secreto el ciudad de zamboanga

infinity pool at a private mountain resort

San Ramon public beach
historical government hospital at Veteran's

turn of the century architecture in San Ramon Penal Colony

colourful boats in Sangali..

Sumptuous food at Puericulture

exotic flowers at Palmeras
Cathedral's famous flowers

Confessions of an eMpTy-N (MD-Turned-Nurse)

it never really entered my mind practicing my profession outside my country, much more joining the bandwagon of the nursing industry.. medicine as pre-nursing? just to get out of the country?. my parents strived very hard for me to achieve what i am now .
i passed the USMLE steps 1 and 2 about a decade ago ( there wasnt a 3rd step then) but i still chose to stay. A lot of people were asking me, but i just remained silent.. in my mind, i really don't want to leave my parents, my family.. i want to spend most of my life with them. and im glad i did what i did..
my best friend, mentor, and inspiration during the time when i was moonlighting in one of the neighboring cities of manila was a a lady pediatrician. She was one of the reasons why i went into pediatrics and then eventually to subspecialty..at that time, she was the leading pediatrician of the area. But un/fortunately because of twist of fate, she studied nursing and went to the US for greener pastures..That was more than a year ago..
About a month ago, i received the following text messages:

heidi ____ hi! Good am!
heidi ____ well eto ok naman pero i am going back next year kasi nakuha na namin ang green card. Si doc nandiyan sa sa pinas (referring to her husband)
heidi ____ he will be back here sa US sa Oct then will stay prob for 3 months then uwi naman kami dyan
heidi ____ not worth to work here pag may practice ka na dyan sa pinas. Iba pa rin ang doctor
heidi ____ kaya i am not encouraging you to take nursing.
heidi ____ yes, at least na feel ko and naranasan ko ang buhay dito. Easy money pero di ko ipagpapalit ang pagiging MD ko.
heidi ____ All drs who came here start in a scratch. Sad to say about it pero they never tell the truth kasi nahihiya sila.
heidi ____ yong mga ibang MD from our place denial to death sila na they are doing ok but in reality hirap sila. They are blinded by their American Dream.
heidi ____ Buti na lang God is good all the time at guide pa rin nya ako at did not make that hard for me though nahirapan din ako kahit kaunti. Take care ka lagi.

the elephant boy

i almost cried when he was brought to my clinic. Wearing a white scarf over his head to include major part of his face in order to hide his features. He had a stooped posture, and he was triyng his best not to look into my eyes..Sadness? feeling of desolation? i want to comfort him..

His mother went to me straight, 'tor wala me kwarta..mangayo lang me ug tabang..' bisaya in this chavakano country..

He went to manila, confident that wearing that slightly obvious lump on his right face can be remedied. He was referred by a local ENT for possible diagnostic and treatment purposes with an initial impression of malignancy.. almost two months of stay in a leading government hospital... but the only help they have provided is a vague biopsy result of " atypical cells suggestive of malignancy lymphoma vs undifferentiated CA...suggest.....etc etc etc..."

i was exasperated because they are ignorant of the fact that diagnostics and treatment they sought for in the capital city can be done where they came from. The doctor who first saw the patient has the responsibility to ask around if a specialist is available. there are 2 oncologists in the area.

short of money, iknow they cant afford the treatment, so i referred him for emergency management....he had poor self image, he was trying to cover up his deformed face because of fear and embarrasment? he cannot eat properly because of the mass obstructing his oral cavity. all he can do is drink milk or chocolate drink or water. he was so cachectic.. i convinced his mother to go to the government hospital for chemotherapy..i gave my referral letter and the procedures how to give his chemotherapy.

After 2 cycles, this is the patient...

God is sooo good!

"How can i not believe in God, when i see his miracles everyday..," i remember my mentor saying..

Then the mist came upon me...this time, i'm happy.

cofeemate or breastmilk?

shocked, stunned, shaken, taken aback, appalled, outraged!

who would not? it was the first time i heard of coffee mate being given as a milk substitute for infants..it was about this patient at the government hospital-the youngest of 8 siblings to a 24 year old mother ( she does look forty-ish, though) she was admitted for diarrhea. when i saw her in her foul-smelling bed, the poor child moaned weakly, appeared lethargic, her eyes were sunken, her lips were very dry with multiple oral ulcers and vesicular lesion on the vermillion border. her sunburned hair was very dry and thinning. For people in the non-medical field she would appear to be "well nourished"-because she doesnt look thin at all! But for md's like us, she appeared to be "poorly nourished" ironically, this is because of edema or water retention due to protein energy malnutrition or what we called as kwashiorkor. On close examination- her distended abdomen is actually due to her enlarged liver and presence of ascites or water inside the abdomen.

Aside from her physical appearance, she is suffering from a case of chronic gastroenteritis, a very common condition among children with poor nutrition.

only in zamboanga, only here where you can find children afflicted with kwashiorkor. The PPS (Philippine Pediatric Society) people thought its an extinct condition in the Philippines . At least that was according to a pediatric gastroenterologist from Manila during a special lecture on Lactose Intolerance..I wonder why? Is it under reported? Something fishy is going on here..

Is it because of Cesar Montano's ad on TV..? im very sure they were'nt promoting the product as such..but i vividly remember one particular Tausug patient i had who was suffering from meningitis, was consoled before submitting to a particular procedure..(this time its lumbar puncture) ..

"ayaw ka magtangis kaugun in luha.. parihi sin panyuh supaya makawa.. bukun da dusa ko, dusa sin mo ako nagbabayubayu.. mami man cofee mate lagak!"( stop crying, we will buy coffee mate later promise)..

...and then the child stopped crying...

pagbabagong anyo ng mga badyaw (the transformation)

kawa-kawa boulevard

(their origin)

ang munting magtatambol

(the litle drummer boy)

ang kumakanta
(the lead singer)

ang mananayaw

(the dancer)

modernong badyaw

Kataka-taka. Mahigit sampung taon na ang nakakaraan ng dumaan ang barkong sinakyan ko patungong Davao, at dumaan sa siyudad ng Zamboanga upang magbaba ng mga pasaherong Moslem at Chavakano ay makikita pa rin sila sa karagatan nakasakay sa kani-kanilang bangka at nagsusumamo sa mga taong nanunood upang abutan sila ng bente singko at ito'y kanilang sisirin habang papalubog sa ilalim ng kawalan....

Sila ang atraksyon sa mga lokal na turista. Bukod sa mga pag-aalok ng mga nakuhang perlas, kabibe at iba pang palamuting pambahay na pinaghirapang kunin sa ilalim ng karagatan, sila ay nabubuhay sa pagsisid ng mga inaalay na sentimo ng mga natutuwang musmos na ibig masilayan ang kanilang angking galing sa paglangoy.

Nasaan na sila ngayon? Nasa Canelar, Santa Cruz at Sucabon - mga malalaking kalyeng pa-krus. Upang humingi ng limos sa mga sasakyang nagdadaan..

Ito ba ay senyales ng pagbabago patungo sa mas magandang kapalaran at pamumuhay? nakibagay na rin ba ang lupon ng mga pilipinong ito upang makipagsabayan sa modernisasyon ng komunidad?

Mas masaya, mas kuntento o mas maunlad ba sila sa kanilang pagbabagong anyo?

Walang makasagot sa mga katanungan ko. subalit ito ang aking pag-kakaalam.. sa pamapamahalaaang pagamutan sa may kabilang daan..

ward 8..

obserbahan mo at magtanung tanung ka kung sinu-sino suki sa Gastro..mga batang nagtatae, malalalim ang mga mata, kulay bughaw at maninipis ang bawat hibla ng buhok, may sakit sa balat, kurikong, malalaki ang mga tiyan..

walang iba kung-di ang mga walang malay at maaamong badyaw.

wala na bang magagawa para sa kanila?

kultura kaya ang dahilan? relihiyon? o paggiging ignorante?

ewan

ang maiaalay ko lang ay ang serbisyong mapagaling sila..maturuan ng konti sa kalusugan.

Pero sana magbigay tulong ang iba.

Dahil tao rin sila.

Mabuti pa ang hayup pinagtatanggol ng mga animal rights group.

Mas mahalaga ba ang buhay ng mga ito..?

Sana tapusin na ang pagpapanggap...

Beautiful, moving, perfect…

I'm not a film critic, because I’m not a very eloquent person. I just savour tender moments, the measured movements of every character, and enthralling background harmony every time a sensitive scene is demonstrated. But this time i am obliged to express myself on one of the best films I’ve seen in years..

I seldom cry at movies. And can I please tell you, these are movies with great, moving stories with unusual characters..I envy directors that can create wonderful movies like that.. One of the most compelling films that I have ever seen was that of a Brazilian film- Central Station- directed by Walter Salles.

I ‘m a great fan of foreign language films. One of the great things about foreign films in general is the glimpse that they give you into another culture and the difficult situations that face people. In Central Station, we experience the tragedy of a homeless and helpless boy in Brazil and the absolute lack of assistance in place for him. The actions of the people involved in this situation reflect the different set of values that exist in their culture.

Few film actors can bring a particular movie to life with superb and realistic acting and Dora (Fernanda Montenegro) did just that. A lonely teacher who earns her living by writing for illiterate people in a Brazilian train station, reminiscent of a our LRT station in Monumento during peak hours. The difference is that theirs is a more dilapidated looking. And of course, most Filipinos know how to read and write so that writing for someone to make a living is out of the question . The protagonist is unusual also. A boy who allegedly earns shoe shining before being discovered to act in this film. Awesome! Josue was left all alone when his mother died in the same train station where Dora do her usual “work.” The two characters who had an initial antagonism of each other eventually learned that they must put up with each other in order to survive. The boy was in search of his father, while Dora trying to discover herself. The film will take you on a road trip-a two hours bus drive towards exotic locations in Brazilian rural areas. Just like life. You dream, hope, and strive hard until you achieve success. In real life when you reach the top after a very long and adventures, what you see is as vivid and powerful a climax. You reminisce the past and then you cry…just like in the movies.

And then you hope the film would never end….

the weird in us

moderne marie claire

...by the pond filled with aedes
with her famous idol

sometimes when you get lonely you do the weirdest thing you can imagiine..i met a new friend in one famous gallery (the only one btw) in town..i frequented the area because it offer some unusual things you dont regularly see from other galleries in major cities..its actualy a mediterranean-type small bungalow filled with collections based on the eccentricities of the owner..cant decribe it but you have to be there and see them to know what im talking about..then from one corner i saw her..there are actually a lot of them. they've been there for a month or so. i don't think no one really likes them, because they were really lovely. there were few visitors in the area to begin with.
when i saw her, i fell in love with her right away. and i said to myself i have to have her because theres something on her face that intrigues me..must be her hairstyle laurelled with what looks to me as gumamelas..or so it seems..but theres something special on that facial expression that fascinating.mystery? she doesnt want to look to anyone.

..anyways..she's with me since then..wherever i go, she's always there to keep me company to lessen my sorrows...in this land of intrigue (intriguero/intriguera?) ..a melting pot ..from different races (they're just actually samals, yakans, tausogs, chaka i mean-chavakanos, bisaya, cebuano, some ilocano, batangueno and bulakeno) and just like me- a manilenio.

let me introduce to you my girl friday.....maria clara tiene ara