Opportunities to work abroad came knocking at Jocelyn Andamo's door, promising a higher salary and an easier life. But she never answered. Though she knows that her scant pay as a local nurse may not compare to the compensation abroad, her heart remains committed to healing those in the communities she serves and remedying the ills that afflict the nation.

When the Makabayan bloc announced its 10 Senatorial candidates on August 26, 61-year-old Andamo took the stage to advocate for Filipinos' rights to free, accessible health care and higher wages for health workers. For Andamo, the long-entrenched issues in the health sector cement the need for immediate meaningful change—and she is determined to deliver that in the Senate. 

Andamo's candidacy represents a unique opportunity for genuine representation of health workers, grounded in her lifelong dedication to the health sector. Yet the path to her bid is fraught with challenges, as she must navigate a corrupt political environment where resources flow into the pockets of wealthy political dynasties while grassroots leaders continue to be undermined and vilified.

A Call to Heal

Andamo's first love was dentistry, a passion sparked by her parents—both dentists—who may have implanted the importance of care from a young age. 

But with financial constraints that threatened her education and that of her six siblings, Andamo had to rely on her aunt in the US who offered to cover her tuition fees under the condition that she pursues nursing. Though reluctant at first, she gradually discovered a natural compassion to serve those around her. 

When her training required her to live with an Indigenous farming community for two weeks in the Quirino province, Andamo had a clearer grasp of the country’s health crisis. It was her first experience with community work as a nursing student. She realized that the lessons on poverty she learned during class did not fully capture the harsh realities these families faced. 

The community struggled with poor harvests, preventing them from adequately feeding their families. Malnutrition among the children was rampant. To make matters worse, health facilities were out of reach, making access to immediate care nearly impossible. 

"[Marami] akong areas na [napuntahan] na hindi pa sila nakakita ng nars o doktor. Ganoon ka-deprived yung mga tao of health services, [at] doon ko nakita yung malaking tulong ko sa mga tao," said Andamo. 

Since then, her heart has been set on serving as a nurse in the Philippines. Andamo found herself at odds with her family, who could not fathom why she would turn down opportunities abroad that her peers eagerly chase. 

But Andamo remained firm in her decision, expressing that her passion for serving communities was most important to her. “[She] has many relatives abroad. Despite that and despite the lure of better salary and career advancement, she stayed and pursued her advocacy for people's health,” said Eleanor Nolasco, Filipino Nurses United (FNU)’s president. 

After Andamo graduated with a nursing degree from the Far Eastern University in 1983, she joined multiple nongovernmental organizations (NGOs) that united community nurses and encouraged them to stay in the Philippines. Eventually, these NGOs realized the need for an organization focusing on nurses' welfare and labor rights. This led to the establishment of FNU in 2015, where Andamo currently leads as its secretary-general. 

“We are different from other organizations or specialty nursing organizations that deal with the practice of the nursing profession because we are solely dedicated to the labor rights and welfare of nurses,” said Nolasco. Having worked together for over 40 years, Nolasco said that their shared commitment to serving communities and advocating for health workers' rights unites her and Andamo.

The Cost of Care

Andamo believes that the fight for health workers' welfare is inextricably linked to the pursuit of accessible health care for all Filipinos, driving both her and the FNU to fight for meaningful change. 

The fragmentation of the health care system in the Philippines, resulting from the government's decision in 1991 to devolve national services to local government units, is just one of several factors contributing to ongoing challenges in health care delivery, said Andamo. As a result, health services in disenfranchised areas became more elusive, found a 2018 World Health Organization (WHO) report.

Absent a comprehensive nationwide framework, health care development in the Philippines remains uneven. Only 25 percent of cities and municipalities meet the WHO's recommendation of having at least 4.45 skilled health professionals per 1,000 people, per a 2022 study. Rural and conflict areas are the most underserved. 

Compounding the problem of understaffing is the neglect and exploitation by the government that continue to drive nurses away from the profession. Frequently enduring 12 to 16-hour shifts, nurses receive inadequate compensation—at least a minimum of around P36,000 in government hospitals and P12,000 in private facilities.

Nurses in the Philippines earn the lowest in Southeast Asia, while nurses in Vietnam and Singapore earn P62,000 and P236,400 on average, respectively. In provincial hospitals, Filipino nurses were reported to earn only 65 percent of the legally mandated pay. This disparity stems from precarious and insecure arrangements. Many nurses in public hospitals work on short-term contracts with lower pay, said FNU.

In response to the persistent mistreatment of nurses nationwide, FNU has fervently worked to mobilize and foster meaningful dialogues with government agencies such as the Department of Health. Through their lobbying efforts, the labor association secured an increase in the entry salary for government nurses in July 2020. And 11 months later, FNU successfully blocked the demotion of long-standing senior nurses, according to FNU’s reports.

FNU remains steadfast in its mobilization efforts, actively participating in various rallies to amplify their calls for a better health care system. The labor association continues to engage with the government, releasing statements and maintaining open dialogues to advocate for the rights of nurses. 

Despite some victories in their movement, Andamo said that genuine representation in the Senate would drive more substantial change for the Filipino people. Nolasco emphasized the need for action both in the streets and the legislature, noting that while organizing nurses is vital, entering the legislature would enable the swifter passage of policies that benefit communities at a larger scale. 

“Ibang klase yung crisis natin na ‘yang policies ng government worses the people’s lives, including [their] health,” said Andamo. “Naisip ko kunin yung opportunity para mas makapaglingkod sa ibang larangan. [It is a] continuation of my service to the Filipino people.”

Curing Afflictions

In a political terrain dominated by established wealthy politicians, the road to securing a Senate seat is a daunting task. The lack of sufficient funds and human resources to launch a national campaign are Andamo’s biggest challenges. 

Andamo also feels that her age makes it harder to manage physically demanding activities as the campaign period approaches. But this does not stop her from fighting for their cause. She draws her strength from the support of her family, friends, and other cause-oriented groups. 

Her platform prioritizes improving the health sector in the Philippines, aiming to solve fragmentation through the renationalization of health services and assets. To enhance the welfare of health workers, Andamo proposes a wage of P33,000 for entry-level health workers and P50,000 for all nurses nationwide, in both private and public sectors.

“Yung libreng serbisyong pangkalusugan para sa bayan, yun talaga ang magiging [advocacy] ko sa road sa Senado,” said Andamo.  

House Bill 00208, principally authored by the Makabayan bloc in the 19th Congress, contains plans to implement a free, comprehensive, and nationalist health care system in the country. Unlike the Universal Health Care Act’s structure that results in high out-of-pocket costs for Filipinos, the proposed bill aims to establish a genuinely 100-percent free health care system for all.

The bill has been pending with the Committee on Health since July 2022 and has yet to be sponsored in the Senate. If given the win, Andamo will prioritize lobbying for its immediate passage. 

Despite all doubts, Andamo and Nolasco’s spirits remain optimistic that even without a secured victory, there is no loss in building a platform that amplifies the needs of the Filipino people. “Manalo o matalo ang aming pagtakbo sa Senate, panalo ang mamamayang Pilipino kasi ma-vo-voice out namin [kung] ano yung aspirations ng maliliit na tao,” said Andamo. 

Andamo’s candidacy is a culmination of her years of self-sacrifice and service, presenting a chance to heal the long-neglected wounds of the nation. By championing the needs of the Filipino people, she seeks to restore trust in a system that has often failed them, fostering a meaningful recovery for the entire country. ●