Health

Filipino organizations in Alaska have worked to bring a documentary to Alaska called “Nurse Unseen.” The film was shown at the Anchorage Museum on Wednesday to spotlight a group of immigrants whose service and sacrifices are often overlooked.

It’s a theme that resonates in Alaska, where Filipinos are the largest immigrant group. They can be found at work in hospitals, nursing homes and in many jobs that are hard to fill.

Filipino nurses have a long history of filling in the gaps in the nation’s healthcare system that go back more than a century, when the U.S. colonized the Philippines and the military Americanized training for Filipino nurses.

When producers of “Nurse Unseen” began work on their documentary in 2019, they hoped to tell the story of how Filipino nurses are essential to the national healthcare system. Then came COVID-19.

“That was really the impetus for us to step into action and really move in high gear,” said Michele Josue, the film’s director. Josue also worked with another Filipino film producer, Carl Velayo and Joe Arciaga, a Filipino-American nurse and writer.

In late 2020, a report called “Sins of Omission” brought everything into sharp focus. The National Nurses United exposé found that Filipinos made up 4 percent of the registered nurse workforce — but next to white nurses, had the second highest death rate.

“At the height of COVID, they made up 31.5% of COVID nurse deaths, which is a really shocking number,” Josue said.

So how is it that almost a third of the nurses who died during the pandemic were Filipino? Josue says many support their families back home, so they take extra shifts and jobs that are hard to fill, like in the Emergency Room. Hospitals also recruit them, because they get good training in the Philippines.

“Filipinos are the unsung backbone of health care,” Josue said, “and that’s just a fact.”

Josue says Filipinos gravitate to health care because of a deeply ingrained cultural value called kapwa, which emphasizes the importance of community connectedness, love and caring.

“There are so many other industries, professions, that really rest on the shoulders of hardworking immigrants all over the country,” Josue said. “There should be more narratives out there that outline immigrants in a positive light. It shouldn’t be a bad word.”

Rebecca Carrillo, a nurse from Juneau, says it’s true that many Filipino immigrants come in search of opportunity.

“We came to this country to work and to make a better life for ourselves,” said Carrillo, who retired after 25 years working in the state of Alaska’s Women Infants and Children’s (WIC) nutrition program.

She says it’s a job that once took her up the Kuskokwim River to check out an innovative service designed by Ester Ocampo, a Filipino nutritionist who traveled to fish camps to work with Yup’ik mothers.

“It’s meeting people where they are,” Carrillo recalled, “women who were processing fish, children who were running around, babies on their mother’s back — with Ester trying to ask questions and write stuff down, sometimes trying to entertain kids to stay still for the measurements.”

Carrillo says this is one example of the many ways that Filipino immigrants make a difference in the lives of Alaskans. She says you’ll also find them teaching children in remote communities, where it’s hard to recruit educators – or in her hometown of Juneau, caring for people’s parents and grandparents.

“Ninety percent of health aides and LPNs that staff the (Juneau) Pioneer home are Filipinos,” Carrillo said. “So, if all of those folks are gone, I don’t know how that place is going to continue to run.”

Although Alaska did not lose any Filipino nurses to the pandemic, Carrillo says it’s important to recognize their contributions, which have been overshadowed by a wave of national anti-immigration policies.

From fish processing plants to staffing the Anchorage airport and post office, Carrillo says Filipino immigrants hold down many jobs that help to fill Alaska’s labor shortages. But she says immigrants are often unseen, just like the women in the film, “Nurse Unseen.”

WASHINGTON — An estimated 14,000 Alaskans, and millions of Americans, would lose their health insurance from one feature of the Republican budget reconciliation bill now pending in Congress.

That element is a requirement that certain Medicaid recipients prove that they worked at least 80 hours each month.

U.S. Sen. Bernie Sanders confronted Health Secretary Robert Kennedy about it Wednesday at a Senate hearing.

“Is throwing 13 million Americans off of the health care they have, poor and working class people, keeping America healthy?” Sanders asked.

“Well, I haven’t seen that number. I’ve seen the number 8 million, and … the cuts are not true cuts. The cuts are eliminations of waste, abuse and fraud,” Kennedy said, and he started to explain how at least one million people would lose Medicaid coverage but Sanders cut him off.

The idea of requiring poor people to work to receive public benefits like food assistance has been around since at least the 1980s. The first Trump administration encouraged states to require it for Medicaid.

The Robert Wood Johnson Foundation funded a study of what happened when Arkansas and New Hampshire added a Medicaid work requirement in 2018 and 2019. Katherine Hempstead, senior policy officer at the foundation, said most people who lost their coverage actually did work or were exempt but failed to report it properly.

“That’s the really sort of cruel and sad thing about work requirements is the way that it creates savings for the federal government is really this collateral damage of people who, you know, are unable to successfully document what they’re doing,” she said. “A lot of people don’t have computers. They have to do everything on their phone. They don’t always have internet.”

The work requirement in the bill would apply to adults in the so-called Medicaid expansion population, whose incomes are slightly higher than the regular Medicaid population.

Amber Lee, director of Protect Our Care Alaska, said most of the 76,000 Alaskans in this category are working already, or qualify for one of the exemptions, because they’re raising a child, are disabled or are entitled to care through the Indian Health Service.

But documenting that monthly work would be a burden for the recipient and for the state, Lee said, and it would fall on the same department that had such a hard time dealing with applications for SNAP, or food assistance.

“I think most Alaskans remember that Alaska almost lost our SNAP benefits because of the enormous backlog that they had. So work requirements are going to be a huge lift for the state,” Lee said. We’re going to have to build out the infrastructure to be able to do that.”

Having fewer insured Alaskans means higher cost for the entire health care system and everyone who relies on it, she said.

“It goes up for everybody, because people will wait to get health care until it’s an emergency situation. They end up in the emergency room, and that increases costs for everybody, because those are uncompensated costs,” she said.

The bill would also require copays for people who are in the Medicaid expansion population of up to $35 per medical service.

The reconciliation bill is still in House committees. It’s not certain to pass. Some Republicans don’t like the Medicaid changes and some don’t like that it would add to the deficit by continuing tax breaks that were due to expire.

Following a request by the federal government, the state of Alaska has turned over the personal information of roughly 70,000 Alaskans enrolled in the federally funded Supplemental Nutrition Assistance Program, commonly known as food stamps.

As first reported by NPR, the federal government normally collects information to determine a SNAP applicant’s financial eligibility for the program. The new request goes beyond that, to cover name, date of birth, address, contact information, Social Security number, citizenship status and information about people living in a recipient’s household.

It affects nearly 1 in 10 Alaska residents, who participate in the program.

In a May 6 memo, the USDA said it was requesting that information because of an executive order by President Donald Trump. Numerous news agencies have reported that the Department of Government Efficiency — part of the executive branch under Trump — has used that order to combine personal data collected from several agencies to help the federal government track and arrest immigrants they want to remove from the country.

“Alaska is complying with the federal government’s requirement to share the information as requested,” said Alex Huseman, a public information officer for the Alaska Department of Health.

“Per the USDA guidance on May 6, 2025 … all data related to SNAP is being shared with the federal government,” he said. “This includes any information on a client’s application or renewal, any documentation sent in as part of their application or renewal, or other data acquired by DPA staff while processing applications and renewals.”

The USDA is specifically requesting “records sufficient to identify individuals as applicants for, or recipients of, SNAP benefits, including but not limited to personally identifiable information in the form of names, dates of birth, personal addresses used, and Social Security numbers.”

Huseman said the federal government has not requested that information before.

The Alaska Legislature has previously expressed concerns about the federal collection of Alaskans’ personal data but has not addressed the SNAP data-sharing arrangement.

In 2008, the Legislature forbade the state from spending money to implement the post-Sept. 11 REAL ID program, and only begrudgingly reversed course years later.

In 2017, lawmakers said they did not trust federal government data collection and requested additional privacy protections. Among those lawmakers was then-Sen. Mike Dunleavy, R-Wasilla.

“Federal contractors, businesses, everyone’s a victim here, of the federal government,” Dunleavy told the Anchorage Daily News about the REAL ID program.

The Central Council of the Tlingit and Haida Indian Tribes of Alaska can now receive reimbursements for providing child welfare services directly from the federal government. Both governments finalized the agreement last month.

That means the tribe’s reimbursements no longer need to go through the State of Alaska. Tribal officials say the agreement gives them more flexibility in handling cases where child abuse and neglect may be happening. 

Mary Johnson is the senior director for family services at Tlingit and Haida. She said the tribe will continue working with the state on child welfare services, but it can now look into ways to expand its services.

“What do we need to get into place to license our own foster homes? What do we need to get into place if we do want to initiate a child welfare case within our own tribal court? And how do we go about putting that into action?” Johnson said. “Now we have the resources to make that happen with a lot of work.”

Alaska’s Office of Children’s Services has agreements with tribes across the state to serve Alaska Native children placed in the system. Tribes assist in Indian Child Welfare Act cases. The law sets standards for children’s services agencies to place Alaska Native and Native American children with family members or to keep them in their home communities if they are removed from their family.

That means Tlingit and Haida works with the state to find a suitable place for children to live after they’ve been removed. In the past, federal reimbursements were distributed to tribes from the state. With the new agreement, Johnson said the tribe can now receive reimbursements directly from the federal government.

Johnson said the tribe’s family services generally have a better understanding of a referred family’s cultural background.

“If you are working with a caseworker at Tlingit and Haida, the chances of them being Alaska Native or even a tribal citizen are pretty high,” she said. “So you’re going to be connecting with someone that just tends to know your way of living a bit more than someone who doesn’t. So that makes a huge difference when working with our families.”

Data from OCS shows that more than two thirds of the children removed from their home last year in the state were Alaska Native.

Tlingit and Haida worked on more than 233 cases in 15 states last year. The tribe serves all of its tribal citizens, including those that live outside of Alaska.

Johnson said the tribe hopes to expand its abuse and neglect prevention services through the agreement as well.

“We have communities that are really strong in one area, and that could be a great area to build off of to do a prevention activity so it can be individualized to a community based on their strengths and their needs,” she said.

The tribe will now go into an implementation phase, where officials will continue developing its child welfare and monitoring program to be approved for reimbursements. Johnson said in an email she anticipates the tribe will need six to 12 months to go through the approval process.

Monday was Missing and Murdered Indigenous People Awareness Day. In Juneau, at events like this one — held in recognition of the epidemic of violence against Indigenous people — one name comes up consistently.

“I’m here because of Tracy Day,” said Kanaagoot’ Mike Kinville. He helped take care of Tracy Day when she was still a teenager. Decades later, she went missing at the age of 43. It’s been six years, and her family is still looking for her.

Monday night, advocates for missing and murdered Indigenous people gathered at Kaasei Healing Kootéeyaa, a totem pole created to be a space of healing from gender-based violence.

Those gathered wrote names of loved ones that have been the victims of violence on wood pieces carved out of a dugout canoe and burned them in the fire. 

“It is so hard for me when I see all these faces and all these names and all these families, the amount of pain that radiates out from that, you know, the hurt, the not knowing,” Kinville said. “It’s just — it’s almost crushing.”

Kaelyn Schneider is Tracy Day’s daughter. She has been raising awareness about her mother’s case via social media for years. She said that she feels disconnected from Lingít culture because her mother’s time teaching her was cut short. 

“I need people to understand that when Indigenous people go missing, it’s so much deeper than anyone realizes,” she said. “Not only are these our family members who we love and miss every single day, but these are the people who pass on sacred knowledge to the next generation of our family.”

Schneider said she’s grateful for the people who come together at gatherings like these to share their traditional knowledge with her family. She says they help the families of people lost to violence grapple with their unanswered questions as a community, and fill some of the space left behind.

Living in America right now can feel like you and your dad are trying to fix a car, but you can’t even agree on where the engine is. And neither one of you can fathom how the other could’ve been so wrong this whole time and still drive a car. So you’re glaring at each other, white-knuckling a wrench — and the car’s still broken.

It’s not just you. The Pew Research Center says the political and ideological divide in the U.S. is wider now than it’s been in decades. And in a small town in Alaska — especially one you can’t drive away from — it can feel like there’s no escaping the conflict.

Ketchikan has seen a lot of demonstrations lately. There have been protests and rallies against and for the federal government, the mass firings, abortion, and just Donald Trump in general.

When I talked to people at the protests and rallies, though, one thing stood out. Lots of people talked about resenting people they love because of their politics. They talked about how much it sucks, and how exhausted they feel.

Believe it or not, reporters feel that tension too. So I fired off some emails to family therapists in town. “I need your expertise on navigating pressure points,” I wrote.

I told them I wasn’t comfortable with how reactive and angry I felt, and I didn’t think I was alone. I said I wanted to know if there was a way to not feel that way.

One therapist responded immediately.

“I believe there are a few of us who would appreciate talking about this topic,” she wrote. “It’s certainly at the forefront of my life currently, both with clients and personally.”

_______

Caitlin Andrews has tea and a noise machine in her waiting room. Her enormous therapy dog, Guinness, snoozed in a big armchair next to me while we talked.

Andrews’ practice is called Oilean Wellbeing – that’s Irish for “Island.” She says that in a small island town like Ketchikan, the cavernous political divide “just feels really heavy.” And she says alienation from others in the community is something her clients have been experiencing more and more.

“This is huge. I mean, the week of the elections, that was all my clients talked about. It was affecting everyone in one way or another – whether arguments with their family, not seeing eye to eye, or feeling like their household was going to be affected,” she said. “Those are all really, real things that I think therapists across the country are faced with right now.”

Andrews is a family therapist and works with people across the political spectrum. Many of her clients are teenagers and their families. She says when it comes to religion and politics, everyone needs supportive people to talk to.

“Find the people that you can have constructive, healthy discussions with,” she said. “It’s sad that it can’t be, like, the people you’ve always had in your life — but that’s just life.”

Andrews says it’s normal to feel anger towards the people closest to you, but we should ask ourselves what’s under the surface.

“Anger is not ever by itself. It’s a secondary emotion. There’s always something causing anger,” she said.

None of this is simple. Andrews says it’s important to stand up for what you believe in, but if you care about the other person, it matters how you do it.

“The important part is being able to circle back and talk about that,” she said. “If they’re emotionally mature enough and saying ‘Hey, I want to talk about what happened with our conversation.”

Still, it’s easy for both people in a political argument to take it as a personal attack.

“Especially with family, sometimes people have a hard time separating what they’re supporting versus it being about them,” Andrews said. “Sometimes, when we are upset with another person, it’s projecting something like rejection.”

And Andrews says that sometimes, protecting yourself can mean drawing a line and taking painful topics off the table.

“Go in prepared to say, ‘This is getting ugly, and I love you too much. We’re gonna have to stop talking about this topic,’” she said. “That’s a boundary.”

Some degree of pain is often built into the foundations of family relationships, but Andrews doesn’t advocate for her clients to tear it all down.

“It’s not all or nothing,” she said “I don’t think you have to cut someone off, but you have to really protect yourself.”

She says her clients often feel powerless, like no one is listening. But she told me that I’d already done step one: acknowledging I have a problem.

“That can sometimes be the hardest part,” she said. “A lot of people don’t take that responsibility. People come to me because they want to get better.”

And Andrews believes there’s one thing everyone can control: their reactions to the headlines and the people in their lives who may read them differently. And she says that’s a good place to start.