Empire of Care: Nursing and Migration in Filipino American History (American Encounters/Global Interactions)

Rating:
Summary: Exodus Explained
Review: Empire of Care: Nursing and Migration in Filipino American History by Catherine Ceniza Choy is a socio-historical explanation for the migration of Filipino nurses into the US during the 20th century. Principally, she articulates why since the changes in the immigration laws via the 1965 Immigration Act, travel in the US by skilled workers was made much easier and becoming permanent residents of the US made easier still. Choy's examination leads one to conclude that the permanent structural demand in US hospitals, who relied on the labor of foreign-trained nurses, may have been one but certainly not the only reason for the massive exodus out from the Philippines and into the US. Beyond articulating why so many Filipino nurses came to the United States, Choy undertakes and investigation of the experience of these very nurses. She argues that the US colonial experience developed a highly racialized hierarchy with white Americans at the summit and Filipinos at the base. As per to Choy, U.S. colonials at the turn of the century effectively formed the foundation for subsequent migrations through the creation of an American-style infrastructure and training program, initiating an American-style nursing work culture, by effectively gendering the nursing industry and relegating nursing to "women's work," Moreover, this move, perhaps as an unintended consequence developed fluency among the nurses in the use of English, and by starting programs such as the Exchange Visitor Program (EVP) that eventually brought Filipino nursing students to the US for advanced training.

Under the auspices of the EVP, Filipino nurses were able to obtain further professional training, while in the US, some nurses decided to reside here permanently. As most immigration experiences go, the monster of racialization rears its ugly head in the cases that Choy highlights as problematic: (1) The Richard Speck murder case and (2) the AV murder case in Ann Arbor Michigan involving 2 Filipino nurses. Richard Speck was accused of and convicted of murdering a group of nurses in a Chicago suburb in 1966, which included two Filipino nurses in the EVP program. Choy examines the disturbing fascination with Speck as opposed to the deaths of 22-year-old Merlita Gargullo and 23-year-old Valentina Pasion. The survival of Corazon Amurao and the subsequent trial and the examination of Speck by Marvin Ziporyn "[...] illustrates the American public's growing fascination with the life and mind of murderer Speck and its fading interest in the lives of the young women slain. In such depictions, these women had become only figments of a larger, seemingly more important story about a criminal mind" (Choy 133-4). The 1977 murder case involving two Filipino nurses accused of poisoning their patients in Ann Arbor, Michigan is arguably more insidious. In a move that reminded this reader of the case of Italian anarchists Nicola Sacco and Bartolomeo Vanzetti who were arrested outside Boston in 1920 and charged with the robbing and killing of a shoe factory paymaster and his guard. In the same manner the racialization of the nurses as "Filipino" and the resurgence of the negative imagery of Asians is examined in this book. In the chapter "The enigma of the Little Filipino" (Choy 145-52), Choy undertakes to examine the racialized nature of the case and the subsequent FBI actions relating thereto. The sections that examine for the Speck and VA case read like a highly research detective story - the irony is that it is non-fiction should not escape our reading.

Another "reality" that Choy brings to mind is that nurses form a significant number of Filipinos working overseas. The Filipino Overseas Worker (FOW), as far as the Philippine government is concerned is a resource. The FOW earns hard currency (usually US dollars) and sends back that money to their families in the form of a remittance. Enduring economic crisis in the balance of payments is seen as the leading cause for export of manpower since, as mentioned previously, the remittances keep the country solvent. The sad part to this testament is the double bind that the Philippine government finds itself experiencing. On the one hand there is the very real need for the remittances, the Philippine government did, to their credit, initially try to hang on to nurses to meet health care deficit at home. However, by the 1970s it had no choice but to promote expatriation as a way to earn much needed foreign currency through those very remittances. Ironically, despite having a real health care professional shortage at home, the Philippines was the leading supplier to the worldwide structural demand for nurses and health care professionals. Historians and the author of this book rightfully return to Colonial times to articulate the flow of immigrant to the US. The American-style of hospital administration foisted in Manila and the provinces according to Choy set the stage for later immigration into the US. By interrelating Philippine migration history to US imperial history Choy makes a seminal contribution to the fields of Migration, Asian, and Filipino studies. Scholars who are interested in these three areas and perhaps more should not overlook this book.

Miguel Llora