­u­ca­tion.

Mon­tene­gro, who trained as a carer shortly af­ter ar­riv­ing, is cur­rently look­ing af­ter a 93- year- old woman with Alzheimer’s. Every Wed­nes­day she drives from Dublin to Co Lim­er­ick, where she works full time un­til Sun­day. She of­ten feels iso­lated work­ing in ru­ral Ire­land and strug­gles to un­der­stand the lo­cal ac­cent.

When she ar­rived Mon­tene­gro looked af­ter a cou­ple in Co Meath and be­came close friends with the wife. “I was work­ing 24 hours a day, and dur­ing that time the lady I was mind­ing be­came very ill. It was so sad see­ing her strug­gle in pain, and I tried my best to help her sur­vive, but there was noth­ing I could do. I just had to let her go. It was so sad be­cause of my at­tach­ment to her. She’s still on my mind to­day.”

Work­ing with el­derly Ir­ish peo­ple of­ten re­minds Mon­tene­gro of her own grand­mother. “I looked af­ter my granny in the Philip­pines, so I had that ex­pe­ri­ence of how to han­dle the el­derly safely. I miss my granny, but I ap­ply my feel­ings into look­ing af­ter the el­derly here. Every per­son that I’ve minded I treat like my own granny.”

Mon­tene­gro dreams of bring­ing her chil­dren to Ire­land and hopes to meet her two grand­chil­dren soon. She spends her days off care­fully ar­rang­ing pack­ages for the new ba­bies, filled with clothes, lo­tions and feed­ing bot­tles. “I like Ire­land, be­cause it feels like home now. I’m happy as a carer, and I don’t want to change my job, be­cause I like con­tribut­ing to the love and care of el­derly Ir­ish peo­ple.”

Naida, who prefers not to give her sur­name, does not speak so pos­i­tively about her work as a carer. She ar­rived in Ire­land four years ago, leav­ing two daugh­ters in the Philip­pines. One of her first jobs in­volved look­ing af­ter an el­derly cou­ple. When t he hus­band be­gan mak­ing in­ap­pro­pri­ate ad­vances she didn’t know where to turn for help and handed in her no­tice.

She now cares for an­other el­derly cou­ple in Dublin but says the wife, a for­mer nurse, of­ten ac­cuses Naida of fail­ing to carry out her du­ties. “She makes me feel like I don’t know what I’m do­ing. Peo­ple have to build a re­la­tion­ship and have con­fi­dence in the worker, be­cause oth­er­wise I can­not help them.”

Naida says many fam­ily mem­bers don’t re­alise the im­por­tance of mak­ing the time to call their el­derly par­ents. “I know they are work­ing and busy, but some­times you just need to make the time for small talk. The fam­ily I work for, when­ever the fa­ther tries to reach out to them they say, ‘I’m at work.’ You can al­ways see the dis­ap­point­ment on his face.”

As with De­fi­esta, the church has been a huge sup­port for Naida. “I go to church every Satur­day morn­ing. It’s so im­por­tant be­cause of our cul­ture and tra­di­tions. It makes me f eel l i ke I ’ m back in t he Philip­pines, and I get to meet Ir­ish peo­ple, too.”

Naida plans to spend at least five more years in Ire­land, so she can keep send­ing money home. “It makes their lives eas­ier, so I con­tinue to send help.”

Edna Tua­zon, who con­vinced Naida to move to Ire­land, came here in 2000 but re­turned home in 2007 when her mother be­came ill. She moved back to Dublin in 2009 and be­gan car­ing for a woman with Parkin­son’s dis­ease and de­men­tia. Last year the woman was moved into pri­vate care, and Tua­zon found work in a nurs­ing home.

“Every day they change the lo­ca­tion, so you can’t fo­cus on one per­son. It’s very dif­fi­cult to re­mem­ber all the dif­fer­ent at­ti­tudes and per­son­al­i­ties. The clients be­come con­fused, so each day it’s like work­ing with a dif­fer­ent per­son.”

Tua­zon works a 54-hour week and says she has ex­pe­ri­enced dis­crim­i­na­tion from col­leagues and clients. De­spite the sup­port of her lo­cal church Tua­zon has de­cided to re­turn home to the Philip­pines by the end of 2017.

Clean­ing up the sec­tor

He­len Lowry of Mi­grant Rights Cen­tre Ire­land says leg­is­la­tion is ur­gently needed to pro­tect the rights of im­mi­grant care work­ers.

She says t he statu­tory home­care scheme pro­posed by Min­is­ter of State for Men­tal Health and Older Peo­ple He­len McEn­tee would pro­tect both the car­ers’ rights and those of their el­derly clients.

Un­der the pro­posed leg­is­la­tion the home­care sec­tor would be fully reg­u­lated, li­censed and in­de­pen­dently in­spected. The Gov­ern­ment would also in­tro­duce em­ploy­ment per­mits for the home­care sec­tor and a reg­u­lar­i­sa­tion scheme for un­doc­u­mented home­care work­ers.

“This is about clean­ing up the sec­tor and get­ting our heads out of the sand,” Lowry says. “Peo­ple are in these jobs a long time but can­not get a work per­mit. They re­ally care about the work they do and the peo­ple they care for. They also feel very strongly about the stan­dard of care they should be pro­vid­ing to older peo­ple.

“In some ways we have for­got­ten in Ire­land that a gen­er­a­tion of women be­fore us went into do­mes­tic and care work in the US. The work and l abour of t hese im­mi­grant women is be­com­ing in­her­ent in our labour mar­ket, and fam­i­lies are de­pen­dent on it.”

“There is a huge re­silience and agency among t he Filipino women I know. There’s more of a cul­tural ac­cep­tance around the idea that this is just part of what you do to make a liv­ing.”

Like so many oth­ers, Vicky Belleza hopes to re­turn home soon. “Holles Street has sup­ported me when it comes to my hol­i­days and un­der­stood when I need to go visit my fam­ily. My loy­alty is to the hos­pi­tal. But fam­ily is fam­ily, and we need to go back.”

Work­ing with infants at the Na­tional Ma­ter­nity Hos­pi­tal is al­ways a strug­gle when you’re so far from loved ones, she adds.

“It’s hard, be­cause you can­not take care of your own chil­dren but you have to look af­ter these tiny ba­bies. It’s a real sac­ri­fice. But I’m used to that now. There will be a per­fect time when I will be with them.”

When‘

we went home for our va­ca­tion my son begged me not to take him back to Ire­land. I agreed be­cause he was cry­ing so much I miss my granny, but I ap­ply my feel­ings into look­ing af­ter the el­derly here. Every per­son that I’ve minded I treat like my own granny

“The hus­band made ad­vances”

Above: Lily De­fi­esta (left) ap­plied for her el­dest son, who is 25, to come to Ire­land, but he was deemed too old, so he re­mains in the Philip­pines. Adeliza Ramirez (right) left three chil­dren be­hind when she came to Ire­land. Top: Vicky Belleza has been car­ing for pre­ma­ture ba­bies at Holles Street for 16 years. PHO­TO­GRAPHS: DARA MAC DÓNAILL

New­born nurses: Adeliza Ramirez, Lily De­fi­esta and Vicky Belleza at the Na­tional Ma­ter­nity Hos­pi­tal, on Holles Street in Dublin. PHO­TO­GRAPH: DARA MAC DÓNAILL

Video The Filipino nurses in Ire­land, at irish­times.com

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