FOLLOWING my Manila Moods column two weeks ago about the leakage of the

nursing board exam answers in the Philippines, I got a flood of angry emails from
readers attacking me for saying that all the June 2006 exam takers should be asked
to retake sections III and V of the exam, since it was answers to those questions
which were leaked through several review centers.

A few days after that column appeared I received the following letter from Erlinda
Castro-Palaganas, past governor of the Philippine Nursing Association for Region 1,
in which she basically agreed with all of the points I had raised.

The letter is so good that I have decided to include it here in it's entirety:

Dear Rasheed,

Thank you for your holistic and analytical lens at looking at issues related to the
nursing leakage. It is heartening and very comforting to note that there are still
media advocates who believe in our cause. Comrades from all over the country call
us, The Baguio Braves because we dared come out against the giants when we said,
“there is a leakage” in the last June 11-12 nursing licensure examinations.

In one of our public statements, we, The Baguio Braves Alliance, whose members
include those who exposed the leakage in the June 2006 local nursing board
examination and nursing leaders, denounces in the strongest possible terms the
reckless manner with which the Professional Regulation Commission handled the
fraud that attended the said professional test. Particularly, we take notice of the
following:

1. PRC exerted every possible effort to cover up the fraud. Even if it had
overwhelming evidence thereof in its hand, it still audaciously claimed in a public
statement that there was no leakage.

2. When it could not cover up the leakage, it insisted on conducting the

investigation amidst resounding calls for an independent investigating body. What
were the fruits of the PRC investigation? Nothing. It only acknowledged that there
was leakage but it could not determine the culprits. Was this an admission of PRC
incompetence? Or was its decision to turn over the investigation to the NBI
occasioned by the fact that it stumbled upon evidences that could implicate “friends
and associates” and did not want to be the one to nail them? Pontius Pilate still
lives!

3. It prematurely released the result of the board exam, never mind if several
questions remained unresolved. In correcting the papers, it applied a statistical
treatment that made a mockery of the standards of the nursing profession. Imagine
arbitrarily assigning scores to a core nursing subject!
4. When invited to the Senate for inquiry, PRC Chair Leonor Tripon-Rosero agreed to
attend. But there was a condition: she and the other Commisioners should be given
the list of the questions to be asked. (This was witnessed by Dr. Erlinda Castro-
Palaganas and Atty. Cheryl Daytec-Yañgot.) Even elementary school pupils are not
entitled to that privilege!

5. PRC swiftly conducted an oath-taking of the board passers to overtake the action
of the judicial branch on the issue of validity of the results of the board examination.
The kangaroo court that convicted Jose Rizal was not as fast!

6. After the Court of Appeals issued a Temporary Restraining Order (TRO)

preventing PRC from administering oaths to the June board passers, it launched a
signature campaign among the passers for the junking of the retake position. It is
sickening that the very agency mandated to ensure the standards of the different
Philippine professions is the one spearheading the submission of the determination
of nurses’ competence to a game of numbers. Is the competence of the nurses an
election matter that will be decided by numbers and not by standards?

Every move of the PRC gives rise to more problems. The current crop of
Commissioners is obviously incompetent and without iota of respect for the law.
And yet, why do they behave with seeming impunity? Why do they stick to their
positions like leeches? If they have any decency left in them, they should resign!
The Philippine nursing profession’s image has been dented by the leakage issue and
PRC’s actions have further battered it.

The leakage is an eye-opener. It exposed the bitter truth that our government is
groping in the dark in its handling of fraud. It tells us that cheating is endemic in our
system. And it also shows the damage wrought by a commercialized and
substandard nursing education. The Commission on Higher Education has in recent
years further liberalized and deregulated the operation of nursing schools. This
resulted in substandard nursing education whose products are not adequately
prepared to deliver quality health services, let alone pass a board examination.
Because of the competition among them, review schools resort to all means to up
their passing rates and the unscrupulous ones even buy and give leakage in their
effort to gain comparative advantage over the others. At the end of the day, profit is
the name of the game. Worse, when students pass the board exam, the same is
attributed to the review school and not to one’s alma mater!

Philippine society is now confronted with the issue of whether or not the June 2006
examinees should retake or not. The honest examinees who passed never deserved
the aggravation of facing the prospect of losing their licenses. Had the PRC first
explained its criterion standards in checking the examination and accommodated
and resolved all objections thereto before it released the result, the competence of
the current board passers would not be covered by a cloud of doubt. With the
questionable statistical treatment adopted by the PRC, even the exam result is now
being questioned. Board passers cannot find jobs because the hospitals and other
prospective employers doubt their competence. If reports are to be believed,
patients are even asking the attending nurses if the latter belong to the June 2006
batch. We cannot blame the patients because one’s life cannot be subjected to
chance. But the stigma is also something that the batch does not deserve.

The Baguio Braves Alliance commiserates with the board passers. If we ask them to
retake, they will suffer an injustice. They will go through the same stress associated
with taking an examination, not to mention the costs they will necessarily incur. If
they will not retake, they will likewise suffer the injustice of their capabilities being
doubted by the public. This early, employers have sounded off loud and clear that
they will not hire nurses who became so by virtue of passing the June board exam.
What good then would the nurse’ license be if it is a stumbling block to the his/her
employability?

In other words, the passers of the June exams are caught between the devil and the
deep blue sea. Painful as it may be, retaking the spoiled portions- Tests III and V- of
the examination is the less unjust course to adopt. This gives the examinees the
opportunity to shake off the stigma caused by the leakage, assures them that
employers will not turn them away because of the conviction that they are
incompetent, and regains the integrity of the nursing profession. The retake must
happen soon because the examinees’ fate cannot remain in a state of suspended
animation.

Let not the debate on whether or not the June passers should retake detract us from
a more compelling concern – the liability of those responsible for the mess we are
in. We call on all decent Filipinos to help us urge the government to go after the
perpetrators. We urge fellow nurses and professionals who care for the nursing
profession like the UST group led by Prof. Rene Tadle and Dante Ang, to realize that
the leakage in the Nursing Boards is just a symptom that involves several players
namely: Review Centers that are proliferating and unregulated; resorting to all kinds
of marketing; charging exorbitant review fees; Nursing schools that are
mushrooming with thousands of enrollees and churning out thousands of graduates;
and Board of Nursing certain members of whom are ‘fraternizing’ with owners of
review centers. We urged comrades in this struggle to look at the bigger picture
such as the increasing commercialization of nursing education. With the latest count
of nursing schools in the Philippines of 475, the profit orientation in running the
schools manifested in high tuition fees, point to the survival of business interests as
the primary motive. The regulation of schools are not enforced because of
gargantuan factors such pressures from politicians, Malacanang and prominent
owners of schools/Businessmen. This leads to more pressing issues such as “flying
deans”, unqualified faculty to teach; increase faculty to student ratio; lack of base
hospitals/clinical facilities for student training; and mediocre graduates. It must be
noted that proliferation of nursing schools does not lead to increasing number of
qualified nurses who pass the Boards.

We must acknowledge that the reasons behind the commercialization of the Nursing
Education are rooted to the Foreign demand for Filipino nurses that leads to
migration/nurse exodus to countries that promise high salary & incentives. The pull
factors for this scenario include the high salary (at least USD 3,000/month) and the
Global nursing crisis (fewer women train or remain in nursing workforce in
developed countries, favoring improved job opportunities in other sectors). The
push factors include economic crises; unstable political condition; and the general
climate of hopelessness. This is not to discount the fact that there is the export
policy of the government, nurses bringing in the much needed dollars to prop up
the shrinking economy; overseas contract labor/employment. On top of this is the
obligation of the Phil government to observe GATS-WTO (General Agreement on
Trade & Services of the World Trade Organization) obligations and commitments.
Health services and health professionals are identified as commercial good &
services that can be traded across & among countries in need of additional health
care services, just like the sectors in banking and finance, education,
communication, and tourism. Thus, nursing education and movement/distribution of
nurses are dictated by local & foreign economic forces and government policy.

We urge examinees blinded by the selfish motivation of “no retake” stand and other
colleagues in the nursing profession to understand the implications/effects of this
nursing situation and realize that these root causes lead to the following:
deterioration of the quality of nursing education and its decreasing relevance;
health care crisis (threat to safe nursing practice due to incompetent graduates;
loss of trained & experienced nurses as an effect of migration; high nurse-patient
ratio; and closure of hospitals & other health care facilities due lack/no health care
workers to run the facilities); continuing deterioration of the health status of the
Filipinos; and the commodification of health vs. health as a basic human right.

It is for the above analysis of the nursing leakage issue/concern that we urge every
concerned nurse and advocate to continue to question actions of PRC & BON in their
attempts to “tone down” the leakage scam; conduct education fora among nursing
faculty, students and alumni; organize groups of concerned nurses and nursing
students; pursue legal battle against those who are in involved in the leakage scam;
strategically, initiate reforms in nursing education to maintain educational
standards; propose legislation to regulate review centers; and work for mechanisms
for self regulation within the profession. Collectively, let us call on the government
to pass stricter measures to prevent incidents like this in the future.

Change does not come in a silver platter. We have to work for it. It is a struggle that
can be a painful process. Meaningful changes can not happen if we choose to
remain in our comfort zones. If we do not maximize this opportunity, we loose the
battle forever.
Thank you, Rasheed, for taking time to read this litany. Talking about the situation
of my profession nowadays gives me a high. I just feel sad and frustrated when
fellow nurses give color to our struggle. I see this to be protracted struggle, but we
will pursue. Fighting for the truth is victory in itself. No harm passing on the light.