Empire of Care: Nursing and Migration in Filipino American History
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Empire of Care: Nursing and Migration in Filipino American History
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Overview
Choy conducted extensive interviews with Filipino nurses in New York City and spoke with leading Filipino nurses across the United States. She combines their perspectives with various others—including those of Philippine and American government and health officials—to demonstrate how the desire of Filipino nurses to migrate abroad cannot be reduced to economic logic, but must instead be understood as a fundamentally transnational process. She argues that the origins of Filipino nurse migrations do not lie in the Philippines' independence in 1946 or the relaxation of U.S. immigration rules in 1965, but rather in the creation of an Americanized hospital training system during the period of early-twentieth-century colonial rule. Choy challenges celebratory narratives regarding professional migrants’ mobility by analyzing the scapegoating of Filipino nurses during difficult political times, the absence of professional solidarity between Filipino and American nurses, and the exploitation of foreign-trained nurses through temporary work visas. She shows how the culture of American imperialism persists today, continuing to shape the reception of Filipino nurses in the United States.
Product Details
| ISBN-13: | 9780822384410 |
|---|---|
| Publisher: | Duke University Press |
| Publication date: | 01/31/2003 |
| Series: | American Encounters/Global Interactions |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 272 |
| File size: | 1 MB |
About the Author
Catherine Ceniza Choy is Associate Professor of Ethnic Studies at the University of California, Berkeley.
Read an Excerpt
Empire of care
Nursing and migration in Filipino American historyBy Catherine Ceniza Choy
Duke University Press
ISBN: 0-8223-3089-X
Chapter One
Nursing Matters Women and U.S. Colonialism in the Philippines
As she reflected on her 1920s sojourn to the United States, Filipino nurse Patrocinio Montellano reminisced fondly about her experiences in "the Land of Promise." During her four-year stay, she traveled throughout the United States working as a nurse in Honolulu and New York City, and furthered her nursing education by taking postgraduate courses in San Francisco, Cleveland, and Washington, D.C. Montellano secured her employment through American individuals such as William Musgrave, a former director of Philippine General Hospital, and funded her postgraduate studies through scholarships she had earned with recommendations from Mary Cole, director of the Southwestern Division of the American Red Cross. Upon Montellano's return to the Philippines in 1924, she became field representative and nurse supervisor of the Philippine Chapter of the American Red Cross.
Montellano's experiences of education, work, and travel would not have been possible only a few decades earlier, when the Philippines was still under Spanish colonial rule. Before the U.S. annexation of the Philippines at the turn of the twentieth century, Spain's colonial educational system offered distinct and unequal opportunities for Filipinos based on gender. Only limitednumbers of Filipino girls received some primary education in Spanish charitable institutions. The Spanish university in the Philippines, University of Santo Tomas, excluded women from obtaining higher education until a School of Midwifery was founded in 1879.
In the context of specialized health care work, midwifery was the only area open to Filipino women during Spanish colonial rule. Filipino women cared for sick family members and friends at home, and Filipinos also consulted indigenous healers. However, in Spanish colonial hospitals and other medical institutions, primarily Spanish friars and priests cared for the sick. In 1862, Sisters of Charity and a European nurse arrived to work at San Juan de Dios Hospital. Additionally, Spanish surgeons, or practicantes, and the Filipino male physicians who had graduated from the University of Santo Tomas's School of Medicine practiced general as well as specialized areas of medicine. Furthermore, in the late nineteenth century, the Spanish colonial government encouraged elite Filipino men, known as ilustrados, to further their education abroad in European universities such as University of Barcelona and Central University of Madrid. The most famous ilustrado, Philippine national hero Jose Rizal, was a doctor of medicine. Such opportunities were unavailable to Filipino women. Given these historical contexts, it is no wonder that Montellano characterized the United States as a "land of promise."
Although some scholars have suggested that American colonialism's effect on Filipino women was marginal, Montellano's story reveals some of the watershed changes during the U.S. colonial period in the Philippines that impacted young Filipino women. These changes included the introduction of new professions, such as nursing, and educational and travel opportunities in the United States. From the beginning of U.S. colonial rule, the introduction of these new forms of labor and opportunities abroad were closely linked. Montellano's story further illustrates that, soon after U.S. annexation of the Philippines, important transnational ties had already developed between Americans and Filipino women. These ties enabled Montellano's socioeconomic as well as geographic mobility. American physicians and nurses helped her to secure employment and educational opportunities in the United States. This experience abroad in turn helped her earn an advanced nursing position on her return to the Philippines. Although Americans undoubtedly played a significant role in promoting these opportunities for Filipino women, Montellano's memories also reveal that her determination and desire to study nursing and to see America-even against the objection of her father, who thought that she was "small and frail and too young"-was also a crucial element in the implementation of U.S. colonial projects.
This chapter examines the introduction of nursing in the Philippines during the early U.S. colonial period from the multiple perspectives of American and Filipino nurses. These perspectives highlight the complex ways in which ideologies of gender intersected with those of race and class and shaped U.S. colonial agendas and practices. While the voluminous literature on women and imperialism has made important interventions that challenge the "masculine" nature of imperialism, the scant attention paid to American women's participation in U.S. colonialism in the Philippines continues to erase America's imperial past in general, and perpetuates the popular amnesia about U.S. colonialism in the archipelago in particular. Like the recent scholarly work by Louise Michele Newman, Vicente Rafael, and Laura Wexler on white American women's participation in American imperialism, which has contested this erasure, I argue that U.S. colonial nursing in the Philippines played a critical role in the formation of American modernity, specifically in American women's construction of themselves as civilized women. However, unlike this scholarship that has focused primarily on white American women's narratives and subjectivity, this chapter highlights the impact of colonial nursing on Filipino women's identities and desires.
The perspectives of Filipino nurses merit close attention because they reveal that the beliefs and actions of Filipinos as well as Americans were integral to the establishment of Philippine nursing. They also illustrate the complex ways that nursing and medicine in general provided professional opportunities for an elite group of Filipino women while simultaneously serving to legitimate U.S. colonial agendas that created as well as confirmed racialized and gendered social hierarchies. Unlike other economic, political, and educational agendas in the colony, the popular conceptualization of Western medicine as a universal humanitarian effort to save lives continues to make it difficult for scholars and others to critique its racialist and exploitive effects. As Reynaldo Ileto noted, "Even nationalist writers in the Philippines find it impossible to interrogate the established notion that among the blessings of American colonial rule was a sanitary regime which saved countless Filipino lives." However, scholarship in the growing field of science, medicine, and imperialism has effectively revised heroic portrayals of Western medical practices in colonized areas by arguing that these practices served as instruments of colonial subjugation and control. Yet many of these studies focus on large-scale sanitation projects and diseases, often rendering colonized peoples as coerced and unfortunate victims. I argue that the U.S. introduction of professional nursing greatly influenced Filipino women in ways that were both liberating and exploitative. Although the introduction of professional nursing in the Philippines presented new opportunities for Filipino women, it needs to be understood as part of a larger U.S. colonial agenda that racialized Filipinos and Americans under the guise of benevolent reform. Furthermore, although Philippine nursing was shaped by both Filipinos and Americans, the study and practice of nursing took place in the context of unequal colonial relationships.
Finally, this chapter documents a period of transnational mobility that has been marginalized in Filipino American history. In the early twentieth century, American and Filipino nurses shaped Philippine nursing through travel as well as teaching, training, and practice. American nurses traveled to the Philippines to teach and practice nursing during the early part of the U.S. colonial period, and eventually returned to the United States. As Montellano's story illustrates, Filipino nurses also traveled to the United States to study and practice nursing and then returned to the Philippines. This multidirectional mobility has been ignored in Asian American histories that foreground Filipino migrations eastward to the United States, but have focused on Filipino male migrants, many of whom worked as migrant agricultural laborers and settled permanently in the United States. Although these studies have importantly analyzed the racism and exploitation encountered by these Filipino men in America, more attention to other gendered forms of mobility during this period brings to light the transnational formation of new female labor regimes, such as nursing, during the U.S. colonial period. The formation of this gendered labor force would lay the foundation for the significant migrations of Filipino nurses later in the twentieth century.
THE RACE FOR EMPIRE
The introduction of nursing in the Philippines was part of a larger U.S. colonial and medical agenda that racialized Filipinos and Americans in the context of reform. Health care personnel contributed to the overall U.S. colonial project of preparing Filipinos for self-rule through the introduction of American medical practices. American medicine, they believed, would transform Filipino bodies into a people capable of self-government. "Filipino health" became a forceful metaphor for the primary objectives of U.S. colonialism. As Victor Heiser, director of health in the Philippine Islands, claimed, "To summarize, it is to be understood that the health of these people is the vital question of the Islands. To transform them from the weak and feeble race we have found them into the strong, healthy, and enduring people that they yet may become is to lay the foundations for the successful future of the country." Such concerns for the welfare of Filipinos complemented America's "benevolent assimilation" of the Philippines, which, as U.S. President William McKinley proclaimed in 1898, brought Americans to the Philippines "not as invaders or conquerors, but as friends."
However, these reformist intentions depended on the social and scientific construction of Filipino bodies as weak, diseased, and therefore racially inferior. In turn, American bodies also needed to be reinvented as vigorous, healthy, and therefore racially superior. U.S. health care personnel popularized these constructions of Filipino and American bodies in letters, reports, articles, and books that legitimized and rationalized such racism through medicine. For example, in Victor Heiser's 1910 article on "unsolved health problems peculiar to the Philippines," he presented Filipinos as a primitive people helplessly lost in a timeless past with little hope of entering modernity if not for the tutelage-and specifically the medical tutelage-of modern Americans: "We are practically cleaning up these Islands, left foul and insanitary and diseased by generations of hygienically ignorant peoples. We are stamping out the conflagration of disease started long before American occupation, and not until it is stamped out can we look forward to the modern problems which come so temptingly before us.... We are draining the land, as it were, before beginning the constructive health projects which are going to make these people the strong and healthy race we intend them to be."
Although America's "benevolent" colonialism has contributed to the popular ideology of American exceptionalism, which claims that the United States has a national character distinct from other colonial powers, American colonialism was not wholly unique in its view and application of Western medicine in the Philippines. General similarities can be drawn between American and European colonial medicine. For example, American imperialism in the Philippines, like nineteenth- and early twentieth-century British imperialism in India and South Africa, utilized Western medicine to justify the "white man's burden" overseas, to create racialized hierarchies of peoples, and to dominate those who differed from them culturally and physically. By extension, American nursing in the Philippines functioned in similar ways.
In recent histories of European and American imperialism, Western medicine's "power to heal" and colonizers' justifications for domination over the colonized are inextricably linked. Metaphors of healing in eighteenth-century British poetry and travel accounts provided ideological justification for Britain's nineteenth- and early twentieth-century "humane imperialism" in the "suffering abandon" of South Africa. Similarly, "suffering" among Filipinos justified American colonial medical intervention in the Philippines. After American victories over cholera in the United States in the 1830s and 1850s, an outbreak of cholera in the Philippines in the early 1900s gave American military surgeons and sanitation personnel a righteous purpose in their surveillance of the islands.
Western medicine functioned in different areas of the world to penetrate the colonized's bodies through statistical and laboratory studies. Medical personnel then used these studies to authenticate cultural and racial hierarchies. In the 1840s, British studies of malaria conducted in India involved spleen examinations of approximately twelve thousand Indian villagers. In the early 1900s, American scientists in government laboratories in the Philippines conducted studies of Igorots' stools to study parasites. These laboratory studies linked native bodies to dirt and disease. In the late nineteenth century, British medical officers claimed that the bodies of Indian camp servants, prostitutes, and food vendors "carried" enteric fever into the presence of British soldiers. Similarly, Heiser associated Filipino bodies with disease, describing them as "incubators of leprosy."
In British and American colonies, the colonized often resisted such Western medical intervention when it opposed their own social beliefs and practices. In nineteenth-century India, the vast majority of Indians refused British vaccination to prevent smallpox, opting instead for their traditional ways of surviving the epidemic, such as religious rituals and variolation. In the early twentieth-century Philippines, Filipino cholera victims refused to take American anticholera drugs and continued to consult indigenous healers, such as curanderos. Steeped in their belief in their power to heal, British and American medical personnel linked the colonized's social practices to ignorance and societal backwardness. One British medical officer criticized Hindus as "stupid and insensible" because they refused smallpox vaccination. Paralleling such conclusions, an American chief quarantine officer contrasted Filipinos who opposed American anticholera measures such as quarantine with "intelligent Americans or Europeans."
The introduction of nursing in the Philippines differed from previous American medical interventions because it involved the agitation and participation of American women in the Philippines. Although Edward Carter, a U.S. Army surgeon and Philippine Commissioner of Health, had recommended the establishment of a training school for Filipino nurses before the Philippine Commission as early as 1903, and although the Baptist Foreign Mission Society had established the Iloilo Mission Hospital School of Nursing in 1906, it was not until 1907, with the urging of Mary Coleman, dean of women at the Philippine Normal School, that the U.S. colonial government established a nursing school. Nursing education, like teaching and missionary work, in the Philippines provided white American women with a sense of purpose in the colony. Similar to British nurses in colonial West Africa, nursing offered white American women an international avenue for heroism, one still dominated by, though no longer entirely in the hands of, male medical personnel. Yet, although white American women as opposed to men were predominantly in charge of the training of Filipino nurses, and although they probably conceived their nursing duties as a humane and progressive alternative to traditionally masculine forms of imperial violence, nursing education "nurtured empire" as it reinforced many of the racialist functions and beliefs of Western medicine. The multivolume history of nursing and its section on the Philippines written by Lavinia Dock in 1912 offers one prominent American nurse's interpretation of colonial nursing in the archipelago.
(Continues...)
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Table of Contents
Illustrations ixAcknowledgments xi
Introduction: The Contours of a Filipino American History 1
Part I. Nurturing Empire
1. Nursing Matters: Women and U.S. Colonialism in the Philippines 17
2. “The Usual Subjects": The Preconditions of Professional Migration 41
Part II. Caring Unbound
3. “Your Cap Is a Passport": Filipino Nurses and the U.S. Exchange Visitor Program 61
4. To the Point of No Return: From Exchange Visitor to Permanent Resident
Part III. Still the Golden Door? 94
5. Trial and Error: Crime and Punishment in America's “Wound Culture"
121
6. Conflict and Caring: Filipino Nurses Organize in the United States 166
Epilogue 186
Appendix: On Sources 193
Notes 197
Bibliography 229
Index 245
What People are Saying About This
Empire of Care is an extremely important work, a milestone in Asian American and American studies, and a singular contribution to the emergent field of Filipino American studies.
— author of White Love and Other Events in Filipino History
Empire of Care provides an eloquent analysis and exciting transnational interpretive framework for understanding the political economy of American imperialism and the immigration of Filipino nurses. Catherine Ceniza Choy's lively and vivid history of women who connected the professional and the home spheres to become architects of their own lives against the backdrop of race, gender, and class constructions is an impressive contribution. Students of nursing, immigration, and social history will benefit enormously from this theoretically insightful and absorbing volume.
— author of Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890-1950