The UP Forum (University of the Philippines) | Jan-Feb 2007
Alicor L. Panao
New RP-Japan trade pact may just spell false hopes for Filipino health care workers.
On paper, the landmark Japan-Philippines Economic Partnership Agreement (JPEPA) has all the makings of a mutually advantageous treaty. The recent signing, according to Philippine trade officials, is the culmination of over four years of formal discussions, stakeholder consultations, and numerous research programs on the tariff implications of the agreement. The pact is the first bilateral agreement signed by the Philippines with any country, and the first for Japan in terms of treaties with specific provisions on services and labor. Under the JPEPA, Japan and the Philippines will both open up trade by lowering tariffs on more than 11,000 commodities from both countries. In exchange for the liberalized entry of Japanese goods into the Philippines, Tokyo will allow Japanese hospitals to recruit some 1,000 Filipino nurses and caregivers during the first year of the JPEPA’s implementation. For a labor-exporting, import-dependent country like the Philippines, the pact clearly signifies enormous opportunities.
Or so it seems. Filipino health care professionals hoping to land high-paying jobs in the land of the rising sun may be in for a big disappointment once the reality of Japan’s highly restrictive requirements kicks in. The agreement specifies that Japan will only accept college graduates who are fluent in Japanese, and who pass its health care and nursing licensing examinations-in Japanese.
“Japan is clearly not too optimistic about the entry of Filipino health care workers,” says former UP Asian Center assistant professor Beatriz Mojica, who runs both the Philippine Institute of Japanese Language and Culture and the Nihongo Center Foundation of the Japanese Embassy in Manila. In her presentation during the Philippines-Japan Relations at a Crossroads: Emerging bilateral and regional issues conference a few months ago, Mojica said these stiff requirements are in place because Japan knows that meeting them would be extremely difficult. The certification requirement, in effect, already decreases the chances of Filipino nurses and caregivers of being gainfully employed and benefiting from the JPEPA. “Of course before one can take the Japanese nursing board exam, one must first master the language,” notes Mojica.
Gaining fluency in Japanese, and for that matter, in any foreign language, takes time, not to mention considerable financial investment. The JPEPA requires both nurses and caregivers to undergo a minimum of six months of Japanese Language training. But Assistant Professor Michiyo Yoneno-Reyes, who teaches Asian arts and Japanese language at the UP Asian Center, doubts if it is even realistic for those just beginning to learn the language to expect to pass the Japanese licensure exam for nurses and caregivers. Despite years of healthy cultural exchange between the two countries, the level of Japanese language education in the Philippines remains the lowest among Southeast Asian and East Asian countries in terms of both quantity and quality. Even among information technology professionals, whose field also requires language certification, only about five percent of Filipino applicants pass the annual language proficiency exam.
Since it is crucial that medical instructions be clearly understood and followed, Reyes finds the rigid language requirement imposed by the Japanese government hardly surprising. “If Japanese health workers themselves commit mistakes, especially in emergency situations, foreigners with language handicaps are even more likely to do so.”
Japan’s own employment sector is split over the issue of the entry of Filipino health workers. Some see it as a means to resuscitate the labor market which is shrinking as a result of the country’s aging population. According to the Japan Cabinet Office’s Aging Society Report in 2005, with the country’s falling birth rate, the number of old people will continue to grow to as much as a quarter of the population by 2015 and more than a third by 2050. The total fertility rate has rapidly declined since the postwar baby boom, reaching its lowest at 1.29 in 2003. Given such conditions, Japan’s Business Federation (Nippon Keidanren) believes the dampened economic growth could be more than offset by capitalizing on the contributions of non-Japanese workers. “As markets diversify and de-segment, the diversity of a corporation’s own work force has become a source of profitability,” it notes in its Interim Recommendations on Accepting Non-Japanese Workers in 2003.
The less optimistic, on the other hand, warn of deteriorating work conditions for Japanese health care workers with the advent of a cheaper pool of migrant labor. In a September 13, 2006 Japan Times article, Japanese Nursing Association executive director Reiko Kikuchi urged Japanese policymakers to be more cautious about accepting overseas workers. Stressing that Japan does not suffer from a dearth of qualified nurses, she called upon government to improve the labor conditions at home before opening the door to foreign workers.
Carmelita Nuqui, who heads the Development Action for Women Network (DAWN), a non-government organization assisting Filipino women migrants in Japan and their Japanese-Filipino children (JFC), believes that given the terms of the JPEPA, the prospect of Filipino nurses and caregivers facing a lot of discrimination or treated as second-class professionals is not remote. “They may be given jobs lower than they expect or, worse, may even end up working in entertainment joints for lack of better opportunities,” she says.
Nuqui is also not convinced by the idea of replacing an employment policy that has long been luring many poor women into the Japanese sex industry with one that guarantees a supposedly more secure, decent type of work. Filipino nurses, she says, will mainly be asked to provide incapacitated elderly people with home care, a notoriously low-paid and difficult job. The years have seen hardly any changes in Japan’s ambiguous policy on migrant labor, which is mostly confined to 3K-kitanai (dirty), kitsui (difficult), and kiken (dangerous)-jobs that the locals would typically not take. Nuqui also expresses concern over the policy’s contribution to the continuous disintegration of Filipino families as a result of migration, as well as the drain of much-needed health workers in a country that is already bleeding itself dry of professionals.
Dr. Maria Rosario Piquero Ballescas, who teaches at the Social Sciences Division of UP Visayas, echoes this view, emphasizing the need to consider the human dimension within partnership agreements so as to come up with a better transnational community. As the sending country, the Philippines must ensure Japan’s commitment to providing decent work, especially since most of the workers to be sent are women. She also underscores the need to verify the type of visas the nurses and the caregivers will be given once the agreement goes into effect. This guards against a repeat of the experience of Japan-bound entertainers who, in being allowed to carry only the kougyou or “entertainer” visa, were effectively deprived of many forms of protection and compensation and became vulnerable to abuse.
Ballescas cautions that the new entry point might be abused or misused by people intent on going to Japan at any cost, or by those engaged in human trafficking. “Females dominate nursing and caregiving so the likelihood of these young females ending up as spouses of Japanese nationals is high, like in the past when Filipino entertainers and mail order brides became spouses of Japanese nationals.
According to Nuqui, there are already reports of former entertainers now training as caregivers to reenter Japan, and of entertainers in Japan, training to be health workers in order to obtain valid work visas. “It would be good if they really proceeded to work as health care providers but experience tells us that many tend to return to their former lucrative, though risky, occupation as entertainers,” she says.
Japan’s Ministry of Health, Labor and Welfare, in a March 2002 report estimated the number of foreign workers in Japan at the end of 2000 to be at least 710,000-up by six percent from the previous year but still accounting for just over one percent of the Japanese workforce. This figure includes approximately 100,000 professionals and other highly skilled workers, as well as 54,000 people holding entertainer visas. As of December 2005, Filipinos comprised the fourth largest foreign group in Japan, at 187,000; down by about two percent from 2004.
The opening of Japan’s healthcare sector to Filipino caregivers and nurses constitutes a significant new provision in the agreement; it was the lack of this provision which delayed the signing of the treaty. Proponents of the agreement hope that through its specific provision on the movement of labor, it can compensate for the loss of the entertainment job market after Japan began tightening the entry of entertainers two years ago. The deployment of Filipino workers also fell by 43 percent last year, from 74,480 in 2004 to 45,586-the biggest decline since 1999.
But critics have also expressed alarm over what the Philippine government gave in exchange for the prospect of Japan opening its doors to Filipino health care workers. Environmental groups like Greenpeace claim that the deal includes a provision that could facilitate the entry of restricted and hazardous wastes into the Philippines as part of the list of goods that can be traded whose customs duties will be eliminated completely. In other words, those who are lucky enough to be able to qualify to work in Japan may be sending home along with their remittances, the used diapers, syringes, pharmaceutical and industrial wastes of the hospitals where they are employed for recycling in the Philippines.
Article 29 of the JPEPA’s basic agreement eliminates tariffs for such waste products as ash and residue from municipal incinerators, sewage sludge, clinical waste such as surgical gloves and discarded syringes, industrial residue containing such chemicals as mercury and arsenic, and even old clothes and rags, among others. Akbayan Citizens Action Party Legal Counsel Tanya Lat, in a briefing paper, stressed that most of these products constitute either hazardous or toxic waste that “have very little recyclable value, if at all, and are generally intended for disposal.”
Even the Department of Environment opposed the inclusion of toxic and hazardous wastes in the JPEPA but failed to persuade the government to change its stance. “The JPEPA, we were told, was an all-or-nothing proposition-if we don’t agree to one or two products of the 11,300 there will be no agreement,” Environment Undersecretary Ignacio was quoted saying in an Oct. 26, 2006 Philippine Daily Inquirer news report. “One of the most critical items in the JPEPA for us was the trade in services allowing our overseas workers, our health professionals, into Japan, and that was very important to the Philippines,” he said.
Japan, however, assured the Philippines that it has no intention of using the country as a dumping ground for its garbage. In an October 30, 2006 statement issued by its embassy in Manila, the Japanese government expressed its commitment to the strict enforcement of controls to prevent any illegal export of toxic and hazardous wastes to the Philippines. Japan maintains that it adheres to the framework laid out by the 1992 Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal and does not allow any export of toxic or hazardous wastes to another country “unless the government of such country approves such export.” Yet sometime in 1999, a 6,000-ton shipment of infectious hospital and municipal waste declared as recyclable waste paper from Japan mysteriously found its way to the Manila South Harbor.
The Philippines is also a signatory to the Basel commitment. But like Japan it has not ratified the 1995 amendment to the convention which prohibits trade in all waste, including those meant for recycling.
An assessment report prepared by a team of economists from the Philippine Institute for Development Studies (PIDS), a NEDA-attached research agency earlier tasked to prepare trade proposals for the JPEPA, tries to allay fears by saying that the agreement does not lack for provisions to prevent the dumping of toxic waste to the country. Both Japan and the Philippines, according to the report, are bound by the general principles of efficient utilization of energy, proper management of environment and sustainable development, and the need to cooperate in the field of energy and environment. “Under Article 102, the two countries mutually agree not to relax environmental measures to encourage investments by the other party,” says the report.
Nothing in the treaty, according to the PIDS economists, bars the Philippine government from taking measures it considers appropriate for protecting health, safety, and the environment, or to prevent what it perceives as deceptive practice. “Trade liberalization under the JPEPA does not mean or imply, that the ability of any of the two countries to control trade in hazardous and toxic wastes or, more generally, to protect the environment, is at issue.” Republic Act 6969 expressly prohibits-even for mere transit-the entry of hazardous wastes into the country.
The economists also note that similar economic partnership agreements signed by Japan with such developed economies as Singapore and Malaysia also include provisions eliminating tariffs on waste products.
The JPEPA is still awaiting ratification by the Senate but when it comes into effect, trade officials project an increase of 1.7 to 3.3 percent in the country’s GDP due to the influx of foreign investments. Japan is currently the Philippines’ leading source of foreign direct investment (FDI) and its second largest trading partner. Japan is also the country’s biggest aid donor, giving us much as 41.76 billion yen in official development assistance in 2002. The JPEPA, says trade officials, will work to further deepen the close economic ties that link the two countries.
Nevertheless, PIDS economists who prepared the Philippine government’s trade proposals prefer prudence in assessing the benefits that could be derived from such trade agreements. PIDS president Josef Yap, in a December 2005 report titled The Boom in FTAs: Let Prudence Reign, noted that even though free trade agreements could help boost growth, they are actually neither necessary nor sufficient since most cases of economic stagnation are a product of internal factors. Such is the case in the Philippines, according to Yap, so that economic resources would be better allocated if these were channeled to agricultural productivity, improving governance, and strengthening institutions rather than finalizing the JPEPA, negotiating the China-ASEAN Free Trade Agreement, or pursuing a free trade agreement with other countries.
But what about the huge potential market for Filipino health care providers?
Reyes believes nurses and caregivers are better off setting their sights on industrialized English-speaking countries which hold Filipino professionals in high regard and offer more attractive employment packages.
Mojica is more straightforward. “Japan is obviously saying no and the insistence on language and national professional certification requirements is its subtle way of putting it.” A Filipino of average intelligence would need at least one thousand classroom hours of Nihongo lessons in order to pass the level one examination of the Japanese Language Proficiency Test and that may still not be enough to hurdle the national board exams for healthcare professionals in Japan. “How many parents can afford to spend thousands all over again after sending their children to nursing schools just so they can work in Japan? It just isn’t worth it.”