Immigrant workers, most of them from the Philippines, keep the lone hospital in a shrinking North Dakota prairie town staffed, CNN reported on Saturday after spending a month in Hettinger, a community of about 1,100 people. The documentary, “30 Days Inside: Hospitals and the Immigrant Workforce,” airs at 8 p.m. Eastern on Sunday.
“Do you like McDonald’s?” was the first question Marichu Castillo Villamiel heard when she applied for a job at West River Hospital, CNN reported. The interviewer wanted to know whether an ultrasound technician from the Philippines could settle in a town with one grocery store and almost no immigrant community. “Yes, I’m willing,” she recalled answering, though she added, “I don’t like McDonald’s much because I can make my own burger.”
Ms. Castillo Villamiel got the job and is one of 19 foreign workers at the hospital, which also treats patients from Montana and South Dakota. She waited out the bitter prairie winter before bringing her three daughters from the Philippines six months ago, hoping the temperatures would at least feel familiar. “Because this is my dream,” she said of coming to the United States to work.
She came on an H-1B visa, the skilled-worker program that runs three years and is generally renewable for three more. West River Health Services has used it to recruit Filipino nurses and lab technologists for posts that have sat empty, in one case for more than a decade. The Trump administration has now proposed a $103,000 fee for such visas, though many hospitals have an exemption, and the shifting rules have left the hospital unsure what comes next.
“It is something we expect to potentially affect us in the future as it continually changes,” Alyson Kornele, the chief executive of West River Health Services, told CNN. “We never know what’s going to happen.”
The staffing problem reaches well beyond Hettinger. “All rural areas are experiencing population loss,” said Dr. Cathy Houle, a family physician at West River. “We’re seeing, increasingly, it’s difficult to recruit and retain people to work in the medical field.” The hospital sits two and a half hours from Bismarck, the nearest big city, where staff members meet newly arrived immigrants at the airport and drive them down.
The recruits told CNN they felt welcome in Hettinger, where the vast majority of residents are White and native-born, in a part of the country that voted heavily for President Trump. CNN filmed friendly waves from passers-by on walks to places like Pastime, a steakhouse bar run by one local family for more than four generations.
The week before school started, three Filipino teachers arrived to fill more public-service jobs. All of them cried when talking about the people they left behind, CNN reported, and after school they sat in the cafeteria on video calls with their families, chickens roosting in the background of one call as the sun rose in the Philippines. “One of my students (told) me, thank you for coming here, you left your daughter in the Philippines just for us,” said Zaira Chinte, a second-grade teacher. “I’m so touched with that because they see our effort as a teacher coming here.” The school held a welcome gathering where Ms. Castillo Villamiel and other Filipinos brought home-cooked food and parents met the new teachers.
During the shoot, CNN’s crew did shifts in the emergency room and attended scheduled surgeries; patients invited them home to talk about the immigrant workforce. On the first day of filming, Ms. Castillo Villamiel performed an ultrasound for Mayra and Hugo, expecting their fourth child. Three weeks later, on one of the ER’s busiest days of Labor Day weekend, Dr. Houle delivered their son, Emmanuel, during a 72-hour on-call shift. “It’s really a privilege to be part of that,” Dr. Houle said. “Especially with a family that’s nice and welcoming as they are.”
Not everyone in town agrees about the newcomers. Leona Freymiller, who has had two surgeries at the hospital and spoke with CNN at her home 45 minutes away, acknowledged that “there’s some people that don’t think they should be here,” though she said they should be welcomed. A day after surgery, she took the crew hiking up White Butte, the highest point in North Dakota.
Ms. Castillo Villamiel has put down her own marker. “I can help people here,” she said, “yes, I can stay.”