Posts Tagged 'Philippines'

Home and hospitals

I have returned to beautiful Lobster Cove. I got the requested business class upgrade for the 18 hours in the air from Manila via Tokyo to Detroit.  In Detroit I found out that both Axel and my granddaughter were in the hospital. Both were being examined to determine why they weren’t well. Axel had a spell of something (but heart attack was ruled out) and Saffi was listless and had had diarrhea for several days. Sita and Jim were back again at the hospital they so detest but what else to do?

Axel was dismissed before I landed in Boston but Saffi is still a patient. The hospital won’t let newborns go home until they have gone through an entire list of tests, including spinal taps –as per lawyers’ instructions we suspect. So far, none of the test has been positive and she is looking better.

Tessa was summoned to Logan to pick me up – it’s good to have children look after their aging parents – and take me home. Axel rode along, dismissed from the hospital just about when I took off from Detroit.

We had a Chipotle take out meal. Axel made a margarita took accompany the meal, which I drank too quickly. Going to bed was a good thing to do anyways. I had gone through a 36 hour day compressed into one day: I got up at 4 AM in Manila, arrived at 4 PM in Tokyo and then again at 4 PM in Detroit. I tumbled into bed at 9:30 PM and slept until deep into the morning. It is wonderful to be home.

Old

I observed the first day of the management training that is provided as part of the WHO wheelchair service training package from the sidelines. My Filipina colleagues ran the day in a mixture of Tagalog and English. Not everyone of the participants actually manages a rehab center, some are in charge of developing national policies. This makes it challenging to cater to everyone’s needs. But the trainers are doing a great job.

Not having slept well the last few days I resolved to go to bed early, and treat myself to a facial to get sufficiently relaxed beforehand. I was suckered into getting the anti-aging treatment, which is double the price of a regular treatment.  I am sure my 26 year old colleague was not given that suggestion. Have I now entered that category of old and credulous people who pay extra for the silly promise of looking younger? My brain told me this was poppycock but I bought the package anyways. When it was time to pay, as if to convince me I had chosen well, the beautician pushed a mirror in front of me. Frankly, I thought I looked old and tired.

On the way back to the hotel I stopped at the supermarket to stock up on dried mango for the return trip. There was one line dedicated to retired people. I decided I looked sufficiently old (and tired, though not re-tired) to be allowed in that line which was also populated by a string of young girls. When the cashier saw me she told the girls to step aside and let me through. Old indeed!

Birth of a society

The second wheelchair stakeholder alignment or consultative meeting is over – it was the primary reason for me being here.  Although my task is not done, the hard work is over. Tomorrow we start the managers training meeting for rehab center directors and other people in managerial positions from the government, the national health insurance program, private sector and charities. I will get to serve mostly as a supportive coach to the Filipina trainers; they left me just one session to conduct, on Planning for Financial Sustainability no less!

This afternoon I served as a midwife to the birth of the Philippines Society of Wheelchair Professionals. The first part of the day was hard labor, but then in the afternoon the baby slipped easily into this world. The birthing process was participative and exciting and left spirits very high, swept even higher by a group photo accompanied by Queen’s “We Are The Champions.”

I had asked for nominations for candidates to form a transition committee that would help shepherd the Society into its postnatal period, until such a time that it is strong enough for formal election of its officers. Ten people were nominated or nominated themselves; two of them declined, seven of them did a less than one minute stump speech and eight were on the ballot. Everyone voted for five candidates, a somewhat arbitrary limit informed mostly by practical considerations and my experience that teams of 5 are often more effective than larger teams.

While Maggie counted the votes, the 60 or so participants and soon to be members of the Society created three drafts statements built up from the ideas of each and every individual in the room. After the election results came through, the five members of the democratically elected received their applause and set down to their first task as Transition Committee and fashioned the mission statement out of the key words that the group had identified from three drafted statements. Transition_committee-PSWP

And while the Society’s mission was being created, the rest of the participants brainstormed possible objectives and settled on four, an easy process of convergence as the glue among the participants had already set, in spite of quite divergent individual agendas and concerns.

Maggie gave me a brief refresher on hash tags and @ signs and supervised my first Instagram postings on this newly born society and its first pilots.

A research team from JHPIEGO, a Johns Hopkins affiliate, invited everyone to dinner to share the results of a consultation they conducted on Monday morning – a nice example of synergy between organizations who sometimes compete and sometimes work together, as we did here – both of our programs funded by USAID.

I ended this great day deeply tired but very happy and treated myself to a massage in the hotel spa. Unlike the sketchy spa in our previous, much more upscale hotel, this spa was great and open till midnight.  My massage was splendidly done by Nellie, who I might visit one more time before it is time to return home.

Wet Sunday

Sunday the remains of the latest cyclone hovered around Manila. It was a day to stay indoors and take care of other assignments, read and take naps. I decided to take a late breakfast but that was a mistake; everyone and their brother, and especially little overweight brothers, milled around the various self-service stations in random movements. The description of the breakfast arrangement is priceless: a showcase of a live interactive kitchen and the intent to “make your gastronomic adventure more festive.” Today I am going to try breakfast at 6 and visit station 7, the kimchi and other fermented foods station.

During a few dry spells I took a walk in the neighborhood of the hotel. It was Sunday and therefore quiet for a change. We are near the UN and the University of the Philippines faculty of allied health services and the university hospital. The buildings hint at past grandeur but it is gone now. The Radium and X-Ray Therapy Institute had known better times, its function chiseled into its grand façade.

When the mall opened I checked out eyeglasses but found little reason to purchase an extra set here. The prices were only slightly lower than in the US. This is true for many of the brand name offerings at the mall which clearly caters to the well-heeled citizens of Manila. Only the nail and spa places are a bargain for us. After the pedicure a facial and massage is still on the program.

Two women who had just flown in from the US joined us for dinner. One is from Johns Hopkins University who will share the findings of a research study about wheelchairs. The other is from the US Cerebral Palsy Foundation and arranged her last minute flight, this event being too good an opportunity for her program to meet with key stakeholders to miss. We went out to the Seafood Market restaurant, recommended to us by both the concierge and the reception staff, a short walk from our hotel.

The restaurant turned out to be quite a dining experience. When entering the restaurant one receives a supermarket shopping cart and then helps oneself to fresh fish, displayed on ice, vegetables and fruits. When done the cart is wheeled into the kitchen and a short while later the contents of the cart return to the table transformed into a most wonderful meal.  For about 20 dollars each we had sweet and sour fish, scallops, jumbo prawns and a mountain of stir fried greens. For dessert we had picked mangoes and watermelons which were delivered to our table prepped for easy eating. What a concept!

Work, eat and play

It was a nice reunion at breakfast where I found both my US colleague and my Filipina co-conspirators – the same team I worked with in Cambodia earlier this year when Massachusetts was still covered under lots of snow.

I love breakfasts in Asian hotels because they serve both Asian and western breakfasts and I get to sample a lot of different foods. I started with sticky rice rolled in some sort of leaf, eaten with caramel and roasted coconut. Then I had a crepe, again with caramel and this time with banana slices, and of course lots of fresh fruit.

After breakfast we reviewed our plan, divided roles and I started to prepare for the sessions I am running. M. and I went to the mall for lunch and to hunt for flipcharts but we got sidetracked after an overdose on Japanese food – M. had a facial and I had my toenails done in a nail spa that reeked of toxic liquids but made my nails presentable again.

It is weekend here and in the rainy season, or maybe any season, it is mall time. The place was filled with Filipinos who are visibly doing well. But on the way to the mall you have to dodge the street urchins, some younger than Faro, who have already learned the rules of street life. A young mother held on to the littlest of her brood of four, five? I wondered about her story. It was a very sad and disturbing sight, just steps away from the good life.

Later I met a new member of the team,  a young Mexican physical therapist who was one of the trainers of last week’s intermediate wheelchair fitting course. She is also representing the newly founded International Society of Wheelchair Providers, supported, like all of us here, by the American taxpayer via USAID. We plan to lay the foundation this week for a local society, and possibly future affiliate of the international society.

For dinner (there is always a reason to eat here) we went back to one of our favorite places during our last visit, a shabu-shabu restaurant (akin to Mongolian hotpot). We had our Filipina colleagues do the ordering to avoid the fish lips and other weird edibles that M. and I ordered last time, not knowing what was what. For desert they had brought the fruit durian. I was amazed that the restaurant was OK with us bringing in our own dessert, and, even more amazing, something that had a rather pungent aroma that wafted through the place as soon as the Tupperware container was un wrapped. We all got to try a piece – not bad actually, until the burps set in. We also got to try malang, another tropical fruit, small white globules, a little like lychees, that made a very nice ending to the meal, and that may also have contributed to the not so great burps.Maggie-and-durian

Rewards

photo 3Manila-pedi

just_rewardsWe ended the managers’ meeting with some wonderful comments from participants who told us they got a lot out of it even though we were rather critical of the design. If a doctor tells you that he realizes there is a whole service delivery system that needs to be in place for other caretakers and technical folks outside his consultation with the patient, then you know you have scored.

Filipinos are big into social media, especially facebook, and picture taking. Something it took a long time to get from one side of the room to the other or even to the bathroom because at every step there was someone with a camera and people lined up for a picture. The handing out of certificates required pictures to document handshakes and smiles from multiple angles.

We had earlier said goodbye to our lead trainer who was heading off to Vietnam where M will join her so I got a promotion to lead trainer and was in charge of the speechifying and certificates and thus subjected to the picture taking. But that was only fair since M played that role last week.

M and I celebrated the completion of our assignment and claimed our just rewards in the form of a pedicure, followed by a Korean dinner, followed by one of the exquisite and artful pastries we had been eyeing in the hotel lobby since we arrived. Of course we should have had one but we couldn’t make up our mind which to choose and took two which we only half ate. As with many of these pastries, they look nicer than they taste and they are much too big. I had the second half at the airport, all 2000 calories I believe, and am full for the ride home.

It was a short night; the taxi picked me up a little before 4 AM. I had expected a swift ride to the airport through an empty city but was mistaken. Although the ride was fairly swift, the city was all but empty. Our hotel is located on the edge of what looks like a popular entertainment district with many side walk eateries, hawkers, karaoke bars, 24 hour massage places and ladies of the night. The place was hopping with sidewalk cafes full to overflowing and neon lights blinking to entice passersby inside.

At the airport there were long lines to get in, long lines to get checked in and checked out. I had once again asked for a wheelchair (now I now it is a transport wheelchair, not for daily living use) and was wheeled swiftly past the lines by my handler Erwin. I was upgraded for the two short flights that bookend the long one from Japan to Detroit – for that one I return to a middle seat in the back. You get one you lose one.

Fish lips, eel and bamboo pith

The stakeholder workshop, where I was given pretty much free rein, is over and now I am piloting a managers workshop design where the reins are quite taut. I found myself procrastinating, balking at having to read a script. I kept postponing the preparation for the sessions assigned to me until early this morning when time was up. And even though I had prepared my 50 minutes, once I stood in front of the class I forgot my lines and improvised in a way that made sense to me. Even though I did engage with the participants, more than my lines suggested, it didn’t feel right.

Our lead trainer is now quite familiar with the approach and design; not only has she been immersed in using the manuals that we have to work from for some time now, and completed a five day workshop on basic wheelchair training just last week, as a PT she also know the technical and clinical side of things really well. This in stark contrast with M and I who are learning as hard as the participants. I still have to prepare for my last session on monitoring and evaluation (I know something about that). Once again, I am procrastinating, preparation postponed to sunrise.

I am quite tired and full from our 2nd Shabu-Shabu/hotpot meal. The menu consists of 95 items displayed in alternating white and yellow lines, like an excell spreadsheet. I was given a pencil and make our selection, like on a sushi sheet. The wait staff didn’t really speak English and so we were on our own. We were both intrigued and put off by things like black fungus, chix leg mushroom, tao pao, Taiwan pechay, polonchay, sotanghon, mini ngoh hiang, fried fish skin, squid balls, pork intestine, pork vein, pork kidney, pork liver and beef tripe

We felt very brave to order the fish lips, crab roe balls, and bamboo pith. M is one of those rare Americans who likes eel so we had one fished out of a tank sitting on the sidewalk and presented to us for approval, slithering through the fish catchers hand. Five minutes later it appeared elegantly dressed (but still raw) on our table before it was dumped, head and all, into the hot pot. There was local lettuce (a disappointing pile iceberg leaves), leathery bean curd sticks, rice noodles, small sweet local scallops, wontons, dumplings and thinly sliced beef. It was a little much for three people but not filling in the way an Italian overdose would be.

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