Filipino healthcare workers vs COVID-19
"Data is a double-edged sword because when lumped into traditionally larger categories, we’re obscuring the truth."
Welcome to The Breaking Point, a weekly newsletter that draws on the historical legacies of injustice based on the news cycle and culture trends to understand what in the world is going on. If you like what you see, please feel free to forward it around. I’m a one-woman team, so the structure of this newsletter may change over time as I learn new things.
As a Filipino American, I was always drawn to the idea of being a nurse or doctor largely due to my cultural upbringing. I even joined a nursing program back in high school when I didn’t know I wanted to be a journalist. Nursing also happens to be such a prominent field for folks in the Filipino diaspora. I can name many of my Filipino friends and members of my family tree who are in the healthcare industry from nurses to doctors to caregivers around the world. And since the coronavirus pandemic started, I’ve been increasingly worried at the thought of them being on the front lines.
In the United States, Filipinos are four times more likely to be nurses than any other ethnic group in the country, according to experts. U.S. Filipino healthcare workers — many of whom are relied on by families in the Philippines for allowances — are now facing a staggering toll of COVID-19 infections and mortality rate. In the largest Filipino enclaves in the country such as California, New Jersey, and New York, Filipino healthcare workers are essentially in the sacrifice zone working to save people’s lives.
While Asian Americans rank low, according to data, in terms of COVID-19 deaths, Filipino Americans within the Asian American umbrella are disproportionately dying from the virus. Still, this heart-wrenching data is not widely talked about. In this week’s newsletter, I talked to my friend, Maria Theresa Dizon — who came to me with the idea — about Filipinos in the medical field, being an Asian American during the pandemic, data disaggregation, and more. We both grew up in Saipan, Northern Mariana Islands and were raised by Filipino immigrant parents. Dizon, 23, is currently a researcher at the Department of Epidemiology, Analytics, and Evaluation Division at the Multnomah County Health Department in Portland, Oregon.
Figure of the week: 14
As of Sunday, the number of people killed in Louisiana as a result of Category 4 Hurricane Laura. More than 350,000 residents across the state still don’t have electricity, while 85 water systems are out of service.
This conversation has been condensed and edited for clarity.
Rachel: Hi Maria, how are you holding up? How's your heart?
Maria: It ebbs and flows! I keep myself hopeful despite what is going on throughout the world. Every day, I try to find joy and rest to balance out a long workday.
R: That’s so great to hear. Let me ask you, how has your experience been as a Filipino American in the mainland?
M: I came to Portland for school back in 2017 and I found it to be full of culture shock! Portland, I feel, is not as diverse as it presents itself to be. It was so hard to assimilate and basically reorient your life to a foreign environment. In spite of that, I appreciate pushing my comfort zone and creating a home away from home all the while I’ve been here.
R: I had that exact feeling when I moved to Portland back in 2014. You’re absolutely right about the city not being as diverse as it presents itself to be.
What was your major? Why did you choose the field you're in right now? Did you feel pressure in any way from your family to be a nurse or doctor?
M: I graduated with a BS in Community Health in 2019. I am now an incoming Master of Public Health student in the fall at Oregon Health & Science University. I’m inspired by witnessing and living through health disparities as I grew up in Saipan. I always had a macro level perspective that drew upon questioning what underlying factors affect health and access. I’m a researcher by heart who loves community-based work.
I am still (lovingly) encouraged to pursue the clinical route all the time. In essence: While a doctor/nurse looks at an individual, a public health practitioner looks at an entire community. I see the benefits of both fields!
R: Early congratulations on your Masters! What were some obstacles you found to be hard to navigate as a Filipino American? How did you overcome it?
M: First, I often think about the intersectionality of identity and the place you call home. Being Filipino American is not a one-size-fits-all experience. While we find our culture to be common ground, the literal place you were raised brings in another layer of complexity. I found it hard to relate to other kababayans (as we call it) since they grew up in the “mainland” and I didn’t. I struggle to identify as Filipino American until this day. My Saipan upbringing is integral to my identity and I don’t ever want to lose that. I’ll always say “I’m a Filipino born and raised on Saipan.”
Secondly, realizing the reclamation of Filipino identity is a reclamation of self. While I am fluent in the Tagalog language and have been surrounded by the Filipino community all my life, it was only until I moved to Portland that I realized there was a huge gap in my knowledge. I didn’t understand how we came to be, the centuries of colonization, our diversity in native tongues, and the internalized racism that still persists within us today. I’m reading more, listening more, and seeking more about our culture, our art, and our history. This reinstills a great sense of pride and identity in me. To me, this is a lifelong promise to do just that.
R: Yes, girl. I feel you on that, essentially going down this road of self-discovery and that there was a huge gap in your knowledge about our Filipino identity. It wasn’t until I became active with the Northwest Filipino American Student Alliance in college did I start to really fill in those gaps.
How has the pandemic affected you personally and professionally as an Asian American, specifically Filipino American woman?
M: The anti-Asian sentiment was even more apparent as the pandemic rose. I remember walking to my local health clinic for a regular check-up. A man from the corner of my eye began charging at me, saying “F--k you chink! I f-king hate you!” I was completely in shock to even engage with him. I was scared, hurt, and angry all at once. I didn’t leave my house for a few weeks after that because I was that hyper-conscious of myself. As much as I try to play off that experience as mere ignorance, racism sticks with you. You feel it daily.
As for my professional life, part of me is glad that more people are seeing the connection between our work and the direct effect on their individual lives. I do wish it wasn’t through these circumstances. Everyone suddenly knows what public health is and what we do as we keep tabs on the pandemic’s prevalence across the international, national, and local levels. While there’s a literal COVID-19 pandemic, there’s a second pandemic for the public health workforce facing a unique level of stress. While we try to survive this pandemic and its effects, we are also coping with the demands of work and serving the community in this scary time.
R: Medical ranks are filled with Filipino healthcare workers, many of whom have suffered severe impacts of COVID-19. Why do you think there are so many Filipinos in the field?
M: We have embodied a great sense of altruism and that naturally flows to the type of work we choose. While that may be true, it’s critical that we recognize that the US colonized the Philippines and replicates harm by using us as labor supply in exchange for the American Dream. I also see that going into these fields is a generational thing, because all their moms, dads, titos and titas do it too.
Source: University of California, Berkeley (Photo from the Philippine General Hospital School of Nursing Ninth Annual Announcement and Catalogue, 1915-1916, U.S. National Archives, College Park, MD.)
Side note to the point of historical legacies of injustice: The history of Filipino nurses actually goes way back to its colonial roots, specifically the long colonial and imperial history between the U.S. and the Philippines. In the early 20th century, the U.S. colonial rule fostered a vast medical workforce in the Philippines. Long story short, the U.S. leveraged western medicine to rationalize its annexation of the Asian country. Years later, after World War II, the U.S. was faced with massive nursing shortages, giving Filipinos an opportunity to work in America. Filipino nurses were so valued at the time that they became such a high export. If you want to read more on this history, I highly recommend the book, Empire of Care: Nursing and Migration in Filipino American History.
R: Filipinos are disproportionately dying of COVID-19, yet this specific data is often eclipsed because we are lumped under the Asian American umbrella. In states like California, where Filipinos account for roughly one-quarter of the Asian American population, Filipinos still account for at least 35 percent of COVID-19 death rates. How important is data disaggregation in times like these? What changes do you propose should happen?
M: I’m a strong advocate for data disaggregation on all fronts. In my work in public health — particularly in community-based research and epidemiology — I interact with data on a daily basis. The importance of data is especially highlighted in the ongoing pandemic as we use it to guide decisions. Now, more than ever, people are seeing the direct link of macro-level data to the individual lives. For example, a spike in numbers of positive cases can lead to state leadership reverting back to prior reopening phases.
Data is a double-edged sword because when lumped into traditionally larger categories, we’re obscuring the truth. I see it when Filipinos get lost in the Asian category. I see it when we merge diverse groups into one AAPI umbrella term. However, when disaggregated, we’re creating visibility! That’s a form of racial justice and equity to me. Having standardized data collections of race and ethnicity alongside government policies that enhance our ability to collect it are a few ways to do just that.
R: Yes to data disaggregation as a form of racial justice. Thank you so much for chatting with me, Maria. Is there anything else you'd like to add that you think would be important to mention or for people to know?
If you’re reading this, get up and drink some water. Continue to cultivate little pockets of joy throughout your day!
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That was my friend, Maria Theresa Dizon, everybody. If you want to follow her work or touch base with her, follow her on Twitter at @mariatdizon.
Critical reading list, because I said so 📖
Citizenship applicants caught in backlog distraught over inability to vote this year: ‘I feel like my voice is not going to count’ by Michelle Ye Hee Lee, The Washington Post
Dermatology Has a Problem With Skin Color by Roni Caryn Rabin, The New York Times
Can you trust the police to tell the truth? Reliability under scrutiny as cases tossed by Alene Tchekmedyian, Los Angeles Times
More than 100 Aboriginal sacred sites — some dating before the ice age — could be destroyed by mining companies by Lorena Allam and Calla Wahlquist, The Guardian
She Was Sued Over Rent She Didn’t Owe. It Took Seven Court Dates to Prove She Was Right by Danielle Ohl, Capital Gazette, and Talia Buford and Beena Raghavendran, ProPublica
Big Oil Is in Trouble. Its Plan: Flood Africa With Plastic by Hiroko Tabuchi, Michael Corkery and Carlos Mureithi, The New York Times
‘Cascading disasters’: What a hurricane means when you live next to a refinery by yours truly, Rachel Ramirez, Grist
thanks for reading, and don’t forget to subscribe if you haven’t already. see you next week!