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Empire of Care: Nursing and Migration in Filipino American History

by Catherine Ceniza Choy

This book is personal for me and it has been on my mind throughout the pandemic, which has hit Filipino American nurses particularly hard. My mom is Filipina and she came to the United States to work as a nurse. Part of the reason I like Empire of Care is that it is my family story. But, also, it reminds us that we need to think about Asian migration to the United States through the lens of empire. One reason why we have so many immigrants who came to the United States from the Philippines to work as nurses is because in the early 20th century, when the Philippines became a colony of the United States, there was an effort to civilize Filipinos teaching them American standards of ‘health’ and ‘cleanliness’ (I’m using air quotes here). That enterprise of empire resulted in the United States starting nursing schools in the Philippines. Later in the 20th century, graduates of those schools migrated to the United States to address a nursing shortage here. It’s a really interesting story. Thinking about immigration to the United States through the lens of empire is a big shift in the study of migration. Immigrants aren’t just coming to the United States because they want to start the American dream. They are often coming to United States because the United States went over to and disrupted their country first. The lens of empire shifts how we imagine the choices that were available to immigrants, the particular opportunity structures that were made available to them in different locations in the world. And also why we have so many people coming from one place or another. So, the Philippines sends a really large number of immigrants to the United States every year. It’s one of the few countries that maxes out its number of allotted visas. A lot of it has to do with a colonial relationship between the Philippines and the United States that goes back over a century. Get the weekly Five Books newsletter The author underscores that “the larger demand for services in highly developed countries” is inextricably linked to “the export of manufacturing to less developed countries” and how both flows contribute to the “larger process of global restructuring” and “increasing worldwide mobility.” She suggests the exportation of skilled labor denudes less developed countries like the exportation of natural resources, pointing out that nurses are even more unequally distributed between highly developed and less developed nations than doctors. There are a lot of reasons why it is a good thing and a bad thing. Countries like the Philippines are very worried about brain drain. We also know that countries like the Philippines receive so much money in remittances from Filipino workers in the United States and around the world. Asian American are understood as products of the immigration law changes in 1965, which prioritizes people with professional skills. It contributed to how Asian Americans are understood, in the broader imagination, as upwardly mobile, as successful, as good at math and science.

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