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From U.S. to Philippines, Nurses Mobilize in Typhoon Haiyan’s Wake

4:41 pm in Uncategorized by Michelle Chen

Originally published at In These Times

When Typhoon Haiyan made landfall in the Philippines a week ago, the destruction was swift, total and unsparing—showing the disproportionate impact of disasters on poverty-stricken communities of the Global South. The international aid response is still struggling to grapple with the scale of the storm damage.

But it just so happens that many Filipino immigrant workers in the United States are uniquely well-suited to lend a hand in the recovery. The Philippines is a major “exporter” of highly skilled nurses and other healthcare workers to the U.S. and other Western nations. There’s a long history of transnational cooperation in the Filipino diaspora—the country is supported through a massive network of migrant remittances. And in the U.S., Filipino immigrant workers also have a rich history of activism within the labor movement, forming a key part of many progressive unions, including the National Nurses United (NNU).

Out of this tradition of labor activism and deep diasporic ties comes an initiative by nurses with NNU’s Registered Nurse Response Network (RNRN), many of them Filipina, to send a solidarity relief mission to the Phillipines.

Immediately after the typhoon struck, the NNU put out a call to members asking for assistance and received some 1,500 responses from both Filipina and non-Filipina volunteers. The union is now sending an initial team of nurses to the disaster zone to start coordinating a medical response delegation that will ultimately deploy to the disaster zone in collaboration with local partners.

RNRN, first formed in the wake of the deadly Indonesian tsunami of 2004, ran a relief delegations to Haiti after the earthquake, as well as general medical missions to the Philippines and other countries, as a way both to meet emergency nursing care needs in humanitarian missions and to foster international labor solidarity.

The pending mission to the Philippines has special significance for nurses in the Filipino diaspora. Ironically, many of the health workers who went to work abroad in the West to support their families are cut off from loved ones in the storm’s aftermath and unable to use their skills to help heal their communities. Together with other fundraising and aid efforts by diaspora groups, the delegation may help some nurses to directly help stave off the health crisis brewing in the wake of the storm. Read the rest of this entry →

Rethinking Care

6:17 am in Uncategorized by Michelle Chen

Originally published at Jacobin Magazine

Growing older is hard, and taking care of an aging loved one is hard work. For those of us who are aging or living with a disability, your family might hire a caregiver for day-to-day support: getting out of bed, minding medications, bathing and cooking meals — and sometimes serving as a medic, housekeeper, therapist and closest companion, too. Yet for all the loving care that health aide gives every day, she’ll be lucky if she takes home enough money to make this month’s rent.

Caring Across NYC cover

A report by Align NY highlights the struggles of direct care workers.

Welcome to the “care economy” — the booming service sector that has emerged from America’s rapidly graying boomer population. On the surface, in-home elder and disability services offer a more family-oriented, community-based alternative to a traditional nursing home. But for the care worker, this apparently progressive model also means workdays that never end, along with the twisting of sensitive interpersonal relationships of care into a massive, barely regulated industry, rife with exploitation.

But the industry is shifting. The Obama administration just closed a longstanding labor-law loophole to provide federal minimum wage and overtime pay to home care workers, starting next January. The widely hailed rule change affects potentially two million workers — typically low-income women, including formal nursing aides and domestic workers providing medical services. It’s a step toward dismantling exclusionary laws that have for generations pressed poor women to the margins of the workforce.

Direct care workers typically earn only around $20,000 annually, with few opportunities for career advancement. Many are primary breadwinners but must rely on public assistance to scrape by. Even those hired by third-party healthcare agencies and financed by Medicaid are routinely shorted on wages or forced to work withering schedules.

Currently 21 states and Washington, D.C. provide some wage and hour protections to care workers. But strengthened national labor laws (the first such expansion since domestic worker regulations were reformed in 1974) will help boost wages nationwide and strengthen oversight.

But despite incremental reforms, home care workers still lack many standard federal protections for the right to unionize and workplace safety and health standards.

Moreover, many of the indignities they experience on the job are deeply ingrained in the society that lies outside the home. The epithets that a worker’s client occasionally spits at her reflect a legacy of racial and gender marginalization in domestic work. The sector has historically been associated with poor women of color and, more recently, immigrants; not surprisingly, nannies and housekeepers were originally completely excluded from the landmark Depression-Era Fair Labor Standards Act.

Likewise, when a boss arbitrarily shorts a care worker’s wages, locks her in the basement, or puts his hand down her shirt and threatens to fire her if she tells, she may have essentially no legal recourse. Because as a low-wage worker without union representation — or perhaps an undocumented migrant working “off the books” — she toils in the “gray economy,” virtually invisible under the law and constantly vulnerable to abuse.

One New York-based home care worker recently described her job in a report by the labor advocacy group ALIGN NY: “[The clients] treat us like we are disposable. Like a napkin, to use and throw away.”

Read the rest of this entry →

Aid Groups Fight Anti-Prostitution ‘Oath’ on Free Speech Grounds

3:05 pm in Uncategorized by Michelle Chen

During the 2012 International AIDS Conference in July, ACT UP activists protested U.S. HIV/AIDS policies, including the PEPFAR anti-prostitution pledge.(Michael Fleshman / Flickr / Creative Commons)


Originally posted at In These Times

One of the few bright spots in the global response to the HIV/AIDS epidemic has been PEPFAR, the United States government’s program to fund treatment and prevention for vulnerable populations across the Global South. But several years ago, lawmakers singled out one group of people as less worthy of that care. In fact, aid groups must publicly denounce them—or risk losing U.S. funding.

That’s the basic idea behind the “anti-prostitution loyalty oath” embedded in the global AIDS initiative legislation. As a condition of receiving federal funds, organizations must adhere to avaguely worded anti-prostitution pledge, essentially swearing to the government that they do not support or promote prostitution. The extent of this restriction on their work is unclear; the only thing that is clear is that federal health authorities have sought to impose ideological views on aid workers in a way that could undermine both public health and organizations’ free speech rights.

The policy has been blocked on constitutional grounds in lower court decisions, but the White House will now take the case to the Supreme Court, which will rule later this year on the question of whether the government can link support for U.S. health organizations to the adoption of certain ideological positions on prostitution. Read the rest of this entry →

Settlement for New York Home Care Workers Highlights Injustice in Labor Law

7:43 pm in Uncategorized by Michelle Chen

Caring Across Generations via flickr

Cross-posted from In These Times

After years of working a thankless job, more than 1,500 home healthcare aides in New York got some long overdue recognition this week, along with a $1 million paycheck in a landmark legal settlement.

The lawsuit involved home health aides working for a private provider of care to seniors and people with disabilities in New York City. The main allegations centered on a typical problem in the home care workforce–getting shorted on wages and overtime pay, thanks to huge gaps in labor protections. McMillan’s Home Care Agency, according to the suit, “consistently underpaid its workers and never paid overtime, despite frequently working more than 60 hours per week.”

Although the settlement deals with New York state labor laws, which offer more protection for this sector than federal labor standards, the mistreatment of these workers sheds light on a national problem. Many home health workers nationwide don’t earn enough to survive and are denied meaningful protections for minimum wage and overtime under both federal and state law.

The settlement awards the workers in the class-action suit with just over $1 million, divided up according to the number of unpaid overtime hours worked. Going forward, the settlement also prohibits the for-profit company from retaliating against workers who speak up about wage and hour violations.

According to the National Employment Law Project, one of the groups leading the litigation, the workers represent just a tiny percentage of the 250,000-strong home care workforce in New York state, but it could compel employers across the sector to take labor protections more seriously. That is good news as the sector might need to expand by an estimated 100,000 workers in the next decade to keep pace with demand for services, according to an analysis by PHI New York. Read the rest of this entry →

Nurses, Patients Voice Frustration Over Avoidable Hospital Staffing Crisis

8:54 pm in Uncategorized by Michelle Chen

Cross-posted from In These Times

Image: Kaiser RNs One-Day Sympathy Strike to Support Other Kaiser Caregivers (

It’s a universal health care frustration: the emergency room. Endless waits and doctors who treat patients like products on an assembly line. A new study confirms the exasperation: A large portion of patients believe they’re being treated poorly by an overstretched system.

According to the survey, conducted by National Public Radio, the Robert Wood Johnson Foundation and the Harvard School of Public Health, about one in every three patients, who spent at least one night in a hospital in the past year, reported that “nurses weren’t available when needed or didn’t respond quickly to requests for help.” Though only a minority reported being dissatisfied overall, many respondents felt the hospital’s traditional frontline staff hadn’t given them adequate attention.

But what’s behind the numbers? In NPR’s informal follow-up Facebook poll, nurses sounded every bit as vexed as the patients:

We received hundreds of responses and read them all: piles of stories about nurses feeling overworked, getting no breaks, no lunches and barely enough time to go to the bathroom. Even worse, many nurses say breaks and lunchtimes are figured into their salaries and deducted, whether they take them or not.

Many nurses were reluctant to speak on the record, fearing their bosses’ reaction. One nurse reflected the sense of tension and helplessness at work: Read the rest of this entry →

As Helping Hands for Elders, Home Care Workers Push for Respect

5:30 am in Uncategorized by Michelle Chen


Cross-posted from In These Times.

Somewhere in your community today, an elder person is wondering when she’ll be able to take her medicine today, or have a chance to see the sun. And her mind will be put at ease once her aide arrives to help her get dressed, eat breakfast or take a walk in the park. For millions of aging households, a home care worker is the only person who provides the day-to-day assistance and emotional interaction they need to function. Yet, typically, that worker is neglected herself–by the government.

Workers caring for our greying population are intimately woven into our family lives, but are alienated from essential labor protections–though that could change soon. As we’ve reported previously, a longstanding loophole in the Fair Labor Standards Act excludes home care or “companionship” workers from minimum wage and time-and-a-half overtime regulations. Nationwide, about 2.5 million home care and personal assistance aides–projected to grow to about 3.8 million by 2020–work around the clock to help their clients handle the basics of life, while often themselves scraping by on poverty wages.

Back in the early 1970s, Rep. Shirley Chisholm called attention to the plight of home-based workers who had been shut out of regular labor standards. A generation later, workers’ rights advocates are pushing the Labor Department to follow through on a proposed rule change to extend federal minimum wage and overtime protections to currently excluded home care workers–who are disproportionately female and of color. Read the rest of this entry →

Facing Maternity Care Gaps, Midwives Push for Birthing Justice

12:39 pm in Uncategorized by Michelle Chen

Walk for Midwives in Huntsville, AL. (Photo: Heather Ellis via

Cross-posted from In These Times

As wondrous a phenomenon as childbirth is, we often view it as a form of medical purgatory–hours of drug-dampened agony under starched sheets and sterile lights. But more women today are thinking outside the box about labor. Home-based births have shot up in recent years. Advocates across the country have persuaded governments to broaden medical coverage for out-of-hospital birth services.

And in the shift toward more natural childbirth, midwives are at the forefront. Born of a movement to reclaim the childbirth experience from the medical establishment, today’s professional midwives are a modern incarnation of an age-old vocation, defining themselves as an alternative to the hospital ward. Yet the workers who undertake this unique labor of labor long struggled for respect and equality under healthcare laws.

Midwife-assisted birth at home or at a birthing center–a facility specializing in childbirth and pregnancy care–allows many women with low-risk pregnancy to give birth safely without interventions like surgery. Advocates say this process provides a more holistic experience for a woman in a familiar setting, sans the medications or presence of a gaggle of strangers in scrubs. Read the rest of this entry →

Health Workers Deliver First Aid to Protest Movements

6:18 am in Uncategorized by Michelle Chen

Tahrir field hospital. (Kamal El Tawil via TwitPic)

Cross-posted from In These Times.

Warning: Defending your rights may be hazardous to your health. Potential side effects can include rubber bullets, tear gas, and batons wielded with impunity.

The recent uprisings around the world illustrate the physical risks involved in intense street protests. At the same time, movements are also discovering the connection between health and activism in another way, through medical workers joining the front lines to deploy their skills and their conviction.

Amid the brutal clashes with security forces at Tahrir Square, barebones field hospitals have held the line, thanks to a grassroots network of Tahrir doctors. One volunteer, Ahmed Adel, who has been aiding wounded protesters since January, told Ahram Online, “Treating the injured protesters here again makes me feel the revolution is about to be completed.”

But hospitals are by no means safe havens. Mohamed Fatouh, a leader of Tahrir Doctors, told the LA Times, “The people are refusing to go to the ambulances because they think they go to the general hospitals, and from there they go to the police.” Read the rest of this entry →

Ten Years On, Sick Ground Zero Workers Still Without Proper Care

6:07 am in Uncategorized by Michelle Chen

U.S. Navy photo by Photographer's Mate 2nd Class Bob Houlihan. Creative Commons.

This weekend, the public will mourn a site of loss, recasting the painful memories and haunting fears that still hover over the aftermath at Ground Zero. But the people who worked and breathed that tragedy in the days and months following September 11 won’t be at the primary commemoration ceremony for the families of victims. The Mayor’s decision to limit the attendees by excluding the 9/11 first responders is an unnerving metaphor for an unhealed scar of 9/11. Many of the rescue and recovery workers who labored at Ground Zero have been plagued by a metastasizing medical crisis, aggravated by chronic political failure.

This week, 9/11 firefighters and police chiefs rallied to demand changes to the rules governing compensation for health problems tied to poisonous air and debris at Ground Zero. They want federal funds to support treatment for cancer, which is currently omitted from the primary legislation covering Ground Zero-related medical needs. For years, researchers have been uncovering fresh evidence of widespread and devastating illnesses afflicting a large portion of people exposed to the aftermath; ongoing health issues range from crippling lung and breathing problems to post-traumatic stress disorder. But adequate funding for 9/11 workers has often been ensnared in political gridlock, not to mention the general incompetence of the healthcare system.

The UK Guardian reports that new research could trump politicians’ concerns over potential cancer liabilities:

Cancer treatment has been specifically excluded from federal health funding, with officials arguing there has been insufficient evidence to prove any direct link between the toxins present at the site and the disease.

But last week the results of the first large-scale study, published in the Lancet, found that firefighters who were involved on the day of the attacks and in the weeks that followed had a 19 percent higher risk of contracting cancer.

The study looked at 9,800 male firefighters, comparing those present during and after the attacks with those who were not involved.

Beyond the study’s findings, there’s disturbing anecdotal evidence of cancer and various other problems, like gastric ailments and the inflammatory disease sarcoidosis. No one knows what the long-term effects are, but whatever the fate of these responders, there are about 15,000 people currently receiving treatment who will need answers soon. Read the rest of this entry →

Under New Guidelines, Cheap Birth Control Pays Off for Working Women

6:00 am in Uncategorized by Michelle Chen


"Pill" by Beppie K on flickr

Cross-posted from In These Times.

Washington’s Old Boys’ club still has its knickers in a wad over the deficit “compromise,” but women across the country can breathe a slight sigh of relief this week. The White House just issued health reform guidelines that will mandate insurance plans to provide birth control to women at no extra cost. The measure is long overdue, part of an array of preventive services recommended by the Institute of Medicine for improving women’s health. But the promise of broader contraceptive access coincides fittingly with the debate over the nation’s budget woes, because birth control is an economic issue.

Consider how essential birth control is for working women. When women can control whether and how many children they bear, they can delay pregnancy until they feel they’re ready, and in the meantime focus on career goals, finishing school, paying off that mortgage or signing divorce papers. The “choice” in reproductive choice refers not only to her ovaries—despite the right-wing scaremongering about unfettered female sexuality—it’s about every choice in life affected by pregnancy and sex.

At the height of the economic crisis, the costs of family planning grew more severe, as did the consequences of having to forgo it. According to a 2009 study by the Guttmacher Institute:

Overall, 29% of surveyed women agree with the statement, “With the economy the way it is, I am more careful than I used to be about using contraception every time I have sex.” Those who are financially worse off are more likely than others to agree with this statement (39% vs. 19%).

The same economic dilemma ironically creates barriers to contraceptive care. Eight percent reported sometimes skipping birth control “in order to save money,” and this was “more common among those who are financially worse off.” Read the rest of this entry →