It’s a scene that would be at home in most people’s nightmares. Your mother wakes up gasping for breath. It’s happened before because she’s asthmatic, and this is the sort of thing that happens to people with asthma. Frantically, you call the only number you have for such emergencies; the cell phone belonging to the local ambulance driver. He takes a while to answer because it’s 2 a.m. in the deep provinces of the Philippines and most people are sound asleep. When the driver finally does answer, he sounds groggy and irritated at having been awakened. “Sorry sir,” he snaps before hanging up, “but tonight I’m off duty.” This is the only number you have. Desperately, you consider your options. By the time you come up with one, however, it doesn’t matter because your choking mother has died in her bed.

As nightmarish as that sounds, it recently happened to someone closely related to my wife. I’m not disclosing the exact relationship or location here to avoid increasing the heat. But the horrific event made me seriously ponder what it means to live on the outskirts of a developing country.

What is a 13A Visa

In the United States, life is like a Sears catalogue; you simply open the pages and order what you want. Need a doctor? Fine, just make an appointment and come on in. Or, better, go to the nearest Urgent Care and you will find help. If it’s an emergency, of course, there’s another easy solution; dial 911 and someone will come. You may not know exactly who or where from but rest assured that they will possess the skills necessary to help if they can. And if there are any questions regarding your financial viability, well, they won’t be asked until long after you are saved, and the paramedics gone.

In the Philippines it’s different. While some big cities – such as Manila and Davao – have fairly advanced emergency systems, in the provinces you’re often on your own. And even if you can somehow get to a hospital, without a good amount of cash or credit you still could be left to die.

My wife’s mother, who worked for many years as a traveling midwife on Siargao Island, tells the story of a patient she once treated on the remote island of Suyangan, about two hours away. During a difficult delivery, the woman lost so much blood that she needed a transfusion. So, my mother-in-law, doing what the situation required, put her on a small pam boat and set out for General Luna, the nearest municipality with a hospital. To make a long story short, the boat was too slow, and the woman died in my mother-in-law’s arms.

Here’s the thing; being in the Philippines is like going back in time. You feel like you’re in California during the Gold Rush of 1849, or perhaps on the vast plains of middle America in the days of the Old Wild West. To some extent, you have to fend for yourself. To a large extent, I wouldn’t have it any other way.

Because being here is a choice we all make. And though there is much to lose, there is much more to gain. What it comes down to is the age-old balance of safety versus intensity. While I may not feel as safe in the Philippines, I somehow feel more alive. And, in the final analysis, for me, that’s more important.

The death of my wife’s asthmatic relative raised quite a hue and cry in the province where it happened. Angry accusations were tossed back and forth and lots of finger pointing went all around. In the end, the errant ambulance driver who seemed to value his own sleep over someone else’s life was pressured to resign. Does that mean that the victim of the next medical emergency will fare any better? Frankly, I fear, your guess is no better than mine.

David Haldane

A former Los Angeles Times staff writer, David Haldane (website fell in love with the Philippines on his first visit there in 2003. A few visits later, he also fell in love with the beautiful young Filipina to whom he is now married and, with whom, he has returned many times. David has written extensively about his experiences in the Philippines for several publications, including Orange Coast and Islands Magazine. Today, he and Ivy live with their seven-year-old son in Joshua Tree, California, where David works as a reporter and weekend news anchor for the local FM radio station. His award-winning memoir, Nazis & Nudists (available at the link below), recounts, among other things, the courtship of Ivy and finding a place to call home. For David that turned out to be in Surigao City where, at the tip of a peninsula jutting north called Punta Bilar, he and Ivy are building their dream home next to a lighthouse overlooking the sea. They hope to be living there soon.

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papaduckSteve ZonerAlex Mooneykathy frenchPaul Thompson Recent comment authors
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Paul Thompson
Paul Thompson

David; Your article put a light on facts that most people do not think about in their day to day life here, and thank you for pointing it out. I live in a rural Barangay in Bataan, the duty driver of the emergency truck normally can’t get the truck running is the normal excuse. Since 1999 we have lived here full time and we have always had our own transportation. There have been times when someone from my purok is at my gate (Never during the day, only at night LOL) needing a ride to a hospital. I cannot imagine… Read more »

kathy french
kathy french

It is sad that it takes a person losing their life to get the ball rolling on such life and death matters. In the states we often hear of off duty police, or fire ,men and women helping in emergency situations. I am glad the person resigned because it was not the right response in such a situation. If someone wants a 9 to 5 job they need to not be in that line of work. Their expertise may be needed at inconvenient times as well.

Alex Mooney

Great article! People definitely need transportation of some kind in case of a medical emergency just like Paul Thompson was saying. The thing is if you live in rural America you’d face the same exact problem. Expats in the Philippines definitely need a plan when things go bad and an emergency is ongoing. The average response for an ambulance in the USA is 8 minutes, that’s 8 minutes too long for someone with an emergency when you could have gotten them to the hospital if a car was available in those 8 minutes. I understand some provinces don’t even have… Read more »

Steve Zoner
Steve Zoner

Similar things still happen in the States too. Some medical conditions are such that you either move as close as possible to a care facility, or you know that every day can be your last. The incident I remember happened to a friend of mine, and it was so similar to this incident in so many ways. He was the oldest in the family. When he was younger, and the oldest of his sisters was 16 going on 17, she was dating a young man in his early 20s. Long story short, for similar reasons as in the original story,… Read more »


If the young man had a cell phone and even if his service was cut off, you can still call 911. But even doing that may not have saved her life.


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