Four Filipino nurses tell Alison Moore what brought them to England, how they find nursing here and their hopes for the future

Teresa Canlas, 25, came to the Maidstone and Tunbridge Wells trust from the Philippines in early 1999. She now earns just over£15,000 per year as a D-grade staff nurse on a rehabilitation ward.

By this time next year a new house in her home town, a few miles from Manila, should be testimony to Teresa Canlas' work in Britain.

Like many Filipinos working abroad, Teresa has been sending back money regularly to her family. So far she has been able to buy land to build a new family home, on which work should start early next year.

'If ever I leave England I can say I bought that land and that house while I was working here, ' says Teresa.'I went back home in April - on a month's holiday - and saw the land I had bought. That felt good.'

Nurses in the Philippines earn£100-150 per month so the£200250 Teresa is able to send home is a significant sum. But while the money she can earn working in Britain is a strong motivating factor, Teresa is also enjoying her time here.

Teresa was one of around 50 Filipinos who came to Tunbridge Wells in February 1999. She was initially employed as a B grade, while she underwent an adaptation period and got her UKCC PIN number. 'It is the system here which is different - giving drugs and IV, having to check things with two other nurses, and protocols for blood transfusions, and so on, ' she says. 'But when it comes to nursing care it is just the same.'

One significant difference she has found is in discharge:

Filipinos would be sent home to their families to recuperate, whereas in Britain there is liaison with social services and care arrangements to be sorted out.

Teresa originally came to Kent on a two-year contract, but now expects to extend that, and has no immediate plans to return to the Philippines. Since she arrived many of her former colleagues have followed her, working throughout England and Scotland.

Charlie Palma, 25, left his job in Manila to move to Kent last year. He is currently working in accident and emergency and earns around£15,000 a year.

The idiosyncrasies of the English language have proved a taxing problem for him in his first year of working in Britain.

'I speak English (it is our second language from when we start school) but the jargon and colloquialisms were new - such as spending a penny! But the patients and doctors have all been very supportive.

'As time goes by we are starting to understand most of the commonly used terms, but not all of them.'Even now, he says some accents can be hard to understand, and he occasionally has to ask patients to explain what they mean to avoid misunderstandings.

Charlie would be the first to admit that a combination of factors has brought him to the Kent and Sussex Hospital in Tunbridge Wells .As well as the chance to earn money to send back to his family, he wanted to travel.'I'm a person who loves an adventure - I want to explore other parts of the world, and England was a good start, ' he says. 'But it is also for my personal and professional growth - to widen my horizons and my competencies.'

After his adaptation period, he was put on a care-for-the elderly ward, but yearned for a switch to A&E - an area he had specialised in while in the Philippines.

He moved to A&E in June and has already been asked whether he will extend his contract to early 2002.Although he wants to continue working abroad until he is in his late 20s, he plans to return to the Philippines eventually.

Benaida Baldonado, 31, worked as a general nurse in the Philippines before coming to Kingston Hospital, Surrey, in April last year. She earns£16,000 a year and works on a medical ward.

Working in Britain has been a mixed, but predominantly happy experience, for Benaida.At points she has felt professionally frustrated and has encountered some racism from patients and their families.B ut overall her welcome has been warm and she has been surprised by the affection nurses engender in Britain. 'For me the orientation period was a very difficult stage, ' she explains.

'We are used to doing virtually everything, not under supervision. When we came here we really had to start from the bottom.

'However, I would say that practices here are safer - especially on giving IV drugs. In the Philippines you don't have to check it with another nurse. Here, mistakes can be minimised.'

She has found more of her time is taken up with mundane tasks - dressing and washing patients, and helping them to go to the lavatory.

In the Philippines a relative would virtually live in the hospital and take care of many of the patient's personal needs - not least because it reduces the eventual bill. And it is not unusual for patients who really need to be in intensive care to remain on a general ward because it is cheaper.

Racism has not been a major issue for her - but it has surfaced occasionally. On one occasion when she was the most senior nurse on a ward, she felt a patient's relatives found it hard to accept she was 'in charge' and kept expecting someone more senior - and white - to appear.

Another staff member heard them asking whether she could speak English - but Benaida, when told of the comments, would not complain or take the matter further.

Instead, she puts much of their attitude down to anxiety over their relative's condition and diagnosis.

On the other hand, she has been surprised by the gratitude expressed by patients and the high regard nurses are held in the wider community. She has now been joined by a sister, who is working at a hospital in Leeds, and has no definite plans to return to the Philippines. Benaida - and every one of the other 33 nurses who came to Kingston in the early part of 1999 - has said she wants to extend her contract when it runs out early next year.

Victor Bordado, 31, came to Kingston last October after periods working in the Philippines and in Saudi Arabia.

He earns£16,000 per year as a D-grade on a surgical ward.

Like many other Filipinos, when Victor thought of working abroad America seemed the natural destination. But tougher immigration policies in the US - and a recommendation to an agency specialising in recruitment for the UK - saw him heading for Surrey instead. His fiancee hoped to follow him, to study in central London, but 10 months later she is still in the Philippines and Victor is using his time in Britain to build up savings and travel around Europe.

Victor has already had one period of working abroad - he was poached from a top cardiac unit in the Philippines by the Saudi Arabian ambassador, who was one of his patients. This led to three years working as one of a team of paramedics assigned to the Saudi royal family. At one point he was based in Ohio for eight months when his 'charge' underwent heart surgery and recuperation in the US.

Despite this cosmopolitan background, the informality of British hospitals came as a shock.' Some of the staff who work with me laugh when we call senior nurses 'sir'or 'ma'am', ' he says, adding that such deference to doctors and more senior staff was normal in the Philippines - and adjusting to first name terms has been difficult. Like many Filipino nurses working in Britain, he would have greater status among his fellow professionals if he had stayed in the Philippines.

'I have a two-year contract that has to be fulfilled. We are treated very well here, so I would consider staying, ' he says, praising the support the hospital has given Filipino nurses through a mentor system and a dedicated co-ordinator.

He is currently working three 12-hour shifts a week on a surgical ward and often does extra shifts to bring in more cash.

'In the heart centre in the Philippines we would work five to six 7am-7pm shifts a week, ' he adds. 'I had some doubts in my mind before I came. We are bombarded with the assumption that British people are very snobbish and have a stiff upper lip. But I would give it nine out of 10. It is like you are accepted as belonging to a community - and that is something which money cannot buy.'