Humanizing immigrant nurses

Filipino nurses have long filled a U.S. nursing shortage — and Kingfield author Catherine Ceniza Choy busts stereotypes by telling their story

A specialist in Asian American history, Kingfield resident Catherine Ceniza Choy is trained to look beyond stereotypes. Doing so isn’t just her profession, it’s part of who she is.

Growing up in a New York City apartment building, many of Ceniza Choy’s neighbors were Filipino nurses. Those women were her mother’s friends and an integral part of the city’s Filipino American community.

But as she grew older, Ceniza Choy often saw — and still sees — contrary media images of these women; they are portrayed not only as polite and obedient, but sexualized as small and exotic brown objects.

Now a historian and a professor of American Studies at the University of Minnesota Ceniza Choy just published her first book, "Empire of Care: Nursing and Migration in Filipino American History" — the only book that explores Filipino women’s lives in America.

The book, published this month by Duke University Press, tells the history of how American nursing institutions became an early part of the United States’ regime in the Philippines, and why Filipino nurses have emigrated worldwide.

To research her book, the engaging Ceniza Choy interviewed 40 Filipino nurses working in American hospitals and volunteered at a Filipino hospital for several months to understand why so many choose to emigrate. She said going to the Philippines and interviewing nurses there helped her see the nurses as multidimensional people, not just as immigrants or her Mom’s friends.

"I was struck by their adventurous spirit. I learned that [they] also thought of their work here as an adventurous form of travel, not strictly a money-making enterprise," Ceniza Choy said.

The nurses’ history The book is written for an academic audience and occasionally uses stuffy language, but is overall very readable; Ceniza Choy hopes it will help Americans remember some of their own history.

"I still get asked how I learned to speak English so well. People seem to have forgotten that the Philippines was a U.S. colony for 40 years," she said.

The U.S. colonization of the Philippines after 1898’s Spanish American War emphasized Western medicine, and the country’s first nursing school was patterned after American medical schools. Though Filipinos considered nursing as men’s work in the late 19th century, American schools changed that by discouraging men from applying to the schools, while welcoming middle- and upper-class women.

To further complement Western-style schooling, the U.S offered a nursing exchange program; Filipino nurses could work for two years in an American hospital as further "training" in their field. Both Filipino- and U.S.-owned agencies recruited recent nursing graduates for exchanges in the U.S., Canada and Europe.

The recruiting agencies profited by charging nurses high-interest loans for their airfare, and earned rewards from short-staffed American hospitals. However, Filipino nurses were frequently exploited by their new employers, who often paid them less than their American counterparts, offered the least desirable hours and assignments, and often did not offer any educational component for the Filipino nurses’ work.

Despite news of rough working conditions, Filipino nurses still came. Ceniza Choy writes in her book that there’s no simple explanation for the trend.

Nurses in the Philippines earn comparatively low wages and work in less-equipped clinics and hospitals than their American counterparts. A disorganized and ineffectual professional Filipino Nursing Association hasn’t improved working conditions, due to cronyism and favoritism. And even though the Philippines has many fewer nurses per person than in North America and Europe, their government encourages exporting nurses to get American dollars into the Filipino economy. Plus working abroad appeals to the nurses’ interest in travel and excitement.

Her own migration Ceniza Choy, who spent the majority of her life on the East and West coasts, accepted an American Studies faculty position at the University of Minnesota in 1999 for a reason natives might find surprising: the Twin Cities’ many unique Asian American groups.

"The Twin Cities has the highest population of Hmong Americans in the country, and the second-highest population of Korean-born adoptees in the nation," said Ceniza Choy. "The vast majority of Asian American research is on Japanese and Chinese Americans, and I thought I could make a real difference by researching those groups that haven’t been studied as much."

Ceniza Choy structures her Asian American history classes to include the experiences of Hmongs and Korean adoptees– subjects not always included in general Asian American history classes.

"My favorite response was from an anonymous student who wrote [in an evaluation] that they’d never heard a professor talk about Hmong history before, and he or she was sharing the books with their mother to read," said Ceniza Choy.

Her husband, Gregory Paul Choy, is an Asian American literature scholar who teaches at the University of St. Thomas. The academic duo chose Kingfield, with their children — 3-year-old Maya and 1-year-old Luis — partly for its seemingly high population of scholars.

"I don’t know if it’s higher here, but it seems like there are a lot, and academics do tend to stick together because we are all transplants and have each other for extended families," said Ceniza Choy.

Through her book and her teaching, Ceniza Choy is working to dispel the stereotypes and myths regarding Asian Americans. "I’m optimistic that I can make a real difference. My contribution is small, but it still matters," said Ceniza Choy.