The Devastating Toll of COVID-19 on Filipino Nurses

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Brian Lehrer: Brian Lehrer on WNYC. Rosary Castro-Olega retired from nursing in 2017, but when the pandemic hit last year, she decided to pitch in and help. Rosary passed away from the virus on March 29th, 2020. She was the first healthcare worker in Los Angeles County to die from COVID-19 according to Kaiser Health News. Rosary was Filipino American and though she was first to pass away in her county, she was hardly the last Filipino American to pass away in the United States from COVID. Filipino Americans make up 4% of nurses in the US but account for almost 1/3 of the nurses who have died from COVID-19 nationwide.

Joining me now to discuss their reporting on how Filipino Americans came to work the front lines of the COVID-19 pandemic so much and why they've been disproportionately affected by the virus, are Tracie Hunte, correspondent for The Experiment, a new series from the Atlantic and WNYC Studios, and Gabrielle Berbey, who is the associate producer for The Experiment. The new episode is called The Sisterhood. Tracie and Gabrielle, welcome to the talk show side today. Thanks for coming on.

Tracie Hunte: Oh, thank you so much for having us. This is so exciting. [chuckles]

Gabrielle Berbey: Hi, thanks, Brian.

Brian Lehrer: The statistic that you're reporting is based on Filipino nurses are 4% of nurses in the US but account for nearly 1/3 of the nurses who have died from COVID-19 nationwide, it's so devastating. Tracie, how much do we know about why nearly a year into the pandemic?

Tracie Hunte: This is, I think a question that a lot of people are looking at right now. There's actually a group of Filipino academics and activists and researchers who are trying to break apart this data, but it's a combination of a lot of just historical factors. There's the fact that in New York and New Jersey and LA, those were the parts of the country that got hit the hardest with COVID-19, and those are also the parts of the country where a lot of Filipino nurses are concentrated. Then you add in the fact that Filipino nurses are also concentrated in what they like to call bedside care or critical care.

These are the nurses who were helping you go to the bathroom, making sure you're getting your medicine, who are coming into your room to check on you, and that sort of stuff. They're just very, very close to you. At the time I think when Rosary died, the hospital that she was working at hadn't organized out a COVID unit or a COVID floor, so people were just coming in. It was a lot harder to actually separate out or at least it wasn't much harder, they hadn't begun to do that process of separating out which patients had COVID and so on and so forth.

You have Filipino nurses who are mostly doing this kind of work and then on top of that, we all know this, we've all seen these viral videos from nurses a year ago talking about the fact they didn't have proper PPE, that they had to reuse their mask and so on and so forth. A lot of Filipino nurses that we talked to talked about this

cultural thing of not wanting to rock the boat or speak up for themselves, and so when they were getting this bad PPE, they weren't necessarily raising a fuss about it or something. It's all these factors that just made this devastating statistic happen and it's something that people are still looking into and trying to better understand.

Brian Lehrer: Now, listeners, I wonder if there are any Filipino American healthcare workers out there listening right now. Nurses, doctors, nursing aides, cafeteria workers, anyone, you want to call in and tell a story or ask a question, 646-435-7280. How do you think your pandemic experience in your profession compares to the experiences of some of your colleagues who are maybe not Filipino American? Or why did you enter healthcare work, especially in the United States? What has this experience this past year made you think, I don't know, about whether or not you want to even stay in this country or what policy responses are needed here to address this yet another disparity?

Give us a call at 646-435-7280 or tell some of the history through your own story or family member's story, or friend's story of Filipino nurse immigration to the United States which is such a story, 646-435-7280. For anyone who would like to add something first person to this reporting, 646-435-7280.

Gabrielle the recent episode of The Experiment aims to answer why so many nurses, most of them women, left the Philippines to work in the US healthcare system. It really begins in the late 1800s at the end of Spain's colonial rule when the US came in. Take us back to that moment in time. We're going to play a clip in a minute from your piece, but take us back to that moment in time. What did that transition to "independence" after the Spanish-American War look like?

Gabrielle: I don't know if I would consider it independence. The Philippines, after the Spanish-American War in 1898, it became a colony of the US. It joined the ranks with Guam and Puerto Rico, to become a colony. The United States, when they came in, they said we're going to be different from Spain, we're going to do colonialism differently. They actually didn't even call it colonialism, they called it benevolent assimilation. We're going to benevolently assimilate the Philippians into the United States. Part of that benevolent assimilation meant bringing healthcare and education, Americanized healthcare and education to the Philippines, part of that was also to civilize Philippines.

Benevolent assimilation was like, we're going to civilize population. We're going to the Filipino population, we're going to incorporate them. They brought Americanized healthcare to the Philippines. They set-up schools, nursing schools taught in English and started to train a lot of Filipino women in particular because bringing US gender norms also to the Philippines. In the US, a lot of women are nurses. They build these Americanized nursing schools in the Philippines and they start to train Filipino nurses and Americanized nursing. These classes are taught in English and it's an American educational framework.

Brian Lehrer: Part of that assimilation effort, the so-called having people "benevolently assimilate" was bringing Filipinos into the healthcare system. I see you spoke with Catherine Choy, a Professor of Ethnic Studies at UC Berkeley, a Filipina

herself, who wrote the book Filipino Nurse Migration. Let's take a listen, 38 seconds, to how she phrased that initiative.

Catherine Choy: They pointed to the presence of disease and "primitive, dirty uncivilized ways of Filipinos". The Philippians needed Americans to colonize and uplift them, specifically through the lens of healthcare. They established nursing schools and actively recruited Filipino women specifically, and actively discouraged Filipino men from entering the profession.

Brian Lehrer: Gabrielle, after the set-up that you gave to that clip, anything you want to add after it? Nursing as a tool to assimilate or colonize, anything on that additionally?

Gabrielle Berbey: No. I guess the only thing that Cathy mentioned when we spoke to her was that, even though the US would then use this wealth of nurses in the Philippines to bring them to the United States, the intention was really to train Filipino nurses and Americanize healthcare for the Philippines serving the Philippine population. I guess that's one thing that I would add to that.

Brian Lehrer: Tracie, Filipino nurses were being trained in US hospitals for decades, but the demand for Filipino nurses really shut up in the 1960s and I think your report says partly because of feminism?

Tracie Hunte: Yes, that was a surprising part of it and I guess it makes a certain amount of sense. After World War II, with more women going into the workplace, a lot of American women were like, we can do other things than be nurses, and they became more interested in other professions. That's one reason why the US was having nursing shortages and when they were trying to figure out where can we recruit from as far as bringing nurses from other countries, the Philippines was just waiting. You have nurses trained up to American standards, they speak English. That was just like the best place to go it seems for a lot of recruiters at the time.

Brian Lehrer: Now, this podcast episode is centered on the experience of a group of friends who have known each other since college. It's a group of six women. The time is the 1970s. The place is Manila, the Philippines. Let's take a listen. First, we'll hear Nora and then Joyette in this clip.

Nora: Checked each other. Oh, did you finish studying this, did you finish studying that?

Joyette: We would pretend to be reading in the library, but we would all be napping.

Speaker: When it came time to pick a profession, they all looked at each other.

Nora: What are you going to be and she said, I don't know, what about you? I don't know.

Speaker: They just picked nursing.

Joyette: It wasn't this strong desire to be a nurse. It was a, I fell into it kind of thing.

Brian Lehrer: This group of Filipina nurses lost their friend very early on in the pandemic. Let's take a listen to another excerpt about what that experience was like with a very powerful and emotional clip where Joyette talks about what that was like when she got a call from her friend's daughter. Listeners, this is about one minute long and a heads up for anyone who might feel like you don't want to hear about a COVID death, maybe come back to us in about a minute and a half.

Joyette: She said, "Mom's not going to make it. We're sending voicemail clips to say goodbye to Rosary," and that was the hardest, that was the hardest. That was the hardest to do.[sobs] You had to compose yourself to say something to a machine in order to be played over the PA system into her room because there was no one in her room, no one. How fair is that? It infuriates me. It infuriates me when we get to the political situation of it, whether or not she was Filipino and she was at risk, to begin with, whether or not there was the preference to put the Filipinos upfront, you know what, that's water under the bridge now she's gone, she's gone.

Brian Lehrer: Gabrielle, I want to go to the issue in that clip. Joyette is speculating on whether there was a preference to put Filipinos upfront. Can you talk more about what these nurses were telling you in regard to that?

Gabrielle Berbey: When we talked to Cathy, the historian, one thing that she talked to us about was how historically, through these waves of Filipino migration to the United States, Filipinos have been recruited to front-line positions within hospitals. This is like a historical trend and we see the highest concentration of Filipino immigrants, Filipino nurses, in critical care, acute bedside care positions. These nurses are today and historically have been recruited to be put in these frontline of the frontline positions.

Brian Lehrer: Let's take a phone call. Here is Lordis in Manhattan. You're on WNYC. Hello, Lordis.

Lordis: Hello. Just a quick short comment. I don't want to gloss over the fact that the United States did take over a country that had just won its independence in a hard-fought two-year revolutionary war. It may not have, it was a new nation when those ships under [unintelligible 00:14:45] sailed into Manila Bay.

Brian Lehrer: Yes, you want to make sure that, and I think we did discuss that a little bit explicitly before, but Lordis, do you want to go on for one more thought about how that affected the country, the people in the country at that time, or even rippled down to affect people who then came to come to this country?

Lordis: I think that [silence] what I actually want to speak to, I actually want to speak to the fact that this is a myth in the United States that they are not colonizers and they were.

Brian Lehrer: Lordis, thank you very much. Joining us now for a few minutes is Gertrude Tan, a nurse in Los Angeles County who was featured in this episode of The Experiment and she was a close friend of Rosary Castro-Olega. Gertrude, thank  

you very much for joining us for a few minutes.

Gertrude Tan: My pleasure.

Brian Lehrer: What would you like to say either about your friend or about the story? Maybe you've heard the whole piece now that you're a part of?

Gertrude Tan: You mean as far as how I got to meet Rosary or of my opinion about it?

Brian Lehrer: Yes. Go ahead.

Gertrude Tan: I'm sorry. I met Rosary with the group of six women to one of the parties. Actually, I was already working with her prior to that, but because she worked a different shift, there was not much close relationship with her, but through the years as we socialized with her, we got to know her. Actually, we became very close to a point that I even got her as one of my godparents to one of my children.

She was a nurse that worked in the med surge unit or medical-surgical unit. Very nice, she loves her patients. She has a twin, Rosalie. She worked in the same hospital where I worked and then after several years, she retired, but during the pandemic, there was an increased need for nurses and she helped. That's how she got the disease. This was devastating to most of us because we loved her dearly. She was the seventh person in that group.

We didn't know what to do. We could not even get to the hospital. We could not even talk to her. We were only getting communications via her daughter and her twin sister. She died and that was a big blow to us because our hands were tied. We couldn't even take care of her. We are nurses and we're supposed to be taking care of friends and family. We can't even get a hold of her.

Brian Lehrer: Tracie, you want to pick this up? You want to ask Gertrude anything?

Tracie Hunte: Gertrude, so nice to hear from you again. I was just so struck when you were making that point about we're nurses and we couldn't even take care of her. I think that that's like one of the hardest parts of this disease is that it gets in the way of normal human behavior.

Gertrude Tan: Exactly.

Tracie Hunte: I know that you retired before the pandemic started. I was curious, like, do you remember, were you hearing from a lot of other Filipino nurses who are in your age group or cohort who were thinking about going back to work?

Gertrude Tan: Actually, no. I am still employed. I believe you're talking about the other nurse that retired. That's fine. I work, but I'm the longer at the bedside, but currently, I'm off because of a medical leave of absence. Now, most of us have retired, but myself and another nurse, the other person does not see herself retiring. The others are scared of going back. Who would not be scared? We are both

vulnerable. We're over 60 and we have medical conditions. How could you-- My hat's off to those who are still working despite their vulnerabilities, but come on, let's face it. Why do you want to be on the front line at this time? My children are. They're in the front line, but they're young. Now we know that it affects everyone, not just people with diabetes, not just people with comorbidities. It's still scary. We know we have the vaccine, but we still have to keep our guards up, right?

Tracie Hunte: Yes.

Brian Lehrer: Gertrude, thank you so much for giving us a few minutes today. This is WNYC FM, HD and AM New York, WNJT FM 88.1 Trenton, WNJP 80.5. Sussex, WNJY 89.3 Netcong, and WNJO 90.3 Toms River. We are a New York and New Jersey Public Radio. We're almost out of time with Tracie Hunte, correspondent for The Experiment, the new series from the Atlantic Magazine, and WNYC, and Gabrielle Berbey, who is the associate producer for The Experiment. This new episode is called The Sisterhood. Of course, you can listen to it wherever you get your podcasts.

Listeners, one scheduling heads up, Mayor de Blasio will be on at 11:30 this morning. We'll talk about the departure of the Schools Chancellor, Richard Carranza, and the person the mayor has already named to replace him, and much more, but hold your mayor calls till 11:30. Mayor de Blasio coming up at 11:30 this morning. Tracie and Gabrielle, just to finish up our segment, you both say in the podcast that Tracie, that you're an immigrant, and Gabrielle, that your family's from the Philippines. I'm just wondering how you came away from this reporting, maybe even more personally informed than you were, Gabrielle?

Gabrielle Berbey: Yes. I have a lot of healthcare workers in my family and nurses and doctors from the Philippines. This did feel, and I guess I never really like stopped to ask why I had so many that worked in healthcare. This piece allowed me to ask that question and explore that and interrogate why. Part of our show is looking at how these larger historical forces shaped our everyday lives. I feel that that was something that I wanted to report it in Rosary's story, that's something that I felt within my family. Yes, it was this personal revelation in a way.

Brian Lehrer: Tracie, a final thought.

Tracie Hunte: Yes. My mom, she's a radiation therapist, was a radiation therapist, so not a nurse, but she was awesome. She was recruited from the Caribbean to come to the United States to fill this healthcare worker need. One thing I kept thinking about, especially as I was talking to all these Filipino nurses, was that they had-- I kept coming back to the thought of like, what do we as a country owe these immigrants who are now dying disproportionately trying to keep us all safe? I think that that's something that we really have to sit with and think about.

I think we also have to think about what this does, how this reverberates and affects other countries as far as us bringing in nurses, and how does that affect nursing shortages in other countries. It made me think about nursing in a much more global sweeping way than I hadn't before.

Brian Lehrer: Tracie, you want to just say something about this new series, in general, that you're working for? A lot of our listeners probably don't even know that this exists until hearing it in this segment. It's The Experiment, a podcast series from the Atlantic Magazine and WNYC?

Tracie Hunte: Yes. Our tagline is Stories From an Unfinished Country. I think the way we've been thinking about it is how these big historical things impact and intersect with people's ordinary lives. I think this nurse story is a really great example of that because the history of how Filipino nurses are in LA in the first place is such a big-- it's such a historical, complicated reason. I think those are the kinds of stories that we'll be doing. Yes, it's going to be great.

Brian Lehrer: Good luck with it, and congratulations.

Tracie Hunte: Thank you so much.

Brian Lehrer: Thanks, both of you for coming on.

Gabrielle Berbey: Thank you.

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