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The Geographical Imaginations and Mobilities of Filipino Nurses: an Exploration of Global Therapeutic Networks in Metro Manila, the Philippines

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The Geographical Imaginations and Mobilities of Filipino Nurses: an Exploration of Global Therapeutic Networks in Metro Manila, the Philippines TITLE PAGE The geographical imaginations and mobilities of Filipino nurses: An exploration of Global Therapeutic Networks in Metro Manila, the Philippines Maddy Thompson A thesis submitted for the degree of Doctor of Philosophy in the School of Geography, Politics and Sociology at Newcastle University. August 2018 A map drawn by Nicole, one of the participants. She has drawn the world surrounded by a stethoscope. i Abstract This thesis challenges the commonheld notion that being a Filipino nurse involves an aspiration to migrate to the global north. I analyse how women and men negotiate, interpret, and resist the pressures of migration, engaging in new mobilities within the Philippines and beyond. Drawing on Global Care Chain thinking and the mobilities paradigm, I call for an orientation towards Global Therapeutic Networks (GTNs) to better explain the complex, multiple, and varied experiences of those involved in global transfers of care. I adopt and develop the geographical imaginations approach to examine and understand the agentic decision-making practices undertaken by nurses within larger GTN pressures. Focusing on the experiences of nurse students and graduates living in Metro Manila, rather than overseas, brings light to the hidden stories of those involved in the global circulation of care who do not migrate. Drawing on 48 interviews and 39 mental maps with nurse graduates and students, I examine four key areas. Initially, I explore how young women and men are drawn into nursing education in the Philippines, examining the intersections of nursing, overseas migration, therapeutics, and socioeconomic mobility. Secondly, I explore how participants understand what it means to be a Filipino nurse in the context of global healthcare circulations. I demonstrate expectations of exploitation are largely accepted by nurses, regardless of migratory desire. Thirdly, I turn to employment experiences, focusing on volunteerism, ‘call centre nursing’, and entrepreneurship. I explore novel mobilities nurses engage in to achieve the goals of migration without leaving the Philippines. Finally, I examine the geographical imaginations and migratory intentions and aspirations of nurses. I draw attention to the importance of sociocultural mobility as a deciding factor in decisions to migrate, and of where to migrate to. I contribute to wider debates on global circulations of healthcare and migration decision-making approaches. ii Dedication and Acknowledgements First and foremost, I offer my kindest gratitude and thanks to each of the participants in this study. Without their participation and willingness to share their narratives, this project could not have been completed. I also wish to thank the gatekeepers, facilitators, contacts, and others that I met who assisted with my research, particularly the College of Nursing at the University of the Philippines, Manila. Over the past eight years, Newcastle University has been my academic home, and I am grateful for the intellectually stimulating environment and strong social support network provided by both staff and students. In particular, I would like to thank Alastair Bonnett and Anoop Nayak, my supervisors at Newcastle. Alastair as my supervisor over three projects has provided me with endless patience, advice, laughter, and wasp stings. Anoop is my first port of call for any crises, no matter how big or small, and has been a friend and supervisor throughout the process. Cheryl McEwan, at Durham University, has also provided me with insightful supervisory advice, usually from afar, and has supported me countless times at conferences. I would also like to thank Jon Pugh, Alex Hughes, Simon Tate, Peter Hopkins, and Alison Williams for providing me with advice and opportunities throughout my PhD journey. Furthermore, Matt Jenkins is the best proof-reader/copy editor any researcher could ask for (and a great colleague!). While I am certain errors remain, none are the fault of Matt. Instead, his selfless and tireless efforts to correct my rogue commas and surplus brackets have allowed me to better express my arguments and present the words of my participants. For this, I am truly thankful. Both postgraduate and teaching fellow offices have been my lifeline. The social support and camaraderie over the last four years have been invaluable. In no particular order, and with my deepest apologies for any omissions, I would like to especially thank Diana, Alessandro, Fraser, Wilbert, Clare, Robin, Nathar, Laura, Emil, Ged, Liam, Helen, Manuel, Stefan, Alex, Graham, and Alena. Furthermore, Jenny and Carl, I love both very dearly, and I am very glad we got to do this together. Finally, Matthew. He is the best in every way possible. I would never have got through this without him, and am eternally grateful for the friendship we have. On top of this, I’d like to thank the hundreds of fellow geography postgraduates I have met through my various roles with the Royal Geographical Society (with Institute of British Geographers), with a particular mention to Phil Emmerson who lights up my conferences. I would also like to thank my kind and welcoming colleagues in Canada at the Balsillie School of International Affairs, and particularly those working in the diverse and exciting International Migration Research Centre (IMRC). In particular, I am deeply indebted to iii Margaret Walton-Roberts for the time she dedicated to me when at the IMRC, her invaluable comments, and the opportunities she has since afforded me. I would also like to thank Jenna, Lacey, and David for welcoming me into the department, as well as Lorenzo for repeatedly singing his favourite ‘ancient melodies’, and Rachelle who welcomed me into the most fantastic family I have ever met. It was a genuine pleasure working with the IMRC, and I am proud to be affiliated with them. My short time spent in Canada has had deep and lasting impacts on both this thesis and my wider approaches to academia, writing, and research. My time spent in Manila was filled with incredible experiences, many of which were only made possible because of the wonderful people I met. My time would not have been the same without Andy (although I may have been a few kilos lighter), and I’ll forever be glad that we met. Rose is an amazing friend who always keeps me smiling, even through the tears. She not only helped me find participants, travelling with me through monsoons, but she helped me to appreciate tequila, and taught me a couple of dance moves. There is also May: our travels were some of my absolute high points, and I only hope I can repay you in the next few months. I would like to thank ‘Boss Steve’ and ‘Ma’am Jen’, and everyone else at the Star of Manila, especially Tisha. You guys kept me smiling, kept me safe, and kept me working when my Wi-Fi wouldn’t work. And to Stephanie, grow up to be as amazing as your parents and you’ll have no problem! I would also like to thank Lady, Garland, Jingle, Jay-Ann, Joy, Maria, Jason, Steve, Janee, Donna, and Ged. Last, but by no means least, I could not have done this without the support network of my closest friends. I would like to thank Georgie for her ongoing support and love (and welcome Harry to the world!), Andy for making sure we never lose touch and coming back to Newcastle, even if just for a year, Marcus for keeping me slightly more chilled out than I otherwise would be, and Steven for being there whether I need to drink, dance, or laugh (or all three). I would also like to thank Claire, Tracey, and Mark. Finally, Klöe, my closest and oldest friend who I love dearly, and who, perhaps more than anyone has put up with my moods, frustrations, and got me out of my low points. Living with Klöe throughout most of the thesis was a cherished experience. This thesis is dedicated to Luke Gaul, who will never be forgotten, and, as always, to my Dad. BLD. iv Table of contents TITLE PAGE ..........................................................................................................................................................I ABSTRACT ........................................................................................................................................................... II DEDICATION AND ACKNOWLEDGEMENTS ........................................................................................................... III TABLE OF CONTENTS ........................................................................................................................................... V LIST OF TABLES AND FIGURES .......................................................................................................................... VIII LIST OF KEY ACRONYMS .................................................................................................................................... XI CHAPTER 1. INTRODUCTION ......................................................................................................................... 1 1.1 THESIS AIMS AND OBJECTIVES ....................................................................................................................... 3 1.2 RESEARCH CONTEXT ...................................................................................................................................... 4 1.3 CONTEXTUALISING PHILIPPINE MIGRATION ................................................................................................... 9 1.3.1 ‘The Stop-gap Program’ (Tigno, 2014, p. 19) ......................................................................................
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