Brain Drain in the Philippines

1. Brain Drain in the Philippines Connie Gundayao Health Students� Action - Philippines

2. At A Glance: Philippine Health Situation 50% of the population has no health care access. 5 out of 10 Filipinos die without getting any medical attention. Only 60% of the population has full access to essential drugs. (AHW 2004, CHD 2004, NIH 2005)

3. 10 mothers die daily due to pregnancy- and childbirth-related causes. The average hospital bill is three times the average monthly income. 23.4 M Filipinos still do not have access to toilets. CBHP experience would double this figure. (AHW 2004, CHD 2004, NIH 2005) At A Glance: Philippine Health Situation

4. Hemorrhage of Health Human Resources Philippines is the no. 1 exporter of nurses worldwide 85% of Filipino nurses work abroad in some 50 countries (approx. 163,756 nurses in 2003) From 1999-2003: Licensed 27,342 nurses yet over 56,000 went abroad. Increasing number of nursing schools: 170 (1990s) ? 251 (2003) ? 470 (2006)

5. Hemorrhage of Health Human Resources Phenomenon of doctors becoming nurses to go abroad More than 9,000 doctors have already left as nurses from 2002 to 2005. 80% of public health physicians have taken up or are enrolled in nursing. 90% of Municipal Health Officers (MHOs) are taking up nursing and expected to leave the country.

6. Obstetricians and anesthesiologists are rapidly depleting, followed by pediatricians and surgeons. At least 37 Philippine nursing schools offer abbreviated 2-year courses for doctors to become nurses. More than 60% of nursing schools are geared mainly for �second coursers� Pharmacists are the next target for employment abroad

7. TESDA has trained over 50,000 caregivers in the last 5 years and over 24,000 have been deployed abroad. An estimated 15,000 health professionals leave the country annually for employment abroad. Decreased enrollment in medical schools of 10%-55% in the last 2 years. Hospitals closing down for lack of doctors/nurses: 200 completely closed, 800 partially closed (2003-2005)

12. Other consequences Decline in the interest of young Filipinos to study medicine � evidenced by a drop of 53% in NMAT examinees with Yr. 2000 as baseline Decline in the applicants for medical residency positions to become specialists with an average of 50% Nurse to patient ratios in provincial and district hospitals now 1:40-1:60 Loss of highly skilled nurses in all hospitals across the country

17. Proposed Courses of Action Policy Level Review/scrap �labor export policy� Regulate the outflow of health professionals Increase health budget, improve the salaries & working conditions of health workers/professionals Reorientation of health science education Advocacy & Mobilization Awareness-raising among health science students/ Exposure to social realities �WTO out of health� campaign

18. Other Proposed Reforms National Health Service Act (2-year service in the Philippines) Compensation from receiving countries Bilateral agreements with Receiving Countries

19. Challenges Sustained and concerted efforts at the country and global level Involvement of the health professionals into the campaign