By Carolina S. Ruiz Austria

The word "Heresy"

was used by Irenaeus in Contra Haereses to discredit his opponents in the early Christian Church. It has no purely objective meaning without an authoritative system of dogma.

Monday, May 29, 2006

Health, Rights and Filipino Women

This piece is in reaction to the PDI's Editorial May 29, 2006 entitled:"Goodbye, dear nurses." (Carolina S. Ruiz Austria)

As we brace ourselves for the impending mass migration of Filipino nurses into the U.S. because of recent US policy developments, we should also probably be reflecting on how ironic the new policy is in the face of the US' policy environment of late: the host of explosive migration policy-related issues its embattled public of migrants has brought to the world's attention.

Images of thousands and even millions (across the country) marching against similarly pending legislation to crack down on migrants, was a sight to behold in the news.

Amid the racial tension and debates on how supposedly the illegal migrant population was putting a strain on the US' resources, of for that matter, in the name of the the all-purpose issue, “the war on terror, “comes along another policy that actually opens doors for more migrants.

Leave it to the GMA administration of course to embrace the developing policy as a totally positive development without regard for the deteriorating quality and availability of health care in the country.

For even as the US unabashedly pursues such "out-sourcing" without regard for the long-term effects on its foreign sources (unlike the U.K. which as mentioned in the editorial has resorted to debt condonation and aid arrangements), on our side of the fence, our own government and how it approaches the health care situation is definitely part of the problem in huge measure.

Yet the issue of migration for work is far more complex than policy makers and even media usually approaches it. To be sure, the out-migration of Filipino nurses has been a phenomenon since the late 50s.

Likewise, even as there are more and more men (even male doctors) going into nursing, culturally and in accordance with dominant gendered standards, it has remained predominantly a "female" profession.

According to a 2005 policy study which covered the trends in international migration among nurses, "Whilst the issue of international migration of nurses is sometimes presented as a one way linear "brain drain," the dynamics of international mobility, migration and recruitment are complex, covering individual rights and choice; motivations of nurses to career development; the relative status of nurses (Women) in different systems; the differing approaches of country governments to managing, facilitating or attempting to limit outflow or inflow of nurses; the role of recruitment agencies as intermediaries in the process." (Lorenzo;Kingma and Buchan: 2005)

Often enough, even as we grapple with the seemingly macro issues of massive deterioration in local health systems, the inappropriateness of quick fixes in mass recruitment for migration schemes, we tend to miss out on the facts staring us in the face. More than ever, debates over migration policy have underscored (and surfaced) two very important issues we face in the era of globalization: the prominence (and persistence) of gender and racial geopolitical inequality.

It should matter somehow that the “sources” of workers for the relatively low-paying “service industries” of the developed countries are are the developing countries and majority of those recruited are women from the third world. Yet even as this bit of information tends to this day, to conjure up the usual imagery of masses of ethnic women being rounded up for slavery before white male (colonial) masters, it is hardly this simple to sum up. True, women and children continue to be trafficked and duped into migration for work schemes, but this isn’t the only picture.

More likely, masses of working women who have had to struggle in their own countries to overcome gender stereotypes (or even knowingly embrace some of them by being influenced in their selection of university education) are making choices, sometimes as individuals, often along with their families and friends, to earn and survive. Many more are making these choices with self-improvement and a better life in mind.

Ironic as it is, on one level, one woman’s decision for economic empowerment is just another nation’s quick fix and low-cost, market-ideology driven answer to their own health care problem.

This makes the problem so much more challenging and daunting to approach. Even among us who strive to protect women’s rights, there are many who may find it difficult to distinguish between “protection,” and sheer disempowerment.

Notable in the past are the policies, which focus mostly on limiting the rights of women to travel and work abroad. Again the irony: “in order to protect your rights, we have to violate them.”

“Rights” after all are accorded to citizens in the classical Western liberal sense, by the State. It is citizens who are the subject of law and the legal protection it affords.

In the consideration of policies and measures to take whenever “public interest” or even “national interest,” is invoked, I cringe to think whatever draconian strategies will be undertaken to undermine the rights of women and in turn curtail their ability to decide.

Traditionally, pornography, prostitution and other so-called immoral displays have long merited the most stringent approaches: raids, imprisonment and exposure to a host of risks (not the least of them rape) in the process. Even health clinics (tellingly called “hygiene clinics”) were never designed to promote the health nor the well being of women in prostitution but rather to assuage the fears and address the “health” of a decidedly male public.

And even when women are not the active participants in any pre-defined criminal act (as prostitution has been so defined), but are in fact the usual victims of violent crimes (often including sexual assault and rape), leave it to policy makers to limit women’s mobility by prohibiting night work (as our labor code still does except of course even with globalization and the burgeoning demand for women to work in call centers, our Labor Department has made exceptions).

In many cities and municipalities across the country, with every fluctuation in crime statistics, women’s mobility and right to travel has been routinely violated through the imposition of curfews --- on women.

So what pray tell will policy makers do in this case of nurses choosing to leave the country? Are we blaming them for the crisis in health care (which was already in a sorry state largely due to an unjust budget allocation which automatically prioritizes debt-servicing)? Shall this administration find yet another way to misappropriate their remittances along with that of other migrant workers? Or even more tragically, shall overseas working mothers be blamed for their children’s insecure futures because of growing up without a mother? (Indeed many local observations and studies managing to link delinquency among young people to the absence of their mothers reflect the gender bias in their expectations in parenting)

Meanwhile, while globalization has ushered in the downfall of many welfare states and shattered the “dream” of it for many others, it has actually also brought us closer to a full-scale interrogation of many notions around the concepts of state, rights and citizenship.

If women are indeed citizens, and citizens are accorded rights, why have women’s rights (on the top of the list being sexual and reproductive rights) been harder to acknowledge and recognize all these years?

In becoming “subjects of law,” (for originally only men were accorded citizenship and treated as legal subjects), women faced the built-in inability of law to grapple with a thing such as women’s rights.

How many women, despite the existence of an amended rape law or even such a thing as policy against sexual harassment, continue to find that their entitlement to legal protection does not merely depend on their citizenship or being the subjects of law? Rather, when women invoke the law’s protection, it automatically requires more from women, that is, to fit the bill and standard of what a “worthy” victim (woman) ought to be.

Rather than decide for its citizens and impose policy directives aimed at controlling the outflow of nurses (whether pushing them out the migration window as government is doing now or shutting down that window as government was wont to do in the case of Filipino entertainers to Japan), the state could very well do a better job if it provided the enabling conditions for the exercise of rights. If women had a real choice between a well-paid job at home and a slightly better or even enormously better paying (and safe) job away from home, women would already be better off in their exercise of options.

As the editorial mentions, the US itself ought to be framing better policy attuned to the needs and situations of its neighbors (and even its choice sources of human fodder) instead of just its own cheap and quick fix solutions. Indeed if there is one notion that the era of globalization has also pushed as developing discourse are the concepts of “global citizenship,” and “human rights” as ethics.

States are rarely no longer in it (that is the mandate to protect) just to recognize their citizens’ rights. As the U.K. and others with similar policies are demonstrating, citizenship is no longer the sole basis for rights claiming. To be sure, the “Human rights” we speak of now at this day and age are no longer just the same rights societies used to speak of when welfare states were strong, many economies were closed and trade barriers were deeply rooted in traditionally “nationalist” sentiments.

Neither are they the same “rights” that came into question only after the fact of violation or exercised solely in the public realm mostly by men.

The human rights we speak of now must stand up to a more truly globally egalitarian standard of ethics than ever. (That is race, class and gender across geopolitical and economic boundaries)

In so saying, States that recruit migrant workers for whatever purpose or scheme should be committed to the human rights of migrant peoples.

In the case of Filipino nurses, the government can at least begin informing would-be migrants about the state of legal policies and rights protection in the various recruiting countries.

As much as I miss my relatives in the states and commiserate with my American friends over their government (and President), I wouldn’t consider advising any Filipino nurse to put the US on the top of their list.:-)


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