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Abstract
Notions of care have multiple inflections in the lives of Filipino medical workers in Singapore. The present paper explores ethnographically how Filipino migrants narrate and experience ambivalent notions of care as they move across borders. Their labour is fraught with ambiguity as they distance themselves from ideas of care in their working lives. They position themselves as professionals and attempt to shed the long-standing associations of Filipinos as ‘unskilled’ care labour in the global economy and the feelings of shame ‘care’ evokes. However, discussions of care are at the heart of their narratives on the forms of sociality they have left behind in the Philippines and on their notions of how one ought to live in the world with others.
Acknowledgements
The author thanks the organisers of the ‘Diasporic Encounters, Sacred Journeys’ conference held at Keele University in June 2009. The author is very grateful for the opportunity to share her work at this conference and thanks all the participants for their valuable feedback on this paper. For helpful comments, the author thanks her supervisor Dr Leo Howe. The author also thanks the Gates Cambridge Trust for providing the funding for her participation in the conference and for her field research.
Notes
1. In 2007, the POEA estimated that 8.73 million Filipinos were working in various destinations across the world. An estimated 9000 nursing professionals and personnel left the Philippines in 2007; the vast majority went to the Middle East (Saudi Arabia, Kuwait and the United Arab Emirates), followed by Singapore. Actual numbers are likely to be significantly higher because not all migrants go through the POEA.
2. In the present paper, the ‘medical workers’ I refer to are primarily nurses in various positions. I use the term medical ‘semiprofessionals’ to capture the variety of healthcare migrants who straddle the boundaries between ‘professional’ and ‘worker’. As I discuss, the ‘professionalism’ of medical workers is always in question and open to being undermined by various groups (e.g. doctors, other care workers/professionals, patients).
3. ‘Ambiguity’ is a term I use to capture the experience of being in between two states, whereas ‘ambivalence’ is used to capture contradictory emotions (e.g. feelings of desire and fear, pride and shame, familiarity and shock).
4. Remittances in 2006 from Overseas Filipino Workers (OFW) to the Philippines were estimated at US$12.7 billion (POEA Citation2006).
5. According to the Singapore Nursing Board (SNB; Citation2007), approximately 50 per cent of foreign nurses in Singapore are from the Philippines. In 2007, half the nurses who registered with the SNB were from abroad. However, these figures exclude the many Filipinos who work in Singapore as nursing aides, auxiliaries and caregivers.
6. As Zelizer (Citation2005) argues, even personal intimacy—joking, cajoling, consoling and sympathetic listening—are, at least in part, ‘skilled practices’.
7. Many of my informants specifically mentioned the white uniform as something alluring, ‘neat’ and professional’ when speaking about what appealed to them about nursing.
8. In other countries, for example Singapore and India, nursing is still regarded widely as ‘dirty work’ (see George's (Citation2000) work on nurses from Kerala). Nursing as ‘dirty work’ is a far less common assumption in the Philippines.
9. Many male nurses in Singapore are nursing aides and healthcare assistants. It is the female nurses who are more likely to come to Singapore as staff nurses.
10. The work of migrant nurses is certainly relevant to debates on ‘emotional’ and ‘affective’ labour. For further discussion, see Hochschild (Citation1983) and Hardt (Citation1999).
11. Domestic workers enter Singapore on the ‘work permit’, which is the most restrictive of the legal work visas for migrants in terms of rights. When I speak of the ‘migrant hierarchy’, I am referring to this system of work visas. In practice, however, there are migrants who arrive in Singapore and find themselves in irregular situations. Many sex workers, for example, may find themselves in even more vulnerable situations without any legal protection.
12. However, I discuss later the blurring of social class among Filipino migrants. The distinctions between ‘middle class’ and ‘upper class’ are not so easily understood.
13. A notable exception is the growing number of nurses who are active members of a Protestant Evangelical church targeted at Filipino professionals (the Filipino Congregation, a part of a larger Singaporean church). The Filipino Congregation is growing rapidly. These nurses are far less ‘private’ in their social lives. I hope to elaborate more on this group of nurses in future work.
14. Choy (Citation2003) points out that US nursing institutions in the Philippines set out to recruit nursing students from ‘respectable’ families so they could be more easily cultivated into ‘gentlewomen’.
15. Sosy, which comes from sosyal, is a translation of ‘social’. It generally pertains to those who act as socialities, displaying ‘classy’ or posh sensibilities.
16. See Bourdieu (Citation1984). See also Pinches (Citation1999) for a discussion on the Philippines’ new rich and growing middle class. There have been similar discussions on caste politics in India (see Pandian Citation2000).
17. For a useful discussion on paid and unpaid care labour, and diverse economic relationships that exist beyond capitalist relations, see Gibson-Graham (Citation2006).
18. Virtue is spoken about more often in terms of the nation than in terms of faith. That said, given the predominance of Roman Catholicism in the Philippines (the religion of my informants), there is, in these instances, a strong taken-for-granted relationship between their Catholic faith and the Filipino nation.
19. For further critical discussions on ‘reciprocity’, ‘utang na loob’ (debt of gratitude) and power and their complexities in social relationships in the Philippines, see Rafael (Citation1988) and Cannell (Citation1999).
20. In this paper, my intention has not been to suggest that an ethic of care is absent from the labour of nurses. However, what I have found striking is the way that nurses perform a distance from ‘just care’ when they speak about work; that the relationship between nursing and care is not uncontested, but layered.