Nursing Wounds: A closer look at the smirror nurses’ deployment ban
NURSING WOUNDS: A CLOSER LOOK AT THE NURSES’ DEPLOYMENT BAN
LEONIDES Hill, or Diesh to friends, is a single mother of two children and a registered Filipino nurse by profession.
The past two decades saw her working in various hospitals both here and abroad. Her first six years were spent in the Philippines before leaving for Saudi Arabia for another three-year stint.
She then returned to the Philippines to work here for four years before landing a job as a registered nurse in Germany. She has spent the last three years at the Saint Willibrord Spital Emmerich-rees Hospital located at the North Rhine as a geriatric nurse.
While it’s expected of a nurse’s work-life balance to take a turn for the worse every so often, Diesh said that nurses in the Philippines face more challenges and workload than the usual burdens that go with eight-hour shifts.
The only time local nurses get to sit down is when doctors prepare the orders to be carried out during the course of the nurse’s shift. This usually happens in the morning.
In Germany, any additional hours required during emergency situations result in additional compensation, which is more than she could say for local nurses to whom overtime pay is out of the question.
Philhealth payments
IN both cases, the risks nurses face hardly changes. When outbreaks occur, it is almost always an allhands-on-deck situation.
Pandemics such as the coronavirus disease (Covid-19) multiply the risks and workload a hundredfold. The novel coronavirus has infected more medical frontliners than government wants to admit.
In other countries, a second wave of infections has already put a strain on their struggling healthcare system, leaving some hospitals very little choice but to close shop. In Italy, more than a hundred doctors have died due to the novel coronavirus. It’s no different here at home.
Recently, the 744-member Private Hospitals Association of the Philippines Inc. (PHAPI) revealed that more than 300 small private hospitals are on the verge of closing as they were swamped with Covid-19 patients “and the failure of the Philhealth [Philippine Health Insurance Corp.] to release insurance claims.”
Rustico A. Jimenez, president of the association, said in a report that only a small fraction of the membership base had received some form of payment from Philhealth.
The risks are real, not a figment of anyone’s imagination. This is why nurses and other medical staff are lobbying for government to lift the deployment ban on Filipino nurses so they can go back to work in their respective host countries.
Return reasons
AT the risk of infection or succumbing to the disease, the least these nurses want are salaries sufficient enough to help their families get by should the situation escalate further.
“The reason why I want to go back to working abroad as a nurse is obvious,” Diesh said. “The salary we get in the Philippines is
not enough. I would not have second thoughts of staying, more so now that there’s a pandemic, if it weren’t for my two children. Both are suffering from cardiomyopathy. Their medicines alone cost more than P1,000 each day. If I’m going to work here, I will not be able to afford it.”
“I wasn’t planning on leaving,” Diesh added. “I already set my mind on staying beginning February. But my children got sick. By the time March arrived, I’ve spent nearly all my savings on medication alone. I have no choice but to leave.”
Diesh’s plans to return to Germany soon got shelved in April 2 by the Philippine Overseas Employment Administration (POEA) through Governing Board Resolution (GBR) 9, series of 2020.
The GBR imposed a temporary ban on the deployment of 14 medical categories.
The resolution states that in pursuit of the national interest, “or when public welfare so requires, may, at any time, terminate or impose a ban on the deployment of migrant workers” as stated in Section 5 of Republic Act 8042.
Over 600
WITH the alleged shortage of mission critical skills in the country, especially medical workers at the time of pandemic, the resolution aims to “engage temporary Human Resource for Health (HRH) such as medical and allied medical staff to complement or supplement the current health workforce or to man the temporary medical facilities to be established in accordance with Section 4 (k) of this Act.
“Provided, that HRH to be hired on temporary basis shall receive the appropriate compensation and allowances: Provided further, that all HRH serving in the front line during the state of calamity due to Covid-19, shall receive an actual hazard duty pay from the government,” using Section 4(m) of Republic Act 11469, otherwise called the Bayanihan to Heal As One Act, passed on March 24, 2020, as basis.
Included in the deployment ban are the following professionals: medical doctor/physician; nurse; microbiologist; molecular biologist; medical technologist; clinical analyst; respiratory therapist; pharmacist; laboratory technician; x-ray/radiologic technician; nursing assistant /nursing aid; operator of medical equipment; supervisor of health services and personal care; and, repairman of medical-hospital equipment.
Over 600 overseas Filipino workers (OFW) were affected by the Philippine Overseas Employment Administration’s (POEA) existing deployment ban for healthcare workers.
International Labor Affairs Bureau director Alice Q. Visperas told the Businessmirror a total of 643 medical workers were “stranded” due to the ban.
Thousands leaving
EIGHT days after the POEA issued its GBR, the Inter-agency Task Force (IATF)-EID, through Resolution 23, series of 2020, issued on April 10 a directive to
ban the deployment of Filipino healthcare workers.
April 13 arrived and the IATFEID revised Resolution 23, allowing the deployment of “all medical and allied healthcare professionals with perfected and signed overseas contracts as of March 8, 2020, provided they execute a declaration of their knowledge and understanding of the risks.”
The POEA said the move aims to ensure the country will have a reliable pool of medical workers amid the Covid-19 pandemic. It said it will remove the ban once the public health crisis is over.
It noted that without the ban, thousands of Filipino medical workers will go abroad to be employed especially since other countries are also dealing with the Covid-19 pandemic.
Only medical workers who “perfected and signed overseas employment contracts as of March 8, 2020” were exempted from the ban.
In an online press briefing on June 5, Labor and Employment Secretary Silvestre H. Bello III said POEA was only able to deploy 1,107 Filipino healthcare workers last month with the implementation of the deployment ban.
Employment contract ACCORDING to a group of nurses unofficially named Prisonurses, there are several issues to consider, foremost being outstanding contracts signed by these nurses prior to the issuance of the lockdown.
“Can the deployment of Filipino healthcare workers who have outstanding foreign employment contracts be suspended during the existence of national emergency?” they’ve asked.
Moreover, “can POEA revise the minimum requirement for deployment, which is a perfected and signed overseas employment contract as of march 8, 2020 and include issued overseas employment certificates on or before March 8?” April Glory, a 2006 nursing graduate who served the country as a registered nurse for six years before choosing to work abroad, said that it was her decision to stay for good in 2018. After living in the city for a full year, she realized that her savings are not sufficient to make ends meet.
“I started processing my papers until March when the small number of infections started increasing,” she said. “As a result, government issued a ban on deployment of health workers. The problem is that there are two documents released—one by the POEA, the other by the IATF. The IATF document allows deployment if you have existing contracts.”
Core issue
GLORY added that “regardless of whether one has an OEC [overseas employment certificate] or not, the person can leave.”
“The POEA resolution, on the other hand, says one can only leave only if they procured an OEC dated on or before March 8. It’s impossible for health workers to get an OEC on or before March 8 because most government offices were already closed at the time,” she said.
“Because of this, more than 700 health workers with contracts abroad, mostly nurses, were hit by the ban.”
It was long been the impression that there is a shortage of healthcare workers in the country,
If we’re going to put our lives on the line, and we have little choice but to do it, I don’t think there’s anything wrong in wanting to work for better pay, especially in these uncertain times,” April said. “We have to look after ourselves and our families just as much as we have to look after the welfare of the sick and the dying.”
—April Glory, nurse
Prisonurses said. There is some truth to the claim.
A 2014 study penned by Department of Health Policy and Administration, College of Public Health, University of the Philippines, concluded that “the current and existing health human resource need in government hospitals is a fundamental problem that the national government must address.”
“This need is the inability of a significant number of local government units to provide the minimum acceptable number of health human resources and mix of medical specialties in public hospitals,” the paper added.
tricky questions
OTHER statistics, however, show a different picture.
Based on the POEA list of deployment of nurses from 2000 to 2019, a grand total of 227,889 nurses have so far been deployed to other countries in a period of nine years. Of the 1,346,850 examinees who took the nursing licensure exam, 580,359 had passed within the same time period.
April added that of the 470,000 health workers in the country, government banned the deployment of only 700 individuals. “Many more will be left in the country to help deal with the pandemic here,” April said.
“The alleged shortage is one of the reasons why they imposed the ban,” April explained. “Another is that they want to secure the safety of the health workers by not allowing us to go to countries where the pandemic is at its peak.
The question they are putting out there is that why are nurses choosing to offer their services abroad when we have a shortage of health workers here?”
According to her, “there is no shortage of health workers in the country as statistics show.”
Citing the Johns Hopkins University site on Covid-19, “it says there that the Philippines stands second in line in a list of countries where health workers are at risk of infection.”
“We’re not safe here anymore than we are safe outside the country,” April said. “So why are they forcing us to stay?”
onus, challenges
MICHAEL Anthony Loarca and Jerrick Gomez who worked as registered nurses in the Philippines since 2006 and 2009, respectively, said that the real problem stems from the “temporary employment” scheme the government is offering them.
This will run only for three months.
“There’s no security of tenure,” the group said. “Our contracts abroad, after three months, could end up void. We will all start from scratch if we agree to this.”
Filipino nurses today are fighting an uphill battle on two fronts: to secure their family’s future both as frontliners in the struggle against the pandemic; the other as workers fighting to earn their keep.
Their call to lift the ban is seeing some attention, especially from Foreign Affairs Secretary Teodoro L. Locsin Jr., who early on cited their constitutional right to choose where they wish to be based.
However, they’re not out of the woods yet; not by a longshot. And it seems the longer they wait, the harder it will be for them to make ends meet.
Top that with the ever-growing concern for their health due to Covid-19, health workers are facing a tremendous amount of challenges.
filling the need
BASED on recent data from the Department of Health, as of May 28, roughly 2,480 local health workers have tested positive for the Covid-19, leaving the death toll at 31 and recoveries at 1,228 as of May 10.
In the case of nurses and nursing assistants, those who tested positive have reached 905 and 155, respectively. Doctors tallied at 695.
On this account, the World Health Organization (Who)western Pacific Region Covid-19 Incident Manager Abdi
Mahamud said that the infection rate of health workers in the country, having reached 13 percent, is “worrisome.” The region pegged only 2 percent to three percent.
“If we’re going to put our lives on the line, and we have little choice but to do it, I don’t think there’s anything wrong in wanting to work for better pay, especially in these uncertain times,” April said. “We have to look after ourselves and our families just as much as we have to look after the welfare of the sick and the dying.”
She insists, “the profession needs to be treated with dignity and with respect.
“If I’m offered better benefits somewhere else, that’s where I’ll go,” April added.
Worker welfare
TO provide alternative employment for the affected OFWS, the Department of Labor and Employment (DOLE) said it endorsed them to the Department of Health (DOH), which is currently in need of additional medical workers and volunteers for its Covid-19 response.
The DOH earlier announced it has around 15,000 additional medical workers to boost its capacity in dealing with Covid-related cases.
Aside from alternative employment opportunities, Visperas said the affected OFWS could also avail of the DOLE’S cash grant program it calls Akap (hug).
Under Akap, Covid-affected OFWS are given each a cash aid of P10,000 (about $200.61 in current exchange rates). Currently, the P2.5-billion program has benefited 145,000 OFWS.
In contrast, some host countries have also tried to ease migrant workers’ financial difficulties. Singapore, for example, suspended the levy it exacts on foreign workers, according to accounting firm and Swiss entity KPMG International Cooperative.
In its “Government and institution measures in response to Covid-19”report on May 27, KPMG said the foreign worker levy (FWL) for themonth of April and May 2020 will be waived by the Singaporean government.
“Additionally, a FWL rebate of S$750 (about P26,754) per month for the months of April and May 2020 (from levies paid in year 2020) will be granted for each work permit” or holder of the S-pass, which allows mid-level skilled staff to work in Singapore, “with payout accelerated to help businesses manage costs,” the KPMG online paper said. With additional reports by Samuel P. Medenilla