Merchants of Care

The COVID-19 pandemic left a battered health care industry in its wake. Waves of illness lay bare its weaknesses, eviscerated its staff, and strained hospital finances. Poor working conditions are driving workers to burnout, even as hospitals are pressured to spend less on labor.

To bolster their workforces, hospitals in the U.S. and Europe have dramatically accelerated hiring from countries like the Philippines, India, Nigeria, Zimbabwe, and Jamaica. These countries have long sent trained, experienced nurses to work abroad. But since the start of the pandemic, what was once a steady trickle of nurses leaving their home countries has become a flood.

Quartz, in partnership with Type Investigations and the Pulitzer Center, traveled to India, Nigeria, the Philippines, the United Kingdom, and the United States to investigate the consequences of this global movement of nurses. We spoke with dozens of nurses, along with recruitment agency employees, hospital officials, public health experts, government health agencies, and researchers. Our four-part investigation found an international bidding war for health care workers, yielding opportunities for some nurses but exposing others to exploitation—and leaving poorer health systems scrambling to cope.