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The 1960s brought big changes to America.
20世纪60年代，美国发生了天翻地覆的变化。
"There are certain historical events.
“发生了一些历史事件。
New Great Society programs such as the establishment of Medicare and Medicaid.
比如推出了各种社区政策，推出了医疗保险和医疗补助福利。
There are civil rights and women's social movements.
还爆发了民权运动，女权运动。
American women have more opportunities to enter other kinds of occupations.
美国的女性有了更多的机会从事其他岗位的工作。
All of these things converge to increase the demand for nursing services,
上述种种无不扩大了这个国家对护理岗位的需求，
but also to result in even more nursing shortages in the US."
但也加剧了美国护士不足的问题。”
In just three years, nurse vacancies nearly doubled.
短短三年时间，护士一职的空缺就翻了将近一倍。
Nearly one in every four nursing jobs was vacant.
几乎每四个护理职位就有一个空缺。
To fill the new shortage the US turned to the Philippines again.
为了弥补这些空缺，美国再次将目光转向了菲律宾。
But this time it was different.
但这一次不一样。
Immigration policy in America changed drastically in 1965, with the Immigration and Nationality Act.
1965年《移民与国籍法》颁布后，美国的移民政策发生了巨大的变化。
For the first time, people from all over the world could apply for immigrant visas.
破天荒地，世界各地的人都可以申请美国的移民签证了。
Then, on top of sponsoring hospitals --
而且，除了赞助医院——
labor recruiters and travel agencies started targeting Filipino nurses with ads that promised bright futures in America.
用人单位和旅行社开始投放广告，将目光对准菲律宾护士。他们在广告中承诺，在美国一定能给她们光明的前途。
"One particular ad featured a basket that was decorated with the Philippine flag.
“有一则广告甚至在海报里画了一个围着菲律宾国旗的篮子。
It's addressing the Filipino nurse saying, Dear nurse,
下面的文字也是专门对菲律宾护士说的：亲爱的护士，
if you're not happy where you are right now, contact us.
如果您对您当前的处境不甚满意，不妨联系我们。
And we can't promise you happiness, but we can help you chase it all over the place."
我们不能承诺给您幸福，但我们能帮您追寻幸福，直到天涯海角。”
So Filipino nurses began filling the shortages around the US.
于是，菲律宾护士开始填补美国各地的护士空缺了。
But soon many experienced discrimination.
然而很快，很多人就受到了歧视。
The American Nurse Association added licensing requirements to limit their entry to the US.
为了限制菲律宾护士进入美国，美国护士协会增加了许多许可要求。
The nurses who did pass those requirements, came to the US and ended up in underpaid, lower positions.
即便有的护士通过了那些要求来到了美国，最终得到的也是低等薪酬和低等职位。
Still, it’s this phase of migration that lasted through today and transformed the US healthcare industry.
尽管如此，这一移民方式依然持续到了今天，还改变了整个美国医疗保健行业的面貌。
The temporary pathway established 20 years earlier, became a permanent migration route.
20年前开通的这条临时通道竟成了一条永久的移民之路。
And hospitals now had a way to draw nurses whenever they wanted.
美国医院现在也已经有了想招护士，无论是什么时候，就能吸引到护士前来应招的办法。
But focusing on what pulled so many nurses to America, overlooks the forces that continued to push them out.
问题是，将注意力集中在究竟是什么吸引了如此多的护士前来美国这一问题上就会忽略掉仍在将她们逼出美国的那些因素。
Which brings us back to the Philippines.
这就又回到了菲律宾国内的问题上。
This is Ferdinand Marcos who ruled the Philippines with an iron fist.
这位是费迪南德·马科斯，菲律宾的铁腕统治者。
In 1972, under martial law, he began to rule as a dictator.
1972年颁布戒严令后，他就开始了以独裁者的身份统治菲律宾。
He was behind more than 3,000 extrajudicial killings, and tens of thousands of tortures and incarcerations.
3000多起法外处决，还有数万起酷刑和监禁的幕后黑手都是他。
As a result of the unrest, the economy that was starting to pick up fell into a recession and unemployment skyrocketed.
动荡的结果就是，刚开始回升的经济又陷入了衰退，失业率直接飙升。
But instead of addressing the lack of jobs...
问题是，（菲律宾政府）却并没有正面解决失业的问题……
"The Philippine government actively promoted and publicized labor export,
“菲律宾政府积极宣传并推动劳务输出，
the export of Filipino workers to countries throughout the world."
试图将菲律宾老公输出到其他国家。”
That’s because Filipino workers overseas were starting to send hundreds of millions of dollars back home to their families.
这是因为当时已经开始有巨额汇款被海外的菲律宾工人汇回国内了。
And the Filipino government wanted to keep that money coming.
菲律宾政府希望这笔钱能源源不断地汇回菲律宾。
Over time, that government push led to global migration,
随着时间的推移，政府的推动催生了一波全球性的移民潮，
making the Philippines the largest exporter of nurses in the world.
菲律宾成为了全世界最大的护士出口国。
Nearly 20,000 nurses leave the Philippines every year.
每年都有近2万名护士离开菲律宾。
They go to Saudi Arabia or Australia. The UK. Germany.
她们去了沙特阿拉伯，澳大利亚，英国，德国。
But many of them have ended up in the US.
不少人兜兜转转，最终还是来到了美国——
Where nearly one-third of all foreign-born nurses are Filipino.
一个几乎1/3的外国出生的护士都是菲律宾人的国家。
With the US recruiting nurses on one end and the Philippines pushing them to work abroad on the other,
一边是美国大力招聘护士，一边是菲律宾鼓励护士们出国闯荡，
both governments have benefited from Filipino labor.
两个国家的政府都从菲律宾劳工身上捞到了好处。
Over the decades, a total of 150,000 Filipino nurses have come to work in US hospitals.
几十年下来，来美国医院工作的菲律宾护士也已经有15万人了。
And after years of exploitation and discrimination,
遭受了多年的剥削和歧视之后，
Filipino and Filipino American nurses have organized in the US.
菲律宾护士和菲律宾裔的美国护士开始在美国组织起来反抗了。
They pushed back on exploitative practices and have fought for better working conditions.
他们对剥削性的工作予以了抵制，也为争取更好的工作条件付出了努力。
But surveys show that a large number of Filipino nurses are still concentrated in bedside and critical care.
然而，调查显示，还是有大批的菲律宾护士分配到床边护士或危重护理等工作，
Some of the most dangerous and strenuous nursing work.
左不过都是些最危险、最艰苦的护理工作。
It’s the kind of work that’s put them disproportionately on the frontlines of the fight against the coronavirus.
她们自然也就成了抗击新冠病毒前线上最大的人口群体。
The pandemic has taken an outsize toll on Filipino healthcare workers.
这场大流行对菲律宾医护人员造成的损失尤为严重。
Of the 318 health care workers lost to the coronavirus as of May, at least 30 are Filipino.
截至5月份，被新冠病毒夺走的318名医护人员中，有至少30名都是菲律宾人。
And still thousands remain on the frontlines.
目前仍有数千名菲律宾医护人员镇守在抗疫前线。
In April 2020, as the coronavirus spread in the Philippines, and the shortage of nurses across hospitals became a problem,
2020年4月，随着冠状病毒在菲律宾蔓延，菲律宾各大医院也出现了护士短缺问题，
the government temporarily banned healthcare workers from leaving to work abroad.
菲律宾政府临时推出了禁止医护人员出国工作的政策。
"And while it might seem like an appropriate idea for Filipino nurses to remain in the Philippines,
“虽然留在菲律宾对菲律宾护士来说似乎是一个恰当的想法，
It's also important to remember that Filipino nurse overseas migration
但同样重要的是，还记住吗，菲律宾护士移民海外
is a longstanding phenomenon that has been actively promoted by the Philippine government."
是菲律宾政府自己积极推动且已经推动了很长时间的一大现象。”
Even though the ban was eventually lifted,
尽管禁令最终被解除了，
it points to the instability that Filipino nurses have to live with on both sides of the migration route.
但菲律宾政府的这一举措依然表明了，菲律宾护士在移民路线两端都没有稳定的处境。
Pushed and pulled between countries, Filipino nurses continue to get caught in the middle --
辗转于菲律宾和外国之间的菲律宾护士至今仍然是骑虎难下的处境——
even as they strive to work on the frontlines, providing critical care.
即便他们很努力地奋战在疫情一线，提供着危重护理服务。
Like they always have.
从前的她们又何尝不是如此。
