Health imperialism

Published January 24, 2023, 12:05 AM

by Raymundo W. Lo, MD, FPSP


Dr. Raymund W. Lo

Recently, a news article stated that Germany and the United Kingdom are luring second-year nursing students to continue their studies in their countries with free tuition and lodging. Once they finish their nursing course, they have to serve a period of time in that country but can also bring their families with them to reside permanently. The German ambassador was quick to deny it the following day, citing an ongoing government-to-government project that is already recruiting nurses and other health professionals to her country.

Whichever version is true only emphasizes the point that we are fast losing our health professionals to more economically developed countries, leaving our hospitals grappling with staff shortages that cripple patient services. This is more acute in private hospitals which cannot afford to pay wages equal to government-owned hospitals. Even the latter are not spared the problem. Many private hospitals cannot fully utilize their bed capacities for lack of nurses. That impacts their earning capacity, and so it becomes a vicious cycle.

We may end up with a rash of hospital closures if this keeps going on. Simply, we cannot pay our health care workers (HCWs) be they doctors, nurses, medical technologists, physical therapists, or radiologic technicians — the same rate that other countries are offering. We can’t even pay them enough for their own subsistence, let alone for their families.

We can’t begrudge these HCWs their need for better pay, much less their desire for better working conditions and opportunities for professional advancement. I have personally given good recommendations to many of our med tech staff who have applied for jobs abroad, knowing they deserve better. But our own patients also deserve to have good health care, and without these HCWs, we can’t serve our fellow Filipinos well.

We are reduced to being the training grounds for staff that, in one to two years, will fly off to North America, Europe, the Middle East, and even Singapore, Japan, Australia, and New Zealand, with their families in tow. This is a massive brain drain that is hemorrhaging our health system.
To my mind, this is just the extension of our imperialistic past. The colonial powers have gotten rich and progressive on the backs of countries they have colonized. With the wealth derived from colonial exploitation, they are now able to afford to offer better pay and benefits to lure our HCWs to their hospitals.

The exploitation continues with countries like the Philippines, which are being seen as sources of new wealth, this time of health skills, without having to invest in education and training. We put up the colleges and universities, hire teaching staff, provide excellent curricula, and teach the best available students. Once they graduate and pass the board exams, our hospitals hire them as raw talents, whom we have to train and mold into excellent HCWs.

That takes a lot of thought and effort on the part of the hospitals in putting up quality systems that mold the staff into very competent and caring staff. As soon as they are well-trained and competent, we lose them to these countries. They’re practically stealing our staff at no cost to them. Our leaders are even making it easy for them with government-to-government agreements!

Let’s not just throw up our arms in surrender. Let’s act to correct this unjust situation and turn it to our advantage. We may not be able to prevent our HCWs from leaving, but at least, let’s make these countries compensate our educational and training institutions for their efforts and sacrifices, and in the process, provide for better salaries for the remaining hospital staff so that they will stay. Otherwise, our health system may no longer be able to carry the strain of severe understaffing, which leads to poor patient care and bad health outcomes.

Our government should demand that for each HCW a country hires, they should fork over a certain amount, to be given to the educational institutions and hospitals in which these workers studied and trained. Call it reparations, or talent tax, or whatever term you might use, as long as it is given to the rightful entities. These sums of money must be channeled to augment the pay of the teachers and the hospital staff that took part in the production of the finished products these countries are importing.
Yes, our HCWs are now just commodities for export. But we’re losing a lot more than just manpower. It is the wealth of talent we have built up for our health care system that they are taking. It’s time to make these countries pay for depriving us of the services of our countrymen at the expense of the health of our people.