I Miss The United States (and other lies)

The past few days have been troublesome. I knew one day I would get to personally experience the state of health care in the Philippines but I was hoping that day would come at some distant time in the future, far far away. Instead, the time came sooner than later when Sunday morning my back experienced a devastating muscle tear. What caused the tear is unknown – I simply bent over my bed to pick up a notebook, felt a rip and then I collapsed to my knees. Things became progressively worse and, in addition to the excruciating pain, my body stopped producing urine for awhile.

By Monday morning I knew a doctor visit was inevitable and the inability to urinate was the impending evidence of a kidney problem. It was a simple process in my mind – Go to the doctor, get a urinalysis and/or check the back muscles. In my head, this should be an Emergency room visit. Despite my repeated attempts to express this I was forced to wait patiently while person A called person B who consulted with person C to get a doctor recommendation. Ten phone calls later, a doctors name was obtained and we were headed out to the hospital. Ok…we’re making progress…..

We passed hospital security and headed into the elevator up to the 4th floor. There was no doctor – he was out for the day. The doctors placquard read “Pain Management” at which point I explained to the secretary that I don’t need pain management right now, I need a urinalysis. There was a 5 minute conversation in Ilonggo that discussed all my symptoms, when the pain occurred and I repeatedly heard the word “massage” thrown about. At this point I was fully convinced that if I were lying down bleeding to death on the floor, somebody would pick up the phone to call their sister/cousin/aunt to determine the best band-aid to use. Filipinos like to discuss everything – apparently to death – apparently to my death!

We left the office of Dr. Pain Management and headed towards the urologist we had been referred to (there was no triage system, we simply went from doctor referral to doctor referral based on the secretary’s diagnosis). This time the secretary was out and we had to wait. Forty-five minutes later, she arrives and the same conversation as previous begins to take place. I listen intently to the Ilonggo trying to pick out the nature of the discussion at which point my simple frustration turned to anger. I interrupted the conversation to inform the secretary, “I have severe lower back pain, nausea, a bit of dizziness and my body is not producing urine as it should. I need a urinalysis.” What should have been an emergency response turned into another five minute Ilonggo discussion: if I can’t pee I can’t give a sample. I countered the conversation with the fact that I could squeeze out “a little” at which point we got the referral to go downstairs to the lab and perform the urinalysis so everything would be ready when the doctor returned. Thank God, we’re making progress now and I might not die after all.

It wasn’t a laboratory as one would consider a normal American laboratory. It was a lab/pharmacy/mini-mart. I was escorted by my guides to the counter, paid my 60 pesos ($1.20) and given my urine cup. All the intensity of my emotion dropped considerably when I paid that 60 pesos – that price (which included the lab testing and results) makes the American health care system look grossly negligent. Surprisingly I produced a decent sample and just under an hour later, we had the results and headed back up to see Dr. Urologist. I was feeling slightly better knowing I was able to pee now.

Dr. U was quite friendly and we had a lengthy discussion on kidney functions. He was fond of his occupation and loved sharing the wonderful world of Kidneys. I was happy he was happy but I was ready to move on. Some of my results were a bit on the ‘high’ side but all in all, they were in a normal range. He suggested a sonogram/blood test to be certain but we were both fairly confident that it was not a kidney issue. Why I was only able to urinate minuscule amounts for the 12 hours that passed was a mystery and still is. I declined the sonogram/blood work (I was in too much pain to waste on unneeded testing) and we headed out with a celebrex prescription to go see doctor number three.

Not surprisingly, Dr. Rheumatism was busy (Dr. Back/Neck was even busier) – I was patient 24 and they were currently seeing number 4. I am not a very patient patient and so we filled my prescription and left. I had a massage that evening and, though I am still experiencing pain, I am much better. Assuming the massages continue to work, I won’t be going back to the hospital. I would rather swallow broken glass.

Despite my perception of chaos management in the Filipino health care system (a simple system for simple people and simple needs), I wouldn’t trade anything here for anything in the US (ok, I ‘could’ use a Dr.Pepper).

Simple Province

Simple Province

The kindness and hospitality of people here far exceeds that of America and people here, though having very little, are easy going, very relaxed and generally happy. Visiting the mountain province of Abwanan only hammered that point home and, though it may be reverse discrimination, I enjoyed the extra hugs and handshakes simply because I am a white American. I smile every time I hear a stranger on the street shout “Hey Joe” and it’s all but impossible to appreciate the big grins of little children pointing at you. I am continually flabbergasted watching 3, 4 and 5-yr olds run around several blocks of neighborhood to play – safely. Child Protective Services would have a heart attack here. Even with the floods, the typhoons, the incessant brownouts, learning to eat without silverware, bucket showers, loud roosters and cramped jeepneys, it is one of the best places in the world that you can ever call home. More to come later, it’s time to schedule my next massage.

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