U.S. Plan to Lure Nurses May Hurt Poor Nations

New York Times, May 24, 2006

As the United States runs short of nurses, senators are looking abroad. A little-noticed provision in their immigration bill would throw open the gate to nurses and, some fear, drain them from the world's developing countries. The legislation is expected to pass this week, and the Senate provision, which removes the limit on the number of nurses who can immigrate, has been largely overlooked in the emotional debate over illegal immigration.

Senator Sam Brownback, Republican of Kansas, who sponsored the proposal, said it was needed to help the United States cope with a growing nursing shortage. He said he doubted the measure would greatly increase the small number of African nurses coming to the United States, but acknowledged that it could have an impact on the Philippines and India, which are already sending thousands of nurses to the United States a year.

The exodus of nurses from poor to rich countries has strained health systems in the developing world, which are already facing severe shortages of their own. Many African countries have begun to demand compensation for the training and loss of nurses and doctors who move away. Public health experts in poor countries, told about the proposal in recent days, reacted with dismay and outrage, coupled with doubts that their nurses would resist the magnetic pull of the United States, which sits at the pinnacle of the global labor market for nurses.

Removing the immigration cap, they said, would particularly hit the Philippines, which sends more nurses to the United States than any other country, at least several thousand a year. Health care has deteriorated there in recent years as tens of thousands of nurses have moved abroad. Thousands of ill-paid doctors have even abandoned their profession to become migrant-ready nurses themselves, Filipino researchers say.

"The Filipino people will suffer because the U.S. will get all our trained nurses," said George Cordero, president of the Philippine Nurse Association. "But what can we do?"

The American Nurses Association, a professional trade association that represents 155,000 registered nurses, opposes the measure. The group said it was concerned the provision would lead to a flood of nurse immigrants and would damage both the domestic work force and the home countries of the immigrants.

A nurse in the Philippines would earn a starting salary of less than $2,000 a year compared with at least $36,000 a year in the United States, said Dr. Jaime Galvez Tan, a medical professor at the University of the Philippines who led the country's National Institutes of Health.

Based on surveys, Dr. Galvez Tan estimates that 80 percent of the country's government doctors have become nurses or are enrolled in nursing programs, hoping for an American green card. "I plead for justice," he said in a telephone interview. "There has to be give and take, not just take, take, take by the United States."