A Mission of Solidarity: A Canadian’s Experience in Manila

May 16, 2008, 11:00, the National Centre for Mental Health
The patients, in their burgundy gowns, clamber to the bars of the locked-down ward for mentally ill young women, asking my name and nationality, reaching through the bars to shake my hand, telling me bits of their personal stories, asking me if I have seen their relatives. This ward is grossly overcrowded, without enough beds for the patients, who are forced to share beds or sleep on the floor, as many young women are doing, without mattresses or pillows, no blankets in sight, no personal comforts. The noise and the smells are overwhelming. The census shows there are 117 patients in this ward, with only one nurse!

This nurse cares deeply for her patients. She expresses to me, “as the only nurse in this ward, how can I provide even basic care to so many patients, let alone the type of care that would truly improve the lives of these mental patients?”

This nurse is performing socially necessary and productive work, but is forced to work in dangerous conditions, risking her own personal safety in an overcrowded and sadly under-funded hospital. Without back up, she cannot take a single break on her 8 hour shift; meals are taken at her station. If her replacement nurse is ill or delayed, she will work up to 16 hours unable to leave her station. And for what pay? A take home pay of less than p 8,000/month, or about 6 Canadian dollars per day.

As a Canadian, I ask myself, “why is this happening to the nurses and to the patients?” “Where is the health budget and what are the priorities of the Gloria Macapagal Arroyo (GMA) government that such deplorable conditions for both patients and health care workers could be allowed to continue?”

In a demonstration of solidarity for the struggles of the Filipino people for national and social liberation, my family and I are spending 7 months in the Philippines. As a midwife from Vancouver, Canada, naturally my alliance lies strongest with the health sector. On May 16, 2008, I had the privilege of an orientation with the Alliance of Health Workers and to tour 3 hospital facilities with AHW organizers: the National Mental Health Centre (NMHC), San Lazaro (SL), and Philippine General Hospital (PGH). This article recounts my experiences and the lessons I drew from that inspiring day.

Debt Servicing Over People’s Health: Mistaken Priorities of the GMA Government

All across the Philippines, the conditions that Filipinos face in their workplaces, in factories or fields, in their communities, and in their homes do not support health. Filipinos continue to get sick and die from preventable and often easily curable infectious diseases. Poverty, low wages, unsafe working conditions, and an absence of government social programs in housing, sanitation, basic nutrition, and health prevention lay the foundation for the ill health of the people. While 80% of the population of the Philippines lives on less than $2 US dollars per day, multinational pharmaceutical corporations are reaping billion dollar profits and benefiting from GMA tax-break schemes.

1:00, San Lazaro Hospital for Infectious and Communicable Diseases
A patient at San Lazaro hospital arrives at the admission ward, sick with an infectious disease, such as typhoid, dengue, malaria, tetanus, or cholera. It was the poverty of their families and communities, a lack of adequate housing and sanitation, and enforced hunger and malnutrition that led these patients to contract the disease in the first place. Yet, to obtain a diagnosis, this patient must pay a fee to use the laboratory diagnostic equipment, which is now owned by a multinational corporation and ‘leased’ to the hospital for a fee. If the patient can afford to pay for their diagnosis and is admitted for treatment, a myriad of other user-fees must be paid, including a daily bed fee. Even the poorest of patients must pay at least 10% of their total hospital bill. At San Lazaro, a hospital bill can amount to 3 months of salary for a patient! Every day at San Lazaro, patients sick with highly infectious diseases are turned away and sent back to their communities due to lack of funds. In fact, half of the population of the Philippines will die without the benefit of medical attention!

In the context of this gross unequal distribution of wealth, I learned there are multiple issues facing the health care system of the Philippines: a lack of affordable medicines; rising user fees in hospitals; contracting out of health services and medical and diagnostic equipment; income generation programs in the hospitals, such as private pay wards that divert essential resources to those able to pay; dilapidated hospital buildings, and non-functional and outdated equipment; and most significantly, the mass exodus of skilled health care workers, especially nurses and doctors. During my tour I learned from one union organizer that the union is assisting nurses to take up other skills such as tailoring to earn additional pisos to supplement their income as nurses!

The health care system of the Philippines is starving for funds as health care workers are forced to leave the country in droves to work overseas in order to support their own families. It is estimated that more than 150,000 Filipino nurses are working overseas, with the Philippines as the number one exporter of nurses. Following closely behind is the export of doctors, with the Philippines as the number 2 exporter of doctors! During my health orientation and hospital tour, it is painfully obvious to me that the GMA government lacks the political will to provide employment for the health sector and simultaneously provide health care for the people.

Turning a blind eye to the health crisis, the government continues to borrow funds in the name of corporate profit and increase the national debt in order to remain a ‘junior partner’ of the US. The national health budget remains inadequate, with only 0.34% of GDP spent on health. It is shocking that, given the health situation of the people, the military budget is 6 times the health budget, while debt servicing is 63 times the health expenditure! With their hard-earned remittances, overseas Filipino workers are floating the corruption and corporate favouritism cum tax evasion and ‘business incentives’ of the government, which is committed to privatization, trade liberalization, and market deregulation; a commitment to the irrational economics of imperialist globalization over much-needed investments in the Filipino people themselves.

Since the government refuses to take responsibility for the health of the people, the burden falls on the health sector workers themselves to leave the country and support their families, to fill in the huge gaps left by the government. In 2005, the Philippines economy received USD 10B-12B in overseas cash remittances from the labour of the OFWs.

The Experience of Overseas Workers: The Live-in Caregiver Program of Canada

The experience of Filipino workers in Canada demonstrates that the Arroyo government is willing to sell Filipino nurses into what amounts to ‘modern day slavery’ rather than provide a viable economic plan for the health sector in the Philippines.

The Live-in Caregiver Program (LCP) of Canada recruits highly-skilled workers to come to Canada to provide 24-hour per day live-in domestic and care-giving work for often below the minimum wage. The program results in the de-skilling of the majority Filipino women who, living in the employers homes as domestic servants, are highly susceptible to exploitation, abuse, and forced prostitution.

On the flip side, the LCP allows the Canadian government to privatize essential childcare and home care nursing and programs, citing the availability of ‘economically viable’ private alternatives through the exploitation of imported cheap labour from abroad.

Canadian-based Filipino organizations, such as SIKLAB, call for the scrapping of the LCP as a racist and anti-woman government policy!

Hey GMA! The People Respond!

3:00, Philippine General Hospital
PGH workers crowd into the PGH All Up Workers Union office, preparing for a medical mission into a poor community. As health care workers, the All Up Union members take seriously their mission to serve the people. It takes dedication and perseverance to withstand the conditions they face daily in their work, let alone to add to their burdens the challenge of union organizing to fight for the rights of health care workers and all oppressed and exploited sectors of society. Despite the myriad of tasks to complete for the medical mission, an All Up Workers Union representative still makes time to tour the hospital with us, explaining the issues and conditions of the workers. This dedicated worker and organizer also shares how the union actively engages in campaigns for pay raises, better working conditions, and against the economic policies of the government.

Campaigns such as the one to raise health sector salaries p3000 across the board show that health sector workers are rising up to demand that their needs be met without being forced to separate from their families and endure the hardships of overseas work.

PGH workers and AHW organizers are active in the Health Sector Alliance Against JPEPA, exposing and opposing the government’s corrupt intentions to increase the export and exploitation of Filipino health care workers at the expense of the Filipino people.

Thank you to all of the workers and organizers who took their time and shared their struggles and their lessons with our family. Your struggles are a true inspiration to us, and we stand in solidarity with you.

Makibaka! Huwag Matakot!