Philippines part 3: Palawan to Manila

We are back in Manila (well, Quezon City) from the island of Palawan, which was our most recent stop of the Medical Mission.

I cannot believe how warm and welcoming the Filipino people are! The hospitality has just been amazing. Each stop on this mission, we have been "hosted" by a local rotary group (or, in our last stop in Rio Tuba, by the Rio Tuba Mining Company). Other than seeing the bazillion medical and surgical patients that present to us, we have rarely had to worry about where we were going to eat or sleep for the nights on the road. Granted, this was a medical mission in a foreign country, and one traveling under such circumstances has to expect our share of the unexpected. When the surgical team was operating until 2 AM or, on another occasion 6 AM, we found ourselves almost without a place to crash and worried we may not eat (good thing for emergency snack packs! I have eaten a LOT of pili-nut-flavored snacks and prawn crackers). We left our "dorm" in Tarlac around midnight one night just to drive through the night to the next town, and had to hop from house to house before finally arriving, close to 2:30 AM, at the right one. I was about ready to just sleep in the van at that point, after stumbling around in the dark, well past my desired bedtime (9:30 PM) with my inflatable neck pillow trailing behind me at all times.

We had to be "evacuated" from the villa where we stayed on Clark Air Force Base (thought of you, JB and Wendi!) around Angeles City. Luckily, someone was there to collect our various belongings and send them to the "new" villa while we were off seeing patients! Due to flights being fully booked, we almost got stranded in Palawan (we learned that there was a 72 hour boat ride we could take back to Manila) but somehow, someone pulled some strings and we took a private 19-seater jet back to the main island! While Filipinos and the "Filipino way" to me seem very laid back (there is such a thing as "Filipino time" and, let me tell you, it is SIMILAR to Nigerian time), it continually impresses me that they can get things done, and done well. As the Filipinos say, "bahala na" (or "go with the flow"). One has to do that, in order to survive here! :)

Here are lots of overdue pictures from the past few stops:

Seeing patients around (Capas)/Tarlac.

Pre-screening surgical patients- Tarlac

Typical surgery day case list (I think they did 52 surgeries on one, very busy day!)

Us with Ems, the nurse in charge (doesn't Kelvin blend well into the Hospital Van [trailer] advertising also the Mayor, T.J. Rodriguez?)

one year old on whom we did a frenulectomy (very difficult with a willful toddler with teeth!)!

KV and Lei in "minor surgery" (lumpectomy!)

hordes of patients waiting for us (I think I saw 60 patients, mostly with complaints of cough, in one afternoon. Maybe this means my clinic productivity will go up on return to UCD!)

Nice to see some peds (I truly felt like a family physician on this trip-- some medicine, some peds, some minor surgeries, some major surgeries)

Then onto Pampanga

seeing outpatients

Man with very advanced gout

Milk Code (or sign put forth by lactation Nazis), which, admirably and very persuasively, encourages exclusive breast feeding

On the jet from Puerto Princesa to Rio Tuba, Palawan (that's Dr. Carbajal, the first Filipino specialist [ENT/ophtho] in the U.S., at the right)

This picture of a baby in the Rio Tuba hospital cracked me up

Sad case: 19 year old girl with ascites and abdominal mass of unsure etiology.

She is going to be taken to Manila for evaluation/treatment.

Kelvin kept talking me into helping him with excision of large lipomas, which tended to bleed like stink and which we had to do in the main OR.

Large lipoma- mmm

with Loreta, Stephanie, and a manicurist who turned the OR break room into a salon

While in Palawan, I actually got to do a lot of operating.

Here is me with Dr. Quevedo, the OBGYN on the trip, with whom I got to do some TAH/BSOs and tubal ligations (interestingly, which many people here [it is a largely Catholic country] object to performing)

A 20 cm (ovarian) mucinous cystadenocarcinoma (cancer) which we resected.

Me with Dr. Baron, the head of the whole mission operation

Postop checks

Despite the long hours in the hospitals, we were able to enjoy some aspects of Filipino life

I loooove the fruits here! I think I mentioned that I tried Star Apple for the first time. I have definitely eaten more than my share of awesome mangos, which always have been, by far, my favorite fruit. I haven't yet had the opportunity to try durian, apparently a real stinker, but I will try it if the opportunity presents!

Pictured below are, in sequence from left to right : 1) star apple, 2) mango, and 3) cashew fruit (I didn't know cashews came from fruit!) Can you see the cashew on the top? :)

Trying "balut" (duck embryo), which I was not such a fan of.

By a local "tricycle," one of the main forms of transportation

Some sightseeing we were able to do:

Cagsawa ruins (church buried in 1814 by the eruption of Mt. Mayon)

Mt. Mayon eruption (as pictured on a picture taken on 12/23/09). No, we were not caught in this eruption -- this is a picture of a picture!

Crosses atop Kawa Kawa mountain, a hill above Ligao City in Albay Province where we hiked a bit

Badminton on Palawan (some of the little exercise we have gotten a chance to do-- unless you count as exercise, as my sister considers, Olympics-WATCHING!)

Another thing about the Philippines which I find very amusing is their love (and seriousness!) of karaoke which you can read about here. While I love to sing, I don't really love to sing in public. I have maybe gone to karaoke about 3 times in my life (prior to this trip!). Since being here, where a karaoke (or videoke??- I'm not sure the difference) machine can be found in most restaurants, some streetcorners, and many living rooms, I have volunteered way more times than I would ordinarily found comfortable. Maybe I'm losing some of my inhibitions. and, not knowing the people here, I care less about what people think. Maybe I'm more confident. Who knows. However, despite my being willing to try, I have to say that it is INTIMIDATING singing karaoke with native Filipinos, most of whom (in my opinion) belong on "Filipino Idol," or at least the show "Filipinos Got Talent," which is similarly popular here. I dare you, someday in the future, to sing karaoke with a Filipino. You will be totally humbled!

Just a reminder: Yes, this is a work trip :)