Stabbing in Taguig

Last Sunday a neighbour of our driver, Noel, tried to kill him with a filed down screwdriver.

Noel and his wife Tina had just popped into a friend’s place to check on their kids. They were walking back to their motorcycle when their friend’s next-door neighbour, a notorious and violent drunk, approached them. Apparently without provocation or warning he began stabbing both of them. Tina received a minor wound and rolled away from the attacker. Noel fought back but was still stabbed four times; the first from the back and the others in the front. The most severe wound, 5 cm deep, actually “touched’ his heart according to the doctors. His left lung was punctured.

Tina managed to separate the two men and, curiously, the attacker then seems to have left the scene, leaving Noel pouring blood and his weapon (which is now with the police). They piled into a tricycle which took them to the local “hospital”. This establishment said it could not treat them because it didn’t have an X-ray machine—what kind of hospital does not have an X-ray machine?—and advised them to go to one of the private hospitals in the city.

An ambulance began driving them to Medical City in Ortigas, but Noel figured it would be better to go to Makati Med, presumably because it is nearer to where we live. Unfortunately, the ambulance driver did not know where Makati Med was—what kind of an ambulance driver does not know that?—so, in between passing out from the pain of his stab wounds, Noel had to direct him. At one point in his frustration he even said he would even drive himself.

We received a call from a distraught Tina at about 7 in the evening and rushed down to the accident and emergency ward at Makati Med.

It’s been rather a grim week since then, but thankfully Noel and Tina are doing quite well. Tina was discharged last Tuesday and Noel on Thursday. They and their two kids are staying with us since the psycho who committed this crime returns to the neighbourhood intermittently. Until we can get him locked up, which I am determined to do, they will either remain with us or we will help them find them somewhere else to live.

Accident and emergency at Makati Med

An accident and emergency ward in an inner-city hospital is not designed to display the most positive aspects of a society. In fact it is the epicentre of urban stress (in the UK, for example, the ward is usually full of abusive drunks). Last Sunday, in addition to stab victims Noel and Tina, a young man was a carried in by two friends covered in blood from 3 gunshot wounds, one in the neck.

I’d like to be able to say we saw hardworking and dedicated professionals delivering high-quality care under difficult circumstances, but in truth I didn’t find the place too encouraging. Although the care that Noel and Tina received seemed reasonable, the atmosphere of the ward was extremely casual, with medical and auxiliary staff wandering around texting, joking, and chatting. In fact it was something like a bus station with blood.

Despite the clear sign on the door limiting guests to one per patient, there was no attempt to enforce this rule, either within the preliminary area or, incredibly, in the operating area, where visitors milled aimlessly about, getting in the way of medical staff and spreading their germs over the patients.

In addition to the general lassitude of the staff, there was also an indefinable feeling of sleaziness about the place. From the word go, I felt that patients were regarded as a lucrative source of income rather than as lives to be saved. OK, private medical care is a business, but as a foreign employer willing to foot the bill for his employee I could almost feel the rubbing of hands as soon as I entered the swing doors. Initially, I wondered whether I was being paranoid, but that was before I received the bill (see below).

Taguig police station

The violent attack on Noel and Tina happened in front of several witnesses. The attacker was well known to the police, having already accumulated a thick police blotter. The incident was even written up in a local paper. Yet here in the do-it-yourself Philippine state nobody is going to get off their fat asses unless prodded from above.

Frayed and Tina visited the nearest police station the day she was discharged. Their presence was clearly an inconvenience to the first policeman they met, who claimed that unless Noel was actually dead there was nothing they could do. Fortunately, they persevered and the next cop they spoke to was prepared to take Tina’s statement and was quite helpful. Of course this was after they told him that they had contacts who knew the Taguig mayor.

By this stage, the attacker was back in the neighbourhood (he had left for 24 hours after the attack) and could easily have been picked up. Alas, Manila’s finest could not move until they had additional corroborating evidence from Noel, who was still seriously ill in hospital. Nor is a sight of his ghastly wounds enough; they need a certificate from the hospital that he was indeed nearly stabbed to death.

We can do all that (Noel’s testimony and the hospital certificate), but guess what? The attacker has now disappeared again, no doubt because he found out from the station that a case was being filed against him. The police have told us that, once there is a warrant for his arrest, the attacker can be arrested anywhere in the country. That sounds great, but since the local police station has shown no interest in pursuing a criminal in Taguig, what can we expect from policemen in Iloilo, or Laoag, or anywhere else in this vast disorganized and uncomputerized country of 90 million people? Our only hope seems to be that he will be stupid enough to return, which actually seems a reasonable possibility.

Makati Med hospital bill

The realization that the attack on Noel and Tina was going to be an expensive affair dawned when Tina was discharged at a cost of P22,237.75 ($480). Unlike Noel’s, her wounds had been superficial. In fact beyond some cleaning up, a few short consultations, and two nights in a shared hospital room with Noel (cost P2,400 per person per night) she had received almost no treatment and few drugs.

I was therefore primed for a shock when we went to discharge Noel and I got it.

Noel received no complex surgery. He was stitched up in the accident and emergency room and after that he received numerous tests, including an endoscopy, CT scan, and a large number of X-rays.

Although the bill was nickel and dimed to the max (alcohol swab = P1.96), the lengthy computer printout is not presented in a way to aid understanding, which may or may not be the intent.

Nevertheless, here is the summary:

Room and board: 9,800
Pulmonary lab dept: 3,888
Pharmacy: 25,250
Laboratory: 5,300
Operating room: 27,395 (I think this is for the endoscopy)
CSS: 3,181.53 (your guess is as good as mine)
Radiology department: 8,035
CVDL: 6,590 (see above)
Emergency department: 13,374.13
Switchboard section: 65

Total: 122,738.16

We had just absorbed this when the accountant told us sweetly that this did not include the doctors’ fees, these could be picked up from the cashier.

The doctors, only one of whom we met (Dr Duran), were as follows.

Dr Gabriel: 2,200
Dr Duran: 20,000
Dr Cedeno: 25,000
Dr Sanchez: 3,500
Dr Gonda: 4,000
Dr Diaz: 7,500
Dr Dy: 4,500
Dr Tuazon: 16,800

Total: P83,500

The total bill for Noel’s treatment was P206,238.16 ($4,325), bringing the bill for Noel and Tina’s stay to P228,475.91 ($4,805).

In case you are wondering about insurance, I initially thought that Noel was insured with PhilHealth through Frayed’s company. In fact although the office had given Noel the forms he had not yet filled them in. So it goes.

Sadly for all of us, this story is not over by a long shot. I’ll add updates when there is something to report.

Comments

[Jon Limjap]

Makati Med has become an atrocious hospital when it comes to charges. Medical City *was* in fact a better option.

[cvj]

I remember when i happened to visit the Makati Med ER back in the 90's, i heard a man crying out in the vernacular in pain 'Aruy!' 'Aruy!'. Next thing i heard was someone singing that Tagalog folk song 'Aruy aruy aruy aruy aruy aruy aruy...' I think they call that phenomenon 'Emergency Room Syndrome' where those who are used to seeing (and treating) emergencies start to take it as normal everyday stuff.

[torn]

Jon -- I agree. The last straw was when I learned last night that Makati Med is charging P3,500 each for Noel and Tina for the certificate so we can bring the case. That's just so outrageous.

cvj -- Yes, that's exactly the sort of thing we saw. In other circumstances I would say that the Filipino's ability to make light of a bad situation (kids laughing in the rain, etc) is a national strength. However, I would have thought that casual and unserious attitude would have been left at the door of an operating theater.

[Sidney]

Torn... don't tell me that YOU are surprised...

Nothing you tell here surprises me...
No, that is not true... I am surprised Noel survived his ordeal...

Makati Med is supposed to be in the league of the "better" hospitals.
You should visit some smaller hospitals in the poorer neighborhoods and you will truly understand that your odds aren't all too good to get out alive if you got a serious accident.

I always wanted to do a photo series about hospitals in Manila... but that is quite a challenge. Maybe one day...

And I will not even comment on the eagerness of the PNP to catch criminals... ;-)

[Mila]

Holy cow, I'm terribly sorry to hear about what happened to your driver T and F. A double blow, from the medical industry and the police.

[howie]

You perform a service by posting in such detail about Makati Med. It is notorious for apathetic service and overcharging. Perhaps more reporting like this will enable someone to synthesize and actually come up with an accident victim's guide to Metro Manila hospitals, with corresponding fees. That may put the terrible ones in their place and highlight the underrated ones.

[PAXDomini]

I'm an American-Filipino and I was not impressed at all by the ER at Makati Med. I had a good experience though at St. Luke's. My mother is a nursing alum from St. Luke's and knows the the system very well. I can't believe they charged close to 5k at MM when I paid a little over 1k at St. Luke's for ER treatment and had my gallbladder surgically removed and spent close to a week in my own private room. Just have nothing to do with elitist hospitals! And let me tell you something about the staff at St. Luke's ER: they were hopping and had no time to waste.

I believe you can waste a lot of money and time (don't be surprised if you're swindled) if you are misinformed in a foreign country. Sadly drinking and lewd behavior is very common in poor neighborhoods, and the police are part of the problem.

When will Filipinos change...for the better? My relatives in PI think
I'm a highly opinionated American when I bring up this subject. The problem is Filipinos have collectively become passive and the few who speak out are labeled as radicals or unpatriotic.

[tin whiskers]

Can we take medical or industrial X-Ray without X-Ray tube i.e; Daylight X-Rays?

[JP]

I am Filipino by birth, but grew up in the USA, and now work as a physician here in the states.

In Manila, any expat or returning Filipino would do well to consider medical care, if needed, only from hospitals certified by the USA-based JCAHO/JCI (Joint Commision on Accreditation of Healthcare Organizations/Joint Commission International). If one receives care one thinks is substandard or is charged unreasonably, one may then report said institution to JCI -- said issue may then be reviewed by JCI at next round of re-certification.

In Manila JCI-certified hospitals are, sadly, only 2: St. Luke's Medical Center, and The Medical City.

[Demi]

Better move to Davao: ironically, it is much safer. the Duterte's do not tolerate such crimes. Before the week's end, the perpetrator would have been executed in Davao by "justices of the peace". Unfortunately, this is the kind of policing the PH needs. It is essentially a lawless society ruled as a mafia state of powerful families.

[Bob]

When my wife needed surgery, your report on your experiences at Makati Med stuck in our mind. We considered Makati Med but decided on Manila Doctor's Hospital. My wife had major surgery, a six day hospital stay in 2011 for about one-half what you paid in 2008 for Noel and Tina's care.

[Jan]

Your driver had eight doctors? I bet only one or two actually participated in his treatment. I've a brother who also had surgery at the MMC too several years ago and the total cost was way beyond what we anticipated.

[Jan]

You should have kept it a secret from the hospital staff who was footing the medical bills. Then you would have been charge far less than what you paid/