A Visit To The Doctor

My bodies reaction to the difference between the high desert climate of my home and the tropical climate of my current abode is to revisit my old friend, walking pneumonia. A bit of a rattle when breathing made me decide it was time to get it treated. New location equals new experiences.

The hospital in town has signage that makes it obvious that most  of its clientele is pregnant or bringing in a new papoose  – I fit neither category.  I presented myself  to the reception desk and was given a form to fill out, which I did. A little later a nurse came out and looked at the form. Ten minutes later she came out and took my blood pressure 120/80 and left. A few minutes later she came out again and told me I needed to see a respiratory specialist, “go to the corner, one block to the left and then left again, back a half block”.

The Doctors office was rather worn and had benches inside and outside in the entry way. No frills that the patients need to support. There was a single receptionist and a lot of people waiting. The doctor was due shortly and I was number 11 on the list. I went back out to the benches in the patio and waited. There was an earthquake 2 weeks before and the power was intermittent while repairs to the power grid were made.  We were in an off stage so there was no fans on or lights. The office did not appear to have air conditioning even if we had power so the benches in the hall were a good choice anyway since they were the closest to fresh air.

As I awaited my turn I observed the other clients/patients. I was one of the better dressed in shorts, a polo shirt and canvas shoes. Most were in pants, tee shirts and flip flops. It is a commentary on economics not individuals. One lady appeared to be older than I and she had a tattered dress and no shoes. she was so frail I prepared to catch her if she fell in my vicinity.  There was one gentleman in what looked like new jeans, nicely polished shoes and a button shirt, two ladies were dressed as if working in an office or about to go out on the town. We seemed to represent a cross section of the populace. I was the only white person in a sea of various shades of brown. I am also a foot taller that most here so I really stand out. Glaringly and grotesquely stand out. So be it. Every person stopped at the desk and gave the receptionist some money as they went out.

My turn with the Doctor eventually came and I found my way back to a nook where he sat behind a small desk with a weak light illuminating his desk. It appeared to be battery energised. He was very nicely dressed and had an open shirt with a gold crucifix. He reminded me of a young Ricky Riccardo (that dates me). He greeted me politely and in perfect english asked me to describe my problem. As I did so he made a few notes and asked a few questions. He then stood up and listened to my chest. As he sat down he said my left lung was clear and I had no breathing sounds in my right lung. He said I had what was commonly called walking pneumonia. He gave me a detailed discussion of what he thought and wrote a prescription for three medications, describing in detail how to take them. He said if my breathing got worse in the next week or if it was not cleared up after the medication was completed  to come back and he would send me for a chest x-ray. We parted and as I left I stopped at the desk and paid for the visit. It was 250 pesos, which at the current exchange rate is 5 dollars, yes $5.00.

I took my prescriptions to the pharmacy and got an antibiotic for respiratory infections, an anti-mucolytic to help clear the lungs and a powder to mix with water to help with the throat irritation. The total cost of the three drugs was 1450 pesos. The total cost in Dollars was just under $30.00. No copay, no insurance and no hassle.

In the US I would have waited hours to see the ER doctor and had to pay the $75.00 co-pay up front before they would see me. The visit would have been much more expensive and mounds of paperwork involved. In the US health care is a very big, very profitable enterprise with great expense to the tax payer and some individuals. In the Philippines it is simply a way to fix sick people and keep others healthy.

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Transportation

Sticking with my Southeast Asia travels it is interesting the differences in transportation from area to area.

Thailand seems to be the most complete and varied in its transportation offerings. In many areas a Toyota pickup with a row of seats down each side and a set of steps off the back with hand rails seems to be the least expensive and pretty safe. They run a route and in many ways are like the Jeepneys in the Philippines. There are tuk-tuks much like in India which are comfortable and will take you to a location of your choice, rather than a route. Motorcycle taxis are common and very practical, but I have personally (unfortunately) seen two people killed on separate occasions right in front of me on motorcycle taxis so I will not use them. That and the one time I did, the rider took a short cut between rows of oncoming traffic and then up the sidewalk. I would rather be back flying a helicopter in combat than do that very often.

The shining star in Bangkok is the overhead rail system. The trains cover very well planned routes and are fast and clean. They are crowded during rush hour but other than having to stand they are great. During non rush hour they are a dream and an all day pass is inexpensive and a great way to explore and visit the wonderful malls. There are buses but I have not used them in town, although I see lots of them and they always seem crowded. I have used them cross country but the language issue popped up and I almost got on the wrong bus more than once.

Have the desk clerk or someone that speaks your native tongue write down your hotels name and address in Thai before you go, it may save you a panic when you are returning. Also if you are going to the airport, there are two of them, be sure the taxi driver understands which airport you are going to unless you don’t mind missing your plane.

Vietnam seems to be least varied as the most available transport to tourists are the venerable Toyota taxi.  Mai Linh  and Vinasun (green and white in color) are reliable and have meters. I prefer Vinasun since it has always seemed less expensive to me. My experience from the airport in Vinasun is 1/3 what a non metered cab is (150,000 dong  vs 500,000 dong) to my hotel, as an example. I have been dropped off blocks from my desired destination because of language issues. Maps and written directions are a must. I have learned not to leave the hotel without written instructions of where I am going and a well written description of the hotel and its surrounding area, all in Vietnamese. If you are English speaking don’t expect much help in an understandable fashion, although the people are wonderful and do try.

Prices by taxi are so reasonable that I would not try to figure out the city bus system although I understand it is very good, the language issue can be a real problem. There are motorbike taxis but are your nerves really worth the money saved, and the same language issues. Vietnam is a wonderful place to visit but Hanoi and Ho Chi Minh City  are easy to get lost in. Be prepared and spend your time enjoying instead of frustration.

Finally I am not so hot in math and even the metered taxis have a shortcut in dealing with the dong so when trying to figure out a $1.00 US is d22,300 and when the meter shows 190 and you don’t see the 000 in small numbers to the side (the fare is 190,000) and you have bills in denominations of 1000, 10000, 100000 (some in similar colors) for someone like me it gets a bit hairy. Just saying!

Philippines has a vast network of Jeepneys, buses and trikes which can get you anywhere you wish to go and being a series of islands (7107 of the) both air and water transport abound. The most picturesque are the jeepneys which come in various capacities, condition and decoration. Universally if you are over five and a half feet tall you are bound to bang your head from time to time. As time goes by and some restrictions kick in much of this will change. Other areas besides Luzon have different designs and in many cases safer and more comfortable vehicles but the traditional Jeepney may live on for a long time.

Buses are also somewhat varied. The old idea of a chicken bus (literally a bus in which some passengers may have a few chickens with them) seldom is seen but there are different bus ‘classes’ so one must determine what they are willing to trade – money or comfort. The least expensive are crowded and have no air conditioning. The next level is crowded and has air-conditioning. The best are fairly modern buses with WiFi and air-conditioning and more spacey and comfortable seating. Most of the buses are second hand from Japan, as most of the jeepneys are made from surplus parts removed from used vehicles in japan. Even some of the small boats I have used for island hopping are powered by used Isuzu truck diesel engines with the trucks transmission giving them forward, neutral and reverse. In bad weather an extra night in a hotel prevents a horrible amusement park ride. Small boats and big waves are not for the faint of heart. If you need a ride and see a jeepney or a bus stick out your arm. They will stop regardless if you are at a bus stop or just along the road side. The conductor will collect your fare along the way.

The trikes are a motorbike with a sidecar. Many of them are so small that it is worthy of Charlie Chaplain trying to get in and out. I have been stuffed in some that I had to be pulled out by the driver or an onlooker and ended up on my hands and knees. Some are driven by the same kamikazes as the motorbike taxi’s in Thailand and prices can be widely varied. So the cheapest ride is in a jeepney but it travels a route and the most flexible is a trike but your nerves may suffer a bit. There are a number of private services which operate with new vans from Toyota or Hyundai that are swift, convenient and comfortable, but significantly more expensive. Still, they remain cheaper that similar services in America or Europe so it is all relative.

The biggest savior in the Philippines is that MANY people speak English (and many other languages also) so it is easy to get directions. I have found, for me, that basing myself in the Philippines and traveling from there is extremely convenient. It is actually cheaper to go to Bangkok and return to the Philippines and then Hanoi and return to the Philippines than it is to go to Bangkok, then Hanoi, then return to the Philippines. Of course I have friends that live in Vietnam and Thailand that feel that where they are is the best place to be :-).

Transportation is a part of the culture and experience of the country you are visiting. Enjoy and experience the thrill of it all.

 

Posted in Old Age, Philippines, Thailand, Travel, Uncategorized, Vietnam | 1 Comment

Cafe Cubana

Back to Makati and the restaurant next to the filling station and one of the more interesting restaurants I have ever seen.

Cafe Cubana

So first a necessary editorial comment. I was in grade school when Fidel and his gang took over Cuba and replaced it with the glorious communist paradise it is today. I was in high school during the missile crisis and our classes were routinely interrupted by B-52’s thundering overhead as they took off “to the south”.  I have not seen, nor can I think of,  anywhere that people are better off under communism than they would be under any system that allowed one to benefit proportionally from the fruits of their own labor.

That said, the cafe is liberally (pun noted) decorated with Cuban and other communist brick-a-bract. There are large blow-ups of TIME magazine covers of Fidel and his henchmen. There are unending items on the walls and hanging from the ceiling festooned with the red communist star. I sat at a table and looked up and looking down at me was a communist military pilots helmet with prominent red star. As a former US military pilot that just didn’t look right to me at all. The staff was dressed in khaki and olive drab ‘uniforms’, many of which included a cap or beret with the ever present red star. A few had on a jaunty fedora sans star.

All that said it is a wonderful restaurant. It has an open front that is full width and on the street so the patrons can watch the passers-by. Since it is literally ‘an open front’ the restaurant is open 24 hours a day. The service is fantastic and the menu is top notch. Mojitos (Cuba’s national drink and Hemingway’s favorite) are made by hand as Hemingway would have demanded. If in Makati you MUST visit and dine at this top notch establishment. Been there, done that, shudda bought the ‘T’ shirt.

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The Most Unique Place On Earth

The highest concentration of unique mammals on earth is found in the Philippines on the island of Luzon (where I am as I write this). There are 7,107 islands in the Philippine Archipelago and the main individual  islands each have their own personality. The meat of this post is copied from “How to Geek” so I do not claim originality for that, only an intense interest since it is one of my favorite places.

[A survey of the Earth reveals, rather quickly, that islands are hot spots of diversity. Cut off from mainland areas, the contained ecosystems of islands offer a place for creatures to evolve, adapt, and thrive. While the big names in island diversity, like the Galapagos islands and Madagascar, are the most likely to spring to mind for most people, recent research has revealed that Luzon Island, the largest island in the Philippines, has the highest number of unique mammals on Earth.

Why Luzon? Not only is it a large island and distant from any mainland area, but it also has several other factors that favor a diverse ecosystem. First, it’s a volcanic island that has never been connected with any continent. Second, it’s quite old (for comparison, it’s at least five times older than the oldest of the Hawaiian islands). Finally, the island is home to many high and separated mountain peaks. These high peaks serve as sky islands of sorts, where mammalian families have split into separate species over time as they adapted to conditions on the different mountains.

cloud rat

As a result of these conditions, researchers found that of the 56 species of non-flying mammals located on the island, like the northern Luzon giant cloud rat seen here, 52 of them are found nowhere else in the world.][Indicates what I copied from “How to Geek”]

No I do not lump the people here into this interesting fact, but they are of special interest to me also. The  majority of the people of the Philippines are Malay and known  as Filipinos. Others include the Negritos (negroid pygmies) and Dumagats (similar to the Papuans of New Guinea). There is a fairly strong influence of Chines splashed throughout, as well as the Spaniards who claimed the Philippines and brought the Catholic religion of which 80% of the population follow today.  Simply traveling around Luzon one notices differences in physical features and cultural attributes, leave Luzon for another Island and more differences are apparent. So if one is trying to find an interesting and unique place to visit both historically and culturally I highly recommend the Philippines.

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Medical Care

Tromping around in a strange land sampling the local delicacies is part of the fun of travel. Sampling something that had an adverse passenger can prove disastrous.   A scrape or encounter with a prickly whatnot can cripple you for life if not cared for properly. I have not encountered a problem on this trip but I have met 2 people that have. My own experience a few years ago is a steady reminder to me to be careful.

last week I saw a young man that had a large sticker in his hand. He cleaned it out and cleaned it with alcohol, adding a bandage for protection. A few days later it had grown and now had a significant amount of pus – he cleaned it again, sprinkled some amoxicillin on it and re-bandaged it. After a few days his entire hand looked like a cabbage. Off to the doctor. Doctor sent him to the hospital, that hospital sent him, via ambulance, to the best hospital in Manila to see top level surgeons. To be continued.

Last week in Vietnam I was talking to a back packer that scraped his foot. I noticed he was wearing sandals but his right foot had a sock on it. His foot had become infected and he went to a Saigon doctor. Sore cleaned, a weeks worth of penicillin and a bill for $250.00 US dollars.  He was to go back this week and get it checked and pay again. I am very sure that a local would not have paid that much but what choice does a tourist have?

Two years ago  ate something that did not like me and after thinking I would explode I spend 4 hours in the ER, two shots and some nasty tasting glop I walked out a hundred dollars poorer but in much better condition.

My worst experience was 4 or 5 years ago when I started vomiting around 8 in the evening and vomited every 15 minutes or so until 6 in the morning. By that time I was so weak I could barely crawl to the door and summon the hotel guard.. He and another gentleman helped me to a trike (no ambulances in the town at all) which took me to the emergency room. Two IV’s (one in each arm), both with something added via hypodermic, plus a shot, an EKG, 2 nurses and visits from two doctors and by nightfall I could leave. They wanted to move me to the ward but I only had enough money to pay for the services already rendered (about $125.00 US dollars) and the rules are you do not leave the hospital until you pay the bill, and I had stayed as long as my money would allow. Had I stayed longer I would have had to contact the embassy to contact folks at home to wire money to the hospital.

The upshot is – know where you are going, what you will do if there is a problem and what local customs are – and be careful. I recommend you investigate travel medical coverage, it may seem pricey but an unexpected problem, particularly for older travelers (like maybe a heart attack) can be incredibly expensive or even life threatening. Realize that the western response time of 10 or 15 minutes for an ambulance can easily be an hour or more if where you are even has ambulances. Often a taxi with a bonus to the driver if you get to the hospital fast may be your best hope.

Often when we travel we take a bit of a gamble here or there. Don’t gamble with your health.

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Why I Travel

Seems like a dumb question to me but I am often asked “at your age, why are you traveling” (71 as I write this) and I suppose the blunt answer is ‘I may be old but I am not dead’. I have answered the question with “to learn” but one person actually said “well you probably aren’t going to live a lot longer so how will you use what you have learned”.

The truth is I have a lot of reasons and learning is one of them, searching for answers is another. To keep going is another, I figure if I stop for too long my body will stop also. To experience more is another, but the primary reason is to meet people. For those that know me that may be the strangest reason of all. First and foremost I am blessed with the greatest friends anyone could ever wish for right at home. I number true friends, the ones you can call at midnight and not be sworn at, at more that a dozen. Very few people can say that. If someone called you as you were walking out the door to a concert you had been waiting for for 6 months and said I really need someone to hold my hand, how many people would you do that for and how many would get an excuse and an ‘I will be there tomorrow’? I have 2 primary groups of friends and most are veterans (veterans really are  brothers) but there are a half dozen  that are not vets but are brothers regardless. I have friends that were in law enforcement and friends that have done hard time. I even have a few that are bums like me. So why do I need to meet people.

Twenty years ago I met a Chinese surgeon from Hong Kong in a rock ledge bar overlooking the ocean in Laguna, Mindoro, Philippines. we talked way into the morning. I met a Canadian oil worker in the Bangkok airport who had been staying on the beach as a windsurfer for 3 months. I met an Australian  man that owned hydroponic flower gardens in Vietnam on an airplane going to Saigon. On a tour bus I sat next to a primary grades school teacher from Dublin that back packs somewhere different each summer to increase his scope of knowledge so he can motivate children to learn before they get trapped in the system. I sat next to a gentleman on a boat having lunch that wanted to discuss American politics (and he was very knowledgeable on the subject). Mid way through the conversation I commented on his English and asked if he had gone to a western university. He said no, that he was from an industrial province in China and had gone to a Chinese University majoring in English and was teaching English in the local high school.

On an all day tour we had a group lunch and I sat across from a young lady that had been a lab tech in Africa during the Ebola outbreak.She talked about the horror and the fear. After she returned to England she was recruited by a charity group from Japan or Korea (senior memory lapse as to which one she said) and was currently working at a children’s hospital in Laos. In Inchon, Korea  I learned of a doctor in Manila that was successfully removing stem cells from an individual and injecting them into their hips or knees. The stem cells generate new cells replacing the damaged ones eliminating the need for surgery.  It will be forever before that is approved in the US.

I met geochachers from New Zealand in Puerto  Galera, retirees from Scotland in Pattaya and a Zamboni driver in Kansai Airport in Japan. There are lots of other people and a few more reasons but I assume you get the idea. I can watch the Travel Channel and the Discovery Channel and rot or do something, after all, I am not dead yet!

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Cu Chi Tunnels

Two years ago (May 2014) I went to Vietnam and one of the places I visited was the War Museum. It was necessary for me as a veteran of the war, but I do not necessarily recommend it to Americans. On this trip in July  of 2016 I decided on one more war related tourist tour. I went to the tunnels of Cu Chi. The tunnels are a remarkable example of guerilla war ingenuity and are often referred to in retrospectives of the war. It should be noted that I have significant claustrophobia and I intended to try to do at least the first section (30 meters) of the tunnels. Cu Chi provided one war related activity and one very personal psychological activity.

The tunnels are an engineering feat and if one wants to really understand them then go to https://en.wikipedia.org/wiki/C%E1%BB%A7_Chi_tunnels or other good history sites. Needless to say they are an important historical site and well worth visit despite the long bus ride.

Our tour guide was the son of a person that escaped after the war and went to the US. He spoke good English and had a lot of knowledge which he presented very well. On the bus he talked about Vietnam in general, the war a little, and lots of ‘general’ facts and comments, such as 35 people a day are killed in Saigon (Ho Chi Min City) in traffic accidents, mostly on scooters or pedestrians. He said there are 14 million people in Saigon and 12 million scooters. There are not more cars because the government adds a massive tax to control even worse traffic. He said a scooter is $20,000.00 US and cars are priced accordingly. I have no idea if the figures are correct but they are interesting.

Back to Cu Chi. The people in the tunnels were farmers by day and guerillas by night. After the war they were considered war heroes and received a special stipend from the government. They are credited in a large part for the communist victory (I credit the American Congress and Walter Cronkite). Whatever, they had an incredible operation.

The site has numerous war relics including a tank that had run over a mine and many types of man traps and other items. One of the most interesting was a collection of weapons that one could fire. I recognized an M-60, an AR-15, an M-14 and an AK-47. You paid by the bullet in 10 round minimums. A number of people were firing M-60’s and AK-47’s. I do no mind telling you that I DID NOT enjoy being scant yards from the firing area and the sound of those weapons in the jungle echoing off the range back stop was not good for my soul.

Finally we came to the tunnel entrance and one by one we lined up to enter. I was not he first and after a few went in one of the people backed out and departed the area. I got to the entrance looked inside and also thought better of it, climbing back out and letting the others go on. In all about half of our group went the first 30 yards and one person, an Australian, went as far as the tour allowed. I am glad I went, I will not go to that particular place again and I am not sure I recommend it unless you are a historian. Over a million people a year are said to go there and if it rings your bell or want to fire an old M-60 it might be a great place. Not for me.

 

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