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Inside PNAA News January 2014 SPECIAL EDITION

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We appreciate your feedback. Please send us your Comments, etc. The Editors.

Inside PNAA Online Newsletter Editorial Staff

Madelyn Yu, RN, MSN Editor-in-Chief

Ferdinand Luyun, RN, BSN Associate Editor

Mel Carrillo, RN, BSN, NEA

Majuvy Sulse, MSN, RN

Manelita Dayon, RN, MSN

Ghie Alagano, RN, BSN

Contributing Editor Western Region

Contributing Editor Eastern Region

Contributing Editor North Central Region

Contributing Editor South Central Region

January 2014

Winter Edition | Volume 3 | Issue# 13

A Google Image

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Opening Remarks 1st Global Summit of Filipino Nurses Theme: Filipino Nurses Worldwide Unite for Global Health and Nation Building 16 January 2014 Victoria B. Navarro, MAS, MSN, RN President, Philippine Nurses Association of America A pleasant good morning to all. Secretary of Health Eugenio T. Ona, Secretary of Commission on Filipinos Overseas Imelda M. Nicholas, Nursing Co-Conveners, Distinguished Guests, Nursing Colleagues Worldwide, Friends of Nursing and more importantly our future, the nursing students. We have made history. For the first time, since the increasing trend of nurse migration, mostly to the United States more than five(5) decades ago, Filipino Nurses are converging to be part of our nation building. The significant impact of Filipino Nurses in our country’s economy (a gain thru remittances of those working overseas) and health care (a loss due to lack of qualified health professionals in rural barangays) sets a very contrasting tone. This dichotomy of oversupply in the metropolitan areas (the leading primary source country for nurses internationally) and undersupply in underserved areas is an ongoing challenge. The nurse migration that sustained the Philippine economy for decades is also eroding the health and wellbeing of its citizens. However, we now have an opportunity to make it right for the Philippines. At the conclusion of our Global Summit, we will articulate how each one of us, from the Philippines and from various host countries can be part of the 2005-2030 (HRHMP) Human Resource for Health Master Plan to “ensure that the Philippine Health Services have an effective and well-motivated workforce and are appropriately managed.” Supporting the Global Summit is the educational program of the 9th International Conference demonstrating our Global Health CSR (corporate social responsibility) as professional nursing organizations. The Philippine Nurses Association of America (PNAA) together with its conveners, The Philippine Nurses Association (PNA), The Association of Deans of Philippine Colleges of Nursing (ADPCN), The Association of Nursing Service Administrators of the Philippines (ANSAP) and The Commission of Filipinos Overseas (CFO) are walking hand in hand to support our Philippine government and our people fulfill The 25 Year Road Map.

Be part of our History by mapping our Future.



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1st Global Summit of Filipino Nurses In Manila America, Inc.; Philippine Nurses Association, Inc.; Association of Deans of Philippine Colleges of Nursing, Inc.; and the Association of Nursing Service Administrators of the Philippines, Inc. wherein all parties agreed to harness the potentials of Filipino nurses (both domestic and global) for collaborative partnerships to provide for competent and sustainable health work force that is able to contribute significantly to the attainment of universal quality health care and the development of the country. The summit culminated in a symbolic ceremony On the 16th of January 2014, the iconic Manila Hotel served as witness to another historic event- the first global summit of Filipino nurses. Session topics were presented by a distinguished panel of experts in nursing practice, public and foreign policy, healthcare administration from government agencies, academia, and international non governmental organizations and were woven together by the theme “Filipino Nurses Worldwide: Unite for Global Health and Nation-building�. Delegates came from near and far, including faculties and students of local and international schools and colleges of nursing, members and officers of national Filipino nursing organizations and of their regions and chapters, and representatives of governmental agencies. While most of the delegates are of Philippine descent and are nurses, a number were nonFilipino citizens of foreign countries who serve as host to thousands of our Filipino nurses abroad and are nonnurses. The mosaic that was created not only by the demographic and geographic diversity of the delegates but also of the diversity in roles and specialties is necessary for a truly meaningful summit that represented the global Filipino nurse. The highlight of the summit was the signing of the Memorandum of Agreement among the Commission on Filipinos Overseas; Philippine Nurses Association of

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where the conveners and international participants were asked to pour sand brought from the different countries represented into an hourglass. The mixing of the sand in an hourglass represent the solidarity among the conveners and the international nursing community in the accomplishment of their mutually agreed upon goals within a limited amount of time. The 9th International Nursing Conference (INC), held on the 17th of January 2014 immediately followed the summit. Podium presentations for general sessions were delivered by a cadre of experts in topics that included clinical advances, technological innovations, biological and psychosocial research, quality improvement, and professional issues. The planners also accepted an unprecedented number of poster abstract submissions, which came from the Philippines, USA, Bangladesh, Haiti, Indonesia, Japan, and Sudan.


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Meeting of the Minds: First Global Summit of Filipino Nurses Convened

The First Global Summit of Filipino Nurses was successfully held last January 16, 2014 at the Manila Hotel. With the theme: Filipino Nurses Worldwide: Unite for Global Health and Nation-building, the summit brought together over 300 Filipino nurses from overseas and in the Philippines. The summit formally opened after the entrance of colors and parade of delegates representing more than ten countries. It was jointly convened by the Commission on Filipinos Overseas, the Philippine Nurses Association of America, the Philippine Nurses Association, the Association of Deans of Philippine Colleges of Nursing and the Association of Nursing Service Administrators of the Philippines. In her welcome remarks, Sec. Imelda M. Nicolas, as the original convenor of two Global Summits of Filipinos in the Diaspora and one of the movers for the Regional Summit in Europe, recognized that Filipino nurses, “wherever they may

(L-R: Ms. Victoria Navarro of PNAA, Mr. Noel Cadete of PNA, Ms. Elizabeth Roxas of ADPCN, Ms. Linda Buhat of ANSAP and Sec. Imelda Nicolas of the CFO.)

be, are forces to be reckoned with, catalysts for change and reform, doers towards better health for respective communities, advocates for quality nursing education and working conditions, supporters of rationalized and needs-based domestic and international deployment policies and programs�. The CFO, under the leadership of Sec. Nicolas, has long been advocating for overseas Filipinos to be partners in the national development efforts of the Philippine government. Department of Health Secretary Enrique Ona delivered the keynote address, while Commission on Higher Education Patricia Licuanan

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discussed the Philippine Program of Action for Higher Education. Dr. Peter Buerhaus, via livestreaming from the United States of America, presented the “Challenges and Opportunities Facing Nurses in the United States during an Era of Slow Jobs Recovery and Health Reform Implementation�. Two panels of discussion were also held. The first one was on the 25-year workforce planning for Health Human Resources in the Philippines, and the second was on the issues affecting nurses globally. During the afternoon workshop, the participants were divided into three: the Philippine-based nurses, the United States delegates, and the delegates from other countries. They were all requested to share their experiences in terms of education and employment, and what they can suggest to improve their situation. Likewise, the participants had to share their insights on how they can contribute to the nursing field, their Filipino counterparts all over the world, and the motherland. Lastly, they were asked for their recommendations on how to strengthen the network of Filipino nurses globally. The highlight of the event was the signing of the Memorandum of Agreement among the convenors on the implementation of the Balikturo Project and the creation of a database of the contributions of Filipino nurses and its outcomes.

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Balik-Turo: Teach Back and Giving Back at its Finest By: Becky Graboso PNA New Jersey PNAA and PNA- NY held its Balik- Turo program at Colegio de San Agustin in Bacolod City which was attended by over 500 students who appreciated the knowledge shared and imparted by the speakers. The participating students came from many nursing schools around the city. Thank you Susan Gador, Rosario-May Mayor And Marie Ortaliz and Cindy, PNANY president elect of PNA-NY for organizing the mission and letting us take part in this noble and humbling experience. The group was invited to the ABS-CBN morning show to talk about this medical instructional mission.

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PNAA- PNA Tampa Bay Balik- Turo at Pamantasan ng Lungsod ng Maynila. Thanks to the effort of Rosario-May Mayor and Ariel Zabala, PNA Tampa President for coordinating the event and to the sponsors who are members of PNA Tampa Bay. It was a great homecoming with Luz Newell and Penny Pattalitan. Great job Dr. Gilmore, dean of PLM.

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PNAA Medical Mission after the Summit

JOY of giving is PRICELESS

Patients were provided lunch

Ramon Magsaysay Hospital nurses willing to learn from us and we learn from them too. Calling all U.S. nurses to share their time in Medical Mission and Balik-Turo.

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PNAN.DC Chapter: Crew for Medical Mission with fiends from other States.

With Zambales Governor Hermongenes Ebdane, Jr. in Iba.

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A Tribute to Filipino Nurses all over the World By: Atty. Arnedo Valera Migrante Heritage Comission Nurses Without Borders: What can be done to help our modern day heroes and address the problem of brain drain in the Philippines? Revisiting the Labor Export Policy In recent years, however, the policy of commoditization and deployment of nurses for overseas jobs has been revisited because of its social costs. Analysts found that this policy actually aggravates instead of addresses unemployment in the nursing profession. The massive brain drain it creates also contributes to the deterioration of the public health care system in the Philippines. The Philippine government’s labor export policy faces the constant risk of uncertainty. It is vulnerable to the imbalances or instabilities of the world’s labor market demand and supply. The nursing sector, for instance, has been vulnerable to fluctuations in the US market and other foreign destinations, owing to economic recessions and domestic pressures against the importation of foreign nurses. Some host countries have been besieged by armed conflicts, particularly those in the Middle East and North Africa (MENA). Economic recessions in the US in the early 1990s and the latest episode that began in 2008 have led to a decline in demand for Filipino nurses. Jobs were being filled by locally educated nurses. From 15,382 in 2009, the number of Filipino nurses who took the US NCLEX examination for RNs or licensed practical/vocational nurses nose-dived by 37 percent to just 9,789 in 2010. In the first quarter of 2011, the figure plunged by 52 percent to just 1,454 as against 3,024 in the same quarter in 2010. As a result, the decline in the entry of Filipino nurses in the U.S., among other reasons, has spawned huge unemployment in the nursing profession in the Philippines. According to the Commission on Higher Education (CHED), some 400,000 Filipino nurses were unemployed in 2012. Unemployment has driven some nursing graduates to seek

other jobs such as those in call centers. Others go back to school to pursue higher degrees or work as caregivers abroad. At the same time, the number of nursing schools jumped from 200 in 2006 to 491 in 2012, with 2 million enrollees. So intense has been the competition for the few available job slots – whether foreign or at home – that board examination standards have also been raised to quality competency that has taken a toll on aspiring RNs. The number Nursing Licensure Examination (NLE) passers was a low 35.35 percent in December 2012 (16,908 out of 49,066 examinees) – albeit slightly higher than December 2011 (33.92 percent) and December 2010 A Google Photo (35.35 percent). In July 2013, 16,219 qualified out of 37,887 examinees – or a slight improvement of 43 percent. Amid the oversupply of RNs who remain in the Philippines, only 15 percent can be absorbed in the health industry, mostly in government hospitals and other institutions as well as private hospitals. Out of 1,600 national-based hospitals, only 90 are government-run. The rest are private hospitals. Many of these hospitals face the constant threat of closures, mainly due to the outmigration of experienced nurses and doctors. The push factors are low pay amid inflation, lack of benefits, poor working conditions, government corruption, and uncertainty in career development. In fact, more and more physicians train as nurses for better opportunities in overseas jobs. Brain drain Medical researchers and social scientists agree that the “brain drain” out-migration and the transnational marketing of Filipino nurses and other professionals are hurting the public health care system. While the Philippines exports tens of thousands of its health professionals, 7 out of 10 Filipinos die without being attended by health personnel. At least 50 percent of the population have no access to health care; only 30 percent of the country’s 42,000 barangays have health stations. Continued to next page

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Most alarming of all is the declining access to health services, indicated by the drop in immunization among children – from 69 percent in 1993 to 60 percent in 2003. Corruption, in the form of kickbacks and absence of biddings, further restricts the availability of essential drugs and facilities for the poor. The Philippines already has one of the poorest public health care systems in Southeast Asia. The government’s total health expenditures in proportion to GDP is only 3.3 percent, based on reports by the National Economic Development Authority (NEDA) – or way below the WHOrecommended minimum 5 percent of GDP. The 2013 figure fell from 2009’s 3.8 percent. The Philippines’ public health expenditure is lower than Thailand’s 4.1 percent, Vietnam’s 6.8 percent, China’s 5.2 percent and especially Cuba’s 10 percent, and the United States’ 17.9 percent. In short, the claimed GDP growth in the Philippines (7 percent) does not translate to a proportional increase in public health expenditures. Some public health advocates, like registered nurse and UP Staff Regent Jossel Ebesate, have attributed the deterioration of the country’s public health service to the government’s neoliberal and labor-export policies. These policies are blamed for the reduction of budgets for social services, freezing of wages, unjust labor conditions, and failure to address the exodus of professionals and skilled workers to foreign countries. While it is true that remittances prop up the economy and allow some families to have more spending power, the money is not transformed into national investments that can boost long-term development. Additionally, analysts have concluded that being a perpetual supplier of human capital hurts the country’s national development. It doesn’t allow for a public health system where Filipino nurses and doctors can serve with adequate compensation and benefits they deserve. These are compelling reasons to support proposed policies and legislation boosting domestic employment of nurses. The government should seriously also consider the proposal to hire unemployed nurses and deploy them to provide urgent health care services in the country’s poorest municipalities. There should also be a strong resolve to protect the employment rights and benefits of Filipino nurses abroad, amid reports of workplace abuses and discriminatory practices in many countries. Proposed solutions include bilateral labor agreements to protect the Filipino nurses’ labor rights. Urgent appeal As we reflect on these solutions, I would also like to make an urgent appeal that resonates with the conference theme. The devastation wrought by super typhoon Yolanda should serve as a wake-up call for the national govern-

ment. Eastern Visayas is the country’s third poorest region where the social divide is also the widest, with the upper 30 percent earning eight times more than the bottom 30 percent. The majority of its 4 million residents – mostly of farmers and fisher folk – has long suffered from an extractive economy that depleted the region’s logging and mining resources, with no meaningful economic productiv-

A Google Photo

ity for the people. Poverty has made them more vulnerable to both natural and man-made disasters. It has left them without the capability to recover their losses. By the way, Eastern Visayas has seen many of its nurses going abroad. It ranks fifth in the country for having the most number of nursing schools and fourth in term of enrollees. The millions of displaced families urgently need medical assistance and infrastructures as they start rebuilding their lives. They cannot rebuild their lives without their medical needs being addressed first. So I would like to appeal to all of you here today to use this occasion to join hands and come up with short- and long-term plans to support the rebuilding of Eastern Visayas. This is a great way of giving back to our country of birth. After this conference, I am flying to Tacloban and Carigara, Leyte to discuss Migrant Heritage Commission’s project REVIVE (REBUILDING VISAYAS WITH VIBRANT ECOLOGY). We are here for a long pull. We need to rebuild lives and rebuild the future of communities impacted by Yolanda/Haiyan. Project REVIVE calls for addressing as its first task medical needs of communities, livelihood projects and building of storm shelters which can also function as health care centers. As the saying goes, “Charity Begins at Home.” I would revise this slightly and say: “Charity, Compassion and Care Begin at Home.”

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Summary of Memorandum of Understanding The following organizations entered into a memorandum of understanding during the 1st Global Summit in Manila Hotel:

Carmel V Subd., TandangSora, Quezon City, herein represented by its President, DR. MARIA LINDA G. BUHAT, hereinafter referred to as the “ANSAP”;

The PHILIPPINE NURSES ASSOCIATION OF AMERThe COMMISSION ON FILIPINOS OVERSEAS, a ICA, INC., a professional organization of Filipinoduly constituted agency of the Philippine Government American nurses in the United States of America with with principal office address at 1-7/F, Citigold Center, principal office ad1345 Pres. Quirino dress at 8303 Avenue, corner OsWindfern Road, meña Highway, MaHouston, Texas nila, Philippines rep77040, USA represented by its resented by its Chairperson, SECREPresident, VICTOTARY IMELDA M. RIA B. NAVARRO, NICOLAS, hereinafhereinafter reter referred to as ferred to as “CFO”; “PNAA”; “These organizations agreed These organizations that there is a need to harness The PHILIPPINE agreed that there is the potentials of Filipino NURSES ASSOCIAa need to harness nurses (both domestic and TION, INC., is a the potentials of Filiglobal) for collaborative professional orpino nurses (both dopartnerships …” ganization with mestic and global) principal office adfor collaborative dress at 1663 F. T. partnerships to proBenitez Street, vide for competent Malate, Manila and sustainable City, herein reprehealth work force sented by its Presithat is able to condent, NOEL C. tribute significantly CADETE, hereinafto the attainment of ter referred to as the “PNA”; universal quality health care and the development of the country. The ASSOCIATION OF DEANS OF PHILIPPINE COLLEGES OF NURSING, INC., with principal office address The above organizations committed to the following: at 137 Matahimik Street, Barangay Central UP Village, Diliman, Quezon City, herein represented by its Presi1. Continue to promote professional growth towards the dent, ELIZABETH R. ROXAS, hereinafter referred to as attainment of the highest standards of nursing; the “ADPCN, Inc.”; 2. Collaborate with all parties in disseminating and imThe ASSOCIATION OF NURSING SERVICE ADMINISTRATORS OF THE PHILIPPINES, INC., with principal office address at No. 1 Diamond Street cor. A. Rodriguez

plementing knowledge and technology to Filipino nurses worldwide, and provide evaluation reports of outcomes of initiatives; To next page

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Summary of Memorandum of Understanding 3. Collaborate with all parties in the implementation of the Balik Turo Exchange Program, the mechanics of which shall be drafted in a separate document.

of schools, deans and faculty members who are members of the organization; and

• Create programs to enhance competencies of deans and faculty members, and retain experienced and qualified nurses and faculty in the Philippines;

Specifically, each party agrees to: A. The PNAA shall:

D. The ANSAP shall:

• Provide all parties con-

• Continue to uphold

cerned with information on nurses/nursing organizations under its umbrella;

policies and standards for nursing practice;

• Provide all parties

• Partner with profes-

concerned with a list of nursing organizations under its umbrella; and

sional nursing organizations and the CFO in responding to disasters and the needed rebuilding that follows;

• Create programs to retain experienced and qualified nurses and faculty in the Philippines.

• Provide all parties concerned with updates on various activities of nurses/nursing organizations in the United States of America and its territories. B. The PNA shall:

• Provide all parties concerned with information on nurses/nursing organizations under its umbrella; and

• Provide all parties concerned with information of various activities of nurses/nursing organizations undertaken in the Philippines; and C. The ADPCN shall:

• Participate in the development and recommendation of relevant policies and programs that would uphold quality nursing education in the Philippines;

• Provide all parties concerned with a current list

E. The CFO shall:

• Continue to promote the welfare and well-being of overseas Filipinos and maintain stronger ties with them through its Diaspora to Development (D2D) program;

• Provide infrastructural support and coordination to the Balik-Turo Program;

• Develop a database of contributions of overseas Filipino nurses/nursing professionals and their outcomes in the Philippines;

• Provide all parties concerned with matrix of activities undertaken by overseas nurses/nursing professionals in the Philippines; and

• Collaborate with the Department of Health (DOH) on generating information for all parties on outcomes of these initiatives and recommendations for future activities.


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Emma Pacris Circle of Presidents (Michigan)

Ariel Zabala Circle of Presidents (Tampa Bay Florida)

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Comm. & Marketing


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