Elizabeth Capadngan is a nurse at Doctors Community Hospital in Lanham, Maryland. She is among the Filipino nurses who have had their lives documented by photographer Rosem Morton.

For generations, Filipino nurses have been on America’s front lines

Photographs by Rosem Morton
Story by Fruhlein Chrys Econar, CNN
Published October 8, 2021

Elizabeth Capadngan is a nurse at Doctors Community Hospital in Lanham, Maryland. She is among the Filipino nurses who have had their lives documented by photographer Rosem Morton.

Jennifer Bulaong kept a close tally of her work hours.

She arrived in the United States in 2019 with a group of fellow nurses from the Philippines, landing first in Florida before being deployed to a hospital in Missouri. And thus started her count: 5,200 hours in three years, the terms of the contract she signed with her recruitment agency. After that, she was free to permanently join the rest of her family, which had been waiting for her in Maryland since 2016.

“That became the goal, the target,” she said.

For years, she kept her head down and chipped away at the hours to close the gap between time zones, from 12 hours, to one, to none. It’s a story familiar to many other families in the diaspora, a story of distance and hard-fought reunion. But when the coronavirus pandemic hit, Bulaong and many other Filipino nurses like her found themselves part of another story with larger roles: frontline workers.

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Jennifer Bulaong’s mother, Leane, is also a nurse. She’s seen at right, next to her youngest daughter, Jillian, who is on her laptop for a virtual nursing class. On the left is Jillian’s grandmother Ricolia Ramos.
Jennifer, left, visits her family in Maryland in September 2020. Here, they cook Filipino food for her to take back home.
Jennifer, left, hugs her family goodbye before flying back to Missouri.

“During those first few months of Covid, you just had to focus. I had to do this, I had to help,” Bulaong said. “It took a few months for everything to sink in. I was (in) work mode.”

Grim statistics emerged as the pandemic continued, highlighting how it disproportionately affected Filipinos and other healthcare workers of color. Filipinos make up 4% of registered nurses in the United States, according to National Nurses United, the country’s largest nursing union. But according to a February 2021 report published by the group, 26.4% of nurses who died from Covid-19 and related complications in the United States were Filipino. They accounted for 83 nurses out of the 314 deaths where race and ethnicity data was available.

These numbers bring to light a community whose role in the larger national story is often untold. And perhaps few are better suited to document this intersection than photographer and nurse Rosem Morton, who immigrated to the United States from the Philippines when she was 17.

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Ernest Capadngan holds his newborn daughter, Eliana Grace, while his wife, Elizabeth, fills out their daily infant report. They both work as nurses in Maryland.
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Lovella Eugenio falls asleep in her car after she arrives home from work. She juggles two full-time nursing jobs.

At the onset of the pandemic, Morton used her photographs to show the world inside of a Baltimore hospital, chronicling how she and everyone around her adjusted to new regulations and processes, and how the threat of infection loomed over the quiet moments at home with her partner, who is also a nurse.

Her current project, “Diaspora on the Frontlines” — supported by the National Geographic Society’s Covid-19 Emergency Fund for Journalists — is an extension of that earlier work. It seeks to reveal the inner lives of Filipino nurses and their families beyond stories of trauma.

When Morton was younger, she says she was often asked questions such as: “Why is your English so good? Why are there so many Filipino nurses? Why are you here taking our jobs?” They’re the kind of questions many immigrants like her encountered; questions to which she only had vague answers. But the deeper she dove into researching the history that informed this project — the connections that continue to tie the United States and the Philippines together — the more she found a foothold into those answers.

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Brian Chavez, left, and Mark Abordo get ready for work. They are both night-shift nurses in Baltimore.
Abordo, left, and Chavez leave the hospital after a shift. They try to match their schedules as much as possible.
Chavez gets ready for bed. He often works back-to-back shifts in the hospital.

All the nurses Morton worked with came into contact with Covid-19 patients.

She photographed Lovella Eugenio leaning affectionately on her husband as he plays the guitar. Eugenio, who works in the same hospital as Morton, juggles two full-time nursing jobs and battled through her own coronavirus diagnosis.

There’s Ernest Capadngan, who works at a biocontainment unit. He de-stresses by looking at memes to help cope with the grief he’s had to witness daily.

Morton photographed Bulaong on one of her visits to Maryland. Bulaong’s mother, Leane, is also a nurse, and her sister and father are both nursing students. All of them, except for Jennifer, tested positive for Covid-19 in December. And though they have since recovered, Leane still experiences some lingering effects of the virus.

Ronald Eugenio plays the guitar while his wife, Lovella, decompresses after her nursing shift.
Leane Bulaong takes care of her plants as a way to decompress.
Ella Bontogon paints at home during her days off from the hospital.
Elizabeth and Ernest Capadngan work out in different areas of their home. They try to stay active on their days off.

“I want people to pay attention to this community because they’re an important community besides the statistics. These people are living really full, diverse lives that we should get to know.” Morton said. “It’s important because these people have always contributed to the wellness of the country, the world.”

Filipino healthcare workers in the United States are at once ubiquitous and invisible.

Immigrants from the Philippines make up over 13% of all foreign-born health-care workers — more than any other country — according to 2018 figures from the Migration Policy Institute. And then there are the US-born Filipinos who have followed in the footsteps of relatives.

But the joke, as once told at the Emmys, is that you rarely see them on medical TV shows like “Grey’s Anatomy” and “ER.”

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Lovella Eugenio wears a mask and tries to distance herself when she spends time with her mother, Lolita Flores. She worries about getting her mother sick.
A note on Eugenio’s family board says: "Mom have a good day. We love you - The Cool Kids." She responds with: "Thank you my children. I love you all too.”
Elizabeth Capadngan has masks, hand sanitizer and cleaning materials in her car.

Their presence, however, is an enduring legacy of the United States’ colonization of the Philippines in the first half of the 20th century, a history that Morton herself wasn’t completely aware of at first but is now eager to further explore.

“I feel like I uncovered this box. I was so enraged by what I've learned,” Morton said. “This is really important for us to learn, to just even understand why we're here.”

In “Empire of Care: Nursing and Migration in Filipino American History,” a 2003 book that serves as a reference to Morton’s project, author Catherine Ceniza Choy challenges the “benevolence” with which the United States accepted migrants from the Philippines. During its rule, the United States imposed its culture, values and language on its colony. Choy found that it created an Americanized nursing program that inadvertently primed Filipinos to fill the nursing shortage after World War II, thus setting off a mass migration.

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Red Cross nurses in the Philippines pose for a portrait in 1919. (UtCon Collection/Alamy)
Rudolfo Eladio Acena poses for his 1919 graduation portrait at the Philippine General Hospital School of Nursing in Manila. He migrated to the United States a year after his graduation. (Courtesy Bjoring Center for Nursing Historical Inquiry)
Felicidad Nolasco Acena poses outside a Filipino YMCA club. Acena was a Filipino nurse who migrated to Cleveland in 1926. (Courtesy Bjoring Center for Nursing Historical Inquiry)

A combination of US and Philippine government policies, as well as the interests of American hospitals, Filipino recruitment agencies and professional associations, contributed to a culture of migration that encouraged Filipinos to work in the United States, according to Choy.

These days, approximately one in four working Filipino adults in the country are frontline healthcare workers, according to data cited by a JAMA Network report. And Filipinos continue to heed America’s call, especially as the pandemic drags on and the psychological toll has caused nurses to quit in droves.

Like many in their profession, both Bulaong and Morton are reassessing the role that nursing plays in their lives after 18 months of being in the line of fire. Bulaong has since fulfilled her contract and has finally moved to Maryland with her family. Morton is taking some time off to focus on photography. But this year alone, Bulaong has seen her hospital in Missouri bring in more nurses from the Philippines every month.

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Marc Bontogon wears personal protective equipment before entering a patient's room. He works the night shift as a telemetry nurse.
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Elizabeth Capadngan watches her husband, Ernest, leave for work.

Those nurses still think about their home country, about its own desperate response to the pandemic and the relatives they left behind. But the nature of their work, of their lives in the United States, demand that they also save their energy for the battles fought here.

“The way we've been programmed is (that) we want to go to America because this is how we'll make it, this is how we will better our lives,” Morton said. “Not the narrative that America also needed us to be here.

“I think that has definitely changed the way I've seen the profession and how I want other people to see it as well.”

Credits

  • Photographer: Rosem Morton
  • Writer: Fruhlein Chrys Econar
  • Photo editors: Fruhlein Chrys Econar, Brett Roegiers and Sandra Stevenson