AmericanLola

I enjoy writing about life in the Philippines, and especially enjoy helping people understand cultural aspects of life in the Philippines. I in no way claim to be the supreme authority on such things, but what I have learned, I can share. I also enjoy talking about Cebuano and explaining things I have learned in hopes that it will make things easier for others. But, it is not always easy for me to think up a post from thin air! So, I am going to open it up for anyone who would like to ask a question in comments, and I will do my best to answer. As always, others will also chime in with their their ideas, so your questions will get several answers for sure!

On another note, AmericanLolo and I will be leaving for a year in the States at the end of this month! We are bustling around getting things ready to go, and things ready to stay. For us, whenever we ‘go home,’ we leave home. We very much look forward to seeing all our kids (7) and grandkids (14) and my parents and sisters and all our friends! We will be living out of suitcases from the time we leave this month until the beginning of October! Good thing we are still young! We look forward to keeping in touch with all of you through LiP!

I received an email from a man whose fiance has a medical emergency in the family and she has asked for help. This kind of situation is always a difficult one to deal with. Many questions come to mind. Is there really a medical emergency, or am I being scammed? Am I the first resort or the last? Am I responsible for my fiance’s sister-in-law’s, brother’s, medical problem? How do I find out what is true? How can I be generous without being taken advantage of? And on and on.

First of all, let me explain a little bit about the system. There are two kinds of hospitals in the Philippines, public (government: city or provincial) and private. In government hospitals the costs of the room, Operating Room and doctor’s professional fees are underwritten by the governing agency (the fees are less). Medicines may be offered at a discounted price, but the patient must buy them and give them to the nursing station for the patient’s use. If blood is needed, the family has to come up with it, usually at P1,200.00 per unit, and this covers the testing of the blood. All fees not covered by PhilHealth must be paid before a patient can be discharged. Often, a poor patient can appeal to the hospital administration for a further discount, or to the mayor or some other dignitary for help in paying the bill. When someone is sick and in the hospital, families pull together all their resources to meet the need.

Private hospitals usually require the patient to show their PhilHealth insurance card upon admission. Usually there is no down payment, but the expenses at admission are for medicine, IVs and oxygen. People need money for medicine, as private hospitals also just give the family a prescription and the family goes out to find it and buy it. Patients have to pay all fees (room, OR and professional fees) before they can be discharged, just like in a public hospital, so it is at the time of discharge that people really scramble to get money together.

If someone is asking you for money to help with a medical emergency, it is fair to ask for the name of the patient, the name of the hospital and the landline phone number of that hospital before committing any money. If this brings cries of, “You don’t trust me!” just say that you are sorry but this is the “American’ (British, Australian, Japanese, etc.) way of doing things. If she cannot give you that information, don’t send any money. I would also advise rethinking your romantic situation at this point. If she does give you this information, figure out the time difference and call the hospital during business hours. Remember that the people answering the hospital phones are not expecting to speak to a foreigner and may be flustered. Speak slowly and politely, using ‘Maam’ and ‘Sir’ to address people. Do not tell your story. Stick to business.

Ask for the billing desk and begin by asking if (name of patient) has been admitted, if yes, then explain that you are calling to check on the status of that patient’s bill. Say that you are a friend of the family and have been asked for help. Speak slowly and just stick to what you want to know: Has the patient been admitted there? How much has already been paid on the bill? What is the balance as of today? Does the patient have PhilHealth? Can I send money directly to the hospital to help with this bill? Which money service do you recommend? The best time to help is when the patient is ready to be discharged and there is a clear total on the bill, but there will be costs for medicines before that.

A request for medical help can come at any point in a relationship. Have you been here to meet the family? Do you know what they are like? Questions to ask yourself are, are these people truly poor, or do they have other resources they can draw upon in this situation? I would say that if you know they are very poor (Pick any two: live out of town, or in a squatter area, 1-2 room house/shack, keep a pig and chickens, kids go to public schools, small TV, no cable, one cell phone in the family) then go ahead and help as much as you can, if you want. But if they are middle class (Pick any two: home made of cement, have an air con unit, own a motorcycle or other vehicle, large TV with cable, kids attend private school, all have cell phones, own fighting cocks) then don’t pay the whole bill, just pay part and let them work out the rest. This establishes some limits to what you will do in the future as well. If they are using a private hospital, that indicates they have some money (or know you do). If they are in a government hospital, then they probably have some genuine needs.

Culturally, there is a lot of pressure on a girl who has a foreign boyfriend/fiance when the family has a need. She is one of the resources that the family will draw upon. If the need is genuine, she should not hesitate to give you more information about the medical situation, the hospital etc. How much you give is up to you.

My last bit of advise is, don’t loan the money, give it. If you must make a loan, never loan more than you can afford to never see again. If you are asked for a loan, you can compromise by giving what you can afford instead. Loaning money will just give you an ulcer and make you mad at the family because even between Filipinos, people do not tend repay loans unless the loaner can prove he now needs the money more than the loan-ee, and no one will think a foreigner needs money more than they do, as a rule. Of course there are exceptions, but until you know that the situation you are in is clearly one of those exceptions, give and don’t loan, or only loan what you can afford to give.

I hope this is helpful!

CORRECTION: Just this week I had a patient admitted to a local private hospital, so I am now up close and personal with this process. Yes, a down payment is required, the amount depending on the procedure. Having PhilHealth lowers the amount of down payment. It was P2,500.00 down for a normal birth, but they added an additional P10,000.00 when it became apparent that a c section would be needed.

When we first came to the Philippines, I went to the LTO (Land Transportation Office), showed them my California license, paid some money and was given an ‘official receipt’ that was good for six months for the real thing, and told to come back for the hard copy. About six months later, the hard copy came. Pretty painless.

The next time I needed to renew I had moved to another town and also needed to change the address. This was a little more involved, and they had added a ‘medical certificate’ to the process. For the medical certificate, I was sent to the Provincial Hospital where I paid 10 pesos and was given a number. When my number was called, I went to the desk and my blood pressure was taken, a form was signed, and that was it. Evidently, blood pressure was the only essential, medically speaking, for driving a motor vehicle. Nearly blind? Ok. No legs? Ok. No blood pressure? No deal.

That time time I had to keep renewing my ‘official receipt’ for three years because my plastic license never came. It turns out the LTO in Manila, where the plastic cards were made, burned down, and my card with it. I finally re-applied and got my card in four months.

The last time I had to renew my driver’s license I was in a new city again. There were a lot of people the day I went to the LTO, but in only an hour and a half, I had my freshly minted plastic card in hand! Wow, I was impressed!

Which brings us to this last week. My husband discovered his card had expired the end of February. Mine will expire in June, when we will be in the States, so we both went to renew our driver’s licenses. The first item of business was the medical certificate, but now it is the real deal! Businesses offering medical certification cluster near the LTO, along with the smog test places. Paying customers have their blood pressure checked, are weighed, measured, checked for color blindness and myopia. (If someone couldn’t see the number on the color-blindness test, they just told him the numbers, I noticed) The next stop is the drug test, so don’t stop at the CR before you go for a renewal. After the results were found and my picture taken, it was back to the LTO to sit in line for quite some time. When my name was called, I found out I was renewing my license too early. When I explained I would be out of the country, I was told to bring a Xerox of my plane ticket… Okay, I’m out for this round and will have to come back another day. In the meantime, my husband was waiting for the cashier to call his name. At 11:49 the whole place closed for lunch, so we went home. We had been there for about three hours.

My husband went back after lunch and after waiting a while, and after needing the card to be redone since it said he was Filipino, he came back with the much awaited license. Whew!

My friends all told me I should have gone to the LTO at the mall which is very fast, so I went there the next day with my half-done paperwork and a Xerox of my plane ticket. No deal. Since it was an early renewal, it was a special case and this office did not do any special cases, so I had to go back to the other place.

I went the next morning, arriving at 7:30 am. They open at 8 and I was one of the first in. No LTO staff came to my window until 8:45, and then a woman with what must have been a fixer slipped up to that window and the guy gave the window lady P20, and she went first. But I was not far behind. I got my picture taken again, waited for the cashier and the final call for the plastic card, and walked away with my license at 9:15 am.

I am so glad it is good until 2011!

My husband and I have long been promising to go visit a friend who now lives in Surigao. We finally got it on the calendar and went a couple weeks ago. Traveling from Cagayan de Oro, is is about a six hour trip. Because we got off to a late start, we spent the night at Dottie’s Place in Butuan City, and had supper at our favorite place there, True Brew.The next morning we were off to an early start. Once you get out of Butuan, the traffic is reasonable and the cement roads in good repair. The weather was great and the scenery very lush and green. We passed Lake Mainit which was amazingly large, considering it was between the highway and the ocean. In Surigao we stayed at the Gateway Hotel. it was very nice and the food was excellent and reasonable in price. Our friend lives in the Municipality of San fFrancisco. We looked at places to stay closer to our friend’s home, but none of tthe resorts served food. They all seemed to be bed and beer joints, probably with an all night karaoke thrown in extra.The town of Surigao and the surrounding area was especially beautiful! After a while I realized why I found it so attractive. There are no billboards! I guess Surigao is hit by so many typhoons that billboards are just not a good investment, and I say, “Hurrah for the typhoons!” Everywhere there was a clear view of skylines, mountains, fields, and the ocean.Surigao is known for the fish, crab and other seafoods, so if you go, be sure and enjoy the local seafoods!

[Disclamer: I know all families are not like the ones I am telling you about, but my observation is that the arrival of a foreigner into the family nest brings out the worst in many families. It is a Filipino cultural value that all must benefit from the good fortune of one; that there is limited good in the universe, so those who have more must share with those who have less or be considered stingy and a bad person.]

I have two friends who have foreign suitors. These are girls I have known since they were in high school. I know their families. Let me tell you some of the problems they have, on this end, when they have a foreign boyfriend. I will change the names to protect all parties.

The first is Suzy, my former neighbor. Suzy’s parents are poor. Her father is basically a lazy, arrogant fellow who has depended on his wife to support him all their married life. She is now out of work, but they rent out rooms in their small house and the mother raises pigs (Daddy won’t get his hands dirty). Her rich aunt has an internet café, so her parents told her, “Go to the internet café and find a foreign husband!” After a while, she found a nice fellow named Tommy in England. They met online and chatted and sent letters for several years. A friendship developed. Tommy is not rich. At last report, he had a job in a grocery store and some other side job. Last year Tommy came for a visit. He took Suzy and her family for one night in a very expensive hotel (probably because it was the only one in town to advertise online). When they got to her home, he gave her some money to help with food. Susy’s parents and family were very friendly and welcoming to Tommy, and were able to speak some English with him. But what Tommy did not know was that all the time, while the family was talking to Suzy in Cebuano, they were asking her to ask Tommy for money. Suzy replied with a smile on her face so that Tommy would not know what they were saying or how embarassed and frustrated she was. They were badgering her and shaming her and giving her a really hard time. Tommy left, none the wiser, and Suzy and her parents didn’t speak to each other for at least a month after he left.

This year Tommy came back for a longer stay. By this time, Suzy had moved out because she was sick of the pressure from her parents, especially her father, to get money from her boyfriend. When it came to light that her father was carrying on with a girl younger than Suzy, she brought her mother here to CDO to live with her in the apartment Tommy paid for. Her mother had gone back to her dad before Tommy came the second time. This time, she spent a lot less time with her family when Tommy was here. But still, they were constantly asking. Her father wanted a new cell phone with a camera, and was furious when Tommy gave Suzy one, and he only got her old one. Tommy is gone now, but there are constant calls from Suzy’s mother asking for money to buy rice and pay for the cable, etc. Suzy’s wedding in June will be pretty traumatic, I am sure, with her dad demanding an expensive wedding to show off to his friends, and the rest of the family hoping to get something before Suzy takes off for England as soon as possible to get away from the whole mess! Question: How do you think Suzy will feel if Tommy brings up the idea of moving to the Philippines, where it is cheaper to live, so she can be near her family?

The second is Tiza. She is a cousin of Suzy, but she has a lot nicer immediate family. She is from way up in the mountains and ‘met’ Don, an American from the South, by signing up for a pen-pal when she was still in high school. They have never used the computer to communicate, and it has only been in the last few years that they have been more than just letter-friends. In recent years they have talked on the phone along with the written letters. He sent her money to buy a camera, but other than that he has not sent money after she told him not to. Her family was pretty put out that she would ask him not to send money, because they wanted her to ask for money for them, especially when they had needs. Two years ago Don came to meet Tiza, but was scared to death to come to Mindanao, so he flew Tiza, her mom and sister and brother-in-law up to Manila. He was only here for a week, and Tiza was so shy she hardly talked. This year Don came back, this time for a month, and determined to come down to Mindanao and meet her family and see where she lived, and to decide whether to ask her to marry him. Since he does not speak the language, he does not know that just about as soon as they got into town, relatives were asking Tiza to ask him for money. She just kept smiling. Since he planned to go up to the mountains, to her very remote home place, we suggested that he take a pig and a sack of rice for the village. But in the end, it was decided they couldn’t do this, since they had other relatives who lived near town who would be jealous and demand the same. Believe me, things like this get complicated!

Don is actually still here in the Philippines. Before they left our house, I told Don to feel free to come back here if they felt he had seen all there was to see of the small town. To Tiza, in Cebuano, I said that if it got too difficult, with people making demands, just bring Don back here and spend some time seeing CDO. She was very grateful to have that option.

I will add here that in the mix is the fact that Suzy has compromised her moral standards, so she cannot tell her family, “He doesn’t owe me anything, so I’m not going to ask!” He does owe her, but the family is mad because she keeps it all for herself. Tiza has not compromised, nor does Don expect her to, so she can tell her family that he owes her nothing, and they know it is true because they are never alone.