From East Asia: Kumusta (Hello)....

... from the Philippines!

We have been here just under a week.

Before flying over here (17 hours, plus a brief stop for gas in Guam), Kelvin and I spent a weekend in Westminster (Orange County), outside of LA, where I got to see the La Brea Tar Pits (!!), and where I was introduced to a bunch of So Cal, as well as Vietnamese culture, including tons of yummy foods (pennywort juice, salty plum soda drink, sugarcane juice), Korean bbq, pre-new year festivities (today should be recognized as Chinese and Vietnamese New Year, and NOT my hated V-day holiday), and swap meets (oh.. don't get me started --- I'd never heard this term for "flea market," but it is my new favorite place on earth!).

We are currently in Ligao City, which is about 45 minutes outside Legazpi, Albay province, which was an hour flight (but apparently a very bumpy 8h busride) SouthEast of Manila (main island of Luzon). We are 16h ahead of PST, so jetlag was a bit of a bummer, but, having slept for most of the plane ride (minus time spending playing "Bejeweled," which is rather addicting), we adjusted fairly well.

We have been spending our days at Josefina Belmonte Duran Memorial District Hospital serving the city, alongside a big team (at least 30!) of Filipino and other doctors, nurses, and other staff volunteers practicing in both the Philippines and in the states. There are a few medical specialists, but mostly surgeons, who have been "teed up" here to do major surgical cases (we have been doing more than 20 per day!), including hernia repairs, gyn surgeries, HEENT and cleft cases, as well as thyroidectomies (which, here, are done under local anesthesia, which is awesome to see!).

Kelvin and I have been bouncing around-- seeing tons of outpatient men, women, and kids, and dispensing the meds we have, as well as taking our hand at outpatient "minor" surgeries including lipoma, cyst, and other "lump and bump" procedures. We had a BOA (birth on arrival), a laboring woman (with her 10th child!) who was driven here by tricycle by her family, the first 5 minutes we were here in the hospital! Awesome!

Happy mom and baby #10

We are seeing a lot of advanced disease here-- strange skin lesions, and HUGE goiters. Hypo and hyperthyroidism are surprisingly very common, as are complaints of "dizziness" and blood pressure ("high blood"), which we can help treat in the short term with the free meds we brought. There are good pharmacies, including "generics" here. There are also tons of lumps and bumps which have grown out of control. I'd say that some of our "minor" procedures are not so minor!

A modest-sized goiter

Seeing outpatients

Char Lu was one of our awesome translators (while English is very prevalent here, I still feel that I need to learn Tagalog, which is interesting in its interspersed English and Spanish words!).

In Minor Surgery (this is like our SURG 2 rotation!)

A sebaceous cyst which I removed and, miraculously, did not pop in the process!

Having seen a few people with heavy vaginal bleeding (who'd bled down to hemoglobins of 3 and 5) who I felt needed surgeries, I've also scrubbed in (loosely meant here, where flies frequently buzz around the OR and people wear sandals most of the time... not so fun when blood drips on them!) on a prolapsed cervical myomectomy, and did part of my first hysterectomy since med school! Being here almost makes me want to be a surgeon, or go back and do an OBGYN residency.... almost :)

Me with the resected specimen-- a very globular uterus with adenomyosis and endometriosis (however, no pathology reports are available so we will never know!)

It's been wonderful. Great medical practice, great experience in surgery, and working with just great people. The town is really cute-- today, we visited a nearby hill, Kawa Kawa, and got to see some countryside (otherwise, it's been long days- 7 am till about 9 pm in the hospital). The people are sooooo warm, welcoming, and extremely helpful, polite, and accomodating.

The food is awesome! We have had tons of varieties of noodles (pansit), fruits (star apple and jackfruit, which I'd never tried), variations of banana snacks, and sweet rice wrapped in banana leaves. Ligao City is also home to the pili nut, which is heavenly, esp. when glazed.
Mmm. It's dangerous I'm largely wearing scrubs.. hope I fit into clothes later on in our trip.

Out and about

Riding a "tricycle" to mass in town

in the trike with Lita

Riding the "jeepney," the public transportation which is like a bus-jeep hybrid

Well- tonight we have a bit of a "conclusion" dinner.

We may do some exploring tomorrow before flying back to Manila on Tuesday. Then we head off to a few more villages in the next 2 weeks, including Zambales, Pampanga, and Puerto Princesa on Palawan Island.

This is surely an adventure!!!

Miss you! Hugs!

Take care ("Ingat" in Tagalog)!

- Tara (and Kelvin, or "Kevin" as everyone erroneously calls him, and "Dr. Yu" as his nametag erroneously reads :))