Regional towns are relying on importing nurses like Mae, who take the jobs at a huge personal cost

Mae Montecalvo is crying as she finishes a video call with her two young daughters, aged two and five.

She is surrounded by toys they have never played with as she sits in a share house, in a New South Wales country town nearly 6,000 kilometres from where they are: in the Philippines with their grandparents.

“It’s almost six months that I have been separated [from] my kids and … I miss them a lot,” she told 7.30.

Women cuddles swan soft toy while on video call with daughters. The mother is crying.

Mae Montecalvo says goodbye to her daughters over the phone.(ABC News: Richard Mockler)

“One day they are going to appreciate what I did for them … why mummy left us … they will understand it.”

Ms Montecalvo is one of a number of Filipino nurses who have come to regional Australia to work in the nation’s substandard aged care system.

She is in the town of Gilgandra, population 4,295, with 15 fellow Filipinos as the answer to an understaffing crisis, but despite having worked as a nurse in her home nation and Saudi Arabia, she still has to study to meet Australian requirements.

Mother holds phone during video call with her daughter holding up a koala toy to the phone camera

Mae Montecalvo shows her daughter one of the toys she’s bought for her.(ABC News: Richard Mockler)

Meeting those requirements is one step towards what Ms Montecalvo sees as a better future for her family in Australia.

“Working here in Australia and having a salary here is better compared to working in the Middle East,” she said.

“I’m sending half of my salary to my parents and for my kids [in the Philippines] … and then saving the other half for the upcoming visa [fees].”

Australia must ‘drastically improve’

Female healthcare worker squats next to seated elderly woman in aged care facility who is holding a book.

Mae Montecalvo checks in on a Cooee Lodge Hostel resident.(ABC News: Richard Mockler)

Despite coming here to help an ailing industry with serious issues, bringing her family will still come at a financial cost.

Ms Montecalvo is waiting for her training visa to be upgraded to a temporary skill shortage visa so she has the right to live in Gilgandra for four years.

It will also allow her to apply to sponsor her children to live in Australia, but even though she can send her daughters to school here, she won’t receive government support, meaning they will have to pay thousands of dollars in school fees each year.

Nor will Ms Montecalvo and her children have access to Medicare.

7.30 has approached multiple federal government departments for comment.

A group of healthcare workers in meeting

The Filipino healthcare workers during a shift handover at Cooee Lodge Hostel.(ABC News: Richard Mockler)

In Australia, recruits from the Philippines make up 6 per cent of the registered nurse workforce.

Jerome Babate from the support and advocacy group Filipino Nursing Diaspora Network, says that securing Filipino healthcare workers is becoming increasingly competitive between Western nations and Australia needs to do more to help them.

“If Australia wants access to world-leading healthcare for its citizens … it must live up to its welcoming reputation and, I would say, drastically improve its international recruitment strategy to be competitive in that field,” Mr Babate told 7.30.

Fast-tracked training and visa processing are some key areas Mr Babate thinks will entice Filipino workers to choose Australia over other options.

A dining room at an aged care facility with workers in blue hair nets helping serve food to residents

The Filipino workers help serve dinner at the Cooee Lodge Hostel.(ABC News: Richard Mockler)

According to the Department of Home Affairs, temporary skill shortage visas are given priority processing with employer sponsored visas for regional areas at the top of the list.

Standard processing times for temporary skill shortage visas range from under six days to up to four months.

The 2021 census reported that 40 per cent of registered nurses and aged and disability carers in Australia were born overseas.

Ken Griffin from the Australian Primary Heath Care Nurse Association (APNA) is concerned by the trend of recruiting overseas workers to do jobs or live in locations that Australian workers don’t want to.

“We should always be making sure we aren’t blind to the reason someone from Australia didn’t want to work in that place,” Mr Griffin said.

“Overseas trained health workers have always been part of the mix of our healthcare workforce, but it’s fair to say that the system is getting out of balance.”

Workforce crisis

Woman looks through clothes at an opportunity shop

Mae Montecalvo is saving up to pay for her upcoming visa fees and to sponsor her kids to live in Australia.(ABC News: Richard Mockler)

In Gilgandra though, other options were not available.

Donna Dobson, the director of aged care and disability at the Gilgandra Shire Council, struggled to recruit local staff.

“We have a dwindling workforce. Our young people move away to go to university or college,” Ms Dobson told 7.30.

Woman sits in chair inside aged care facility dining room

Donna Dobson led the project to recruit Filipino workers to staff aged care and disability services run by the Gilgandra Shire Council.(ABC News: Richard Mockler)

“We tried the traditional methods [like] advertising, package deals, throw in some steak knives kind of stuff, but it wasn’t really successful.”

Following the Royal Commission into Aged Care Quality and Safety, the federal government requires facilities to have at least one registered nurse on duty at all times.

“We didn’t have the ability to do that … it was quite a lot of pressure for us to try and find good solutions to make it work and to be able to comply with the requirements,” Ms Dobson said.

Donna and team rostering

Donna Dobson and her team at Cooee Lodge Hostel discuss the staff roster for the facility.(ABC News: Richard Mockler)

The town’s aged care facilities had become reliant on casual agency staff which was costing about $300,000 a year.

Ms Dobson started researching an immigrant workforce and with the help of a local recruitment, training and immigration organisation, she landed on the Philippines.

She says that having committed, full-time workers has led to more consistent care for the residents.

“The cost benefits definitely outweigh the costs of the agency staff,” she said.

A classic country pub with a group of people sitting on a table outside

After a shift at the aged care facility, some of the Filipino workers have a drink at the Railway Hotel in Gilgandra.(ABC News: Richard Mockler)

Gilgandra’s aged care facilities will meet the 24/7 registered nurse requirements if all the Filipino workers pass their final exams later this year.

“It’s not an instant solution … they may fail, they might get sick or need to pull out or want to go home,” Ms Dobson said.

“We’ve invested a lot to get them here, so the retention is really important.

“A lot of little towns are dying … if every one of them brought two or three people, it would grow our population significantly.”

Mass exodus from Philippines

Man dressed in healthcare worker uniform pushes medication trolly down corridor in aged care facility

Fred Villalobos is working as a careworker until he completes his registered nurse accreditation in Australia.(ABC News: Richard Mockler)

The council is planning to grow its Filipino workforce in the coming months with an additional 10 workers.

Fred Villalobos is one of the current six Filipino workers in Gilgandra who trained as a nurse in the Philippines.

Like Ms Montecalvo, his qualification is not recognised in Australia so he is undertaking a 43-week accreditation course on top of his full-time work hours.

In 2021, the Philippines’ Department of Health (DOH) estimated that 51 per cent of qualified nurses were working overseas.

Facing a nurse shortage itself, the DOH is granting temporary licenses to nurse graduates who are yet to pass their exams to work in government hospitals in the Philippines.

Male healthcare worker squats next to elderly woman seated on couch in the foyer of an aged care facility

Fred Villalobos finishes the afternoon medication round before heading home to start his online lectures.(ABC News: Richard Mockler)

Mr Villalobos said the reason is the poor salaries offered there for nurses.

“Most of the nurses in the Philippines are going out of the Philippines because nurses are one of the most underpaid professions,” Mr Villalobos explained.

“That’s why most of the [Filipino] nurses are going to the United Kingdom, USA, Middle East, Australia and Canada because they probably get their worth there, unlike the Philippines.”

Mr Villalobos has seven children. His oldest child is studying in Sydney on a student visa and the others are living with his wife in the Philippines.

He wants his children to access Australia’s education system.

Man's hands holding phone with family photo displayed

Fred Villalobos looks at a photo of him and his family on Facebook.(Supplied)

“Australian credentials will give them unlimited opportunities … unlike in the Philippines. Our education is not that recognised,” Mr Villalobos said.

Like Ms Montecalvo, Mr Villalobos is finding it hard being far away from his family and adjusting to life in Australia.

“When you have a bad day, no-one is there when you need a hug,” he said.

“It’s not easy to fit in and it is not easy to become a [second]-class citizen, that’s very hard.”

A group of people cheers drinks at a pub table

Mae Montecalvo says that spending time with the other Filipino workers helps distract her from the loneliness of being separated from her kids.(ABC News: Richard Mockler)

It is a challenge Ms Montecalvo is wrangling with as she visits the local realtor to glance at the listings for sale.

“I need to save a lot of money so I could buy one of those some day,” she said, battling with the costly dream of Australian home ownership.

But first, she wants to fulfil her promise to her daughters.

“After bringing my kids here, I can say that I’m a super mum,” she said.

“The sacrifice will be worth it.”

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