Medical

This is a great concern for most Expats, as medical care is decidedly substandard.  There are a plethora of nursing schools in Butuan, and the quality of the Doctors is quite good.  The system of care is the challenging issue.  If you need trauma care, you will be ignored in the Emergency room unless you have cash or a Philhealth insurance card.  You might be able to reach the point of stabilization by presenting a credit card, but the attempt to pay with one will likely frustrate you to death…Additionally, in a trauma situation, care decisions are guided by Catholic dictums.  If a hospital stay is required, you must have someone with you 24hrs to assist, as well as run to a pharmacy to purchase meds, so that the hospital staff can administer.  If you require emergency care on a Sunday, you may as well just die.  Nursing staffs are generally less than responsive and the rooms are substandard. The best course of action for resident Expats is to create a relationship with a local doctor, so he/she can converse with the staff directly.  Medical Tourism is big business in this country and in the more developed areas, world class hospitals exist.  Medical care in Butuan is generally geared toward stabilization so as travel to one of these climes is possible.  Most meds are available at drug stores w/o perscription or with persistence, other than narcotics, and these can be found ‘on the street’.  It is not uncommon to hear foreigners claim that veterinary care back in their home country is far better than hospital care here.  Local folk generally do not have the requisite skill set to effectively advocate for their loved one in a hospital setting, and often other Expats are requested to intercede on behalf of the patient.  It is a good idea to form a relationship with another Expat as well as having a notarized medical directive in your possession.  Hospice care, assisted living and nursing homes do not exist.  I am often asked to reccommend business opportunities in this clime, and elder care facilities, as well as a crematory are always at the top of the suggestion list. Best advice is to get sick somewhere else.