THE THIRD DAY OF OUR OPERATING AT TECH,
THEN OUR MID-WEEK ONE HALF-DAY EXCURSION BY MY REQUEST
TO SEE BY PRE-ARRANGEMENT THE PHILIPPINE NATIONAL TREASURE
WHOSE ORIGINAL ART WORK T’NALAKS ARE HOME AS SOUVENIRS
OF THE REAL TBOLI CULTURE In The Mountains Around Lake Sebu
January 15, 2003
Our planned half day operating and half day exploring the one cultural item and personal legend of the Tboli people occurred today, almost as planned, with a lot of extra components falling in to what had been anticipated. Our day began with a bit of a delay, since after breakfast, we had a chance to review our post-op patients, all of whom were doing well, and most already home or on their way there. There were rumors that there would be another truck or two of patients brought in to have operations today and possible still later, while we are filling up the schedule. But several of our first patients were not clearly following orders. We put a pediatric bilateral hernia repair on early and in the other room an anal atresia for anoplasty. Mothers had fed both of the children, so they had to be put off to later. We had a fellow who had a colostomy secondary to a stab wound for which he was treated at the provincial hospital by exteriorizing the stab wound as a colostomy. There are enough resources here to carry out the emergency of this kind, but in order to have an elective operation, he would have to go around collecting money to buy the supplies he would need and would be put on a waiting list that for him would extend forever. So, he was on our schedule for colostomy take down and bowel anastamosis. In the middle of all this had popped in a pastor with acute appendicitis. Just what he would have done if we had not been here is a gruesome thought to contemplate.
So, I set about operating, despite my runny nose and the constant cough. It is difficult to stand unconcerned with a mask that fills up during even a short case, and for some reason, this productive rhinorhea has gone into overdrive. We are also running out of supplies. Waning went to Marabel and bought some more anesthesia drug Halothane and Nubain, but we have been wearing gloves only for cases rather than the full operating gowns. I can see the clothes line on which the washed “disposable” gowns are hanging and the gloves are hung out to dry before being packaged and fed into the pressure cooker autoclave over burning coconut husks. We had done 33 cases in our first two operating days, which made us feel like we are several weeks into the project here, but today we were supposed to do only a few cases, with a full list for Thursday, the last day that the Malaybalay BBH team will be here before they drive back early Friday morning to Bethel Baptist Hospital, five hours for them by road and forty five minutes for us by air on Saturday morning. When we rendezvous at Bethel, we start up the whole process again over there, but this time in a hospital with a larger supporting staff. As the BBH team leaves, especially the invaluable Al, who knows where everything is and can set up for anything at all, we will be limited to doing small cases on Friday with our residual expat staff, who are not nearly so competent.
While doing the cases, I stopped over in front of the clinic and saw a crowd of people. I was immediately enlisted to triage a group of patients who needed operation, and looked over a policeman’s father who had a large inguinal hernia, a child with an epigastric hernia, a 23 year old male (who looked “small for dates” as most do here) had a left neck mass along the chain of lymph nodes on the left side. It was not related to the thyroid and seemed to be a lymph node from of cancer, like a lymphoma. I aspirated him, and nothing came back, so he will be operated on to excise that as an excisional biopsy. I declined two patients for operation, each with large goiters, but each with other illnesses that contraindicated operation, such as a new paralysis in one and a high fever in another. The last patient I saw was a young girl with a mucocele of the floor of the mouth, which I simply aspirated, fixing her within the minute of her being seen.
Then came the truck. Ten small size and very worried men spilled out, each with a wide spaced gait like cowboys who had been riding hard all day. These looked just like the five men I had done yesterday with hydroceles, and all ten of these had arrived to have their hydroceles repaired, having heard the word that they did not need to carry these extra liters of a water bottle between their legs from the results in the first group. So, I added a number of them up for Friday. The large inguinal hernia I had put on for Friday under local anesthesia and reported it as such to Ragon Espina, but he was very interested in that patient, and anted to see the technique that I had used for adult hernia repair under local anesthesia, since that is all the anesthesia he can count on up at Leyte. He chased down the patient and tried to have him moved to Thursday, since he will be going up to Malaybalay by road early Thursday morning with the BBH crew and most of our equipment, especially all of it too heavy to be going by our limited baggage allowance by air.
I had heard about the salary scales of people here in the Philippines and what that means to them in their Diaspora through the world in attempt to make a living and supply their family back home with a margin to live on. It may be cheaper to live here and food may be good and abundant, but for any kind of the consumer goods by which the competition is scored, they need the kind of money they can get in tow places and the medicine/nursing route is the way to go get it. The USA (86% of the Philippine graduating class of which Alfred Casino was a member are practicing in the USA, himself included) and the Middle East, which hires droves of the Philippine nurses by the faceless busload arranged through agencies here. I heard from Ragon Espina that the nurses at his Leyte clinic get about fifty dollars per month, but each one of them is studying hard to get their entry exams for US licensure. The majority of the Philippine physicians are also applying for the nursing licensure in the US, since they can get there and support themselves as nursing practitioners, while they take the crash course in qualifying for the medical licensure. Many of the groups that go over rent an apartment for maybe six of them, half of whom are always working while the other half is in the apartment studying in a mutual support group to take the exams for nursing or medicine, which is the golden gate that opens up a whole new world of affluence for them.
OUR AFTERNOON EXCURSION TO LAKE SEBU
TO MEET THE LEGEND OF THE PHILIPPINE NATIONAL TREASURE,
LANG DULANG, AND MY PHOTOGRPAHS, TAPES AND PURCHASE OF HER ART FORM
We drove up to the “Ancestral Lands” administered by the traditional tribal leaders, and went up the mountains to dirt roads along which were the bamboo platform houses typical of the Tboli construction. There area about 60,000 Tboli in the world, and they are scattered in the mountains here. One of them lives above a lake, and has been made notorious by the TV special tape done about her and her kind with the book Dream Weavers being the documentation of the art from—T’nalak weaving. I had collected several of these pieces over the last years, and as eager to meet the Philippine National Treasure who had made the finest of the art works I had specially commissioned. With us in our entourage is Marisa, one of our nurses who has been working in our “Recovery Room” which we keep filling up with patients. Lang Dulang is her grandmother, and, at first reluctant to go with us (she has a new baby she is breast feeding—a practice that is simply done here by passing around all the babies that need feeding at any time to the cook we have in our kitchen who has nursed most of the babies born here until their mother’s milk comes in or if there is one of the others away at the time) but she then came along with us as a living calling card.
When we arrived, Lang Dulang, 75 years of age, and originally reluctant to be photographed, wanted to get into her full traditional costume, as we went up to the elevated long house bamboo platform where she works, along with her daughter, who was already at work when we arrived. Her daughter is Marisa’s mother. I watched as she made the intricate designs with the very simple equipment on a very labor intensive scale. She was working on a pattern, and I had previously bought one of her daughter’s T’nalak. But Lang Dulang herself had just finished a 6.5 meter T’nalak, a masterwork, which she posed with as we took her picture along with some of us who posed with her. I knew that my sisters and the other recipients of the special T’nalak would get a picture with the original artist, so I shot a few more and then asked if she would be wiling to part with the just-completed T’nalak she was holding. They would sell ordinarily for 200 pesos per meter, but this one from the master herself would be 500 pesos per meter. “Fine, I will take it all.” Alison perked up here ears and said she wanted to split it with me. We took some pictures of Land Dulang with the T’nalak, as soldiers went up the nearby tree to pull down the berries that are used in the red die. Lang Dulang pointed out the nearby trees whose root bark gives the black dye that is used with the wax over the abaca fibers keeping it the natural color of the fibers. As we stood with her, looking over the lake, in a scene straight out of the video I had bought, it began to rain. We departed with my telling her of my plan to give her art work to some very special people. She tankded me and we shook hands.
I had met her son, Marisa’s uncle, and now met her other daughter, who is a pitiful sight. She has deeply jaundiced eyes and a big protuberant abdomen, with obvious schistosomiasis and TB of the liver. In the event that anyone wishes to romanticize the lyrical setting of the bamboo platform houses over the lake in the rainforest of this idyllic setting, this picture should give the other half of this scene—a tropical disease which as reached this stage of untreatable advance, also as a consequence of this setting in which she finds herself—the other daughter of Lang Dulang, supported by them.
We went to the same resort on Lake Sebu, where ewe could sit in the lakeside “Salong” bamboo platforms for snacks as we watched the fishermen paddle their dugout canoes to pick up the Tilapia they keep in bamboo float enclosures. Last time we had eaten the tilapia fresh from the lake, but his time we had rice cakes and cold drinks in order to move on for a much more modern imperative. We were going to Marabel in order to go through the frustrating struggle of trying to email my messages home.
That we did. Struggle, I mean. I could not get into my GWU account, so I have no idea whether I have any urgent messages. I tried to attach several messages in writing to my family, but the first several times the system crashed, even when I was borrowing the Yahoo account of the local guru. After an infinitely slow grinding of the process, I believe I may have transmitted one of about ten attempts with an incomplete story of Mindanao, and none of the intact stories of Florida or Cumberland. By now you will either know or have the later sending of what I can forward upon return.
I had a miserable ride back home. Surrounded by our armed security guard (for whom this must be a really tough duty assignment) I was in a cold air shower from the A/C vent I could not avoid, and my nose was pouring faster than the rain had been earlier. When I got back to the room, I paid Alan the US currency he had fronted me in the Philippine pesos for the T’nalak, and then Alison came over to me, trying to hand me several twenty dollar bills. She had spirited the T’nalak into her room and had emerged to announce that she had decided to keep the whole thing, so here was my money back. “No way!” I announced unequivocally.
So, in a dusky fog of URI haze and annoyance after what should have been a rather successful excursion into the biologic and cultural heritage of the Tboli people, I am retiring as directly and early a possible to get up for our biggest OR day yet to come in the morning.