How the pandemic exposed the limitations of “ethical recruitment” of Filipino nurses in a global labor crisis
Recently, overseas Filipino nurses proved to be indispensable in countries where the COVID-19 pandemic pushed health systems to the brink of collapse compounded by the lack of local manpower in the healthcare sector. As the largest supplier of nurses worldwide, the Philippines emerged as a top sending country to fill the workforce gap in Germany where there is a reported shortage of 50,000 nurses. When the Philippine Overseas Employment Administration (POEA) imposed an annual total cap of 5,000 Filipino nurses to be deployed annually, Germany was one of the first countries to apply for exemption. By March 2021, nearly 4,000 Filipino nurses were to be deployed in Germany, a quarter of which were recruited via the Triple Win Project (TWP).
The TWP is a labor migration agreement initiated in 2013 between the POEA, the German Federal Employment Agency (BA), and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) to recruit Filipino nurses aspiring to work in Germany. The goal of this project is to create a win-win-win situation for German employers, Filipino nurses, and their countries of origin while honoring the principle of ethical recruitment. In this case, the latter refers to the provisions of the World Health Organization’s Code of Conduct, in that Germany vows not to recruit nurses from source countries that are already experiencing shortages. Ideally, these arrangements would create a pathway for Filipino nurses to partake in decent work abroad and the Philippines will reap benefits from their remittances, whilst Germany can plug its own nursing shortages.
Filling labor gaps abroad at the expense of the homeland?
Philippine Nurse Licensure Exam passers: 2008-2019
In the context of the pandemic, regulations, or lack thereof, on the local and global supply of Filipino nurses became a highly debated topic. On one hand, the POEA pushed for a deployment cap to ensure that the Philippines does not run out of its own nurses whose work was essential to curbing the unyielding spread of the pandemic. This is especially difficult when Filipino nurses are leaving the Philippines faster than it could produce more of them. As shown above, the number of newly licensed nurses in the Philippines has been lower than the number of nurses deployed abroad per annum since 2015. This trend became especially crucial during the pandemic, since it was reported that the Philippines itself is short of 23,000 nurses to effectively combat the pandemic despite being the largest exporter of nurses worldwide.
On the other hand, the German-Philippine Chamber of Commerce had appealed for an exemption, reporting 2,000 Germany-bound Filipino nurses in the pipeline who had already invested in the preparation process. If barred from leaving, they would lose the opportunity of employment in Europe and be subject to the underpaid and overworked circumstances of most nurses in mid-pandemic Philippines. In this sense, these debates could be framed as a conflict between the Philippine state’s interest in prioritizing its own public health sector during the pandemic versus the individual Filipino nurses’ right to pursue better work conditions and overall well-being.
Triple win or rebranded version of circular migration?
However, these discussions are only confined to the supply side of the equation. The export-oriented nursing education in the Philippines was designed to respond to high demands for their labor abroad. In order to address the crux of the matter, a broader look is needed at the bilateral agreements incentivizing the deployment of Filipino nurses in the first place. That is, to what extent can triple win arrangements deliver on their promise of equally benefitting receiving countries, migrant nurses themselves, and their sending countries? Moreover, did the COVID-19 pandemic expose the limitations of ethical recruitment codes in regulating these processes in global crisis situations?
The first question was put forward by Stephen Castles and DeryaOzkul in 2014 when assessing the tenets of the Triple Win Project upon its launch. Specifically, they explored whether this project is indeed a ‘triple win’ as it claims to be in theory, or if it is merely a new term for circular migration schemes. The concept of circular migration essentially pertains to migrant labor agreements characterized by temporary, repetitive movements between their origin and host countries. In this scenario, migrants can freely move back and forth to optimize their income and send remittances, while providing solutions to their host countries when nursing shortages arise. These arrangements were designed to deliver the benefits of migrant labor for both sending and receiving countries without the political, legal baggage that often comes with permanent migration.
Measuring the success of triple-win schemes in source countries
Source: London School of Economics
From the perspective of source countries, one indicator used to quantify the success of circular migration is remittances. The chart above depicts the five receiving countries with the biggest recorded changes on the amount of cash remittances received by overseas Filipino workers in early 2019. During the onset of the pandemic, several OFWs were repatriated which severely affected the household incomes of their families. This also affected the national economy, seeing how personal remittances accounted for 9.3% of the Philippine GDP as of 2019. While remittances are one way to quantify the benefits (or disadvantages) of circular migration, they tend to fluctuate depending on global events such as the pandemic. To evaluate their success in the long-term, studies have to be conducted on how these remittances were used and invested for the development of the source country.
Assessing the benefits of circular migration schemes in source countries has always had considerable challenges. Most of these obstacles stem from the fact that the nature of circular migration could be antithetical to census data collection systems which are based on two indicators: birthplace and current location. Specialized surveys are often needed to record the patterns of repetitive mobility that characterize circular migration. This is especially difficult to track at the national level because circular migrants do not always go through formal exit pathways during mobility.
Hence, in quantifying the long-term benefits of circular migration in source countries, researchers themselves tend to arrive at competing or inconclusive results, whereas the benefits reaped by receiving countries from these arrangements are more tangible. In this vein, gaps in data have yet to be addressed before we can truly weigh in on claims that they benefit all three stakeholders equally in the long-term.
Ethical recruitment in a globalized yet uneven world
In global crisis situations, the wins and losses in these arrangements become a little clearer. More broadly, some found circular migration to be a cop-out for Global North countries since the system frees them of many political obligations while continuing to reap the benefits of labor from the South. The TWP, in a sense, was supposed to be Germany’s answer to this moral dilemma by committing to the principle of ethical recruitment. Despite this, Germany was among the developed countries that scrambled to fill their nursing shortages with Filipino workers during the pandemic. These countries’ appeals for exemption from the POEA deployment cap occurred at a time when the Philippines itself had exhausted its own resources during the pandemic, exposing the limitations of these ethical codes when they should matter the most.
On the other hand, restricting the mobility of migrant workers is generally a counterproductive policy for both parties. Restrictions often entail an increase in illegal immigration and overstaying, exacerbating exploitation of migrant labour. Moreover, it is easy to empathize with Filipino nurses who find the prospect of better pay and safer working conditions alluring during this pandemic. However, it is equally important to revisit the bilateral agreements designed to meet the demand for this type of labor and to assess if these economic benefits will truly outweigh the social costs for both the individual and collective. Furthermore, these decisions should be armed with lessons learned from previous global crises that resulted in migration traps. For instance, one ought to recall how the demand for migrant labor drastically changed in the wake of the 2008 financial crisis, leaving a surplus of Filipino nurses jobless in their homeland. In moments of crisis, doubts about the inherent unevenness of globalization tend to dissipate when the global order becomes clear. As Castles and Ozkul warned, migration policies are bound to fail if the social dynamics of the source countries are not considered in the grand scheme of globalization.
Patricia Miraflores is a graduate student pursuing a joint masters degree in M.A. Euroculture at the University of Groningen and Uppsala University. She is a recipient of the 2020 Erasmus Mundus scholarship award from the European Commission. Her primary research interests are migration, diaspora, identity construction, cognitive-affect, and illiberal democracies. She spent four years conducting research in politics, government, and history in San Francisco, Berlin, Seoul, Hyderabad, and Hong Kong for her undergraduate studies.