Philippines… Forgotten People, Forgotten Illnesses.

Friday, August 16, 2013
By Wolfgang K Piller MD

Hot off the wire…

Well, nowadays it’s not so much hot off the ‘wire’ as the ‘satellite’ and I didn’t arrive by Zeppelin either. But here the wire started: bus from Cagayan de Oro to Valencia 130 km = 4 hours, bus from there to Davao for a weekend break 180 km = 5 to 6 hours.

Valencia is a biggish city in the middle of nowhere with little to do, but there are eateries everywhere. It’s a place where time is not money, because there is plenty. It’s a culture where many Spanish and then English words have found their way into the main language spoken here, so I guess, there was no synonym in the original language.

I am working the 2nd week in hospital outpatients now and our target group are the thinner ones of the society, the poor. The majority of those are indigenous people with a different culture to mainstream culture, the Manobo. Although they don’t dress in their traditional way now, their skin is often darker, and their hair is styled is differently.

In a week’s time I’ll work in the isolated communities for the rest of my time here and surely I will learn more about them. Like a lot of minorities, they are discriminated against, when they try to preserve their way of living. Just to complete the picture, the main stream Philippinos have been imported successfully over the last century from more northern islands to dislodge the native non-Muslim and Muslim tribes. Many of them only speak their tribal language.

The tropical illnesses seem under control, Malaria and Dengue fever are rare and for Schistosomasis there exists a government programs to protect from the snail-born parasite of the rice fields, which causes cirrhosis of the liver and epilepsy. What is rife here are the illnesses of poverty, the frontrunner being tuberculosis. Weight loss, cough and fever are the typical complaints, often there are no complaints at all, the patients only look ashen and wasted and attend with a different problem, because TB is frowned upon in society. However they should know that only a treated TB is a good TB. TB is easily treated, if one does not have resistant bacteria and enough patience to finish the 6 to 9 months treatment, a fact, the second group of wasted patients would be happy with.

Also, on a daily basis I encounter advanced cancers, treatment is an illusion, because nobody can afford diagnostics or therapy and the NGO only covers primary care. It is cruel, but one Euro only can be spent once. Goiters due to iodine deficiency seem to be the local currency, with abscesses and skin infections being the change.

Chronic bronchitis is a daily occurrence because of the wood fires needed for cooking. So is heart failure in young people due to valve damage after bacterial throat infections, like in Europe before the use of antibiotics. Our patients are grateful, that they can get their medication cheaply for 60 Cent, but some can’t even afford that and some need the money for the bus on top of it.Particularly in the afternoons the patients can’t get back to their communities and they are happy to sleep on wooden boards in a designated area gladly accepting a free dinner.

Donations for “German Doctors”: Account (Konto) 488 888 0, Sorting code (BLZ) 520 604 10, EKK Bank, Germany. IBAN: DE12 5206 0410 0004 8888 80, BIC: GENODEF1EK1, code word Spain, or in our surgery.

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