Lately I’ve been getting questions from Americans about what it’s like retiring in the Philippines, also from Manila friends wanting to know about my experience out in the province. As an answer to assorted questions I’m going into my own experience in some detail.
Living in the subdivision hasn’t meant I’ve made friends here, although I did go to some homeowners’ meetings and a party, which I hadn’t done in Quezon City. People have been friendly in terms of greetings and introductions—more than in the old subdivisions, but so far it’s been neighborliness which hasn’t developed into friendships. There’s little contact, and we don’t seem to have much in common. My Tagalog also remains elementary, despite resolutions to get back to studying.
Although English is one of the official languages in the Philippines, its use is rather restricted—business, official proceedings, one-on-one conversations with foreigners. Group socializing is in the local language. So, for example, you go to an hour-long meeting conducted entirely in fluent English, which everyone speaks, and afterwards one of your dinner table companions turns to you and says, “Sorry, but we’re going to speak Tagalog now.” So you sit there alone as they talk, and for the nth time you wonder whether you should just leave. Eventually you do, and you find better Filipino friends elsewhere. One English-speaking expat I know responded to the problem by simply monopolizing dinner table conversations herself. I was unwilling to do that.
I do have some warm personal relationships outside the subdivision. Within walking distance of Greenville is my friend Nickie, a talented jazz singer I met at Tago Jazz Café. Since she teaches English online we have plenty of stuff to talk about in addition to personal things. I get together frequently with Maggie and Patrick, who found me this house, and others who’ve also become friends.
Twice 15-20 folks from Manila have been willing to brave the hours-long traffic to come out for parties, although not without complaining that I should move closer to the city.
My friend Benjie brings me birthday flowers every year and sometimes drives me home from Manila. I’ve been surprised and delighted at the visitors who’ve come from the States and assorted places in Asia–maybe ten when I was living in Manila and four so far here.
I met up with Marita, my writer friend from Woodstock, New York, in Manila when she was on her second pilgrimage to her father’s homeland. We explored the church and crypt where relatives were buried. (Link/Link)
During her vacation Sandra came over from where she was teaching in Taiwan. We took a boat ride on the Taal Lake together and had endless conversations.
Ida came from Los Angeles. (Link) We met in Manila, did some sight-seeing and went to Benjie’s soup kitchen (Link) where she presented him with a donation from Asian-Americans back home. We also did the boat ride—too windy, water coming into the boat—and sampled some Tago jazz. We had two great Filipino meals at Pamana, which like many restaurants on the ridge road has a view of the lake.
Melanie came from her graduate school program in Thailand. We did another boat ride—also too windy—and an excursion to People’s Park. More endless conversations, but somehow not quite enough. I’m hoping she’ll be back.
Tagaytay people are friendly and have made it easy to set up a support network, although the most important part of it I brought with me. It’s a long bus ride from their place in Bulacan, but my housekeeper Fe and sometimes her husband Jessie come out to stay several days at a time. Fe cleans and fills up the refrigerator with cooked food, and Jessie does the yard and whatever repairs or painting need to be done. As long as all three of us are flexible about the schedule, it works.
Fe worked out a deal with a tricycle driver named Noli, who takes me around on a regular schedule or when I call. Maggie recommended a hairdresser who works in a salon in the nearby Robinson’s shopping center. A haircut is $4, or $6 with tip. Also in the same location is a friendly and absolutely painless dentist who charges $18 to clean teeth.
In Silang, a neighboring town, there’s Asian Massage and a good masseuse named Isabel who’ll come out for 300 pesos an hour plus 200 for transportation. With a 100-peso tip that’s $12 for a good massage by someone who actually listens to the client’s request—please work on my back—instead of automatically reaching for the back of the left leg.
The move to Cavite has been good for my finances. My rent has gone from $440 for a nice townhouse in a gated community in Quezon City (Metro Manila) to $350 for a much nicer duplex in a not-as-plush gated community in Tagaytay. Because it’s roughly ten degrees Fahrenheit cooler than Manila, I haven’t had to install the two split-level air-conditioners I brought with me, saving me $50-$100 a month in electric bills. My total expenses are now under $30,000 a year, including $7,000 for annual private health insurance premiums from a company in Hong Kong which has always been good about paying up.
This brings me to the question people always ask if they’re considering retiring in the Philippines, which is about medical care. Tagaytay is of course not Manila, which has very expensive private hospitals, expensive private hospitals, public hospitals and private or public clinics. My friend Bob had surgery at Medical City, and it went well. (Link) Tagaytay is not exactly rural, but there’s less choice.
When I first came I needed to find a vet. Right before we moved, little Sasha had developed ear mites as a result of her caregiver’s being too casual with the anti-pest treatment. She scratched a huge blister into her ear. I took her to the clinic where her brother had had a stone removed from his bladder, and the vet on duty said, “Well, you could do nothing, you could try this treatment or you could do surgery.” Back home, a visiting friend looked at the clinic card on my refrigerator door and said, “Why are you going to the most expensive clinic in the Philippines?” I took Sasha to his vet at Pendragon, who recommended surgery but warned that it could result in a cauliflower ear—folded over with its insides pooching out.
After she did the surgery, she told me to take Sasha to a vet in Tagaytay every day to have her bandage changed. I found one in a convenient location. He prescribed different meds than the vet in Quezon City—which always seems to happen—and charged $6 each time he changed her bandage. I thought it seemed high for the Philippines. We went there for over a week. Then one Sunday his colleague, who had apparently not been briefed, charged me $2 and said I didn’t need to get the bandage changed anymore.
I had heard about Tagaytay’s reputation for ripping off tourists, vacationers and foreigners. I got so steamed up that on Monday I went to see the first vet with a prepared speech about the difference between being overcharged by a taxi driver or a fruit seller in the market and being overcharged by a health care professional who was in a position of trust. Then I got home, thought about it, and went back to apologize. But I also took Bob’s advice and looked for another vet.
Sasha did get cauliflower ear. I’m glad that the poor girl can’t look in the mirror, see herself and say, “Oh, I was such a beautiful cat. Now look at me. Look at my ear!”
Several people have recommended a Chinese-Filipino clinic in Mendez, about three or four kilometers down the road. They do house calls, which is very handy if you have three cats needing shots. We’re with them now. A Frenchwoman nearby has a shop which will deliver large sacks of dry cat food and kitty litter. We get canned food on our occasional shopping trips to Imus. So we’re all set.
Then there’s medical care for me. I still go to Manila to see the first-rate eye surgeon, Dr. Arroyo of Medical City and the American Eye Clinic, who’s done sixteen “procedures” on my eyes to ward off my age-related macular degeneration. It seems to be in remission now. (Link) I’m now seeing her only once every three months for tests and one of her colleagues every six months for glaucoma and a cataract.
For over a year I was seeing Dr. Michael Satre at Medical City in Metro Manila about my sleep problem, which is common among older people with AMD. When my sleep improved about the time I moved to Tagaytay I suspended the visits with his permission and best wishes.
About a year after moving here, I got a bout of alternating diarrhea and constipation plus abdominal cramps. I couldn’t leave the house for two weeks. The next two weeks were less awful, and then it disappeared. From the Mayo Clinic website I gathered that I had gastroenteritis and, since I didn’t have certain specified symptoms, I didn’t have to see a doctor.
A few months later the abdominal cramps returned. Finally, in desperation I went over to Tagaytay Medical Center–a private but not swanky hospital–and said, yes, I’d see any MD who was available. I was sent to a nice man who prescribed something for the cramps. A week later he confessed that he had no idea what I had but would prescribe based on my description.
The next time I went to the hospital I asked for a specialist and got an internist. Immediately she asked how long I’d been seeing the first guy and pointed out that he’d prescribed only half of a course of antibiotics. She had me take a CT scan, which revealed that I had diverticulitis. She didn’t mention a “resting fast” for my overworked intestines, which the Mayo Clinic website said was standard treatment, but I’m doing well without it. So much for self-diagnosis via the internet.
Oddly, about the same time, my friend Bob in Beverley, Massachusetts also had a CT scan, although for another problem. Mine cost $400; his was $8,000. From everything I’ve seen, this difference in price is fairly typical between the US and the pricier hospitals in the Philippines as well as medical care in South Korea.
Except for the fact that in the Philippines prices vary a lot. The national hospitals can be a bit bleak, but many of the physicians who practice there, like Dr. Mike, also work at one or more of the private hospitals. A friend of mine spent one week at Medical City, which cost the same as three weeks at a national hospital. Looking–hopefully–far into the future, I gave Dr. Mike a copy of my living will and told him that if anything happened requiring long-term care I wanted to be put in the national hospital where he practiced, not in a place like Medical City, where even with health insurance my savings wouldn’t last very long.
Several weeks ago I decided that maybe what I’d assumed was a pulled tendon in my knee was actually something else. I went to Tagaytay Medical Center and was paired off with a doctor who prescribed pills and told me I needed x-rays but the machine in that hospital produced feathery-looking results. He sent me off to a facility in the backend of nowhere, a modern, empty-looking place with glaring but dim florescent lighting, where for $12 I got four x-rays, two for each knee. When I went back, he said I needed surgery. I said something about health insurance, and he said he didn’t feel qualified to fill out the forms, which could be as thick as a book. He gestured how thick, and I sensed the same frustration I’d often picked up from failing students. He seemed personally offended by my statement that I hadn’t taken my meds as he’d prescribed them since the “pain” was usually only a mild soreness and I didn’t take unnecessary painkillers.
“Don’t have surgery done in Tagaytay!” Bob practically screamed over the internet. Dr. Mike said that before I did anything as drastic as surgery he wanted me to talk to a couple of his colleagues at Medical City.
When I went back to the internist, she listened to my tale and recommended a doctor who looked at the x-rays and suggested either an injection every six months or—to start off—a dietary supplement which was supposed to increase the squishy stuff between the bones. He said I didn’t have to take the pain-killers.
Then I went to the physical therapy department where the very impressive doctor also looked at the x-rays and had a very nice therapist start me on a regimen of hot packs, electric stimulation, ultrasound and exercise with ankle weights and a stationary bicycle. I am becoming a fan of the physical therapy department. When I walk out on happy knees, I’m convinced the treatment is working. At other times I’m less certain.
I consider myself both very fortunate and a long way from knee replacement surgery. I did ask advice on Facebook, and the majority who answered said the surgery was well worth it. I gather the results depend on the skills of the surgeon and the persistence of the patient in doing therapy afterwards. A friend in Manila says she knows three people who’ve had knee replacements. Two are very happy, and the other can’t walk–at all.
I guess the moral of the story, if there is one, is don’t settle for the first health care professional you get. In Manila I also saw another eye surgeon before Dr. Arroyo and four doctors before Dr. Mike. When I moved to Korea in 1988, health care there also seemed a bit spotty, but I soon found people and institutions I was satisfied with.
As I said, I’m a city girl by nature and have been since the age of thirteen, when my family moved to Hamburg, Germany. There I discovered the freedom afforded by public transportation—similar I guess to what other Americans feel with their first car. And Seoul is wonderful for zipping around in one of the best subway systems in the world.
There are no taxis in Tagaytay. If you want individual service, this means tricycles for travel within a very restricted area. Fares from one place to another are fixed and easy to learn. Trikes are prohibited from driving on major highways, but some drivers will take you through leafy back roads–which I like– for a relatively high fare. There are jeepneys, which tend to be crowded and not very comfortable, and there are buses, air-conditioned and not.
The bus poses a danger if the conductor sees you as a slow-moving, gray-haired woman needing an assist. Instead of offering a hand up, he may impatiently grab your arm and hoist you on or off the bus, causing you to land hard on a foot connected to a sore knee. If you protest and yank your arm back, the man himself and the passengers behind him may well see you as a white woman who doesn’t want a Filipino to touch her. I’m working on a polite way out of this.
Anyway, once or twice a month I board the bus for my fix of concrete, traffic, polluted urban air, connection with friends, live jazz, shopping, bookstores and whatever. I always stay at the no-frills, safe, friendly, clean Stone House, where a room with bath (shower, actually), double bed, air-conditioning and cable TV is about $30, including free breakfast. Having a home away from home has made it somewhat easier to get into town for concerts, like Tago’s collaboration on a jazz series with the Ayala Museum or regular jazz nights at Tago.
A day or two of Manila is enough. I breathe easier as the bus home starts climbing and the greenness on the other side of the windows seeps inside to quiet my spirit. My ears pop, and I feel drawn into cooler and cleaner air.