Inside a tiny prairie town relying on immigrants for hospital work

PROGRAMMING NOTE: Watch “30 Days Inside: Hospitals and the Immigrant Workforce” on The Whole Story with Anderson Cooper at 8 p.m. ET Sunday on CNN.

“Do you like McDonald’s?”

That was the first question Marichu Castillo Villamiel was asked when she applied for a job at a hospital in Hettinger, North Dakota, a tiny town of about 1,100 people and only one grocery store.

It was the interviewer’s way of checking if the Filipina ultrasound technician would be OK working so far from home in a place without much of an immigrant community.

“Yes, I’m willing,” Marichu remembered she said about a move to Hettinger, though she added, “I don’t like McDonald’s much because I can make my own burger.”

Evelio Contreras/CNN

Marichu got the job and is one of 19 foreign workers at West River Hospital, which serves residents of Montana and South Dakota, as well as the locals.

CNN spent a month in Hettinger to examine the impact of immigrant workers and how they were viewed in a rural part of the country that mostly voted for President Donald Trump. The documentary, “30 Days Inside: Hospitals and the Immigrant Workforce,” reveals life in the community just as it was getting more foreign workers for a vital local resource – teachers in schools.

Marichu welcomed us into the home she shares with her partner, Eric, and her three daughters who arrived from the Philippines six months ago.

She had waited until the snow melted at the end of the bitter prairie winter to bring her girls to America, hoping that at least the temperatures would feel familiar.

“Because this is my dream,” she said about wanting to come to the US to work. “Yes, Hettinger is a home. If I got a chance to live in the United States, a good opportunity, why not?”

“I can help people here, yes, I can stay,” she said.

Marichu came to the US on an H-1B visa for skilled foreign workers to fill vacancies for three years, generally renewable for a further three years. It’s a program West River Health Services has used to recruit people from the Philippines as nurses and lab technologists, looking to fill posts, one of which has been open for over a decade.

But the Trump administration’s clampdown on legal immigration has created uncertainty – as well as the targeting of illegal migrants that fill the headlines. There’s a new proposed $103,000 fee for H-1B visas, though many hospitals have an exemption.

“It is something we expect to potentially affect us in the future as it continually changes,” said Alyson Kornele, the CEO of West River Health Services. “We never know what’s going to happen.”

West River is facing issues familiar to many rural hospitals across the country, with worker shortages exacerbated by young people moving away. The hospital is 2½ hours from the nearest big city, Bismarck, North Dakota, where immigrants fly in and are picked up by hospital staff for the drive down to Hettinger.

“All rural areas are experiencing population loss,” said Dr. Cathy Houle, a family physician at West River Health Services. “We’re seeing, increasingly, it’s difficult to recruit and retain people to work in the medical field.”

If the hospital is happy to have its staff from the Philippines, it seems that the town is too. The recruits told us they felt welcome in Hettinger, where the vast majority of the population is White and native-born. We saw that too, with friendly waves from people around town as we walked to places like Pastime, a steakhouse bar run for more than four generations by one Hettinger family.

As Marichu got her kids ready for their first day of school, we met three Filipino teachers who’d arrived the week before — more immigrants filling more public service roles.

They all cried when talking about leaving loved ones behind and when school ended, we saw them talk to their families on cell phones in the cafeteria. Chickens roosted in the background of one of the video calls, it was sunrise 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 in Hettinger. “I’m so touched with that because they see our effort as a teacher coming here.”

The school hosted a get-together to welcome the teachers to the community. Marichu and other Filipinos brought home-cooked meals as families chatted and parents met their students’ new teachers.

We hadn’t known what we would find when we ourselves had arrived in North Dakota, and Marichu ended up being one of our guides too.

We ate with her and the school community discussing the upcoming academic year, and on our first day filming at the hospital we saw Marichu with Mayra and Hugo, who were getting an ultrasound for their fourth child. Three weeks later, we were there again when Mayra gave birth to Emmanuel on one of the busiest days in the ER on Labor Day weekend.

Dr. Houle delivered Mayra’s baby as just one of her duties during a 72-hour on-call shift at the hospital.

“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.”

In the course of filming 30 days, we learned how to spend time with the town’s families and when not to pick up a camera — to give them space and simply to hang out as Marichu hosted a karaoke night, for instance.

When we were filming, we held our shots longer than we would for a traditional news report to be able to share more of what we were seeing and to capture intimate moments we were privileged to witness.

We did our own shifts in the hospital ER, waiting for events to unfold. We attended scheduled events, like surgeries, where we met patients who invited us to their homes to talk about the immigrant workforce and the community.

Leona Freymiller spoke with us at her home 45 minutes away from the hospital where she has had two surgeries, talking about her children who moved to Minnesota to live in a city.

She also addressed the immigrants working at the hospital, acknowledging, “there’s some people that don’t think they should be here,” though she thought they should be welcomed.

And even though she’d had surgery the day before, she took us to White Butte, the highest point in North Dakota, to show us what this place has to offer.

Far beyond the vastness of the scenery, the hike helped shape our understanding of the people who live in and near Hettinger and those they allow into their lives.

节目预告：请于美国东部时间周日晚 8 点在 CNN 观看《安德森·库珀的完整故事》节目“30 天内幕：医院与移民劳动力”。

你喜欢麦当劳吗？

玛丽丘·卡斯蒂略·维拉米尔 (Marichu Castillo Villamiel) 应聘北达科他州赫廷格 (Hettinger) 一家医院的工作时，被问到的第一个问题就是这个。赫廷格是一个只有大约 1100 人的小镇，镇上只有一家杂货店。

这是面试官了解这位菲律宾裔超声波技师是否能适应在离家这么远、移民社区不多的地方工作的方式。

“是的，我愿意，”玛丽丘回忆起她谈到搬到赫廷格时说道，不过她又补充道，“我不太喜欢麦当劳，因为我可以自己做汉堡。”

埃韦利奥·孔特雷拉斯/CNN

玛丽丘找到了工作，她是西河医院的 19 名外籍员工之一。该医院服务于蒙大拿州和南达科他州的居民以及当地居民。

CNN在海廷格待了一个月，调查移民工人对这个以支持唐纳德·特朗普总统为主的乡村地区的影响，以及当地居民如何看待他们。纪录片《30天探秘：医院与移民劳动力》揭示了当地社区在迎来更多外籍劳工，为学校提供重要资源——教师——的同时，所发生的真实生活。

玛丽丘热情地接待了我们，她和她的伴侣埃里克以及六个月前从菲律宾来到这里的三个女儿一起生活。

她等到严酷的草原冬季结束，积雪融化后才带着女儿们来到美国，希望至少这里的气温会让她感到熟悉。

“因为这是我的梦想，”她谈到想来美国工作时说。“是的，海廷格就是我的家。如果我有机会在美国生活，这是一个好机会，为什么不呢？”

“我可以帮助这里的人，是的，我可以留下来，”她说。

玛丽丘持H-1B签证来到美国，该签证允许技术娴熟的外国工人来填补职位空缺，有效期为三年，通常可以续签三年。西河医疗服务中心一直利用这个项目从菲律宾招聘护士和实验室技术人员，以填补空缺职位，其中一个职位已经空缺了十多年。

但特朗普政府对合法移民的打压造成了不确定性，而针对非法移民的打击也频频登上新闻头条。目前，H-1B签证新增一项10.3万美元的费用提案，不过许多医院可以获得豁免。

“我们预计这种情况未来可能会对我们产生影响，因为它一直在变化，”西河健康服务中心首席执行官艾莉森·科内尔说。“我们永远无法预知未来会发生什么。”

西河医院面临着全国许多乡村医院都面临的共同问题，年轻人外流加剧了劳动力短缺。该医院距离最近的大城市北达科他州俾斯麦有2.5小时车程，移民们先飞到俾斯麦，然后由医院工作人员接他们开车前往赫廷格。

“所有农村地区都面临人口流失的问题，”西河健康服务中心的家庭医生凯西·霍尔博士说。“我们越来越发现，在医疗领域招聘和留住人才变得越来越困难。”

如果医院乐于接纳来自菲律宾的员工，那么小镇似乎也同样欢迎他们。新员工告诉我们，他们在海廷格感到很受欢迎，因为这里绝大多数居民都是白人，而且是本地出生的。我们也感受到了这一点，当我们步行前往像Pastime这样的地方时，镇上的人们都友好地向我们挥手致意。Pastime是一家牛排酒吧，由海廷格的一个家族经营了四代以上。

当玛丽丘为孩子们准备上学的第一天时，我们遇到了三位菲律宾教师，他们前一周刚到这里——更多的移民正在担任更多的公共服务职位。

谈到要离开亲人，他们都哭了。放学后，我们看到他们在食堂用手机和家人通话。其中一次视频通话的背景里有鸡在栖息，那时菲律宾正值日出。

“我的一个学生对我说，谢谢你来这里，你为了我们把女儿留在了菲律宾，”赫廷格小学二年级教师扎伊拉·钦特说。“我非常感动，因为他们看到了我们老师来这里付出的努力。”

学校举办了一场聚会，欢迎新老师们来到社区。玛丽楚和其他菲律宾人带来了家常菜，大家一边聊天，一边与孩子们的新老师见面。

我们自己到达北达科他州时，并不知道会遇到什么，而玛丽丘最终也成为了我们的向导之一。

我们和她以及学校师生一起吃饭，讨论即将到来的学年。在医院拍摄的第一天，我们看到玛丽丘和玛雅、雨果正在做第四个孩子的超声波检查。三周后，我们再次来到医院，见证了玛雅在劳动节周末急诊室最繁忙的日子之一生下伊曼纽尔。

侯勒医生在医院值班 72 小时期间，接生玛雅的孩子只是她的工作之一。

“能成为其中的一份子，我感到非常荣幸，”侯勒博士说，“尤其是能和这样一个友善热情的家庭一起工作。”

在为期 30 天的拍摄过程中，我们学会了如何与镇上的家庭共度时光，以及何时不应该拿起相机——比如，在玛丽丘举办卡拉 OK 之夜时，要给他们一些空间，和他们一起放松。

在拍摄时，我们拍摄的镜头比传统新闻报道的镜头停留时间更长，以便分享我们所看到的更多内容，并捕捉我们有幸见证的亲密时刻。

我们在医院急诊室轮班值守，等待各种情况发生。我们参加一些预定的活动，比如手术，在那里我们会遇到一些病人，他们会邀请我们去他们家，和我们聊聊移民劳动力和社区的情况。

莉奥娜·弗雷米勒在她距离医院 45 分钟路程的家中接受了我们的采访，她在那里做了两次手术。她谈到了她的孩子们搬到明尼苏达州的城市生活。

她还向在医院工作的移民发表了讲话，承认“有些人认为他们不应该待在这里”，但她认为应该欢迎他们。

尽管她前一天刚做了手术，但她还是带我们去了北达科他州的最高点白山，向我们展示这个地方的魅力。

除了壮丽的景色之外，这次徒步旅行也帮助我们更好地了解了居住在海廷格及其周边地区的人们，以及他们允许进入他们生活的人。