A young foreign visitor went into a large Cebu Hospital and came out with feet amputated. Which hospital was it? Which hospital were the first in the world to lose its international accreditation with references by investigators towards the doctor and his team as – (the) ‘teams’ shameless “excuses.” Where was the hospital that was laughing on video at a patient during a surgery? … More on this soon.
This is a story about the hospital system in the Philippines.
There are many Filipinos that don’t think much of their hospital system. It gets worse as it goes to the provincial level of a hospital where most filipinos I speak to think that “that is it” you will die in the hospital or inherit another problem.
The sad fact is, most of the hospitals are understaffed, have poorly trained staff and incompetence runs high. There’s a mix of public and private hospitals but as you get into the country and out of the more developed areas these hospitals are mostly public. The budgets are small and equipment is lacking or dated.
The mindset is among many people that the hospitals are there to make money and treating people is a second exercise. If the Hospital system in the Philippines object to this, well, you have a marketing problem on your hands as this is the perception amongst nearly everyone I have spoken to, Filipino and foreigner alike. I have received many calls from Filipinos with problems of rapidly rising bills. The callers all share the same strenuous stories, which if they don’t pay a hospital bill by a particular time, another day will be charged to their bill. You see, this is how hospitals catch people. They have a checkout time much like a hotel and if you don’t meet that time, a new day is charged on your bill. Sad, when you are in fact out of your room, the hospital will keep running up the billing while the bill is unpaid.
Guards are at the doors to prevent hospital “runners”, so they will prevent people from leaving until the bill is paid. There are situations where you can get a promissory note from the hospital but seriously, how many Filipinos have you dealt with that have honored a debt under a promise and repaid the money owed? For me, over ten years in the country – its a 100% failure rate to repay debt although I am a sucker at helping Filipinos and never expect the money to be returned anyway even if 100% say they’ll pay next salary day – “pR0miC.” as the texts and pleading goes.
The other thing is the white skin effect – quite typical that you find this not just with hospitals, I have been told by many locals when they are in the hospital that I should not come to the hospital or stay clear. It is stated the doctor will think I am part of the family, and the cost of treatment will go up, or they will find it hard to negotiate the settlement of the bill. What a fuck. This sort of crap goes on all over the country.
The Philippines Drive For Medical Tourism and The Philippines Control On Truth.
There’s a push now for the Philippines to be a “medical tourism” hub. What a joke. They need to fix up the system before they can start engaging in the medical treatment of foreigners for procedures, e.g., Dental work, oral surgery, cosmetic surgery, etc.
After living here a while and getting over the “honeymoon phase” of the Philippines, you will realise that Filipinos are highly defensive when they don’t like what they are hearing, especially coming from the mouth of non-Filipino.
Newbies to this country might think that is a bit harsh to say but seriously, after doing some time here, you will know exactly what I am talking about.
You can see this grasp for control of keeping things “all hands Filipino” in the way the constitution of the country is run where foreigners are blocked out, high taxes are charged or bans put in place eg. bans on giving Filipinos secondhand clothing to running domestic shipping business to dating agencies. If it is so “offensive” to the Filipino way no matter if it is true, filipinos will ban it. Article II, Section 19 of the 1987 Constitution basically shows this by mandating a self-reliant and independent national economy effectively controlled by Filipinos. This legislation trickles down from the top restricting outsiders, foreigners, aliens and other words they love to label non-filipinos in all manner of business dealings to zero percent foreign equity share. This level of controling filters down through society and into the culture.
Take therefore speaking the truth. Yes, speaking the truth. Filipinos don’t like the truth being told and they will use their power to ostracise the truth-sayers eg. declaring someone “persona non grata” for raising an issue and they will do this publicly. Do a simple google search for persona non grata in the Philippines and you will be surprised. Jesus, even just to publicly mention on Facebook a posting that your girlfriend is a scammer can get you arrested as recently happened to an Australian. Try suggesting online that in a tourist area the rubbish is unsightly after not being collected and building up and this can get you publicly chastised by the local town counsellors and declared “unwelcome”.
Furthermore, the government enacted legislation to restrict the truth being told. In the Philippines, cracking down on people that tell the truth against wrongdoers and bad business is controlled under Cybercrime Prevention Act 2012, therefore, you cannot post anything on Facebook and I guess go to the media without risking retaliation and possible damages claim or jail sentence. Effectively this is a tool that keeps the Filipino culture on track. The culture is largely about – don’t raise a fuss, don’t complain, if you do not like it leave and take your business elsewhere. Filipinos are placed under threat and in some cases shot dead and silenced as many people have even in the idyllic areas like Boracay, ask the Ati people (the original settlers of Boracay Island) or citizens in Mindanao.
In other cases, common immigration laws are used to rid the so called whining foreigner from the country. Even more recently there were threats from the Immigration Department to stay out of the countries elections or face deportation. Foreigners have been deported for insulting Filipinos – even for trivial matters. It would be nice if Filipinos took on board some of the comments instead of spending copious amounts of energy defending themselves all the time to keep afloat “Pinoy pride” – oops I forgot, its well written online that you cannot get anywhere arguing with a Filipino let alone, they do not understand sarcasm or irony.
So let me ask you a question?
What if you lost your legs through hospital negligence? With all that I wrote above, how do you think your medical negligence claim would stand if you got gangrene or an surgical botch up? How would someone who has never come to the Philippines before in their lives arrive for cheap surgical procedures as advertised, the great new medical tourism hub Nirvana and – something fucks up.
How successful would your claim be?
Even at a local level, for Filipinos hiring an attorney is out of the question. Usually, if Filipinos are “pissed” they walk away and never come back after being ignore or offered a token compensation amount. You have little hope of the media or a journalist backing you up for there has been very little coverage about hospital negligence which has happened. Sometimes its raised and then … mysteriously is never covered again. In some general cases, the person comes back and shoots dead the person who is in dispute. Simple, that is how it is done in the Philippines. It is cheaper to shoot dead someone than endure corrupt court systems and greedy attorneys.
It is quite common for a business to ignore its victims. I witnessed this first hand. Its quite common for Government departments to turn a blind eye as well.
This is the picture of how typical Filipino business act towards victims. Victim complains, jumps up and down and is ignored.
In the backroom, however, business is busy terminating staff and hiring new batches of incompetents. Meanwhile, business does not relate TRAINING with ability. Business refuses to train and invest in proper training and many companies are going through VERY HIGH staff turnover rates and cant seem to work out why… other than to hire three to five times the number of employees that would be used in developed countries for the same job.
Silently, the business will listen, staff will be terminated, restructuring made on the quiet and there’s HOPE – HOPE that THE PROBLEM WILL GO AWAY and that the victim of whatever happened will shut up and disappear.
This is how the complaints system works in the Philippines.
Filipino society is about not making a fuss. Don’t complain, don’t show anger, let the problem go away. This is why Filipinos are seen as “kind, caring” people because they never say a thing in a complaint.
Long timers here know that initially complaining to a company will get no response. “yes sir, yes sir” and …. pfff tt – into thin air it goes. Unlike overseas in countries where people give a shit, Filipinos seriously… don’t give a fuck.
Well, the problem did go away at Chong Hua and so did its International medical accreditation. More on this later.
So how can medical tourism work in the Philippines? Fuck knows… It cannot if they are making fuckups. Foreigners who want to get compensation will be pushing shit uphill. There is ZERO protection for foreigners in the Philippines; the protection is all enshrined in legislation to protect Filipinos. Forget to take the case to court as the system there is bogged in corruption, long waiting times and at the end of it, what would the payout be for a botched operation? – very low because it is in the Philippines.
Filipinos are so hell bent on protectionism it is crippling the country. As I mentioned above it’s about dignity protection, protecting their own fucking ego’s. The country imposes high taxes to make importation mostly unprofitable and protect local inefficient enterprises and the oligarchs that run (and ruin) this country. There are some areas where foreigners cannot operate such as domestic shipping or media and other areas which are heavily taxed and the ownership structures so risky that the risks are just too high having 60 percent in the hands of a Filipino and only 40% in the hands of an investor. Even to an outsider having a Filipino with 60% ownership is a shit business deal. Quite typical of the dating scene where the “inputs” of the foreigners side are far more than the “locals” side. To Filipinos, this is a fair deal with ever increasing expectations to a point of stripping the foreigners dry.
Oh yes… Filipinos go to great lengths to protect themselves and the power brokers even if they treat their customers like shit.
If you want an operation in a Filipino hospital, I would strongly urge you to go back overseas and get it done in an environment that at least has patient treatment standards, accountability and a legal and compensatory framework. If you stay in the Philippines, I would strongly urge you to get some insurance scheme overseas that pays in dollars, euros, pounds… anything but a local policy that has very little treatment coverage. Getting a hospital cover locally that covers the room is nothing – the rooms can be 900 pesos a night for a single hospital room without CR. ITS THE OTHER COSTS that are the killer and your two-bit local health insurance cover won’t cover jack shit.
Test …Test and More Tests
I often hear from foreigners that hospitals are running up testing to run up the bills. You see, this is how things are played out. You go to the hospital, and unnecessary tests are carried out. The hospital asks you to pay and then get reimbursed when you get home with your travel insurance. Simple huh :)?
Well, this is the trick. The travel insurance firms will flip at having chest examinations and X-rays of the chest for a wrist injury to pay back home; this is exactly what I have seen done, and the travel insurance company was not too happy and, of course, there’s always going to be a dispute when that happens. No doubt the hospitals have had “altercations” with overseas travel insurers not paying for testing procedures and that is why they try and get you to pay upfront and you Mr. patient follow-up with your travel insurance company later. The Philippines hospital has wiped their hands of the overtesting… thank you very much.
How hospitals make money
Let’s face it; these guys are money machines and yes, there is legislation in the country that says the hospitals cannot turn people away if they do not have money on them or no insurance, let it be told like everything else in the Philippines – someone has got to pay. That is how the Philippines mostly works if the staff do not pay – the customer pays – but never the business. For the Filipino response system second to “if you do not like it, leave” is “you should be thankful to have a job or for our business to be around”.
There have even been foreigners who have died at the hands of hospitals in Manila.
Heres some ways hospitals make money (these practices may differ between organisations);
⦁ recharge a day’s room on the bill – yes, even if your out of the room, ready to go home if you haven’t “checked out” with billing they will recharge you another day.
⦁ Hide things in bills eg. if you have returned some things eg. meals because they were incorrect to your dietry requirements from the kitchen, they will still charge you for those meals.
⦁ Perform unnecessary testing – The Philippines seems OBSESSED with unnecessary testing, Xrays, Blood tests, scans of sorts even if its irrelevant. In the hospitals, unnecessary testing is done to out of control levels. Tests that will be unrelated to your condition are performed. I know people that had tests done on their chest area for a lower forearm injury and they were billed nearly $500 for those tests.
⦁ Hiding the cost of treatment in the room rate – some hospitals charge a differential rate whether you are in a shared room or a single room. Therefore for the same tablet for example – you will pay a different price for the tablet being in a single room vs someone in a shared room paying for the same medication. I have seen hospital bills and all the costs of pharmaceuticals was disguised under a “room” cost and not itemised. Nothing in the bill is transparent, there are so many charges and break downs you have to request separately from billing fo these. Don’t just take the sum total bill which they present and think that is correct.
⦁ In a lot of cases medications are up to 50-75% cheaper purchased from a pharmacy out on the street than receiving through the hospital dispensed table where they use smaller dose tablets, meaning, eg. if there’s a shortage of 40mg tablets they might use 2x20mg or 4x10mg tablets and, of course, taking those doses in multiples is extremely costly. But this is what they do, they are thinking dispense medication, not save cost to patient.
Be the on top of everything they do and what you are being billed if you are in hospital.
Foreigners are buying into the “mantra.”
The loudest foreigner defenders of Filipino’ism are the foreigners that have been in the country 3 to 6 months or those submissive males that have married and haven’t actually “lived” outside the clutches of their highly protective, jealous Pinay wife.
There are bloggers who say that “you’re a guest”, “if you don’t like it leave”, “I love Filipinos to bits” blah blah blah – fuck me, what bullshit. I can hear the harps playing now … boohoo. I fucking realise we are guests. You will NEVER be a Filipino and will always be considered to have just arrived off a plane no matter if you have been here fifteen or twenty years.
If you really love the Philippines, you need to stand up and get something done about lousy service. I mean in a nice way. Exercise some assertiveness that Filipinos wouldn’t otherwise do. If you really want to do something for Filipinos who basically never get off their fucking arses and complain, do it. You might just save a life and you’ll certainly protect someone’s life if the “service” is that bad.
The other thing is that foreigners start GENERALISING. Yes, they hear how bad the system is and start saying “yes but…” as soon as you start hearing the “it happens in all countries” or “its like that everywhere” line, stop. Don’t buy into that bullshit. It’s called a generalisation. This is the Philippines, not Khazikstan or Costa Rica or the UK and your living here, in the Philippines. Suck on it dude, this is called the Philippines not all the other countries, and this is where the subject matter is. There are moral and ethical obligations here towards humans.
I’ve seen people saying it happens in the US and the UK. Yes, sure does but there’s also heavy penalties and a decent victims compensation system too and alternatives to rectify any fuckups, not a culture hell bent on avoiding blame, putting in place legislation to protect Filipinos and nasty service providers, preventing victims and having a compensation system that’s good for nothing – that’s the Philippines. The place that is known as “more fun” in the Philippines lol.
It’s like I see people commenting on Filipinas that have never been to the Philippines – “wow, look beautiful”, yea, that’s where the fun stops buddy as beyond that there’s a bag of rocks awaiting you.
Exposing life threatening bad practice is not insulting or denigrating Filipinos. You are exposing what Filipinos could otherwise not articulate or be powerless to get anywhere in a corrupt, power driven system. You can make a difference to a lot of people’s futures – both local and foreigners.
CHONG HUA hospital in CEBU lost its accreditation
through medical negligence
Let me tell you about Chong Hua Hospital in Cebu. The writing was on the wall as there were some articles surfacing in the paper eg. Sunstar newspaper article Its a very large, once respected and well-known hospital in the Visayas in the city of Cebu. Did you know that it once had international accreditation? Its doesn’t have any international accreditation thanks to a case of a foreigner losing his legs when he went into Chong Hua.
The accreditation is called JCI. JCI accreditation is considered the gold standard in global health care. JCI consultants are the most skilled and experienced in the industry. Chong Hua no longer has this accreditation, it was stripped of it by JCI. The only hospital globally to have had its accreditation stripped and the first time a hospital has been removed from its accreditation program.
You can see it above I have placed an image or see . “withdrawn”. Accreditation withdrawn http://www.jointcommissioninternational.org/about-jci/jci-accredited-organizations/?c=Philippines
Why? What The fuck? Let’s Break Down The Case –
Back in September 2014 a foreigner living in Cebu was involved in a motorbike accident in Talisay. The patient was treated for a compound fracture to his left leg. The hospital he was first admitted transferred him to what the British Embassy said was the “best” private hospital in Cebu. Chong Hua Hospital.
What resulted in his stay in Chong Hua was a series of negligent errors by the doctor, Agustin Morales and his “medical” team which resulted in the patient getting gangrene, his leg hacked, amputated.
In October 2014, The patient returned to the UK and wrote to the Chong Hua’s medical director, Helen Po … “but she couldn’t be bothered to reply”. That is quite “Filipino” mind you. No doubt there would have been a lot of running around behind the scenes trying to take out heads and rectify the situation in private.
In December, the Chong Hua’s Joanne Cosin conducted an internal “investigation.” And she “believed” Morales’ and his teams’ shameless “excuses.”
What happened next is that the victim in all this sent all of the photographic evidence to the Chong Hua’s American accreditors, Joint Commission International aka JCI international. Of course, JCI on seeing the photos couldn’t believe this. JCI conducted investigations into Chong Hua and were astonished what they found and as a result Chong Hua’s accreditation was withdrawn (AS SHOWN ABOVE – image from JCI’s listings) immediately.
At the time of writing sites still claimed that Chong Hua has JCI accreditation on Wikipedia – Maybe someone needs to go into Wikipedia and fix that and backlink the changed Wiki piece to PFB. The hospital still is accredited by Phil Health and the Philippines Hospital association and the Department of Health in the Philippines. I doubt that these departments would strip accreditations of Chong Hua as to be honest I have seen more filthier hospitals in the Philippines than Chong Hua and I would suspect accreditation standards to be quite low in the Philippines.
I would be interested to know if they still have the JCI certificate proudly hanging in the hospital lobby still?
Just to put the loss of the JCI accreditation into perspective. 770 hospitals in over 90 countries have J.C.I and Chong Hua was the first to fuck it up. The first and only to be removed ever from JCI. Another first for the Philippines … JCI produced a long and detailed report why they removed the JCI accreditation on Chong Hua. You could probably email JCI if you want the details. JCI’s investigation report highlighted 15 serious breaches of BASIC medical practices.
One doctor was Orthopaedic surgeon, Agustin Morales who was instigated in this case. Doctor Morales visited the patient only once.
There were lapses to a point that the patients friend had to go to a store and buy semi-circular travel cushions for 65 pesos each as the required supportive neck brace never arrived as promised. Typically, that is a Filipino promise you should never rely on as any Filipino promise it will never happen.
Key points –
1. Make a hospital plan. I wouldn’t advise anyone to bother in a developed country but like a scouts honour “be prepared”. In the event of an emergency, that you know where to go in the event of an emergency. Be prepared.
2. Research around, ask people – accreditations in the Philippines mean nothing. You need to develop a relationship with people who have their eyes and ears on the ground to find out where to go in the event of an emergency.
3. Get health insurance. Seriously, you do not want to end up in an accident or heart attack and heart attacks affect all ages -where your hospital or operation bill could exceed 1-2.5 million pesos. Does your travel insurance cover that cost? I’m sure your local Filipino coverage will not cover it.
What is the state of your finances and support when you are discharged. Medications in the Philippines is high. Tablets aren’t cheap and usually around 40 pesos+ a tablet. Some things you might need 5+ tablets a day. Some antibiotics aren’t cheap $50-75+ for vials of IV antibiotics.
Does your hospital insurance cover serious operations? Perhaps look at insurance outside the Philippines something that would cover a surgical procedure that could cost 1.5, 2 million plus. Seriously, If you had a heart attack and needed treatment a stay and procedures at the Manila Heart centre or St Lukes will cost you that and more and you don’t want to be short covered and unable to pay.
1. I know of someone taking over 15 tablets a day. Now think about how much that costs with your available finances. Before the hospitalisation they were on 2 tablets daily.
2. Ask questions. If the doctor is no right or has his head up his ass like a lot of Filipino doctors do because they have a two-bob degree equivalent to a nursing degree overseas, find another one. You need to have a “relationship” with the physician not be chasing him up to see where he is hiding. Pay the doctor direct and not via the Hospital to save money.
3. Take notes, accounts, photographs of what is happening. There is a lot of incompetent staff around – no shortage of incompetence in the Philippines. Your notes will be invaluable if you need to lodge a case for medical malpractice although as I mentioned, filing a case tends to lead to nothing or token settlements.
4. Monitor your medical bills daily and find ways to reduce. You will be surprised how quickly bills add up. You may have to pay some costs “under the table” in cash to avoid charges, reduce expenses and look at what you can get supplied from outside eg. Tablets and injectables may be cheaper outside at a pharmacy than what the hospital are charging. You need to see itemised bills DAILY. I have seen people get a 1.5 million peso bill for 14 days stay in a hospital in Manila and that didn’t even include doctors and specialist consulting fees. I have heard of another foreign national who had a stroke and his bill was over 2 million pesos being charged to his travel insurance company for many months of stay. Just remember, you can have an accident or heart attack or stroke in the Philippines at any time – your not indestructible.
Don’t listen to others who say – If something happens ill jump on a plane and goes back. It does not work that way and airlines can refuse you to board. Worse still, if you have complications, you pay for the diversion of the plane or a be offloaded in, e.g., Singapore, Dubai, etc.
If you have a public health cover if you are a pensioner – DID YOU KNOW that some countries will not cover you in their public hospital system if you have been out of the country more than 12 months. Be aware of this. Don’t rely on your government being there to help you when you return.
5. Stop the mantra “I love Filipinos to death but…”, “I don’t want to say anything negative about Filipinos but”, fuck it, its your health. It’s the health and life of other Filipinos also that by speaking out, exposing that you will not only be helping yourself but others in this country also – Foreigners and locals alike.
and lastly … at another hospital called Vicente Sotto in Cebu –
Video of doctors laughing during a surgery in Cebu.Published in