All posts by ELRAP

Religion in the Philippines Joining One Church…or Another!

If you come to the Philippines and are of the Christian religion, you’re in luck. There is every sect of Christianity here with the predominant religion being Roman Catholic to the tune of approximately 80%. There is every conceivable church from the Baptist church, Evangelistic churches, Latter Day Saints, Protestants, and the Seventh Day Adventists. There are two major Philippine-born religions in Christianity which are the Iglesia ni Cristo and El Shaddai. The Roman Catholic church is everywhere and it is not uncommon to see dozens of these churches even in small provincial areas. In the major cities, some of these churches are spectacular. To join the Catholic church here is not necessary, just attend a Mass or go into the church and there will always be people around to attend to you. Mass schedules are usually posted somewhere in the church. Sunday Masses in many of the churches are continuous.


The religion of Islam also is prevalent with approximately 5% of the people of this religion, but the concentration of Muslims is predominantly in southern Mindanao. Quite a few Islamic folks have migrated to areas where they can practice their religion and profession in peace. In Baguio where we live, the Muslim population consists of accomplished business people, and their businesses seem to me to be traditionally owned and managed by the women. There are mosques in almost every major city here.


Buddhism and Hinduism are practiced here, and the combination of the two are around 5% of the population. Jewish temples also exist in Manila, one in Angeles City on Clark Economic Zone, and one in Cebu City. Chabad are sort of the Jewish equivalent of missionaries as their mission is to provide a place where Jews can come to worship and socialise. They are expanding their locations around the country.


Some of the churches such as Iglesia ni Cristo and the Latter Day Saints (Mormons) have rigid requirements for joining with obligations to their church members such as helping fellow members and financial obligations as well. The Iglesia ni Cristo by far and away are the most strict of the religions here as one is never allowed to marry outside of their religion. And if they do, are ex-communicated from their church.


So if you come to the Philippines and want to join a church, you will rarely not find a branch of your particular sect no matter where you are. Below are the statistics of the breakdown percentages of the different religions.


So in conclusion if you’re Seventh Day of Adventist or a Roman Catholic or Islamic or Buddhist or Jewish, just ask anyone in your community where the closest temple is and enjoy.

Roman Catholic
Evangelical Christians
Iglesia ni Cristo
Other Religions
Atheists and Agnostics


The norm for most ex-pats is to gravitate to other ex-pats. If you are in a provincial area there are usually less ex-pats, but you’ll probably get to know very quickly the few that are there. In the larger communities, the ex-pats often have clubs, traditional weekly or even bi-weekly lunches, and sometimes break down their socialization according to nationality. In the several communities that I have lived in, there has been everything from French clubs to ex-pat women’s clubs, to military Veterans clubs, and others. Because of the American military’s presence until the mid 1990’s, there are still VFW posts and American Legion posts in every major city. In Manila, there is even an Elk’s Club!

Many ex-pats decide they want to get involved in projects to help the community and that is normally the common bond with other ex-pats. Also, there is everything from bridge clubs to golfing clubs and just about anything one might have an interest in considering there is a large ex-pat community in this country. It would be fair to say that most of the ex-pats would be around 50 years of age and above while the younger ex-pat population are mostly people that have employment or businesses here so the largest portion are seniors.

Befriending Filipinos is not hard in most major cities, but it is more difficult in the provinces where few foreigners are living. The reason it might be more difficult to make friends in the provinces is that economically you might be considered “wealthy” in certain areas so therefore, the friendships you make might tend to take advantage of your financial capability as much as your good nature . Take it slow when making friends if living in small provincial areas, and expect that you might, from time to time, be hit up for cash if friends with people from lower income brackets. Don’t take it personally if you find that your friends have manoeuvred you into the position of being the local lending institution. Just remember that in such situations, you can always smile politely when asked for a “loan” and very politely say that you have left your wallet at home..or you don’t have enough cash on hand…or you have not yet been paid…anything that politely rebuts the request for a loan without your friend loosing face. Eventually, people will get the message and stop asking to “borrow” money! In bigger cities, finding local friends is much easier as you would likely be on a more equal financial footing (no requests for “loans”!) and in many cases, friendships might be more rewarding from a cultural perspective as well.

Many ex-pats have been known to come to the Philippines to find companionship. We will put this aspect of life in the islands into a different category than ordinary friendship, and will address this issue in a different article at a later time.

Romance and companionship aside, if you come to the Philippines and are looking to make friends among ex-pats as well as Filipinos, to put down roots and get involved in communities, you are not going to have any problems accomplishing that goal!


There are a lot of trade-offs in the third world when it comes to third world chaos that the author describes as freedom. If you have never been to the Philippines, the drivers can be insane. Because of there is little law enforcement in many areas, the law of the jungle does exist. To describe this, you would have to see the way that folks drive here which is absurd, but there is rhyme and reason to their driving habits, and it is just a part of the learning curve.

When driving and you are trying to change lanes or make a turn in traffic you will have to take a directive which is usually by using hand signals. Since there is so much third world craziness in the Philippines, it may take some time to adjust. Other examples of chaos are people throwing their trash on the street, smoking on the street, vehicles belching smoke, among others. Does a long term resident like myself enjoy these things? Well, of course not. I as many other expats have learned to adjust, yet again, it is a trade-off. The last time I visited my family in the States and was driving through a residential area, I was warned not to go even one mile over 25 miles per hour. There were signs on the streets saying that there was photo radar. My father explained to me how his car that I was driving would be billed for speeding and it would be sent through the mail.

There are so many rules and regulations in the first world unlike the Philippines which is the complete opposite to that and therefore something that I call freedom. Obviously, many will disagree, but who likes liter on the street, vehicles belching smoke, and crazy drivers? but from another perspective, freedom lovers as myself hate rules and regulations. In sum, there are pros and cons to living in the Philippines when it comes to the third world chaos, but for many like myself, this is an acceptance for what we describe as our freedom.

– Bruce Silverman

Steve & Eve Go to Laoag!

Steve and Eve, a delightful couple from the United Kingdom, decided to leave their home in the land of misty moors, cricket pitches, and fish & chip shops and head to the tropical environs of Laoag, Ilocos Norte in the Philippines to make it their retirement home. They made the move to the Philippines a little over a year ago, and I had the pleasure of catching up with them just recently to find out how it has all been going.


Steve hails from foggy, soggy England, where Eve, a Filipina originally from Laoag, went to carry out her career as a nurse. They met and married, and then raised a family. Their children, now grown, jumped the coop and when the couple found themselves emptily nesting, thoughts turned to relocating to the Philippines where the climate was more hospitable and the cost of living significantly lower than in the U.K.


When asked specifically, “Why the Philippines?” Steve’s reply was, “Well, I’d been here (to the Philippines, the country of Eve’s birth) about three times, and we’d been married for about thirty odd years, and I thought, well, if it comes to a point where we couldn’t do anything for ourselvesalone, and we could make our money last a bit longer, we could do it in the Philippines…”


Good point, Steve. But then we asked the question on many retiree’s minds: what about medical issues? Unlike in the U.K., the Philippines hasn’t any National Health to speak of. So for Steve and Eve, although it’s all free in England, in Laoag, doctor visits, medicines, surgeries and the like are all on them. But this didn’t seem to bother them. Steve pointed out that there were two hospitals nearby, including Batac General Hospital, should they ever need a doctor, and if anything big should happen, they always have the option of hopping a plane back to the UK for treatment. On top of that, Laoag City Hospital is being upgraded and modernized drastically over the next year or two. And the cherry on the cake, Eve pointed out, as she is a Filipino senior citizen, she can get senior citizen discounts on her hospital bills, pharmacies, and doctors’ offices. Unfortunately, senior citizen discount cards are limited to Filipino senior citizens, but the fact is that the cost of medical treatment is significantly lower in the Philippines than it is in the First World, so in most cases, medical care is affordable. There also exist several medical insurance policies that can be purchased in order to cover expenses in the Philippines—go to the Retireology section of this website and click on Medical Insurance and Health Care Information to read the policies and contact the brokers directly with any questions you may have.


Moving on…


But what about friends? Eve’s family all live in Laoag, so they’re walking on sunshine as far as family dinners go. But sometimes, siblings and in-laws just don’t cut it. Occasionally you want to chat with someone who won’t comment on the fact that you’re balding or the fact that: “Hoy! You’re getting fat.” Both Steve and Eve reassured us that this wasn’t a problem. In fact, Laoag has a growing international community: Americans, Germans, Dutch…even a few other Brits – people from all over—have made their homes here alongside Steve and Eve. Many of them live within a thirty minute radius of their home by bike, their chosen mode of transportation.


Day to day life is just as easy going. As Steve so wonderfully put it, they “just get out there in the morning and see what comes.” When they don’t feel like spending the day with friends and family, they listen to music, read books, or visit the beaches nearby—coincidentally, these are some of the most beautiful beaches in the country—and hardly any people on them. Ex-groundskeeper Steve tends his garden. “Tropical farming is a big kick for me!” They eat out. We asked if any of this got boring over time, considering the two have lived in Laoag for a year at this point, and the answer was a resounding ‘no!’ There’s always something to keep you busy – or not busy, if that’s what you prefer.


Next, we asked about the inconveniences of living in a provincial town. There had to be downsides. Food came to mind here. In a big, sophisticated city like Metro Manila or Cebu, you can get practically anything by way of food. In Laoag? We assumed not. So did they find themselves trekking down to the big city every few months, packing supplies into boxes and dragging them home like refugees? The answer again was ‘no’. According to them, they’ve got everything they need! The freshest fruits, fish right out of the ocean, and it’s cheaper here by half than it is in Manila. On the contrary actually; their friends visit them and stock up on goodies! They hit the nail on the head when they said: “You’ll never starve here!”


Life isn’t all sugar sweet and sunshine in the province though. Steve and Eve do have a list of complaints. Mosquitos, red ants, and toads. Necessary evils when you live on the equator! But overall, life is pretty good!!

Gulliver’s Travels From San Francisco to Manila

We were in Makati for the day, in from the Great Republic of Alabang, and my husband turned to me and said, “I’m inviting you to lunch at the best prime rib place in town.”


Okay then.


“It’s DELICIOUS, and I guarantee you we will be one of only two or three tables there.”


Uh oh.


We are both Makati-bred, and as far as I knew, the only really good prime rib in town since, well, forever, was at the Prince Albert Rotisserie at the Intercontinental Hotel.


“You’re going to LOVE this place!” he tells me as we pull off Makati Ave. into the driveway of a Chinese discount hotel on the seedy side of the street.



We went through the hotel’s front door and headed to the elevator. Up. Stop. Get off the elevator…and get on a different elevator. Apparently the first elevator only takes you so high, in order to get to this steak, you have to undergo a journey.


We stepped out of the elevator and…what can I say? We stepped into the 70’s. It was amazing! Gulliver’s of San Francisco is a classic, tacky-down-to-the-psuedo-eighteenth-century captain’s chairs around each dining table, and the waiters-and-waitresses-dressed-in-period- costume American steak house! The placed oooooozed oh-so-Olde-Worlde charm! It was liked being sucked back through the Time Tunnel to the steak houses of my Midwestern youth, and I LOVED it from the moment I stepped through the doors!


Sure enough, we were one of only two tables in the restaurant, and we claimed our table at the window with a spectacular view of Makati in all its grimy splendor. The menu was perfect—chicken parmesan, lobster tail, but we came for prime rib, and prime rib we would have.


The meat came in three sizes. I took the biggest one. So did my husband. I was salivating as I ordered, and so was he. The wait staff were efficient, spreading a huge, crisp, white linen napkin on each of our laps and bringing us a basket of fresh, hot bread and sweet butter. They smiled as they took our orders, repeated them correctly, and went off to advise the kitchen of our choices, returning but moments later with an icy, frothy brew.


Moments later, the BEST, bar none (sorry Prince Albert Rotisserie!) prime rib I have ever sunk my teeth into on this side of the puddle, thick, amazingly large, beautifully marbled with just the right ratio of fat to meat, crispy on the outer edge and soft, juicy, red, and delicious all the way to the bone, appeared before each of us. On the plate were a baked potato with ALL the fixings—butter, chives (yes REAL fresh chives), bacon, and sour cream; a delightfully stodgy Yorkshire pudding, spinach soufflé right out of Graham Kerr’s Galloping Gourmet cooking show, and the best home-made creamed corn ever! The waiter then appeared with what was essentially a decanter of hot meat juice that he poured over each slab of beef.


I ate everything. EVERYTHING.


The Master Chef at Gulliver’s trained in their San Francisco kitchen, and he has everything down to perfection. The whole experience—the meal, the restaurant itself—was delightful because not only was the food so good, it evoked memories of a bygone era that made the meal taste even better.


Gulliver’s has been there for years, but nobody knows about it. My husband, a Makati native, found out about it because a friend dragged him there on the promise of the best and cheapest prime rib in town…and he was right! Each of our prime rib lunches, with all of the fixings, cost P1200.00, or roughly US$27.00. The restaurant has two branches, one in Makati, and the other in Quezon City, both at the Great Eastern Hotel. You can find out more by going to their web site, , but if you are a carnivore from the 70’s, Gulliver’s is an experience you won’t want to miss!



Palliative Care in the Home

A Filipino Experience

On the heels of last week’s Bruce’s Blog, about caring for a loved one in the home, we publish this week an excerpt from Bruce’s book, The Freedom Handbook for Living & Retiring in the Philippines, written by the adult child of a terminally ill parent who nursed her while living at home in Manila.  The event occurred several years ago, but the story and the advice are still totally applicable:

Margie’s Experience
Caring for a Parent
When we first got the diagnosis that Mom, in her eighties and very active, had colon cancer it was not only a shock, but we also had the hope and expectation that she would get better. We had hoped that she would be able to go through chemotherapy and radiation, which would bring her into remission, or perhaps even a total cure. Sadly this was not to be, and instead we were faced with a steady decline in her strength. Mom remained positive and strong throughout her illness, a testimony to her faith and all the people she cared so much for.
Early on the doctors asked me if I wanted my mom to know exactly what was happening.
I can only say that the decision I made at the time was what I felt was best for her and for our family. My mother was always fiercely independent. I felt that she would want to know exactly what was happening to her, and that she was perfectly capable to make the decisions she felt most comfortable with. She was also very intelligent, and I was sure that if we tried to keep things from her, that she would figure things out on her own . I felt that we needed to be able to trust each other, not knowing what might face us.
However when Mom had to have a stoma, the doctor did not seem to think that she would be able to have surgery at a later date to reverse this procedure. The stoma would be permanent. I asked the doctor at the time to keep this information from her, which he agreed to do, as he and I both hoped she would have an easier time getting used to this new way of life if she felt it would be temporary. We would break the news to her a little bit at a time, to give her a chance to process and deal with it.
As my mother was in the recovery room, having just had her stoma surgery, the doctor came out to talk to me and gave me the worst diagnosis I could have heard. I was totally unprepared for it. He tried to soften the blow as he stated that the extent of my mother’s cancer was worse than they had thought, and that it was his belief that she would only have three months left to live. Chemotherapy was no longer an option.
We stayed for quite a while in the hospital after the surgery; a few weeks. Mom made the decision that she would like to go home, and not return anymore to the hospital. In order to comply with that desire, I set up her bedroom at home as a hospital room, and I hired four nurses who would work in shifts, but live at her house for the duration. I organized with the hospice for amazing palliative care doctors to come regularly to visit mom at home (Editor’s Note:  please refer to the Index of Professionals, “P”, Palliative & Hospice care for recommended institutions). I had no idea what I was doing at the outset, but by the the end of the experience I can say that I was an expert at managing this situation.
Should you want to do the same for your loved one as I did with mine, I would like to share with you a few suggestions:
As a family prepares to take the patient home, on the day of discharge, the hospital gives them a list of medications and supplies necessary to care for the patient. The day that a patient is being discharged is already a stressful day; it is not a good day to run all over town looking for the things that you need so that the patient remains comfortable. In order to prepare for a smooth transition, request that this list of medicine and supplies be given to you a few days in advance of the patient being discharged. This gives the family a chance to get everything ready beforehand. This would make the move from the hospital to the home smoother and less hectic for all concerned. Also, you will have whatever you need on hand so that the patient does not have to suffer while a needed item is obtained from somewhere else.
The hospital should also provide you with a list of all the pharmacies in your area (especially the ones which are open for 24 hours) so that the family is not hunting around, trying to find what they might need. Perhaps a survey should be taken of where to buy certain medications the patient might need, as I found out that not all of the pharmacies have a steady supply of medications needed for I.V. use.
Lists of suppliers, complete with phone numbers and addresses, can be obtained from the hospital as well as their recommendations for suppliers of things such as oxygen tanks, suction machines, hospital beds, I.V. stands, and an ambulance service (Editor’s Note:  ELRAP highly recommends Lifeline Philippines as an ambulance service, please consult Index of Services & Supplies for contact information as well as last month’s Medical Matters blog). Some of these items may not be needed immediately upon leaving the hospital, but the need may arise once the patient is at home. If an emergency happens, the family is left in total panic as they are unprepared to obtain the items they will need.
When we first left the hospital, they suggested that I get some of the medical supplies from Bambang (in the old part of Manila). Although they had quite a lot available there for lower prices than in Alabang or Makati, I did find that it was not always advisable to buy too much of any item since things change, and you sometimes end up with too much of one item that all of a sudden you don’t need anymore. Also some items available in Bambang were of inferior quality, and caused more anxiety than the savings were worth because you could never depend on them. For instance in the case of the stop cock used for the I.V., the ones that I got from Bambang would break constantly, and start leaking, so they had to be changed more often, and ended up costing more.
If the family will need a nurse or a caregiver, or both, once the patient is at home, they should already have found, interviewed, and hired these people while the patient is still in the hospital (Editor’s Note: for Nursing Services, please refer to the Index of Professionals “N” Nurses (readers who would like to recommend a service, please send us an e-mail with the information to (we will have your recommendation vetted with much appreciation), otherwise, we would suggest consulting the local hospital for nurses and/or caregivers). The nurse and/or caregiver can learn directly from the doctors and the nurses at the hospital exactly what is required to care for the patient. They will know not only the procedures and medications, but they will also meet and come to know the doctors. This makes communication between professionals much smoother.
There are agencies where you can hire nurses and caregivers, but these are usually quite expensive (Editor’s Note: about US$300.00-400.00 per month in salary). In my case, I found that the nurses who were recommended by the doctors or through friends were not only more affordable, but better than the ones I interviewed from the agencies. Also, they came with excellent references, as I knew and trusted the opinion of most of the people they had already worked with.
You must assume that most family members, such as myself, have no medical experience when they are faced with taking a patient home, and are totally unprepared for what this means. It becomes quite an overwhelming feeling to know that the care, safety and responsibility of caring for someone you love rests totally in your hands when you have no idea what you are doing.
I was very lucky to work with doctors who did not mind my endless questions, emails, and the letters I would leave at their offices. They treated me with patience and respect. Even though they must have been perhaps annoyed with me at times, they were always understanding. I believe it is important to find doctors who you are comfortable with; they will be important members of the journey you are taking, and you and your loved one must be able to be open and forthright with them.
I cannot stress enough the importance of this. From the beginning an open and honest relationship needs to be established. There are many wonderful, competent doctors in the Philippines, and though it may take some homework on the part of the family or patient to find the ones who you can communicate with, it is well worth the effort and will ease the stress of the situation in the long run.
Families should be informed of establishments such as Alabang Hospice, or other organizations where not only can they borrow equipment, but they can also get counseling and spiritual support.
For example-Asian Hospital has a support group for families and patients with cancer, while Alabang Hospice (a.k.a. Ruth Foundation) has people who volunteer to visit families to help them through difficult times.

Lee Blumenthal from the Big Apple

Native New Yorker Lee Blumenthal grew up in the hustle and bustle of New York City. He loved the quick pace of life, the verve and the vigor of his surroundings… he even loved the cold weather in winter! Like many a nice Jewish boy from Brooklyn, Lee went into “Jewish Engineering”, the rag trade, and a career manufacturing ladies garments—mostly dresses and blouses. For years he did this, and for years he loved it and did well at it.

Eventually, as does everyone who is in the garment business, Lee came to Asia to try and source out a cheaper source of quality goods, and he wound up in Hong Kong.

“I thought I would LOVE Hong Kong, because it’s so similar to New York! The fast pace of life, the highly urban setting, the “get up and go”, the work ethic, discipline, and devotion to business…but I hated it!” says Lee. “People were very efficient, they produced a good product, but they weren’t particularly friendly to foreigners. Outside of the main part of the city, they didn’t really speak English, and didn’t really want to. I was able to get the product I wanted—needed, but I really wasn’t happy living there.” Lee started looking at other parts of Asia for garment production, and his eye landed on the Philippines.

The year was 1986, and the Philippines had just thrown out the perennial dictator, Ferdinand Marcos, in a bloodless coup. There was a new President, Corazon Aquino, English was the lingua franca of trade and commerce, and nearly everybody in the country spoke it with varying degrees of fluency. For those in the garment business, labor was affordable and the product that was turned out was marketable…and the Philippines had an abundance of a little thing called QUOTA into the United States.

“Quota” is the nickname given in the Philippines to the Multi Fiber Arrangement, or the MFA, which governed the world trade in textiles and garments from 1974 through 2004. The MFA imposed quotas on the amount of garments as finished goods that developing countries, such as the Philippines, could export to developed countries, such as the United States. During that time, factories in the Philippines “owned” quota—in ladies wear, jeans, t-shirts, children’s wear—which allowed them to manufacture and ship goods into the U.S. legally. Without the proper “quota”, goods would find it very difficult to enter their market.

Lee came to Manila and started to source factories that owned quota for ladies dresses. He then went to these factories and started to place orders to produce ladies dresses, which he then exported and sold to the buyers he knew back in the United States. Business was good, and in 1989 he decided to move to the Philippines.

A big part of the attraction in moving here was that English was a common language spoken and understood not just by the elite and educated, but also—in varying degrees—by the guy on the street. A legacy of American colonization, English serves as a unifying language in this country of over 100 different languages and dialects.

“I liked that I could go into a factory,” says Lee, “ and talk to an ordinary sewer about how to make something. Even if she did not respond to me, she would understand what I wanted. She may not answer me because she was shy, or because she wasn’t confident enough in her English speaking skills to answer me in English, but invariably she would understand exactly what I wanted.”

Despite living here for 25 years, Lee has never put up—or had the urge to put up—his own factory to produce the goods he sells. In his case, there was really no need for him to do so. Lee would go (and he still goes) to the associations of factory owners, like the old GTEB (Garment Trade & Export Board), or currently, to the GBAP (Garment Business Association Philippines) or one of the EPZA’s (Export Processing Zone Authority) to get from them a list of factories that produce his sort of product. Lee then goes to the factories and meets either with the factory owner or the general manager.

“Sometimes the owners of a factory would not want to work with me because I was a foreigner; other times, the factory owner would really want to work with me for that exact same reason!” says Lee. In the first instance, it was never a case of discrimination against a foreigner, but more of a factor of intimidation due to language skills (or lack thereof) or an unfamiliarity in dealing with someone from a different culture (Lee being the exotic creature).

“I would go to a factory and ask if they could produce XYZ product, and they would say yes or no. If they couldn’t—or if they didn’t feel comfortable working with me because of my “foreign-ness”, people would still be very nice to me. They would invariably tell me that they had a friend who had a factory that could produce what I wanted, and then they would pave the way with introductions.” Lee says.

A very important point that Lee stresses is that while doing business anywhere in the Philippines, it is polite business practice to engage in any undertaking with a Filipino who works with you. That person could be your Filipino partner or, as in Lee’s case, a highly adept employee whose “face” in the process is to facilitate any transaction and to sort of act as a cultural buffer if and when needed. In the garment business, and no doubt in other businesses in the country as well, sometimes a buying agent who is Filipino can fulfill this role. The important point is to do business with a Filipino at your side.

These days Lee is mostly out of garment production and “in” to the trading of garment overruns. “Overruns” in the garment business generally means that a factory has produced too much product, the order has shipped, and now they need to sell the product that is left over. In some cases, an order might have been been cancelled by the client, and the factory (now stuck with the goods) has to sell that product, usually at a very small profit, in order to recover their production costs. Lee got into the overruns business when an order he placed was cancelled by his client, and he got left holding the bag.

“Overruns are good business…when they are not your overruns.” says Lee. “When I got stuck with my own overruns, my wife’s uncle introduced me to one of the owners of SM department store, who took them off my hands.” Lee notes that in that particular case, the overruns were 30,000 pieces of sweaters! “Amazingly, SM sells a lot of winter garments! It’s jackets and sweaters mostly, not so much hats and gloves, and they sell them year-round, in spite this being a tropical country.”

Lee started buying overruns from the factories that used to make dresses for him. Business was very good for a long time, but as the Philippines priced itself out of the manufacturing of low-cost garments, factories moved to China, Sri Lanka and to Vietnam. Although the garment manufacturing business is picking up here again, the overruns are now from factories that make a higher-end product. The low-end, super cheap garments that the Philippines manufactured in the industry’s heyday are now a thing of the past.

These days, Lee is back into doing a little bit of production again—making blouses—just to see how it goes. He still doesn’t do the manufacturing himself, he places his order with an existing factory and they do the production.

By law, in the Philippines, foreigners cannot own a business (with a few exceptions in particular industries) in its entirety; companies must comply with the 60% Filipino ownership law. A foreigner can maintain control of their business if not its ownership. It may be that that the foreigner only owns 40% of the company, but the remaining 60% may be owned by a spouse who is Filipino, or barring that, it may be owned by a group of Filipino partners, none of whom own more than 10%-20% of the business in an individual capacity, but who collectively own the 60% majority. The company can then issue contracts granting the foreigner exclusivity in particular transactions. It makes doing business a bit more complicated, but not inordinately so. The services of a good attorney, accountant, and auditor answerable to the foreign partner are imperative to successfully maintaining control of the business (NOTE: take a look at the Index of Professionals on this website, under INDEXES, for referrals).

When asked, “Would you go back to the U.S. to retire?” Lee doesn’t hesitate in his answer. “No.” he says. “Life in the Philippines is easier. I never realized when I lived in New York that trying to make a living there is actually really difficult when compared to doing it here. Even though I used to love the winter and the cold, I couldn’t do it any more. Here the weather is good; it’s a lot easier to get cool if I am hot than to get warm when I was cold like in New York.

“The cost of living in the Philippines is low, comparatively speaking, and the quality of life is good. Being able to afford staff to cook, wash, and clean for me is something I could never hope to afford in the States, and because of it, I have the freedom to socialize more and do more of the kinds of things I enjoy doing.”

Lee has found it easy to make friends—good friends—in the Philippines. “People here very friendly, very warm, and very welcoming.”

Lee Blumenthal is home.

Lifeline Ambulance Rescue Philippines A Very Reassuring Prospect

I interviewed Michael Deakin, the managing director and the dynamic driving force behind Lifeline Ambulance Rescue Philippines, and I have to say that the man is impressive. This product of a Filipino-British upbringing is as passionate about his mission as he is well-versed and well-informed about his business. Michael has transposed two of the primary philosophies from his background in the hotel, restaurant, and hospitality industry onto the ambulance & rescue company he runs. The first is, “We serve you first, in the expectation of payment later”, and the second, “What we serve you is a quality product.”

“Our policy is to never refuse a call, no matter what.” Michael tells me during our interview. Since 1995, Lifeline has been instrumental in saving over 86,000 lives. In 2013 alone Lifeline was instrumental in saving the lives of 9,865 people. Michael measures Lifeline’s success in lives saved rather than in money earned; but he makes sure that there is enough money in the bank to keep the operation not only going, but growing!

Lifeline Rescue was founded by a group of doctors in 1995 to meet a need in Metro Manila for reliable ambulance service. It has since then morphed into what it is today, the first, and the only, dedicated “Emergency Quick Response” (EQR) service in the country. Lifeline are the only fully-equipped ambulance service, staffed with EMTs trained to international standards. Lifeline offers a Medical Evacuation Service by land, sea, or air, anywhere in the country. Airlifts are done in coordination with other service providers, both private and commercial entities, such as Lion Air, SOS International, Assist America, and Philippine Airlines, to name just a few of their partners.

Lifeline has a rapid response within the Metro, arriving on the scene on an average of between 8-12 minutes after the call is placed. The “Red Room”, the 24-hour dispatch room, maintains an internationally-awarded radio communications network and is staffed by highly-trained emergency nurses who receive and direct the calls, dispatch the ambulances, keep themselves updated on current traffic situations, and offer support and medical advice while coordinating with Lifeline’s doctors. Each response team is composed of two licensed nurses or a nurse and an EMT as well as a transport officer. All are highly trained in advanced life support techniques and receive their credentials from the Austral-Asian registry in Australia, following the US model for qualification.

Lifeline’s EMTs are trained in the C,A,B protocols (“C”, circulation; “A” airway; “B” breathing) perfected during the Iraq and Afghanistan wars. The primary concern is to maintain “C”, circulation. “B”, breathing is the last of the three concerns because, as Michael says, “…you can stay alive for five minutes without oxygen. We’re doing CPR to maintain circulation, and therefore minimize brain damage. So even if you’re not breathing, we can breathe for you, but establishing circulation is the most important thing now because if we can’t establish circulation, the patient is dead within minutes…from shock.”

A patient goes into shock from dehydration, during an accident situation, usually from loss of blood. When a patient is dehydrated, the veins collapse, which then makes it difficult to get hydration into the patient to prevent shock. It’s a vicious cycle. Lifeline uses a device called an “intraosseous cannula” that represents state-of-the-art technology for patients who are “in extremis” from shock and/or respiratory failure. “The device is basically a drill which the EMT shoots directly into the bone marrow of the shoulder or the shin of the patient…and yes, it hurts. The device provides the EMT with an access point to effectively administer fluid into the body of the patient in an emergency situation, effectively preventing shock. All of Lifeline’s emergency crews are provided with the device and the training to be able to use it correctly.

On the highways, Lifeline’s EMTs follow the rescue protocols of the American Highways system as well as those of the German Autobahn system. They implement the German extraction protocol, popularly known as the “jaws of life” for vehicular accidents on the highways. Michael notes that there are an average of four extractions from vehicular accidents every week, so the training and equipment are being put to good use!

Their rescue vehicles are outfitted with American equipment and, in Michael’s words, “look just like the ones you see on TV” which is very reassuring somehow, as they look so “western” and “First World”.

A membership with Lifeline for a single person costs P1,000.00 per year (roughly US$22.00), or P3,000.00 per year (roughly US$68.00) for a family of up to ten people, including household staff (maids, drivers, gardeners). Even with the low cost of membership, about 50% of Lifeline’s calls come from non-members. “Lifeline operates on the same principle as a restaurant” says Michael, “the patron comes in and enjoys the product and services with no prior outlay of payment. Those products and services are extended to him or her on the presumption of payment; at Lifeline, we do the same. Our policy is “no questions asked” at the time an emergency call is made. We extend our products and services in order to stabilize the patient, and then, three days later, we send the bill in the hopes of payment. We’ve been stiffed a few times, but for the most part, payment has always been forthcoming.”

The basic costs of answering an emergency call are covered by fees from Lifeline’s membership base as well as by retainers paid to them by their corporate clients. As to the part of the bill over and above the basic costs incurred, Lifeline can and does organize user-friendly payment plans for their clients.

Because of their reputation in the industry, as well as their affiliation with an extensive network of physicians, partners, and hospitals, Lifeline guarantees that even unidentified and presumably indigent patients will always be admitted to a hospital for treatment.

“In the beginning, hospitals did not want to accept such patients because there was no guarantee that they would be paid.” says Michael. So, in the early days before Lifeline’s reputation proved itself out, the ambulance crews were instructed to hand over the keys of the ambulance to the hospital administration in order that the vehicle itself serve as a guarantee of payment for the patient that had been brought in. That protocol is still in place, but these days hospitals are more willing to admit any patient brought in by Lifeline.

If ever an admission for treatment needs to be insisted upon however, Lifeline’s crews carry with them copies of the law that states that hospitals may not refuse service to any person in need of emergency attention. Further to that, each crew is also equipped with recording devices and often also cameras so that they can maintain a record of what has been said and done in any given circumstance.

“We had a case,” Michael tells me, “of a Caucasian man, presumed to be a foreigner, who had been in a bad car accident. He had been driving a cheap car, he was dressed in shorts, slippers, and a t-shirt, with no ID of any sort (not even a driver’s license, it should be noted), and he wound up under a truck. The accident happened in Batangas, outside of Metro Manila, and because the patient was unidentified and presumed to be indigent, hospital after hospital refused to accept him, using the standard excuse in such cases, “we have no room”. Rather than waste time trying to argue with provincial hospitals, Lifeline (meaning, of course, Michael) called in a favor at Makati Medical Center, one of the best hospitals in the country. The patient was driven to Manila, and MMC straight away admitted him.

Makati Medical did stipulate, however, that if the patient would be unable to pay the bill, the hospital would have to come after Lifeline for the payment. Michael did not object.

“The guy was in a coma for over two weeks, with the bills piling up, and during that time we were trying to find out who he was.” Lifeline called the Embassies, foreign companies, bars frequented by foreigners, you name it, in an effort to find out who the fellow might be. Nearly three weeks in, says Michael, “we got an e-mail from a woman in Hong Kong, with a photo of her missing husband, and sure enough, it was the guy! He turned out to be the head of a multi-national corporation there, and he was fully insured.” He had come to Manila for a meeting and decided to make a long weekend out of it before returning to work in Hong Kong, and that is when he got into the accident.

If, unlike the man in this story, a patient were to remain unidentified and unclaimed, eventually they would be transferred to the DOH (Department of Health) or to a government hospital where, being considered indigent, quality of care would be limited by the (very little) amount of funding available for indigents. The moral of the story, then, is always carry ID, and let your family know where you are!

Although they chiefly operate—at the moment—in Metro Manila, Lifeline rescues people from anywhere in the country.

In one instance, a young woman hiking in the province accidentally fell off of a mountain, and then could not be found in order to affect a rescue. The Army and the Marines were called in and they started their search for her at the base of the mountain and were working in an upward sweep, but it was already late afternoon, and soon night would be falling.

Lifeline was called in at this point, and they quickly pulled in one of their best rescue doctors (who was literally in his car with his family and about to drive away on holiday), still dressed in his leather office shoes and work clothes, and put him on a waiting helicopter and flew him to the site of the accident. Pilot and doctor thought they spotted the injured girl, but the pilot could not land on the mountainside. Hovering about a meter off the ground, he called to the doctor, “Just jump a little, Doc!” which is exactly what the doctor did. He went off to find the accident victim while the chopper hovered in place, night falling. Having taken too long, and being (in those days) under a strict “no fly at night” FAA regulation, the chopper pilot tossed out the medical rescue gear and headed back, leaving the doctor behind on the mountain. The doctor returned, triumphant at having located the victim, and found the helicopter gone, but gear on the ground. He picked up the gear, attended to his patient’s injuries and loaded her onto the stretcher, and now, in full darkness, walked her down the mountain by the tiny light of his stethoscope. They were met by a contingent of the Marines about half-way down.

In another instance, a group of friends had gone to the island museum of Corregidor for the day tour, but due to rough seas, the return trip was cancelled. One of the group panicked as he was diabetic and had not brought insulin with him since he had not expected to be gone from home for more than a few hours. Lifeline was called, insulin was procured, and a helicopter was dispatched to Corregidor. The diabetic gentleman was waiting at the helipad, and upon receiving the insulin, he promptly injected himself right there and then. As the chopper was about to depart, he asked the pilot if he could have a ride back to Manila, whereupon the pilot said, “Sure! Hop on in!” and back they went.

The anecdotes go on and on…

“We can rescue anyone from anywhere, or transport a patient anywhere. It’s really just a matter of budget.” says Michael. The cost of an airlift runs P80,000.00 per hour (about US$1800.00 per hour) and the fee for a patient always includes the turnaround time. A “golfer’s rescue” which essentially means picking up a patient by helicopter and transporting him straight away to the hospital, is P50,000.00 (about US$1,100.00) on average. The insulin drop on Corregidor, in the story above, was P37,000.00 (about US$850.00) including the extra passenger on the return flight to Manila. Payment plans for any of these services are easily worked out after the emergency has been resolved, as per Michael’s philosophy.

Lifeline isn’t just a rescue ambulance service. Over the years, under Michael’s guidance, it has become ever so much more than just that. For example, Lifeline, together with service providers and partners, maintains 24-hour ambulatory care clinics, complete with diagnostic services, in several of the top residential subdivisions, schools, and residential condominiums within Metro Manila.

They are partnered with the MRT (Metro Rail Transit) system within the city as well as the highway system on Luzon to provide emergency response.

Lifeline provides a service called Home Care, for patients “who need or desire outpatient medical care in the comfort of their homes. This is especially beneficial to the chronically ill, disabled, post-operative, or palliative-care patients who have difficulty finding their way to the hospital for a routine medical check-up or a change of dressing.” Lifeline coordinates with the patient’s personal physician in order to extend care at home for the convenience of both patient and doctor.

“We also provide what we call our “Go Home” service—as in “go home to die in the peace of your own home among your family and loved ones.” Lifeline have transported end-of-life patients from one end of the Philippine archipelago to the other, and they have also coordinated the effort of repatriating foreigners to their home countries.

“Right now,” says Michael, “we are coordinating an effort with the British Embassy for the repatriation of an indigent British national who is dying.” Embassies will generally not underwrite the cost of repatriating one of their nationals (or their remains), but they are mandated to facilitate the process on behalf of whoever is paying the bill for the repatriation.

In the case of an indigent patient, in this instance a foreign one, Michael tells me, “The mayors in the provinces are often very generous to their constituents—even to foreigners who are their constituents, as long as that foreigner has not been known to be belligerent, a drunk, or a bully. Should a constituent have a medical mishap—an accident, or a heart attack…” for example, many provincial mayors have been known to dip into their discretionary fund to help an indigent person to get some necessary financial aid for medical assistance. “But of course, it is really best to be well insured!”

This particular gentleman is being airlifted from the province to Manila, where he will be ensconced in one of the Lifeline clinics for a few hours of transit time, comfortable and well-attended to, while he waits to board his international flight back to the U.K. Lifeline will have transported him from his home in the province every step of the way until he is safely and comfortably aboard his flight home.

Last—but certainly not least—Lifeline offers an Emergency Prevention Service called “DOC” or “Driver on Call”. This service provides motorists with a better way to get home safely should their ability to drive become compromised by intoxication, medication, illness, or other causes. “DOC” keeps impaired drivers off the road and gets you (the impaired driver) and your vehicle home safely. Once Lifeline’s drivers arrive, you will hand them your car keys and they will NOT return them to you. The service is available to anyone and everyone. Once a call is received, Lifeline dispatches a company vehicle with two drivers, one of whom drives the client’s vehicle home (with the client as passenger), and the other of whom follows in the Lifeline vehicle. Clients call the same emergency number, 16-911, and the cost of the service is P500.00 (about US$11.00).

Although Lifeline presently functions chiefly in Metro Manila, by the middle of 2015, just in time for their twentieth anniversary, they will be just as entrenched in Cebu, Davao, and Dumaguete as they are in the Metro.
By 2017, Lifeline will be operational in every major city in the Philippines.

That, may I say, is a situation I find very reassuring!