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 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.
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.”
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