PSI project seeks to educate foreign nurses on their rights

To address the exodus of healthcare workers from developing nations to western countries, AFT Healthcare and 13 other unions are taking part in Public Services International’s Migration and Women Health Workers Project to raise public awareness and educate migrating healthcare workers about their rights in the workplace and their rights as immigrants.

“The U.S. relies on foreign nurses. We want to make sure that those nurses are educated about their rights,” says Joni Ketter, assistant director for AFT Healthcare. “We cannot stop migration but we can make the public aware of the strain this poaching of workers is putting on healthcare systems.”

The unions also want to strengthen cooperation among unions in countries that send and receive migrant healthcare workers. Part of that cooperation would include an effort to educate healthcare workers before they migrate.

Partnership members first met in Amsterdam, where they established their campaign plan. Recently, they concluded visits to countries that supply healthcare workers. The visits allowed members to see working conditions firsthand and discuss partnership goals with officials in those countries.

Research shows that most healthcare workers who migrate to other countries would rather practice in their homeland, but low wages, stressful and poor working conditions are major factors prompt them to work abroad. As one Kenyan nurse put it: “Home is best, but there is no other way.”

The national coordinators then met in Nairobi, Kenya, for their first site visit. During the trip, participants began preparing “pre-decision kits” to help healthcare workers gauge whether to migrate.

The coordinators also visited Kenyatta National Hospital, a major facility in Nairobi. The hospital had a nurse-patient ratio of one registered nurse to 16 to 20 patients in the private wards and, in the 32-bed general ward, two nurses for 70 patients. And although patients came to the hospital with tuberculosis, malaria and HIV/AIDS, there were no gloves or masks.

The second project meeting took place in the Philippines, the world’s biggest exporter of healthcare labor. Each year, the county sends 14,000 nurses abroad, causing a shortfall at home.

Project partners met with government officials from the Philippines Overseas Employment Agency, Overseas Workers Welfare Administration and other agencies to discuss goals and express concern about the adverse impact of migration. The meeting also included visits to the Davao City Medical Center and a “barangay,” or community health center. The medical center has a 50 percent nurse vacancy rate and nurses earn about $105 a month. In the center’s maternity ward, for example, there were 136 mothers, 99 newborns and three to four people huddled in beds with no sheets. Patients were being cared for by two nurses.

“The difference between Africa and the Philippines is there is no hope in the Philippines. Most nurses believe that the only way to improve things is to leave. In Africa, nurses believe that things can get better,” says Ketter, who attended the meetings as the AFT Healthcare representative. 

The third and final project meeting took place in Bridgetown, Barbados, where nurses are leaving due to a lack of growth and promotion opportunities.

“The country produces well-educated nurses who are in great demand,” says Ketter.

Fortunately, many of the nurses who leave Barbados often return because of family ties. Nurses here run polyclinics that provide basic preventive care for community members. Participants visited Queen Elizabeth Hospital, which has a 50 percent nurse vacancy rate. Despite the shortage of care, conditions were much better than in the other countries the group visited.

In December, participants in the project launched a campaign calling for the adoption of the World Health Organization code of practice for the ethical international recruitment of healthcare workers. Several public events highlighted the value of women healthcare workers and promoted high-quality public health services.