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Poverty threatening health care in the Philippines

Sometime in the near future, the Philippines will run out of anaesthetists. Obstetricians are also a dwindling breed, and pediatricians may not be far behind.

They are among eight million Filipinos -- nearly a 10th of the population -- working abroad, abandoning their poor homeland for better paid, but lesser skilled jobs overseas.

The brain drain is so huge it is threatening the very fabric of the nation.

Medical school enrollment plunged 20 percent last year and one school has already been forced to close. Ten medical schools and two provincial hospitals are threatening to close.

The local medical association says that thousands of doctors are going back to school -- nursing school -- so they can get nursing jobs in Europe, the US or even the Middle East, to work in "dirty" or dangerous jobs like helping doctors deliver babies, inject sedatives and treat ailing tots.

"I call it medical apocalypse, the end of medical practice in the Philippines," Philippine Medical Association president Bu Castro tells reporters.

He estimates that 2,000 doctors leave the country each year, while about 1,000 graduate from medical schools.

Even though they cannot practice medicine abroad, the specialists do not mind the downgrade as they still earn around US$8,000 a month, 16 times the pay of doctors at government hospitals in the Philippines.

More than one million people are expected to migrate or seek temporary work outside the country this year, joining some eight million Filipino expatriates, according to Labor Secretary Patricia Santo Tomas.

Going west

Of the eight million -- almost 10 percent of the country's 84 million population -- some three million are now permanent residents of the US and other western countries.

"You cannot prevent every citizen of the country from looking for greener pastures," Castro says.

In the early 1970s amid the oil crisis, the first wave of migrant workers were construction workers who fed the building boom of the oil-soaked Mideast kingdoms, joined by seamen manning the world's merchant marine fleet.

Domestic workers soon followed to run the homes of the upwardly mobile families mostly of newly industrializing East Asia, the Middle East and western Europe, then entertainers opened up a new front in Japan.

Sailors still make up a big part of the annual deployments, but the government says the new growth areas are service-related sectors -- hospitals, nursing homes for the elderly, or hotel or tourism-related jobs anywhere from Israel to the farthest reaches of the Caribbean.

Filipino workers are found in 120 countries, even in areas where they are banned, such as Iraq. The Philippines is second only to Mexico in terms of labor deployments, and third after India and Mexico in terms of foreign remittances.

On average Filipinos work abroad for 15 years before returning home.

"We're seeing less and less of construction workers and well, fewer domestic helpers. The move is toward more technical and professional jobs," Santo Tomas tells reporters.

The biggest host country remains Saudi Arabia, but there is "significant movement to Asia and the Pacific," with Australia opening up, Japan about to sign an economic partnership agreement with Manila, and Hong Kong about to throw open its Disneyland.

Labor migration

Even China asked for English teachers, though the Philippines thumbed its nose because Beijing's US$200 a month offer was on a par with the pay of public school teachers here, she added.

Santo Tomas says labor migration is a natural progression of globalization and should not be seen as a reflection of the Philippine government's failure to provide a better life for many of its citizens.

"Human resource is now a global resource, the way capital is regarded as a global resource," she says. "If the capital of the more developed economies move, why shouldn't the human resource of developing countries?"

The combined overseas work force and migrant population of eight million sent US$8.5 billion to their relatives back home last year, an amount equivalent to 10 percent of the GDP, half the national budget, and 22 percent of the country's merchandise exports.

With the additional demand this year, remittances should rise by at least six percent to US$9 billion, the central bank says.

The ready cash is a heady fuel for the consumption-led economic growth in the Philippines, an economy that creates only about a million jobs a year, where the unemployment rate stood at 11.3 percent and where the population is growing by nearly 2.4 million every year.
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