63rd Foundation Anniversary of
the Philippine Nurses Association

Keynote Speech of President Edgardo J. Angara
at the 63rd Foundation Anniversary of
the Philippine Nurses Association
on 29 October 1985
Hotel Intercon Ballroom

It is with deep affection that I greet the officers and members of the Philippine Nurses Association on its 63rd Foundation Anniversary. My parents are both registered nurses from the U.P. School of Nursing and ten children were born and brought up by the tender loving care of nurses.

The nobility of the nursing profession, its exalted status as a mission, and not just a job, has always been acknowledged. But once in a while, especially on an anniversary, there is need to reflect on how well the profession is doing in its mission.

What is the association celebrating in this year's Nurses Week - the 27th since late President Carlos P. Garcia proclaimed in 1958 the last week of October as Nurses Week and charging the Philippine Nurses Association with its celebration? The second paragraph of Proclamation No. 539 states: "the purpose of dedicating a period in the year for the promotion of nursing ideal is to develop a consciousness and availability of nursing resources in the Philippine". Given this objective, how do we assess the state of the profession today?

Sad to say, not too well. In 1981, according to the Professional Regulations Commission, there was an estimated total of 134,264 nurses in the Philippines. The ideal ratio, however, is one nurse for every one thousand Filipinos. And yet, the 1980 study of the Philippine Nurses Association showed that 22 percent of the nurses were unemployed.

To the paradoxical problem of insufficient nurses and a large number of unemployed nurses, one must add the poor work conditions of those who are employed. A 1980 PNA survey pegs the average monthly wage of nurses at P500 - P800, plus a living allowance at P100 - P300. Pitifully small as this amount is, it goes down further to P750 - P950 after deductions. This is hardly commensurate with the amount of work that nurses do. It is not surprising, therefore, that a great number of nurses have migrated. And more wish to follow. A 1983 study entitle "the Values of Filipino Women," shows that one of the economic values of women today is the preference for working abroad to earn more money and to have a better life.

The PNA study I cited earlier also shows that for the five year period alone of 1975 - 1980, a total of 15,679 nurses left on job placements abroad through the Overseas Employment and Development Board (OEDB) and the Bureau of Employment Services (BES). Out of this number, 1,962 were immigrants through OEDB. As these figures exclude petitioned immigrants and those who got contracts other than through the OEDB and the BES, the real number of nurses working abroad could be much higher. Moreover, the same figures establish what has long been known, that the majority of our migrant nurses head for the United States, with the Middle East as the next popular destination.

Many students show that we may be losing many of our best nurses to foreign hospitals as well as health service institutions. The findings of Purita F. Asperilla's "The Mobility of Filipino Nurses", for instance, shows that among the common denominators of Filipino migrant nurses in the U.S. are that they belong to the upper third of their class in nursing school and that they obtained ratings of 81% or above in the board exams.

It is not just the hope of material improvement that has caused their migration. There is also a desire to avail of the greater opportunities for better professional training abroad. As Asperilla wrote in her study, "while the prospective salary of these nurses is a motivating factor, it appears that they were constantly looking for more challenges and advancement."

A frequent theme of studies in Philippine nursing is the effect of the exodus on the overall nursing picture in the Philippines. I would like to cite a study made by a U.P. Economic student last year. The study focused on the effect of employment opportunities abroad on the local unemployment rate of nurses. It presents the argument that, while the foreign demand for nurses had contributed to the increase in nursing schools and students opting for a nursing career, it also increased the number of unemployed nurses, as the number of applicants quickly outstripped the number of openings abroad.

Combining figures from sources like the Professional Regulations Commission, the Association of Philippine Medical Colleges, and the Philippine Nursing Association, the study showed that in 1971, for instance, out of 3.808 nurses newly entered into the profession, only 1,275 were absorbed abroad, leaving a surplus of 997 nurses. Then in 1978, out of 11,246 nurses, 1,454 were absorbed locally, while 3,049 were absorbed abroad, leaving a surplus of 6,000 nurses. The study also takes the view that the large number of nurses left unemployed affect the salary levels of those who are employed, the way any surplus tends to depress process.

This is the irony in the phenomenal migration of Philippine nurses. The benefits of foreign employment can be enjoyed only by a limited number while the rest of the nurses have to suffer the negative effects of an increase in manpower surplus. this in turn increases the motivation to migrate.

Another sad development is the urban concentration of nurses. In 1981, the PNA's Department of Economic and General Welfare published a study which revealed that only 12% of the working nurses were employed in the rural areas. And yet this is where three-fourths of our population live. the reason, of course, is economics.

We have the curious situation where large numbers of nurses prefer to wait unemployed until they get foreign contracts or urban employment, while rural hospitals, health or puericulture centers have open position for nurses.

There was a time when the introduction of modern equipment in hospitals created the fear the hospital care would lose that human touch that nurses give and become impersonal and coldly efficient. In the countryside, the fear is not impersonal medical care, but no care at all.

In sum, the country needs more nurses than there are. There would be more nurses, if less of them stopped reserving themselves for foreign employment or work in the cities. the rural areas can certainly use them. What am I saying? I am saying that the country is sounding a call to self-sacrifice directed at the nurses, as it has sounded similar calls to other professions and vocations. I am saying that whle the rest of the country may be ignoring the call - I hope the nurses will not. Would they be fools to answer when no one else is?

I am reminded of my parents who returned to our hometown and went about their duties diligently without looking around to see if everyone else is doing their part. Ask yourselves the question: if not now, when, if not us, who will? And, in the light of your special skills, who can?