Caring for Strangers: Filipino Medical Workers in Asia by Megha Amrith (review)

As healthcare becomes increasingly commodified and globalized, an opportunity structure has emerged for nurses from the Global South to engage in long-term mobility projects through labour migration to high-income countries/cities around the world. Yet migrant nurses are uncomfortably positioned at the interstices of low-status care work and high-skilled professional migrations. Megha Amrith explores the aspirations and experiences of Filipino migrant nurses working in the global city of Singapore as a way to understand the intimate relations that develop between migrant nurses and their patients, alongside the commercial and labour practices that bring these nurses to Singapore but keep them marginalized from mainstream society there. At the same time, Amrith situates Filipino migrant nurses within a broader history of labour migration from the Philippines, while situating Singapore as a stepping stone to more attractive destinations in North America and Western Europe. Amrith deftly draws from her extensive fieldwork in Singapore and the Philippines to maintain this productive tension and duality within each of the chapters of Caring for Strangers.

After the introductory chapter, which lays out the key themes of the book and provides a useful overview of the literature on care work and intimacy, and some brief histories of labour migration from the Philippines and to Singapore, the rest of the book is organized to track the trajectories that Amrith's migrant nurse interlocutors follow. It starts in the Philippines, moves on to Singapore, and then focuses finally on what the future holds for these nurses. The second chapter highlights the political economy of migration in both the Philippines and Singapore, and its intersections with the political economy of care. Amrith details the transnational nature of care work in the twenty-first century, describing the new global movements of health workers, including doctors and nurses and other medical professionals, and also of patients. While this chapter focuses on the structural factors that define and constrain the migration flows of migrant nurses from the Philippines, the subsequent chapter digs into the subjective aspirations that fuel their voluntary migrations. In this chapter, Amrith introduces the idea of a "cartography of care" (p. 49), an evocative phrase she coins to describe the imagined worlds that Filipino nurses are carrying in their heads as they dream of overseas employment. Amrith points to the position of nursing within the Philippines' broader culture of migration, and how the higher status and greater wages that come with being an overseas nurse continue to draw large numbers of Filipinos even as there is an ongoing public health concern about the shortage of high-quality nurses, especially in rural areas of the Philippines.

In chapter 4, Amrith shifts her focus to Filipino migrant nurses after their arrival in Singapore. Having imagined that they would enjoy an elevated status as professionals overseas, these nurses are shocked to experience marginalization and proletarianization instead. Amrith reports on her participant-observations in two care spaces in Singapore—a large, modern government hospital and a religiously affiliated, charitable nursing home—and notes that, in both places, there are ongoing contestations over the meaning and value of their profession of nursing and care labour more broadly. These tensions partly stem from the overarching association of Filipinos in Singapore with low-status domestic work. In the subsequent chapter, Amrith outlines how these differences in meaning and status are negotiated by Filipino migrant nurses in their interactions with foreign and local nurses, doctors, and patients in Singapore, all of whom tend to be Asian of one nationality or another. This is perhaps Amrith's most unique contribution: her exploration of how Filipino migrant nurses are situated within a diverse Asia comprising "First World" and "Third World" countries, and stereotypes about "modern" versus "backward", and "caring" versus "uncaring" peoples. Filipino migrant nurses in Singapore are forced to constantly engage in identity work, often on moral grounds, to reassert to themselves and to others their innate worth as nurses, as professionals, as Filipinos...