Monday, December 15, 2008

The Future of American Medical Care Lies in—Asia?

I recently came across an article that discusses the outsourcing (actually off-shoring) of medical services in America by at least one insurance company ("Insurer Offers Option for Surgery in India"). That's right. Wellpoint is offering to send their clients from the U.S. to hospitals in the third world (specifically India) for treatment—airfare for the patient and a companion included. Depending on one's perspective, that's how expensive and inefficient the medical system in the U.S. has become or how cheap and hassle-free comparable care is in some other countries. In fact a study ("The Wrong Place to Be Chronically Ill") shows that patients in America fare badly comparied to their counterparts in the rest of the industrialized world. So unless President-elect Obama follows through on his stated goal of rationalizing the delivery of medical care in for all Americans, it may not be long before all insurance companies start shipping patients overseas (see "Operating Profit").

This got me to thinking about the state of health care in the Philippines—which of course is also a third world Asian country. Over the past few months I've had various health problems—more than I have had in the entire three years that I've resided here combined (and which by the way are likely age related). As a result I have had to consult with a host of specialists and undergo various medical tests, some of which were as as a hospital outpatient. And while I broached the topic of local medical care in the original post of this blog, based on my recent repeated exposure to the local health care and insurance, more than ever I believe that the Philippines has the potential to become a host country for medical tourism.

It's true that many places and facilities here are backward. Even the state of the art medical centers often have crowded clinics and long wait times to see the doctor. So what else is new? Like so many others, I also encountered those problems in the U.S. as well.

The medical expenses that I've incurred have not exactly been a walk in the park. Still they are a fraction of what I would likely have had to pay in the States for the same kind of treatment. That goes for my insurance premiums as well. As for benefits, my claims have been reviewed fairly and paid within a few weeks of submission.

As for drugs, the Cheaper Medicines Bill that I mentioned in my original post has still not taken effect. So a visit to the local pharmacy can still be an expensive proposition, although somewhat leavened with the occasional availability of generics. However, unlike in the States, here you can spread out the cost of your dosage by purchasing pills by the piece, prescription and non-prescription alike. (Obviously, however, this does not work with liquid medicines). The pharmacist just snips off the desired number of individual bubble-wrapped pills from the foil packet. Another advantage to this method is that by buying just a few pills to start with, you can determine whether or not the medication has intolerable side effects before committing yourself to the expense of the full prescription quantity.

So if you are relocating to the Philippines and are worried about the difficulties that you will encounter in resettling, with proper planning such as selecting a doctor, checking out some of the hospitals, and buying insurance shortly after your arrival (not to mention living a healthy life style), you can eliminate medical care as one of those concerns.

Sunday, October 26, 2008

Destructive Dogma and Demographics

As I briefly mentioned in my original post, overpopulation is one of the most pressing issues in the Philippines. When my wife emigrated from that country in 1969, the population was approximately 35 million. In 37 years it has mushroomed to over 85 million, and about 28% of this growth has occurred since 1990 when according to The Philippines: A Country Study the population was 66 million. And according to the Philippine Information Agency, this country has one of the world's highest growth rates. Although this percentage has dropped steadily since the 1960's, neverthless it will generate a doubling of the population every 29 years well into this century, according to A Country Study.

While contraceptives are available, the Philippine government does not encourage the use of artificial birth control methods. The driving force against instituting such a program is the Catholic Church, specifically the CBCP (Catholic Bishops Conference of the Philippines). The President of the Philippines, Gloria Macapagal Arroyo, also opposes it. The most that the Council and the President will support is NFP (Natural Family Planning), more widely known as the rhythm method ("Vatican roulette"). This entails a couple's having sex only during the woman's so-called infertile time of the month, which in some cases cannot be accurately calculated. In other words, couples must abstain from sex during the rest of the month.

However, a large majority of the people are not buying this bill of goods. A recent poll shows that 71% of Catholics actually want access to artificial birth control methods and support the proposed Reproductive Health Bill, which is sponsored by Rep. Edcel Lagman. This law would not only allow other means of family planning besides the unreliable NFP, it would also encourage sex education in schools with the goal for youngsters to learn responsibility in this area.

As might be expected, President Arroyo said that she would veto such legislation. She says that she is "pro-birth spacing but against "birth control" (huh?). Apparently she has no qualms about imposing her views on the rest of the country, and because she is the Chief Executive, she has the power to do so.

Through some twisted logic, the CBCP has declared all forms of birth control as "abortion" which of course the Church prohibits. But speaking of abortion, each year thousands of women in the Philippines take this course of action. Most of them are poor, married (as opposed to the sterotyped single woman in a one night stand or other uncommited relationship), and are already mothers. Further, they do not have access to or knowlege about birth control and usually choose to terminate their pregancies because they cannot afford any more children. And because they are impoverished and abortion is outlawed, this procedure is typically performed under unsafe and/ or unsanitary counditons by unqualified practitioners. Consequently, many of these women die or suffer health problems for the rest of their lives.

I mentioned the following points in my original post in this blog, but they bear repeating here. To underscore the hypocrisy of the CBCP in the matter of birth control, thousands of children in the Philippines are conceived by parents who live in dire porverty and who cannot or will not take care of them. As a result, these kids, some of whom are as young as four years old are abandoned and are reduced to begging in the street. In turn many fall prey to syndicates who exploit them. Yet the Church does not operate one single orphanage or otherwise provide for these children.

Under these circumstances, for the CBCP and the President to claim that they are "pro-life" is positively grotesque. As long as there is so much as one homeless child and as long as the Philippines is subjected to the high child and maternity mortality rates that kill so many infants and mothers and which are poverty generated, the Church has no business meddling or interfering in national population policy.

Monday, September 8, 2008

Disaster Averted for Now

Although the the population of the Philippines is about 85% Roman Catholic, the southern island of Mindanao has a large concentration of Muslims (known locally as Moros. The settlement of this region by Arab traders and conversion of the local populace to Islam predates the Spanish colonization of the Philippines by a couple hundred years.

As a whole the Moros have never fully integrated into Philippine society and have been a thorn in the side of first the Spanish, then (to a lesser extent) the Americans who succeeded the Spanish as occupiers of the country , and finally the present Philippine central government. In the past few decades the unrest in the Moro areas of Mindanao has turned particularly violent. There have been frequent clashes with government troops and massacres of non-Muslims in the region. In response, there have been retaliatory vigilante and military raids against local insurgents, resulting in a spiral of almost perpetual hostilities. Treaties with rebel groups such as the MLNF (Moro Liberation National Front) and their successors / breakaway radicals, the MILF (Moro Islamic Liberation Front) have been broken, usually by Islamic separatists.

My personal reaction at one time to this chaos was that the Philippine government should let the Moros secede from the country and form their own nation as they are nothing but a huge headache. But now I understand that the region in dispute is too rich in natural resources to just give away. Also capitulation to terrorists is never a good idea. Yet the latest attempt by the government to appease the rebels was just that--de facto surrender in the form an infamous pact known as the MOA-AD (Memorandum of Agreement on Ancestral Domains) that would have allowed the Moros to create a "state within a state" called the the BJE (Bangsamoro Juridicial Entity" in the area known as the ARMM (Autonomous Region in Muslim Mindano) . If implemented, this treaty could have been a disaster for the Philippines as a whole, because it would have allowed the BJE to have total self-rule that was just about total sovereignty including their own currency, relations with foreign governments, and the option to impose Islamic law even on non-Muslims in their territory which in itself is a violation of Philippine Constitutional separation of Church and State.

This treaty got as far as it did thanks to backing of Philippine President Gloria Arroyo. Presently we will see why she supported the MOA even though it would have been against the interests of the country. Fortunately, the Supreme Court issued a Temporary Restraining Order against the agreement, so negotiations with the Moros are heading back to square one. Perhaps this is just as well, considering the consequences of granting near-independence to the BJE. The MOA would have at the very least required a change in the Constitution that would have altered the political structure of the country into a federal system which would have allowed Arroyo to stay in power beyond the end of her elected term in 2010. Importantly, the MOA would set a bad precedent that could fragment the country. After all, there are other indigenous groups in the Philippines whose "ancestral domain' claims are just as valid as that of the Moros. What's to keep them from likewise demanding self-determination over their respective territories?

Moreover, if the Moros are granted self-rule or even complete sovereignty the ARMM, they would not likely be satisfied with this concession. They would likely demand and bully for more and more land, utilizing violence in the process, which is how they achieved their initial claim. Would there ever be an end to it? Would the Moros eventually declare war on the central government?

What is really curious about the MOA is that it had the support of the United States. One would think that the last thing America would do is support a treaty that in effect knuckles under to Islamic terrorists. Yet at the same time, the U.S. is furnishing military and financial aid to the Philippine government in fighting these extremists. For a comprehensive and fascinating discussion on why the U.S. is playing this double game, see "US plays both sides in the Philippines".

Recently the Philippine government dropped its backing of the MOA. President Arroyo is now pretending that she was not happy with the terms anyway (yeah, right), and so the whole matter has been rendered moot.--or has it? The Supreme Court still intends to review the matter further. See "Decide the MOA issues fully".

What this all comes down to is that Philippine unity is weak enough as it is due to the various regional and language divisions , and the demand of any one group should not be allowed as basis for tearing the nation asunder.

Friday, August 8, 2008

An Expat's Perspective on Life in The Philippines (Part 1)

As an American who has lived in the Philippines since 2005, I would like to share my experiences and observations regarding life here with new and soon-to-be residents of this country. Of course, your own experiences in settling in may differ from the following. But my intent in furnishing this information is to try to ease your adjustment, and if I have made a difference, no matter how small, it will have been worth the effort.

Within the first few days of your arrival, you are required to register with the Bureau of Immigration (BI). There are two locations you must visit. The first is the Medical Office to confirm that your physical exam report from your doctor—and you—are in order. My own experience with this step was surprisingly agreeable. I was processed and out the door in about 30 minutes. That’s the good news.

Now here comes the bad news: The second mandatory appearance is at the Bureau headquarters itself, where the registration of the visa that you were issued at the Philippine Consulate in the U.S. will be completed. At Immigration you will have to go through several steps and queue at various service windows, so it is essential that you arrive there early in the day as early as possible, around 7:45 a.m. (doors “officially” open at 8:00 but sometimes sooner). This advice for early arrival applies to the Medical Office as well.

The building where the BI in Metro-Manila is located is dismal and decrepit and not fully air conditioned, so dress comfortably. Take along reading material or anything (or anyone) else that can keep you from going out of your mind with boredom from the tedious delays that you will no doubt encounter. For although the procedure appears to be streamlined according to the instruction sign inside the building entrance, the workers that you will be dealing with are—with a few exceptions—indifferent and sluggish. You can expect to spend 1—2 full business days there in order to complete your registration.

Even so, steer clear of so-called “fixers” who for a fee can supposedly grease the wheels and speed up the process. You’ll just be wasting your money, and might even be entrapped and extorted in a sting operation. Instead, if you have a friend or family member who is a local, try to get that person to accompany and help you work your way through the system. If you have to go it alone, that’s OK, but it just helps to have someone with you to run interference with government workers who might otherwise be inclined to take their time with your paper work or take advantage of a lone foreigner.

Speaking of taking advantage, when my wife Lydia and I were about to pay our processing fees at Immigration, unexpectedly we were each automatically assessed an extra 500 Philippine Pesos in order to qualify for express lane cashier service, although we hadn’t requested this option. It turns out the “express” lane is really very long and slow, as this is where all applicants are directed anyway. Now, the BI also oversees the departure of Philippine nationals from the country, so to make matters worse for everyone else in the queue, travel agents are allowed to cut to the front of the line with stacks of passports to be processed by the cashier while the other applicants just have to wait. In short, the express lane charge is really little more than a shakedown.

By the way, unless you have an appointment, arriving early at the BI is essential for any business that you might need to conduct with that agency—not just registration. Immigration, just like any government office, takes the approach that if requiring a particular form from you is good, then insisting on multiple copies is even better. One way that you can save time and avoid the hassle at the BI forms copier section is to call Immigration the day before you go there. Find out how many copies are needed for the various documents and photos—and the size of the latter—which you will need to present. (Duplication quantity and photo size requirements are subject to change, so I can’t present that information here as it may become outdated in short order). Getting through is difficult, as the lines are usually busy, but keep dialing. It’s worth the effort. Remember, when dealing with this Bureau whether by phone or in person, patience is essential.

As previously mentioned, certain forms, applications along with other information can also be downloaded or accessed from your local Philippine Consulate General. Upon successful navigation of the registration maze at Immigration, you will be issued a receipt for an I-card, which is similar to the Green Card issued to permanent resident immigrants in the U.S. The I-card usually takes a couple months to be generated, and it is your responsibility to follow up and find out if it’s ready to be picked up as there is no automatic notification system.

But even if you follow all the instructions and complete all the requirements, there is no guarantee that your I-card paperwork and issuance will be properly serviced. When Lydia and I applied for our cards, we did so on the same day, so there was no reason to think that they wouldn’t be ready at least approximately at the same time. My card was available for pick-up a couple months later.

However, every time that Lydia called to inquire about the status of her card, she was told that it’s “still in verification”. It turns out that somewhere in the pipeline, Immigration lost her I-card or the supporting paperwork to order it. For months the agency refused to acknowledge that this is what happened, and when they finally admitted they couldn’t find it, they said it wasn’t lost but was just “misplaced”.

Finally after numerous calls, letters, and personal appearances to various BI department heads, Lydia got her I-card. Interestingly, the Bureau of Immigration has a reputation of being among the most corrupt government agencies in the Philippines. But we wound up not paying a single centavo in bribes. Perhaps we were just a lucky exception in not being extorted, but I think it also had something to do with our keeping all the appropriate BI receipts, logging our calls and interviews, and when there was a need for correspondence, sending it via registered mail through a private courier service, (not through the local postal system whose inefficiency is legendary and my personal dealings with which are another story in itself.)

By the way, as a permanent resident, you must appear at the BI every January to file an annual report to advise the Bureau of your current address, whether or not you have relocated within the previous year. The fee for this transaction is currently 310 Philippine pesos. Effective in 2008, the procedure has become more streamlined via a first come-first serve number process. In addition, Immigration sets aside a special area for annual report applicants. This section fills up very quickly, so try to arrive around 7:15 a.m., even if the doors are not yet open. (When Lydia and I went to file this year, we arrived shortly before 8:00 a.m., and there were already 32 people ahead of us.) As with the I-card there is no automatic notification by Immigration to foreigners for this annual filing. The penalty for failure to register is a fine of 200 Philippine Pesos per month, plus the hassle of additional processing queues.

After you’re settled with a permanent address, it’s also a good idea to register with the U.S. Embassy, which you can do in person or on line. One purpose of registering is so that you can be reached in an emergency or notified if political conditions here require that foreigners evacuate the country. Also, you can file for any Social Security or Veterans benefits to which you are entitled from the U.S while you are residing here.

Just because you’ve moved abroad doesn’t mean that you’ve surrendered your right to vote in U.S. federal elections. It simplifies matters if you are a registered voter in a state where you resided before leaving the U.S. The Embassy will furnish you with a Federal Post Card Application which you can mail to that state in order to receive an absentee ballot.

Beyond that, the American Embassy here—or in any other country—cannot assist you if you run afoul of the local laws. Some Americans mistakenly believe that if they get in trouble in a foreign country, the American government will come to their rescue. They couldn’t be more wrong. You are subject to the laws of the land where you are residing, and if you are arrested, about the most that the Embassy can do is find out where you’re being held and notify your family. If you wind up in prison here, you will discover a whole new meaning of “Philippine hospitality”.

This is not to say that the Philippine government necessarily makes it a point to pick on or intentionally make life difficult for foreigners. After all, tourism is an important industry as is relocation to the Philippines by foreigners, and there are many different nationalities residing here, the largest number of whom are Americans. So officials are not out to kill the goose that’s laying the golden egg. But expecting special treatment just because you’re a foreigner is not only rude, it’s counterproductive. A smile and a friendly attitude go much further in getting along here.

Practicality is another important consideration in making life easier in this country. Earlier I mentioned that I had encountered health problems after I arrived here, including a few illnesses and a trip-and-fall accident. Just as in the United States, private health insurance is a necessity as there is no government sponsored health plan. So shortly after I arrived, Lydia and I took out a major medical health policy with a well known insurance company which we still carry.

In addition, the clinic that Lydia and I patronize for our health needs offers a discount program which is well worth the yearly membership fee. It includes free family doctor consultations and x-rays, and reduced fees for specialist consultations and other benefits.

When purchasing insurance coverage here, make sure that you deal with a reputable and well established insurer. In theory, businesses such as these are regulated, but just as in the States, regulatory agencies are prone to being “captive”, that is, heavily influenced by the companies that they are supposed to be monitoring. Cronyism is also widespread, so regulatory agency heads are often appointed by friends and relatives who hold high political positions, regardless of merit and integrity—or lack of same. As a result, insurance companies and other corporations can go belly-up, leaving investors, clients, and in the case of insurance companies) policyholders high and dry. The quality of health care in the Philippines is inconsistent. When it’s good, it’s very good, but in many places especially in the more remote provinces, it can be abysmal if not lacking altogether. Not surprisingly the best hospitals seem to be in Metro-Manila and other larger cities, such as Cebu. It’s true that a great number of medical doctors and nurses are leaving the Philippines for greener pastures. Yet there are still many qualified medical professionals who have stayed behind. In fact, the Philippines has the potential to become a center of medical tourism. Also, I can attest to that compared to the U.S., the price of health care here is a bargain. For instance, I had minor surgery for what would have cost several times more in the States than what I was charged here.

Optical services are comparable in quality to that in the U.S., and eyewear is much cheaper. I saved about 50% on a pair of eyeglasses here as compared to the same prescription, style, and frames in the U.S. (Note: American senior citizens residing outside the United States are ineligible for Medicare coverage. If you have health insurance through a U.S. provider, make sure that their benefits include coverage while you are abroad.

Medicines here are the weak link in the chain of low-cost care and are among the most expensive in Asia. The price of brand name prescription drugs is about equal to that in the States, but as in the U.S. generics are somewhat less expensive. Recently, however, a law was enacted by Congress here to control the pricing of drugs and bring it into line with countries like India, where consumers pay less than in the Philippines for a given medicine produced at identical cost by the same manufacturer.

Dental care is a bargain. A visit to my dentist for a routine exam and teeth cleaning costs the equivalent of about USD$10.00.

Unfortunately, encounters with other kinds of services are often more painful than getting a tooth pulled. Whether the cause or result of corruption and fraud in the Philippines, red tape is common especially in financial dealings. For example, even if you’re a permanent resident and can produce proof of legal immigration status, most banks require that you reside here at least 6 months before you can open a checking account. Starting a savings account on arrival is doable but not easy thanks to the required steps of obtaining a local tax certificate (“cedula”) and a police clearance.

So in order to make sure that you have enough cash on hand until you can start a bank account in the Philippines (and even afterwards), do not close your checking account in the U.S. Make sure that you have a Visa debit card on that bank that is good for use worldwide and does not assess transaction fees. When you need money here, just make a withdrawal from your U.S bank account at any ATM that accepts Visa. The funds that you receive will be in pesos. This is extremely convenient as it saves the time and hassle of converting dollars at a currency exchange office which may offer an unfavorable transaction rate for this service. Just ask Lydia. After arriving here, she had her monthly Social Security benefits transferred to a dollar savings account at a Philippine bank. When she wants take out any funds, she first has to have the bank convert them to pesos. To add to the inconvenience, she must conduct this transaction in person. Had she been aware of the option of keeping her monthly Social Security at a bank in the States via direct deposit there and just drawing on the funds here as needed, she would be having an easier time of it.

When it comes to the international rate of exchange, keeping your cash in the U.S. also allows you flexibility to adjust your withdrawal amounts according to the value of the peso to the dollar at a given time. At this writing the dollar has weakened against the local currency by about 15% over the last year. So this would be the time to convert my dollars into pesos. Conversely, if the peso falls again in value, then I would just change enough dollars into pesos from my bank in California to cover my living expenses.

As the above picture demonstrates, while residing in the Philippines, most likely you will continue financial dealings with businesses in the U.S. But due to the high rate of fraud incidence here, many companies in other countries will not conduct business with anyone having a Philippines address. For example, if you have a home computer and want to shop via the Internet from a business in the U.S., the transaction may be rejected because the merchant or credit card service will recognize the IP (Internet Protocol) address in your computer as located in the Philippines. If this happens, complete the payment of your order through Paypal, which is more accommodating in this area.

However, that won’t solve the problem of companies that refuse to ship to the Philippines (also due to fraud concerns). But there is a way to get around this barrier as well. Just open an account with a mail forwarding service located in the U.S. They will assign you an address with a U.S. city and state, which you can then use as your mailing address for those businesses.

The mail forwarding service will not only receive letters and packages for you and send them on to your address in the Philippines, they will also repackage correspondence in a plain brown envelope before doing so. This is important because mail pilferage and theft are a problem here (which may be why there are no mailboxes on the streets), so you may not want workers at Philpost, the national postal service, to know what you’re receiving, such as letters with a bank’s name in the return address portion of the envelope, or expensive magazines which publishers often send in transparent wrappers. Moreover, there may be instances where you may be the one who does not want your American correspondent to know that you live abroad.

Yet even this step won’t guarantee problem-free transactions with foreign businesses. For instance, if you try to open an account at a U.S. bank via the Internet and use your mail forwarding service as your address, the bank will likely detect that company as a mail drop and will require you to furnish an actual U.S. residence address in order to proceed with your application. In this case you will have no choice but to try to get a friend or relative in the U.S. to accept your mail “care of” their home address and forward it on to you. If they consent, be sure to instruct the bank to include “c/o” before your contact person’s name on the envelope. The bank will likely insist on sending their “hello” letter to that address, so make it clear that all subsequent correspondence is to go to your mail forwarding address instead.

As can be seen, it takes a lot of ingenuity and flexibility for foreigners to make the transition and adjust to life here. This is particularly so in coping with one of the most hazardous aspects of Philippine society, especially Metro-Manila and other large cities: traffic. For a supposedly poor third world country and one where fuel prices are approximately equivalent to those in the U.S, there is a disproportionately large number of private vehicles, motorbikes, and motorcycles on the roads. But what’s really strange is that most of the cars, vans, and SUV’s here are fairly new (Light trucks are not very common, at least in Metro-Manila). Rarely do I see junkers on the streets, in contrast to what I encountered in California. Such is not the case for commercial trucks, many of which are old and dilapidated.

Public vehicles still rule here, including buses and passenger “jeepneys” (or just “jeeps”). The latter might best be described as a cross between a passenger van and as the name implies, a military personnel carrier. Jeepneys ply most main and many side streets in urban areas as well as provincial roads in the Philippines—truly an indigenous form of transportation. The main form of long distance transportation is intercity buses which vary in comfort according to service and fare class. Domestic air and rail service are also available to the more distant cities and resorts. Rail service is also available between Metro-Manila and various locations.

Taxis are also another way to get around Metro-Manila. But beware of reckless and dishonest cab drivers. Many of them use “fast” meters and / or request extra money above and beyond the metered fare on trips beyond a few kilometers. Some of them will even turn away passengers who are heading for a destination that the drivers considers personally inconvenient. Actually, this is illegal, and sometimes cabbies will yield to threats by passengers to report them to the LTFRB (Land Transportation Franchising & Regulatory Board) which is the government agency that regulates them.

When taking taxis, make sure that you have enough small bills and coins to cover the exact amount of your fare. Drivers usually don’t give change. Tips are optional and should be given only if the driver is especially courteous and careful. There is also mass rapid transit in Metro-Manila, which is about as safe a mode of transportation as anything in the Philippines can be. However, at morning and evening rush hour the trains become so packed that you may have to let 4 or 5 of them take the waiting passengers in front of you at your station before you can finally squeeze on board. During this busy time, the trains are divided into “male” and “female” coaches, in order to protect women riders from being molested by opportunistic male passengers under these extremely jam-packed conditions. Such protection is not the case on crowded jeepneys and buses, anybody regardless of gender may become a crime victim. Pick-pocketing, purse snatching, and hold-ups (even in the day time, but especially late at night) are all too frequent. Vigilance is the price you pay, along with your fare when taking public transportation. But if you think about it, this is true almost anywhere.


Traffic jams and gridlock are common, and evening rush hour on the main thoroughfares can last up till 9pm. But beyond the sheer volume of vehicles, both public and private, the overriding problem is the lack of discipline among drivers and pedestrians alike.

Even if you are the cautious type yourself, due to the behavior of others, you literally take your life in your hands in just getting around from one point to another. Drivers often ignore traffic signals, and while there are crosswalks, just crossing the street even in these supposed safe zones is extremely dangerous because in reality right of way for pedestrians is nonexistent. In all fairness, pedestrians’ behavior isn’t much better. In crossing the street, some of them even climb over medians and barriers meant to divert pedestrians to designated crossing areas.

To compound this problem, a lot of jeepney drivers do not turn on their headlights at night under the mistaken belief that they will conserve the life of their batteries this way. This makes crossing some streets on foot after dark almost suicidal.

And to make getting around Metro-Manila even tougher, especially for the uninitiated, most intersections in Metro-Manila do not have street signs. So if you don’t know where you are going before you start your trip, you can become hopelessly lost. Fortunately, there are street maps and map books that can make tour trip easier. Also try to memorize the route ahead of time. Many of the public transportation vehicles and private trucks are poorly maintained and are smoke-belchers. This of course aggravates the already serious air pollution problem. (It’s no wonder that lung problems are a very common ailment here.)

The attitude of motorists is a reflection of the culture here where life is cheap, and people’s mindset is “My family first and to hell with everybody else”. Yet for all the emphasis on family values here, vehicles are often overcrowded, seat belts go unused, and the only car infant restraint is a mother’s arms. Sometimes you will see as many as four riders on a motorcycle, including one or two young children.

However, for expats who nevertheless intend to drive here you can continue to do so with a valid foreign driver’s license for 90 days from the date of your arrival in the Philippines ,so bring along your passport too, or at least a carry a copy of the page showing that date.

You can also convert a valid foreign driver’s to a Philippine DL. Just present your passport, a valid U.S. driver’s license, and ACR (alien certificate of registration—now I-Card). The LTO is another bureau where you can expect to spend several hours to complete your application and will likely be approached by fixers. So see the LTO website in the Appendix, especially the FAQ section.(In my opinion, this is one of the better designed Philippine government websites.)
You can also obtain an international driving permit before you leave the U.S. This document is good for one year, and if you’re a member of the Auto Club, you may be able one through your local American Automobile Association branch. An international driving permit is usually an acceptable form of identification, and to that extent it can be very useful. Speaking of the Auto Club, there is counterpart to that organization here: the Automobile Association of the Philippines (AAP) which performs many of the same functions as the AAA in the U.S. In fact AAP membership holds international reciprocity with the AAA and with Auto Clubs in other countries. But frankly, if you can get by without driving while in the Philippines, you will be better off. For non-drivers, acceptable forms of identification here are passports and I-cards. Another form of identification is a postal I.D., which is issued by Philpost. This card is less commonly used by foreigners, but is recognized by just about any private business or government agency that asks for identification.

In order to adapt to Philippine culture, it’s important for foreigners here to understand the complex psyche of the people here. The smiling faces and hospitality especially to foreigners can mask a temper that can erupt over just a minor provocation. It is this national character trait and not necessarily the result of poverty that is behind the high crime and incidence of violence in the Philippines, for this short fuse cuts across all socioeconomic classes. At the risk of oversimplification, the difference is that a poor person who is aggrieved by a real or imagined slight will take on his enemy directly. The well-to-do and well-connected who have a score to settle will hire thugs to do it for them. Political office here is often won as the local expression so aptly describes via “guns, goons, and gold”.

According to Lydia who was born and raised here , the roots of these character traits can be traced to family dynamics. Filipinos may be very loving to their children, but at the same time they demand total obedience, and kids are trained never to talk back. Corporal punishment and humiliation are common. So people learn from an early age to bottle up their anger. Under these conditions, many individuals displace their hostility against family members by redirecting it to others, or are walking time bombs who simply explode with anger at the slightest perception of ill-treatment and go berserk, or as the phenomenon is referred to here amok.

That was the excuse that the accused killer of an American Peace Corps volunteer used. He claims that in a case of mistaken identity, he thought that she was a male neighbor with whom he was feuding and who he believed was following him. The assailant then supposedly just blindly struck out without even noticing the gender difference between the victim and his enemy. More recently, a man in a town just outside Metro-Manila went on a shooting spree and killed eight people—because he felt that they had been ridiculing him.

There is also a great deal of envy and “crab mentality”. If a crab tries to climb out of a pot of hot water, the other crabs in the pot will pull it back down. So it is with the people here and among Filipinos living abroad. If someone is on the verge of success in an endeavor, jealous co-workers will try to scuttle that person’s achievement, which as a little reflection would show is petty and self-defeating for everybody in the long run.

With the notable exception of such public institutions as the University of the Philippines critical thinking is not encouraged even at the university level, as many colleges as well as most private elementary and high schools are run by religious orders that may emphasize rote memorization instead. But whatever the qualities of tertiary level education here, Filipinos place a high value on obtaining a college degree, and accordingly parents often make great sacrifices to put their children through school up to and including college.

And speaking of religion, this is another factor behind the high crime rate and corruption in the Philippines. Many people here regardless of socioeconomic status have the distorted notion that they can commit just about any legal or moral offense and then absolve themselves through the act of confession, or as Lydia would put it, washing their hands, and repeating the cycle ad infinitum. With the lax attitude here about concern for the greater good, it’s no wonder that when it comes to the environment, many parts of Metro-Manila are dirty. Filipinos as individually are clean to the point of being personally fastidious. But they are woefully indifferent when it comes to their surroundings. Public littering for example is a huge problem. Regardless of socio-economic class, people here think nothing about spitting and tossing cigarette butts, food wrappers, and even garbage on the street.
Lydia and I live directly across from a call center building operated jointly by two well known computer hardware companies, one of many such outsourced service operations in the Philippines. They are staffed by agents whose demographic profiles are middle class, average age range of mid 20’s, and have at least some college background. Yet, despite their age and level of formal education, in general these people are very irresponsible. Most likely they were spoiled by their parents and were never trained to pick up after themselves or to be considerate of others, which is in keeping with “My family first…”. Wherever they congregate, they leave an unbelievable amount of litter.

But their thoughtless behavior doesn’t stop there. Until we complained to their management, Lydia and I were frequently awakened in the early hours by the graveyard shift agents who gather outside the office on their breaks and become as loud and boisterous as kids in a playground—totally indifferent to the fact that across the street from where they are carrying on is a residential complex.
However, no locale is perfect, and on the balance I would still rate the community where we reside as very livable for foreigners and locals alike. It’s very conveniently located and so for the most part is fitting for our needs. And besides the other amenities, it has good overall security which, due to the high crime rate in Metro-Manila, is a key consideration in deciding where to live.

If I were recommend for areas for foreigners to settle in, my choices are Eastwood City (which is actually a community within Quezon City) and Makati City, which is also the main business and commercial center of Metro-Manila. Other good locales are The Fort in Taguig City (near Makati) and Santa Rosa (a thriving suburb just south of Metro-Manila). As far as amenities go, some newer multi-unit buildings are equipped with electrical outlets for both 220-240 and 110-120 voltage appliances. (The former set is the voltage furnished by the electrical utilities in the Philippines and many other countries outside the U.S.) Now, many newer condominiums and apartments are equipped with phone lines. However, in multi-unit complexes, the phone service may be connected to a PABX system and as such is blocked from dialing other landline numbers beginning with a “1” and from calling cell phone numbers.

Whether selecting a multi-unit or single unit dwelling, parents of school-age children should keep in mind that in seeking a residence near a “good” school, private academies are numerous in the better areas of Metro-Manila. For security reasons foreigners usually send their children to these schools rather than to the public grade and high schools. (Incidentally, the school year in the Philippines begins in June. Summer vacation runs from March through May, the hottest part of the year.)

Foreigners may not own real estate in the Philippines. However, they can purchase dwellings without the land on which they are located, so non-Filipinos may own condominium units. For a comprehensive discussion on this topic, please visit http://www.camperspoint.com/article.php3?id_article=153.

If you’re particularly concerned about personal safety, consider locating in one of the numerous private communities or compounds spread throughout Metro-Manila and its suburbs. These communities are usually protected by security guards at the front gate who log in visitors and issue passes to vehicles entering the area. By the way, security guards are also a common sight in most retail stores, banks, schools, and office buildings. Yet, everyday there’s news of bank robberies, muggings, shootings and other violent crimes. But depending on the police for help especially in Metro-Manila is a waste of time. A recent survey showed only 15% of crime victims bother to file a police report. So private security as imperfect as it is, protects people where police can or will not do so. For one thing, law enforcement here is rife with corruption. Often you will hear in the news that captured criminal suspects are current or former police officers who are in cahoots with criminal organizations. Street justice is a frequent means of dealing with crime. Two ways that police confront criminals are shootouts and “rub-outs.” The latter of course is ambushing or shooting perpetrators in cold blood after they’ve surrendered.

And because of the high crime rate, it is so important, whether you are a native or a foreigner, not to call attention to yourself with flashy attire, jewelry or vehicles outside secured areas. Wearing funky attire and a modest life style will not necessarily guarantee your personal safety in most sections of the country, but it does help, and what good is a projection of wealth anyway if all it does is induce stress and bring unwanted attention, or worse?

Obviously, the wealthier you are, the more comfortable you will be in just about any part of the world that you live in, and the Philippines is no exception. The downside is that kidnapping for ransom is practically a cottage industry here which is why the very well to do here are accompanied in public by a retinue of body guards.

Nevertheless, you don’t need to be rich to enjoy a comfortable life style here. For example, if you’re collecting Social Security, as Lydia and I are, you can get along here nicely just on that income alone. (Just try that in the U.S!) However, the senior citizens discounts that you may observe here are given only to elderly Filipino nationals. This is due to the fact that these discounts are mandated by law and are not optional as in the U.S, so businesses will not extend them beyond the legal minimum. The only way that foreigners can avail themselves of these price adjustments is by obtaining a Special Resident Retiree’s Visa (SRRV) which costs about $50,000 USD. This visa also entitles the bearer to other such privileges such as faster processing for exiting and re-entering the Philippines.
As is the case almost anywhere, the further out you live from Metro-Manila, the safer and less stressful life can be unless you have to commute daily into the city. However, due to an underdeveloped infrastructure, the amenities that are available in the larger cities may not be accessible in the smaller towns and rural areas, including such basics as paved roads, municipal water services, and quality medical care. Ideally, the best place to live is in a suburban development that’s within one or two kilometers of urban amenities but yet has a countryside environment. For this, Santa Rosa comes to mind. But the most popular locale for foreigners to reside is Makati City, which is also the business hub of Metro-Manila.

But wherever you choose to live, select a residence that’s not in a low elevation. This is because many parts of the country, including Metro-Manila, are prone to flooding (partly the result of blocked street drainage due to careless garbage dumping) in the rainy season, which lasts approximately from May through February. Typhoons are also an occasional hazard during this time.
March through May is considered summer in the Philippines and as previously mentioned is the hottest season of the year, with temperatures reaching 100ºF (38ºC) and little or no rain. (However, in 2008, due to La Niña, the rainy season started a few weeks ahead of schedule.) When you add the high humidity that is part and parcel of the tropical climate here, the Philippines is particularly uncomfortable this time of the year. Regardless of the heat and humidity there are many forms of recreation and physical fitness venues including gyms and spas. Golf and tennis are also popular. However, the Philippines is a lot closer to the equator than is the U.S., so sunlight here is more intense. Depending on your skin sensitivity and physical stamina this is important to keep in mind when planning outdoor activities. If you would rather “chill out”, literally, with indoor sports, there are ice skating rinks at some of the malls in Metro-Manila. You can also stay inside with the 3 “B”s: badminton centers, bowling alleys and billiard halls. Chess has a large following, and players abound, from the poorest to the wealthiest socio-economic classes.

Thursday, August 7, 2008

An Expat's Perspective on Life in The Philippines (Part 2)

Favorite spectator sports here are basketball, horse-racing, and jai alai. However, there is almost no interest in baseball and American-style football. The term “football” here refers to soccer, which is another moderately popular sport.

Eating, drinking, and conversations about food are important features of Philippine culture. In fact, a common greeting here translates to “Have you eaten?” Personally, I’m very fond of the cuisine here, which is based on a combination of Spanish, Chinese, and Malaysian influences. Lydia is a great cook, and we have most of our meals at home. However, the heat and humidity here along with lax enforcement of health and safety codes in food handling can spell trouble for those who are fond of dining out. So if you’re in that category, stick with well known and reputable (and of course air-conditioned) restaurants before you become adventurous at least until your digestive system has had a chance to acclimate. And even then, don’t let your guard down.

The same advice holds true for water. The drinking water in Manila is chlorinated and supposedly potable, but Lydia and I use bottled water and brand name beverages just to be on the safe side. When ordering drinks in a restaurant, avoid ice as it may come from an unsafe source, and bacteria can readily survive freezing.

Two extra added amounts that you will find tacked on to your restaurant check are a mandatory VAT (value added tax) in the amount of 12% and usually a service charge of10%, so tipping is not necessary. Of course if the service was exceptional, it’s your option to leave an extra amount for the server. (By the way, the VAT is added to just about all merchandise and services, even medicines and doctor’s fees.)

So if paying an additional 22% for eating out is a turn-off or if you just like to cook your own meals, apply the universal rules when preparing perishables. Get only fresh meat and cook it thoroughly, and wash fresh produce well before serving or cooking, and speaking of food preparation, stoves here are powered by electricity or LPG.

Strangely, eggs which are a highly perishable product are not kept in the refrigerated section of supermarkets here. (However, the better stores are air conditioned and, the egg cartons do carry instructions to refrigerate after purchase.)

Personally, I’m very particular about food handling and had a problem accepting this practice. However, so far Lydia and I have not experienced any egg related illnesses here. Perhaps chicken growers in the Philippines don’t feed antibiotics to their birds the way they do in the U.S., This would result in a lower incidence of resistance-induced salmonella in fowl and their eggs. Another oddity is that despite their being unrefrigerated, the stated shelf life of eggs sold at the supermarkets is about 2—3 weeks. Nevertheless, logic dictates buying and using eggs long before their expiration date, cooking them well, and discarding any that have an off smell and /or do not present a firm yolk.

Supermarkets here offer a wide variety of food including American and other foreign products, often produced under license in the Philippines or other Southeast Asian countries such as Malaysia. This keeps the cost down.

A common sight at supermarkets in more affluent areas, along with the shopper is his or her maid, pushing the basket while the employer selects the merchandise. In the Philippines, domestic servants, referred to here as “house help” are an integral part of thousands of households, from lower middle-class through the upper reaches of society, differing only in the number that one can afford to hire. And I’m not talking about someone who comes in once a week to do the cleaning. These maids, nannies, etc. are usually live-in.

Frankly, this utilization of helpers is one aspect of Philippine society that irks me to no end. I look at it as a throwback to the feudal times when this country was a Spanish colony and the natives were exploited as little more than slaves. The Spanish are gone, but now the Filipinos exploit their own. In fact even the word Tagalog word alila which means “slave” is still often casually used in referring to a domestic helper. The tenant farming system which has kept small farmers under the control of large landholders for generations is another manifestation of this socio-economic inequality. Overall, attempts at land reform have not been successful.

I strongly believe that this deeply ingrained attitude and dependence on others to perform tasks that a healthy person or a couple is capable of doing on his/ their own, such as house cleaning and child care is one of the customs that is keeping the Philippines from progressing.

So if you hear Filipinos bragging to Westerners how, for example, family members here take care of each other and don’t stick their elderly parents into nursing homes the way Americans do, chances are there’s at least one domestic helper—usually female—in the household. These girls who are often little older than children whom they care for are the ones doing the heavy lifting, literally, by attending to the physical needs of the infirmed aged and looking after the children while their employers just sit back and gives orders. And speaking of children, child labor is another blot on Philippine society. As I mentioned, a large number of maids and nannies are teen-age girls. Young boys often work as laborers. In poor households, small children of both genders often drop out of school to collect and sell scrap to help support their families—or themselves. It’s like something out of 19th century London as depicted in a Charles Dickens’ novel.

Sadly, the very religious establishment in the Philippines that pressures the people to have as many children as physically possible, no matter how poor or unfit they might be for as parents, does not support a single orphanage to take in the children whose parents cannot or will not support them. As a result, there are a large number of homeless children in Metro-Manila as young as four years old who are often exploited by syndicates that send them out to beg on the streets. There is a government Department of Social Welfare that is responsible for dealing with these children, but there’s only so much that they can do with their limited resources, which are just as subject to internal theft and graft as any other government agency here.

Another dysfunctional feature of Philippine society is disregard for or indifference towards the basic essentials of private and public sanitation, an example of which is lack of running hot water, even in middle income dwellings such as our condominium. Water heaters and devices can be purchased aftermarket and installed into the household water supply system. But they are not considered essential enough to be routinely built into most residences and businesses (except, of course, hotels). One argument for this practice is that because of the tropical weather, hot water is unnecessary for bathing. This overlooks the fact that bathing or washing clothes and dishes with just cold water—even with soap is harder and is inadequate for good hygiene and sterilization. So it's no surprise that personal and public health is another area where priorities are misplaced. Some examples: Public restrooms are usually wretched. Toilets there often don’t work; toilet paper is ordinarily not provided, and as mentioned there is no running hot water available from the sink faucets, even in the public restrooms of first class hospitals.

The Philippines is supposedly a poor country. Yet smoking, which can be a very expensive addiction, is common here among both genders. In fact compared to other Asian countries, Filipino women, for example, have the highest rate of tobacco use. Street vendors even sell cigarettes by the piece for those who can’t “afford” to buy a pack. However, in all fairness what’s truly amazing is that given the general negative attitude here towards public safety and obedience to government ordinances, people here do comply with the ban on smoking in stores and restaurants.

One major part of the economy and a diversion for the people is entertainment, which comes in all forms and price ranges, from cheap bars to the Cultural Center of the Philippines and everything in between. Besides being resilient and sociable, Filipinos are a festive and musically inclined people, so there is a vibrant night life in Metro-Manila and many other locales.
Gambling is another popular past time and can be found in many forms and venues. For the wealthy there are casinos. For the less well-to-do there are the Philippine Sweepstakes Charity Organization lottery, Small Town Lotteries, cockfights, and an illegal numbers game known as jueteng, just to name a few betting activities.

The local movie and television industry is an important part of the culture. Paradoxically, even though public figures here are often the butt of jokes and rumors, there is a tendency here towards undue celebrity worship. Many politicians, including a former president, past and current legislators, mayors, and provincial governors got their start in show business. CD’s, DVD’s, and VCD’s—a hybrid between the two discs are readily available, both in their legitimate and pirated formats. Filipinos are well known in Southeast Asia as a musically talented people, and singers and bands from here are in demand throughout the region.

Because the Philippines was ruled by America for over 50 years until 1946, with U.S. military bases remaining until the early 1990’s, colonial mentality here is alive and well. So movies, television shows, and music, and just about anything originating from the U.S. are extremely popular and imitated. (The most popular soap products especially for women are those that claim to whiten skin.)

English is the second language in the Philippines and is the medium of instruction in many colleges and universities. However, there is a movement afoot to change this, and replace English with Pilipino (Tagalog). Yet even this campaign is opposed by many natives who are from regions that speak other languages and dialects other than Tagalog.

Add to this the fact that many of the customs and words are Spanish in origin from the 300 years when the Philippines was a colony of Spain and administered by officials in Mexico who did their best to erase the earlier influences of Chinese and Arab traders on the people, the result is a huge national identity crisis that manifests itself in odd ways. For example, even though many Filipinos have Chinese ancestry, there is a lingering prejudice among the natives against local Chinese, no matter how many generations they may have been in the Philippines. As recently as the 1970’s, Chinese who were born in the Philippines were not considered citizens and had to apply for naturalization like foreign immigrants.

The local fascination with anything foreign, especially from the Western world extends to fashion-consciousness. Filipinos have a flair for sophisticated apparel design. Along with Hong Kong and Taiwan, they are trend setters for Southeast Asia. It’s no wonder that most of the sections in the daily broadsheets are little more than fashion ads and photo-ops.

Not long ago I attended a debut for one of Lydia’s grandnieces. Of course it was a formal affair, one of the few that I’ve gone to since I’ve been here. So I bought and wore a barong, which is a traditional native long-sleeve men’s top, especially appropriate for these occasions. Imagine my surprise to see that almost every other male at the party was wearing a coat and tie. This may have been a fluke because according to Lydia, when she attended a wedding of another relative in early 2005, shortly before I arrived here, most of the men were wearing barongs. On the other hand, even in the short span of time since then, this particular men’s apparel may losing favor at least with the younger generation.

There are a couple large department stores in Metro-Manila, one of which has branched out into the provinces as well. And speaking of stores, another popular form of entertainment and gathering place is the ubiquitous malls, which are just about identical with their American counterparts in terms of crowds and the shopping experience. In fact, one of the largest malls in the world is located in Metro-Manila.

However, there is a quality control problem with many of the consumer goods manufactured and sold in the Philippines. Some of the upmarket furniture items made here that Lydia bought including those from a first-class department store became defective almost immediately after their one year warranty lapsed. When purchasing furniture here, the best place to shop for quality goods is at antique stores. Older furnishings were crafted more carefully and were built to last.

As with other facets of business, there are laws on the books here to protect consumers, but as with other regulations in the Philippines, enforcement is spotty at best. Also, customer service on the selling floors and from management in retail stores is uneven.

Once Lydia wanted to return an item that she has bought for cash at a well known department store, and she brought it back within the 7day period specified on the sales check. But to her dismay, the store would not refund her cash. Instead the sales person offered her a gift certificate for the amount of the purchase and said this was store policy. However, nowhere on the receipt was it stated “no cash refunds allowed, gift certificates only”. Lydia eventually got her money back but only after she protested this policy to the store customer service manager. And even that was a hassle due to lost time in traveling to and from the store plus the time it took to complete the transaction even though she had called ahead of time.

I also had a negative experience a few years ago when I purchased a cell phone from a well known appliance chain here. The unit was a lemon, breaking down twice within a month after I bought it. Yet the store refused to accept it back or issue a replacement because the phone was under manufacturers’ warranty, and I refused to got through the inconvenience of taking it in for repair at the off site service center after the first malfunction.

There is a government agency called the DTI (Department of Trade and Industry) which among its other functions goes to bat in behalf of disgruntled consumers against unscrupulous merchants. However, I was unaware of this office when I experienced the issue with the defective cell phone, which by the way was finally credited as a merchandise dispute by the issuer of the credit card that I used for making the purchase. At this writing I have not been able to determine the DTI’s effectiveness in resolving customer complaints against merchants. One of the few local products that is in demand here is footwear that is made in the city of Marikina which is just outside of Metro-Manila. Shoes from that locale are competitive in quality and price with their foreign counterparts. Another local product that’s in demand is rattan, which is very sturdy. When we were still in the U.S we had a sofa that was made in the Philippines with this product, and it lasted for years.

While many areas of the country do not even have paved roads, let alone malls, the country is technologically not completely backwards, at least at the consumer level. Computers and the Internet are very popular in the Philippines, and broadband is available in Metro-Manila and other parts of the country. (In fact, at this writing, a project to connect government offices via broadband was the source of a recent scandal that rocked the government all the way to the President and her husband, but that’s a topic for another article.) For those who can’t afford to buy their own computers, there are Internet cafes.

Cell phones including those with Internet connectivity are also extremely popular even in the poorest and most remote areas. In fact Filipinos hold the world’s record in text messaging volume. Signal towers for this means of communication are a common sight even in rural parts of the country that lack basic conveniences as a municipal electric and water supply.

Telephone landline availability can more problematic. But this service is now less in demand with the advent of cell phones, which is just as well. Before mobile phones, obtaining a land line was very difficult, and from the time an order was placed, it could take months to get one installed. As a result, bribery became a means to expedite the process, only to receive access to a communications utility that was second-rate at best. Landline service has improved somewhat over the past couple years and is now fairly modern and convenient. National and international direct dialing are available and inexpensive.

Strangely, one piece of telephone equipment that is difficult to find here is the answering machine, either as a stand alone device or as an optional phone feature. I’ve searched various retail and electronic stores as well as the local internet merchants and have found only one phone model that has this item.

Despite all the hardships and missteps, somehow life in the Philippines goes on, due, at least in part, to the resiliency and sociability of the people. For better or worse they manage not to take life too seriously and find relief in such diversions as gathering with their families or barkadas (circle of friends) to eat, drink, relax, and perhaps engage in the national past time of exchanging jokes and gossiping about public figures and entertainers.

As ruthless as this society has become, there are occasional flashes of compassion and the old bayanihan (community) spirit of cooperation when strangers help each other, such as a usually cold-hearted jeepney driver rushing someone who collapsed on the street to a hospital.

Commerce and businesses manage to operate. Goods and services find a market—but not very efficiently. Government agencies function, albeit not adequately or honestly. Some public works projects do get completed—eventually. These low standards of everyday living are the cause and effect of another flaw in the thinking here: A performance that is barely adequate is still acceptable because it’s better than nothing at all. So the miracle is not that the whole system hasn’t collapsed by now, but that some how, like the Energizer bunny, it just keeps on going.



APPENDIX
I hope that I have presented the reader with a representative view of life in the Philippines, in terms of the both the overall picture and of day-to-day living. Following is a list of websites that you might find useful in learning more about travel requirements from the U.S. and various government agencies in the Philippines.

U.S. Government:

Passport Agency
http://travel.state.gov/passport/passport_1738.html

American Embassy in the Philippines
http://manila.usembassy.gov/


Private mail forwarding services:

U.S. Global Mail
http://www.usglobalmail.com/

USA2ME.com
http://www.usa2me.com/site/default.aspx

USAbox.com
http://www.usabox.com/


Philippine Government offices and their acronyms by which they are more commonly referred to in the Philippines:

Bureau of Immigration (BI)
http://www.immigration.gov.ph/

Department of Trade and Industry (DTI)
http://www.dti.gov.ph/

Land Transportation Office (LTO)
http://www.lto.gov.ph/newdlreq.html

Land Transportation Franchise & Regulatory Board (LTFRB)
http://www.ltfrb.gov.ph/

Bureau of Internal Revenue(BIR)
http://www.bir.gov.ph/

Department of Tourism (DOT)
http://www.philippinetourism.us/
http://www.tourism.gov.ph/

Bureau of Customs (BOC)
http://www.customs.gov.ph/boc_index.jsp

A noteworthy non-government website whose title speaks for itself
http://www.livinginthephilippines.com/visa2.html

An important non-government agency for drivers is the AAP.
http://www.aaphilippines.org/

Want advice on planning a move to the Philippines? Click here and learn from my relocation experiences.