Sunday, March 23, 2014

An Evaluation of Local Medical Care

I recently had  cataract surgery on both eyes and as a result, I no longer need corrective lenses except for reading.  After many decades of wearing eye glasses, it's a strange sensation to be able to see well this way. When I wash  or go to bed, through force of habit my hands still automatically reach to remove eye-wear that is no longer there.

The  cataract procedure itself is somewhat uncomfortable but takes only about 20 minutes and is done on an outpatient basis. Nevertheless, it is surgery; and as such it's still hard for me to wrap my head around the fact that it was performed at an eye center in a shopping mall. Alternatively, my ophthalmologist who is one of the best I ever had,  also has a practice at a well-known hospital here in Metro-Manila, and I could have opted for it to be done there instead. But in many ways, the former was more expedient. 

Importantly, the cost of the operation which came to about $1,200 per eye including the artificial lens was about one-third of what I was likely to be charged  in the U.S. for the same package of services.  True, at my age I probably would have been covered by Medicare, but that health care plan is not available for Americans living abroad.  On the other hand, I do have Philhealth and a private insurance plan that I expect will reimburse me for most of  my out of pocket expenses. 

Back in 2008 I wrote a post that discussed how various countries in this part of the world, including the Philippine, offer good medical care at less expensive rates than in the U.S.  Since that time, I have consulted a number of local physicians and have had state of the art evaluation tests and treatments at medical centers here for various conditions and ailments (ah, the joys of aging). On the whole,  I can say that my overall experience has been positive, and I am convinced that Philippines does indeed have the potential to make a name for itself as center for medical tourism. It may be just a matter of time before this country receives that recognition.

Tuesday, February 18, 2014

Tragic Bus

As I have noted in previous posts, traffic in the Philippines if often a nightmare due to the recklessness and poor upkeep of public utility vehicles which include passenger jeeps and buses. In December, a bus fell off the Skyway, an elevated  roadway in Metro-Manila killing several passengers and the driver. The vehicle was speeding on bald tires causing it to hydroplane on wet pavement,  lose control, and flip over a guard rail crushing a van on the street below. Then this month, a bus  with switched license plates traveling in the northern part of the country fell off a mountain road into a ravine. Several passengers, including two foreigners, died in this tragedy which was evidently caused by mechanical failure.

And while not an "accident" as such, in 2010 a sightseeing  bus in Manila carrying Chinese  tourists  was hijacked by a lone gunman, a former police officer.  Several people died in the rescue attempt that was grossly mishandled, e.g. the failure of authorities on the scene failing to prevent bystanders from entering  the crime scene area while law enforcement personnel  were trying to get the hijacker to surrender, and immediately after the shootout  When the SWAT team finally stormed the bus to save the hostages, their attempt was disastrously haphazard and disorganized. This sowed only more confusion and delay during which time the gunman killed several passengers before he was finally shot and killed by police snipers.  The Philippine government paid damages to the victims' families but through now has refused the Chinese government's request for a formal apology on the basis that the gunman committed the crime as a private individual, not as an agent of the Philippine government. 

What all these bus incidents have in common is that they were the result of official ineptness The first two could have been prevented by closer supervision from the government agency,  the Land Transportation Franchising and Regulatory Board, that grants the approval for businesses to operate public utility vehicles.  The LTFRB finally took punitive action against the Don Mariano Transit and the Florida Transport lines that were involved in the respective accidents after the fact. But for the victims by then of course it was too late.

In  the case of the hostage event, the Manila Police Department should have dealt with the crisis  in a more disciplined and professional manner with better trained personnel.  I formerly believed that the Philippine government  should not accept fault for incident on the above stated reasoning. However, after reflecting on the degree to which an official  agency lost and control and bungled ending the siege, perhaps an apology to China is in order after all. Similarly, anytime that tourists  in this country wind up as victims of harm or violence that is the result of civil authorities' negligence or inaction, the Philippines should pay damage their families and issue a public apology to the governments of the visitors' countries of origin as well. The international negative publicity  that repeated incidents of this nature generate may  discourage would-be visitors from this country. If that happens  to the point that such disregard by the Philippines for safety and human life while  tolerated locally is negatively impacting  foreign investment and tourism, that may be enough to  spur the  government to finally to take corrective measures in this area.Click here to see the reaction of one such foreigner whose father in law died in the Skyway accident.

The official Department of Tourism for attracting visitors here is "It's More Fun in the Philippines". But how much "fun" can it be for foreigners and their families if they come home in a coffin?  

Sunday, January 19, 2014

My Annual Report Filing: An Unexpected Twist

My wife Lydia and I arrived at the Bureau of Immigration on Wednesday at about 6:40 a.m. and there were already  several people ahead of us. The doors opened promptly at 7a.m. By then the queue of course was longer. At about that time a security guard directed annual report filers to the guidance area for help in completing their forms. That's where we should have gone right away, but due to miscommunicated instructions, we thought we didn't have to do so because we had already filled out our papers. 

But once we finally got properly situated in the AR interview area, it took about an hour including waiting time, which might have been less had we gone to that section immediately. Actually, it took even longer for us to assemble and photocopy the required supporting docs (I-card and passport validation page copies, etc)  in the days before the annual report, not to mention the expenses involved, including the notary service fee of P200.00 for each of us . The good thing is that completing that package and having it ready for review before we got there saved a lot of time.

Once the examiner approves the annual report form, there  are  two more stops  to make where another examiner who gives the approved forms a quick  once-over before sending you to the cashier. After the P310 payment, you're done. Be sure to hang on to the receipt as you'll likely need that for next year's AR. 

The unwelcome surprise that I received is that the original examiner determined that there was an error in my permanent resident visa, specifically that it's supposedly the wrong kind.  However,  rather than hold me up for possibly several more hours to get the issue straightened out that day,  he logged the matter and signed off on  my annual report with the understanding that I would address the visa situation ASAP.  The strange thing is that I got the visa in 2005 but it took Immigration nine years to determine that something was amiss(?).

So I returned to the BI on Friday and proceeded to the visa section. I explained my predicament to the clerk, who  took my passport I-card, and the documents accompanying my annual review  inside the office where she evidently conferred with her supervisor.  She returned a short while later with the good news that as far as that department was concerned, there was  no discrepancy in my visa after all. This was because of a technicality that the annual report examiner hadn't considered in his status evaluation. So I sent a notice relaying that outcome  to him.

Yet  I wonder whether he will let it go at that as during the initial interview, he was very insistent in his position.  I only hope that he doesn't pursue the matter further.  The last thing that any expat needs is to get ensnarled with Immigration in a bureaucratic hassle stemming from circumstances that were not of his /her making in the first place.

Friday, January 17, 2014

The New Annual Report: Ouch!

In years past I've written posts regarding the annual report, which is a yearly registration and head tax that runs from early January to early March and  with which most aliens residing in the Philippines must comply. Until a few years ago, this used to be a complex procedure but was then revised and made more user friendly.  During this time, the only requirements  were that applicants show up at  the BI main headquarters or district offices and present their I-card, the previous year's annual report payment receipt,  a copy of their  passport validation page, and a P310 fee. Seniors were exempted from having to appear and instead were allowed to  have a 3rd party present their data and complete the filing in their behalf.  

However, effective this January, some radical changes have been  instituted by the new Bureau of Immigration commissioner that have once again made  completing the  annual report more difficult than in quite some time. The rationale behind this revamping is supposedly a need to clear out the dead wood of improper and fraudulent registrations and to modernize the BI's records.  Yet when the biometric I-card was introduced by Immigration around 2008, its  purpose was to prevent these very problems and  others which had been prevalent under the old ACR/ICR paper filing system.

Here is a list of items necessary for filers to complete the AR
  •   The 4 page form which must be filled out beforehand and notarized, complete with thumbprints.
  •   The filer's I-card plus 2 photocopies , one side of the card on the front and the other on the back         of the page..
  •   2 copies of the filer's passport validation page and date of last arrival in the Philippines page. It's         also a good idea to bring the passport itself.  If it was renewed in the Philippines, bring the expired       one as well. Annual report evaluators sometimes want additional data from this source.
  •  1 photocopy of the  visa page in your passport. Again, if the visa is in an old passport, bring it along with your new one.  
  •  Last year's annual report payment receipt.  
  •  Two 2" x 2" photos of the filer taken in the last 30 days (bring a dated receipt).
  •  Review  the form for  further information, such as instructions that are particular to the filer's particular situation
Arrive early. At the Immigration headquarters in Intramuros, Manila, the doors open at 7:00, and queues start forming around 6:30. Naturally, the later you show up, there will be more people ahead of you and the  longer the process will take. BTW Seniors are no longer exempted from appearing, but they will receive priority service.

For those who plan to execute the filing at a BI branch office, call there first to ensure that they are equipped to deal with this new procedure.  Click here for a list of Immigration branch offices and their phone numbers.

In my next post, I will discuss my personal experience in filing the new AR.

Tuesday, December 17, 2013

December In The Philippines: "Winter" In Name Only

I recently read that a record low temperature of -135ºF  (-93ºC) had been recorded in Antarctica. I don't think this type of weather is likely to occur here in Southeast Asia anytime soon. But when I read about the winter weather in the other parts of the world, including places that are experiencing snow and colder than usual  conditions such as in the Middle East,  not to mention the cold weather in many portions of the the U.S at this is the time of the year, I'm especially glad to be residing in the Philippines. Here in Metro-Manila, December night time minimum low temperatures average is in the low 70º's F (low 20º's C).  Daytime temps reach into  the low to upper 80ºs-low 90º'sF (low 30º'sC). There are only occasional rainstorms, and so far this year, no typhoons have struck MM). The humidity in this quarter is also lower than other times of the year. So all in all,  it's quite comfortable now

But not all of the country experiences tropical weather in December. A popular resort and summer capital, Baguio City, which is in a higher elevation has cooler weather. The typical temperature ranges are maximums in the low 60º's F (20º's C) and minimums in the 50º's F (teens C). Summers there are  pleasant with daytime temps in the upper 70º's and night tmes in the low 60º's. 

The "real feel" in scattered locales even at sea level in the Philippines can also get chilly. My wife says that during December, she uses a blanket at night when she visits her home town of Gumaca, in Quezon province. This coolness might be the result of  breezes coming in from Lamon Bay next to which that locale is situated.

In the area of the Philippines that was struck by Typhoon Haiyan, such as Tacloban City, temps are similar to those in Metro-Manila. So at least after the storm passed, the weather was such that victims were able to cope better than refugees in other countries for whom inclement weather can compound their distress. As mentioned above, for example the Middle East has had cold, wet  weather  that which has only aggravated the misery of the Syrian exiles who are living in refugee camps under already desperate conditions. In Israel, Jerusalem was also blanketed with snow and at this writing some portions of that city have been  without electric power for 3 days. In contrast, partly due to more moderate climate conditions, the typhoon survivors in the Philippines may now be able to start rebuilding their lives. Imagine how difficult even thinking about moving on would be if they were still being battered by an ongoing  hostile weather environment.

In short,  the overall climate in the Philippines tends to be fairly constant year round  without major shifts from region to region. And inasmuch as there are no extreme changes from season to season throughout the country, December here is more or less just another month.  

Sunday, November 17, 2013

Some Thoughts on Typhoon Haiyan

Unlike the earthquake last month that preceded Typhoon Haiyan (local name "Yolanda") , there was ample warning by several days regarding the path and intensity of the approaching storm. So I wonder why more supplies and emergency personnel including the military weren't pre-positioned in or near the locale where it was expected to--and in fact did--make landfall. This obviously would have saved time and lives  instead of having to wait for aid to be transported later into the affected areas under impossible and impassable conditions which prevailed after the typhoon struck. It's true that in the case of Tacloban City, the unexpected storm surge that accompanied the typhoon may have wreaked more havoc than anything else in this disaster. Yet, again, given the advanced data regarding the unprecedented  strength of  Haiyan, "forewarned" should have resulted in a better "forearmed".

As I have mentioned in previous posts, the national cultural  trait of family narcissism is a detriment to Philippine society. This is especially the case in situations such as the aftermath of Typhoon Haiyan where the excuse for looting not motivated by understandable desperation from starvation and / or thirst is "I have a family". The fact that  victims of such a crime may also have families doesn't register with the perpetrator who is oblivious to anyone outside his circle of interest.

In a twist on this obsession here with family, especially nuclear members,   Michael Tan of the  "Philippine Daily Inquirer" gave an account of one of his staffed members who dropped everything to go one of the most storm-devastated towns to try to find her mother. Travel would be very difficult, and what little money that she was able to bring for her mother,and her own personal expenses might be stolen by desperate refugees, so she herself might wind up a casualty.  Further, she and others like her who are searching for family members might just get in the way of rescue operations being conducted for the community at large.   The employee ignored Tan's advice to wait a few days until conditions were more settled and thus her chances of learning her mom's fate would be improved.  As of Nov. 15, Tan has not heard further from her.


As a Jewish humanist  and permanent resident of the Philippines. I was interested to see the extent to which these sources would step up to the plate in assisting the victims of Haiyan. The answer was not long in coming. Several such groups are coming through. Among them are  Jewish Federations of North America, Union for Reform Judaism and American Jewish Joint Distribution Committee. The Jewish Association of the Philippines is also pitching in with donations and a project for repacking relief goods.  The State of Israel has furnished 100 tons of supplies and senior medical personal, and has set up a set up a field hospital in TaclobanHumanist Charities and The American Humanist Association are coordinating relief efforts through PATAS (Philippine Atheist and Agnostic Society). PATAS itself is seeking various donations from local contributors for this project.

Nov.19 Update: Humanist Charities has raised $25,611 in just one day in behalf of  PATAS for aid to the typhoon victims. 


Finally, as I mentioned above, government preparations for Haiyan were inadequate. But worse was the delay and bottlenecks before rescue efforts and supplies began reaching  the decimated areas after the storm  and which are now finally getting through to their destinations. President Aquino has taken  a lot of criticism for this debacle, and taking command responsibility into account, that was bound to happen. Moreover, effective leadership is essential at a time like this, and according to "Analysis: Hero to zero? Philippine president feels typhoon backlash", Aquino may well indeed have dropped the ball.
Yet in all fairness, based on the history of disaster responses both during and before Aquino's administration as well as  onespecially onPhilippine culture the botched response to the Haiyan was almost a foregone conclusion. Almost every time  there's a calamity in this country, there's a hue and cry about how casualties and damage could have been prevented, who's at fault,  and declarations by officials that such lack of preparedness and inadequate response must never happen again. But the fact is that due to a combination of such factors as  institutional inefficiency and corruption at almost every government level and locale, as well popular fatalism, it can't help but happen again and again. So will this time be any different? Will Filipinos finally demand improvements in disaster preparedness and response as intensely as they have, say,  to the pork barrel scandal?  Or will they eventually let the issue slide just as they have in the past?  If this happens, then next time there's a failed government response to a natural catastropheand given the Philippines geographic and geological particulars, there's bound to be a next timethe people will have no one to blame but themselves.   

Friday, October 25, 2013

How Politicians Often Compound the Problems from Natural Disasters

Misuse of government power even during the best of  times is unacceptable. But in the aftermath of  a natural disaster such as last week's earthquake in Bohol province, Cebu,  malfeasance and exploitation by politicians of  such a tragedy for personal gain or glory is  unconscionable. Yet that's what apparently happened on Oct. 22 in the town of Maribojoc.

According to the "Philippine Star" it seems that the Red Cross was halted by the mayor, Leoncio Evasco while  the RC was in the process of distributing  relief goods to quake victims. Evasco demanded that the organization instead turn over the items to him to give to the people, the purpose of which was so that he could be the one to take credit for delivering the aid. But as per the "Star", there are good reason for having relief organizations  give the goods to the people directly: One is accountability. Recipients must sign for the supplies that they receive. Another is impartiality. There is no favoritism by the workers in distributing the aid to the people. However, if the local politicians were to act as middlemen in passing out the aid, they might well indulge in favoritism and give most of the goods to their families and supporters. . Maybe that's the reason that when the Red Cross volunteers refused to comply with the Mayor Evasco's orders, they were told to leave the area

This kind of grandstanding by politicians in the Philippines  is called  epal and is  commonly  practiced by elected officials in order to score points with their constituents. However, another more sinister practice than epal is hoarding of relief goods by politicos. officials. Hopefully, this was  not Evasco's real intention. As I see it,  diverting supplies this way is really a form of looting and should be treated accordingly, perhaps as plunder which in the Philippines is a capital crime.

And corruption before a disaster that results an increase of damage and causalities  when the calamity strikes is just as criminal. Case in point: non-compliance with and non-enforcement of building codes in Metro-Manila. As serious as the earthquake was in Bohol, if a magnitude 7.2 temblor (not including aftershocks) were to hit the National Capital Region, it is predicted that over 50,000  people would be killed due to collapsing structures, falling debris, and fires. Now, I'm not an engineer, but based on the obviously  poor quality of building and infrastructure construction that even a nearsighted lay person like me can see, I believe that the number of fatalities would  likely be much higher, as would  the currently projected number of  114,000 injured.

The only consolation in this otherwise tragic scenario is that maybe at least some of the crooked building inspectors and venal politicians who allowed the city to deteriorate into its present high-risk condition  and who would thus be responsible for the high number of casualties,  would also be among the victims.  And given  that the condition of area would be one of extreme if not total wreckage, it's not likely that any surviving opportunistic politicians could "epal" themselves out of that.

Oct. 28, 2013 Update:
"The Philippine Daily" one of the premier broadsheets in the Philippines has changed its position regrading Mayor Evasco's actions. In an editorial published today, the paper states that he may well have acted responsibly and in good faith by requiring the Red Cross to coordinate relief efforts with his office after all. Yet the fact remains that he may well be the exception that proves the rule, as too many (most?) local politicians unduly interfere in aid distribution for the purpose of  enhancing their image.

Sunday, September 29, 2013

Let's (Not) Get Physical

The issue of participation by foreigners in local politics has recently received attention in the media.  publicity.  According to the Philippine Daily Inquirer, such involvement by non-Filipinos is illegal, at least when it comes to elections for public office. Yet, as the Inquirer has noted, the Bureau of Immigration has applied this ban to include all political demonstrations as well.and went so far as arresting and deporting two aliens for joining  a protest criticizing President Aquino's State of the Nation address. 

Is should be noted that the Philippines is a constitutional democracy, and freedom of speech is a protected right. According to the" Inquirer" this right should extend to foreigners in the Philippines to the same degree as it does to Filipino citizens, as long as the former are not fomenting violence or civil unrest.

But even if the law were clarified to permit non-Filipinos to participate in  overt nonviolent displays of political and social activism, in my mind there is another matter to be considered: delicadeza i.e. a sense of propriety. As a non-citizen (although a permanent resident) in the Philippines, I still consider myself a "guest" in this country. And as such, is it proper for me to get into my host's  face by physically inserting myself in, say, by joining in an anti-governement march, even if I have a stake in the issue that's being contested?

And yet, as a foreigner the posts that I write in this blog are often critical of Philippine customs, culture, and society.  Isn't that just as rude and confrontational as physically participating in  a rally?  I think that there may be some differences. For one thing, in blogging, I'm not part of a gathering  that may be peaceful in its intent but somehow is goaded into violence. Further, my protests are passive.  Those who want to read my posts  must come to my site and read my work. Importantly, if they disagree with what I've written, they can  enter comments, including corrections to any errors I might have made. Unlike in a  demonstration, there's no chance my words will be disruptive or will inconvenience anyone.  On the other hand, you can't as easily argue with someone waving a placard and shouting slogans and / or who may be blocking traffic.

Another thing is that foreign demonstrators, especially tourists and other short-timers here, may be going off half-cocked because they've not bothered  to fully inform themselves about the matter that they're protesting.  Also, if the demonstration turns into a clash with law enforcement they may get injured or arrested..  In the event of the latter, they may think that their embassy will come to their rescue and bail them out (this is especially the case with Americans). That's not going to happen. Aliens who are taken into custody are subject to the laws and legal system of the Philippines just like anyone else here.

Ultimately, of course, it's up to the individual non-citizen here to determine the kind of involvement in which  (s)he will engage regarding local issues about which (s)he feels deeply. And perhaps the law should be amended to remove any ambiguities that stand in the way of foreigners involving themselves in marches and rallies, although as I've emphasized, personally such activity is not my cup of tea. However, until such time, I would urge such would-be protesters to ask themselves how they feel about foreigners demonstrating in their own countries (think illegals in the U.S. who take to the streets  waving flags of their country of origin and  making demands for rights to which they aren't even entitled in the first place), then decide on your course of action.

Thursday, September 5, 2013


As hazardous as driving is in the Philippines,  walking, especially in Metro-Manila  is also often a risky venture. So here are some important pointers to keep in mind while getting around on foot. 

Crosswalks are merely stripes in the road as far as most drivers are concerned, so do not assume that they will automatically yield the right of way. When crossing, wait until the approaching vehicles come to a stop before proceeding, lane by lane.

Sidewalks are often non-existent, even along busy streets.  And where they do exist, they tend to be  poorly constructed. They  are often broken, cracked, or have small, almost unnoticeable but hazardous bumps of concrete. I've tripped and fallen a couple of times over these protrusions.  So watching where you're going should include looking down as well as ahead.  In many places, walkways are blocked by lampposts, utility poles, traffic signs, street vendor stalls, and parked vehicles, just to name a few obstacles.  So if you need to step into the street to get around them and are walking in the same direction that the traffic is flowing, check behind you for vehicles before stepping off the curb.

If you are walking alone on a sidewalk wide enough for only two people and two oncoming pedestrians walking abreast approach you, the person directly in front of you won't drop back by behind his/her companion until (s)he is a few inches away from youliterally in your face. This is evidently due to the personal narcissism that pervades Philippine culture such that people here  often are oblivious to the existence of the "other" i.e., anyone who is not in their personal circle of interest.

I recall a humorous bumper sticker from my California days: "If you don't like  the way I drive, get off the sidewalk".   In the Philippines, that's no joke. If you're walking on the sidewalk along a busy thoroughfare, be aware that  motorcyclists sometimes use walkways as a shortcut to avoid heavy traffic. Be especially alert as they may come up behind you without warning. 

Don't be surprised to see jaywalkers climbing over median barriers when crossing the streets.  They are indifferent to the risk of life and limb and don't want to bother walking to the nearest pedestrian overpass or crosswalk instead, even though there may be  signs warning that pedestrians have been struck and killed trying to cross at that spot.

In short, when you're out and about as a pedestrian, hazards abound.  So stay alert.  Stay focused. Stay alive.   

Friday, August 2, 2013

Bus Stopped

Much has been discussed lately in the local media about the horrendous traffic conditions in Metro-Manila, especially along the main thoroughfares such as Edsa and Taft where there are often gridlock conditions.  Over the years, various plans and solutions have been offered and / or attempted, such as  coding by which vehicles are allowed on the roads only on certain days of the week according to the number on their license plate. But car owners who can afford to do so circumvent this rule by purchasing a second car with plate numbers that have alternate restriction days.

One of the latest "solutions" for easing traffic is banning the numerous buses traveling between Metro-Manila and the provinces  by relegating them to depots at the city, specifically at Alabang (Muntinlupa), Parañaque, and Trinoma (Quezon City) for southwest, southeast, and north bound buses respectively.  Presently, the terminals are located throughout Metro-Manila, and every day hundreds of these buses pick up and drop off passengers at numerous points along city streets en route out of and into town.

Unlike other previous attempts to resolve the traffic mess, this one impacts my wife Lydia and me directly, especially her as she frequently travels to and from her home province. Currently, the bus service that she uses for those trips is a fifteen-minute taxi ride from our home. Soon she will instead have to travel to Alabang, which is about an hour away when traffic is light. And she will be forced to pay a considerably higher taxi fare to get there (about 5x the amount she's now paying), assuming that she can get a cab that will take her to that destination because many drivers refuse to transport that far.  And of course, there are thousands of other passengers likewise affected, many others of whom carry heavy baggage and / or will have to travel on city buses to the outlying depots. 

I don't mean to sound complaining. I suppose that we all need to do our part to help improve the traffic situation. But there are others ways to address the matter such as cracking down and on and removing the hundreds of  "colorum" (unauthorized) pubic utility (city) buses plying the streets every day instead. If traffic is reduced at the expense of franchised provincial buses, as Lydia points out the former will likely use the freed-up space to increase their incidents of speeding and racing  each other for passengers.

In other words, the traffic problem here will never really be solved until the main cause is eradicated: Lack of discipline among the majority of both private and public vehicle driversand in Philippine society as a whole. If the authorities would enforce and if motorists and pedestrians would obey the existing regulations, there wouldn't be a need for this bus station relocation plan in the first place.So until people here learn to behave behind the wheel and on foot—or are forced to do so on pain of stiff fines, all the attempts by the MMDA (Metro Manila Development Authority) to improve the flow of vehicles will wind up as mere band-aid solutions.