How Filipino nurses came to define U.S. health care—and now, Hollywood

Fortune Mallare was 23 years old when she picked up a suitcase and flew to the United States in 1972. Driven by a passion to help financially support her family in Metro Manila, she immediately jumped at the opportunity to work abroad.

True to her first name, Mallare found just that as she was recruited in the Philippines to work as a nurse in the United States during the severe post–World War II nursing shortage.

The benevolent assimilation

When the Philippines became a U.S. colony in 1898, President William McKinley issued a “benevolent assimilation” policy that took over institutions and began developing American nursing programs in the Philippines. The curriculum effectively prepared Filipinos to work in the United States. Students were trained in English, and early licensing exams even included English components.

After the Philippines gained independence in 1946, the United States launched the Exchange Visitor Program in 1948 to promote American democracy and combat Soviet propaganda during the Cold War. It allowed participants from other countries to work and study in the United States for two years. Though not aimed at nurses or the Philippines specifically, many Filipino nurses, who had already trained in the U.S.-style nursing, participated.

Then, in 1965, the Immigration and Nationality Act opened the door to more global migration. Facing a post-World War II nursing shortage, which was exacerbated by low wages and poor working conditions that pushed many American nurses out of the profession, U.S. hospitals turned to the Philippines to fill the gap. This recruitment effort helped establish a migration pipeline that continues to this day.

“They used this to justify the colonization of the Philippines by arguing that this was a different kind of colonialism and imperialism,” Catherine Ceniza Choy, author of Empire of Care: Nursing and Migration in Filipino American History told Vox. “This was a ‘good’ kind of colonialism that would bring education, infrastructure and public health.”

According to Mallare, American hospital administrators and nursing directors traveled to the Philippines to recruit nurses, and she vividly recalls attending a flooded interview in Manila. After being selected, Mallare and others were assisted by a travel agency to secure their visas and flights under a “fly now, pay later” arrangement.

Upon her arrival in Tuscaloosa, Alabama, the experience exceeded Mallare’s expectations. “We were the first batch of Filipino nurses to arrive there, and we were welcomed with red carpet treatment at the airport, greeted by local politicians, the media, and hospital administrators,” she tells JoySauce.

Her photo had been circulated ahead of time, so the hospital director recognized her on sight. The nurses were taken to a restaurant and provided temporary housing in a dormitory-like building. Later, she and her friend were assigned to a county hospital outside the city and given a fully furnished trailer home. With her salary, she began sending money home to support her family and help her siblings go to school.

A generational calling

Today, the Philippines remains the largest exporter of foreign-trained nurses in the United States, with about one-third of all foreign-born nurses being Filipino. Besides viewing nursing as a lucrative profession, many Filipinos see the career as a ticket out of poverty in their home country. While the immigration pathways have shifted over time, more than 150,000 Filipino nurses have migrated since the 1960s, according to Choy. Today, the nursing workforce also includes second- and third-generation Filipino Americans.

In Mallare’s family, nursing became a shared path as her husband and all four of their children have entered the field. However, her second daughter, Janice Nguyen, 47, recalls initially resisting the profession. “I didn't want to be a nurse because I was surrounded by nurses,” Nguyen tells JoySauce. “My parents, my aunts and uncles, and a lot of family friends were nurses, so I was straying away from it. I thought, ‘Everybody's a nurse, so I'm going to do something different.’”

However, she eventually chose a pre-nursing program on a whim with friends and found a passion for science. Nguyen completed her bachelor of science in nursing at Point Loma Nazarene University in San Diego, and became a registered nurse at age 22. While she doesn’t want to pressure her own children into the medical field, she hopes they’ll consider it for its good pay, flexible hours, and global opportunities. She also points out that many nurses now work remotely or in non-clinical roles, making the profession appealing to a wide range of interests.

Carving a new path

On the other hand, actress Amielynn Abellera, who portrays a Filipino American Muslim nurse in HBO Max’s The Pitt, was set on the medical field, following the familial pattern set by her relatives. Abellera was born in the United States to Filipino immigrant parents who both worked in health care. Her father, a family physician, came to the states on an immigrant visa in the 1970s, and her mother, now a nurse practitioner, arrived on an H-1B visa. Abellera grew up surrounded by medicine, spending time in hospitals and her father's clinic. Her extended family also worked in health care, many of whom operated their own shared medical building.

“I actually went to college for pre-medical and I was going to be a doctor,” Abellera says. “I really was almost there. I was applying to medical school, taking the MCAT, and then I just realized that I wanted to kind of switch gears and explore this hobby that I had always had since I was a kid, that my parents had also encouraged because, as Filipinos, we love the arts and that was such a big part of our life. But it was never really encouraged as a career path, or something that can be taken seriously as a vocation. I feel like maybe since their world was medicine, they just didn't know how to encourage it.”

In The Pitt, Abellera channels her upbringing and cultural background into her role. Perlah isn’t just a nurse—she’s a confident, no-nonsense professional who, like Abellera, grew into her Filipino identity and language later in life. The role feels deeply personal as she views it as a tribute to her parents and the many Filipino health care workers in the United States.

Breaking the mold 

Before The Pitt, Abellera portrayed a surgeon in Fox’s The Cleaning Lady as one of the side characters. Filipino actors, particularly those still establishing themselves in the industry, often find themselves cast in medical roles.

Kristin Villanueva, who plays another Filipino nurse in The Pitt named Princess Dela Cruz, also knows this pattern well. She had previously played nurse roles herself. “Well as an actor, you don't get to decide, at least in my level,” Villanueva explains. “When you book something, you take it. But I had a conversation with my reps a few years ago about auditioning for nurse roles, and I told them, I would like to be more selective because I've done them, I've played them. And unless it's a fully fleshed out character, I don't want to audition for it anymore because I feel like if there is a Filipina nurse in a TV show, they're just in the background, or they just say ‘Yes, doctor.’ I did not want to perpetuate that pattern, because I knew that we, as in the industry, could be better.”

Princess, however, broke that mold. Villanueva describes her as a multilingual character, animated, spunky, a force not to be messed with, and a strong worker with a dose of sarcasm. For Villanueva, the role finally reflected the complexity she had long been seeking.

Meaningful representation

While the story of Filipino nurses in the United States traces back to the country’s long-standing reliance on the Philippines to staff its frontlines, meaningful media representation is only beginning to emerge. So why is it only happening now? “The industry is just trying to play it safe. It's the fear that if you make a Filipino or a non-white role, that less people would be able to relate,” Villanueva says of Hollywood decision-makers. “But I've always believed that the more specific a story is, the more universal it becomes.”

As for Abellera, she believes that Filipino and broader cultural inclusion has only recently gained momentum across TV, film, and other industries like food and music. Growing up without Filipino characters on screen meant missing out on understanding and celebrating her culture, especially her parents’ role in the U.S. health care system. She sees today’s shift as a powerful moment not just for herself, but for her daughter, who now gets to see Filipinos on screen. While she’s unsure why it took so long, she credits her generation of Filipino artists for finally pushing representation forward, filling a gap left by previous generations who weren’t encouraged to pursue creative paths.

Filipino nurses aren’t just quirky coworkers. They are leaders, mentors, and main characters in real life. The work ahead, actors and nurses agree, lies in expanding the narrative.

Although Hollywood has made some progress with Filipino nurses, or actors in general, now getting screen time and dialogue, meaningful representation is still rare. Visibility is just one part of the conversation. What’s missing, actors and real-life nurses say, are portrayals that move beyond comic relief or supporting roles. Filipino nurses aren’t just quirky coworkers. They are leaders, mentors, and main characters in real life. The work ahead, actors and nurses agree, lies in expanding the narrative. “When I first started watching The Pitt, I actually was thinking in my head that the main charge nurse there should have been a Filipino nurse because we do that. We are those roles,” Nguyen says. “We don't want to be looked at as small or insignificant. We want to be equal and just as important as everybody else.”

For Brandon De Leon, a 24-year-old newly graduated nursing student from the San Fernando Valley, being part of the overwhelmingly Filipino presence in health care is both a point of pride and a cultural reality he’s glad to see reflected on screen. He sees shows like The Pitt and St. Denis Medical as closer to reality than past depictions, but agrees that there is still room to grow. “Hollywood always wants the big names, but they need to keep a realistic representation,” De Leon says. “I just feel like somebody hasn't got their shine yet, but I believe that somebody in the future will represent the Filipino culture really well. It's not here yet, but I feel like Filipinos are predominantly getting more attention than ever, even with music artists. Social media plays a part, and we're just now gaining more exposure. I just know that us Filipinos will be getting more recognition in due time.”