Pharewell to the Philippines!

I've reached my last few days in the Philippines and it has certainly been a whirlwind! What started with cyclones and major flooding in Manila has ended with a few days in stunning sunshine and tropical beaches! Because so many of the islands here in the Philippines are quite small I guess I never thought about what a huge area the country covers and what that means for it's climate!
Its been another fun week, not as busy as there have been a fair whack of public holidays here over the last few weeks, including yesterday.
I spent the end of last week visiting the English language centres around Cebu, including Niners which is the sister company of the one in Manila. It was actually really fun - Janice and I got to sit in on some lectures and take part in the mock tests they were doing. I'm not going to lie - I was expecting that I would score 9 across the board on my first try and amaze everyone. I barely scraped a 7 which means I would qualify to work in the UK (put that P45 back in the drawer, Emlyn) but only just! And I've been speaking and learning through English my whole life!

With Dianne, the manager of Niners in Cebu

One of the other things I've noticed both in the centres but also in health care facilities is how bashful and embarrassed many Filipinos are about their level of English. Many nurses have been beyond shy when it has come to speaking to me because they think their English isn't good enough and almost like they will be letting the side down if they aren't up to standard. I find it so hard to understand as everyone's English has been so good! Most people I have spoken to whether in hospitals, shops, my accommodation have been completely or almost fluent. I feel we've become arrogant in the West, especially those of us from English speaking countries. We just assume that it's normal that everyone else will learn English and adjust to us but can you imagine any one of us going to Spain or Greece for our sun holiday and just bursting fluently into their local language!? I think the majority of us can say that that is definitely not what happens! (Although myself and a couple of other Irish here did enjoy meeting up and talking Irish occasionally in Notts, mainly to confuse people in the pub who always assume you are English when they see you😂).

The high achievers board from JROOZ, another of the language centres

Before the bank holiday weekend I visited one more clinic with Janice. Every nurse I met there wants to come to either the UK or Ireland so they were all well up for a chat! Don't think the nurse director was sorry to see the back of us, I reckon she thought half the staff would leave with us and try to smuggle themselves back in my suitcase!😂

Some very enthusiastic potential recruits!

As for my bank holidays and weekend, I've had Gareth over this week which has been lovely. He arrived with a few hours left in my birthday and we have spent the weekend just gone on Bantayan Island just north of Cebu. We weren't sure where to go but decided somewhere not too touristy and pretty chilled would be good and that is definitely Bantayan. Top tip: if you want to go somewhere that's easy to get to, don't come to Bantayan! If you want to go somewhere that's a bit of a pain in the ass to get to but totally worth it then this is the place for you!

I hadn't actually checked when bank holidays and things like that fell in the Philippines so it's been a really great bonus that there have been 2 of them while Gareth has been here! 

We've not done anything very touristy or adventurous, lots of beaching, swimming and hiding from the sun at certain times of the day! We stayed in a hut on the beach though and my highlight was definitely this morning when we got up at 5am to watch the sun rise. It was glorious. A lot of the islanders were out fishing or pearl diving which actually made it all the more picturesque as what is unique and exciting for us is just part of the daily routine here.

Fishermen at work while the sun rises over Bantayan Island.

Only a couple of days left here in the Philippines and I will be off the Hawaii on Friday for a quick stop off at another QMC half way around the world! After that it's off to Vancouver where I will be spending 4 days with the nursing students of the University of British Colombia! That's if the hurricane over Hawaii has calmed down and the wildfires around Vancouver and Seattle don't get me! Of all the things I had worried about leading up to this trip never once did natural disasters or extreme weather enter my head! It's definitely a change from the "It'll probably rain but be fairly mild" line that we are used to at home no matter what the season!

So, that's it from the Philippines. I would love to come back some day when I have a bit more time to chill and maybe visit a few other places. The people here are just lovely and so friendly and don't even get me started on the food!👌😛

By the time I next write I'll have said Aloha to Hawaii and will be sampling maple syrup like a local in Vancouver, although I bet the locals don't actually do that!🙈😁

Slán

Kate

Birthday Blog!

Ok, I'm keeping this one short and sweet because it's my birthday tomorrow and I'm not keen on spending today on computering!
Working in Cebu has been great. Janice, my contact here is an absolute dote as well as super organised and we've had a great week of visiting city based and district hospitals.
We visited Oslob District hospital on my first day with Janice. It's about a 4 hour bus journey away but the scenery was stunning and the bus had excellent air conditioning so who's complaining!? When we got off the bus we discovered that the hospital was still a fair bit away so we asked what the best way to get there was. Cue this guy offering to bring us - we assumed in one of the little trikes (like a tuk tuk or side car) but the first surprise of the day came when he arrived on a scooter. And nothing else. With no time for worrying about whether my insurance covered extremely irresponsible transport methods while working, up myself and Janice hopped and we were off. Considering I've not been a fan of bike riding since I knocked half my teeth out when I was 9 I was suitably petrified!🙈 There was also the worry about where the hell you hang on to a man you never met on the back of a bike weaving in and out between lorries and buses on a narrow road - I settled for shoulders, it seemed the least familiar.😓
Anyways, we survived! The hospital staff in Oslob were great, happy to show us around and let us observe what they were doing. I think my favourite thing was the specific clinic they have set up to deal with animal bites. There are a lot of stray animals, particularly dogs, in the Philippines and bites are a regular reason people attend the hospital. It was putting pressure on the small A&E in Oslob so they set up a dedicated clinic to deal with wounds, dressings and administering rabies shots. This leaves the emergency department free to deal with actual emergencies, such a great innovation by the staff to solve a problem which was clogging up their A&E with non urgent attenders.

After our visit we got a chance to take in the view and go for a walk along the water which was a nice change after being stuck in my hotel in Manila for days on end due to the bad weather!

The view on our walk in Oslob 

The next day we visited Primcare, a large clinic in the city centre. It was a lot like our general Outpatient centres in the UK and Ireland. Different sections for different specialities which have their own weekly schedule with nurses working between them all. The 2 things that surprised me were that there was a specific area for drug testing and that the most common minor op performed in OPD is circumcision on young boys. The former is standard procedure, drug tests are demanded by many employers before they will hire someone new. The latter is also normal practice. I guess maybe I should have realised but it's just so off my radar having grown up in Ireland and living in the UK where it isn't common practice but here most boys are circumcised before they reach 5 years of age according to the nurses I spoke to. Another of the cultural differences that I seem to be accidentally stumbling on wherever I go!

With the nurse in charge, marketing manager, building manager & Janice in Primcare 

We also visited Medisense Laboratory Centre this week which is a centre specifically for people who need to have tests done for employment. For example a medical, blood tests and xrays to be granted a Visa to work abroad. Or the standard drug test before getting employment at home. They also work directly with the agencies who are recruiting staff to send overseas.

The nurse in charge also insisted on feeding us before we left which didn't help when one of the other nurses showed me how to use their new fangled DIY obs machine by making me hop up and get my weight, height, blood pressure etc. checked. Just when you're trying to forget what it's telling you it prints out a nice copy of all your results and dietary and exercise suggestions based on crunching the numbers. Mine recommended I do at least 20 minutes of jogging a day😭 A wonderful souvenir when you've been eating your weight in delicious local food for the last 2 weeks.

Pork Sisig, the most delicious thing I've ever eaten in my life. Also the reason for my dietary recs from above mentioned fancy machine😒 Oh, they weren't both mine by the way. More's the pity!

Next plan is to visit the language centres down here over the coming week with a couple of well timed public holidays (my birthday is a bank holiday here, did I tell you I'm moving...?) to chill a bit and hang with Gareth who is currently bussing it to Heathrow with a bag full of Barry's teabags - don't tell me I don't know how to celebrate!

Hoping to have time to do a little bit of exploring over the weekend before G heads home and I head Stateside for the next phase of my journey. 

I left Nottingham 8 weeks ago today and am almost at the half way point of my journey. I'm keeping track with my methotrexate injections (taken weekly on a Wednesday), every time I do it I automatically think about how long I've been gone and count how many weeks I have left! Bit like my own DMARD version of an abacus😂 

Oh and I know you are all DYING to know how the Céilí Band did! Third place in the All Ireland Fleadh, not too shabby. Hup Cnoc!

So that's it from me and my twenties, 30's not looking too bad from this side of the world though😁

Slán fo foill

Kate 😊

Stuck in Manila with you.

So my first week in the Philippines is over and it has been a busy one! First of all the Notting Hill saga continues and I can now safely say I have disappointed nurses all over Manila by living in the wrong Notts. It was straight down to business when I arrived with 3 to 4 visits to hospitals, clinics and Universities every day I was in Manila almost as soon as I arrived. I had the lovely Rodeo as my guide who liked to hold hands when we crossed the road (for my safety, of course) and top up his make-up before each of our visits. He was pretty adorable!

Rodeo & I before our meeting with the president of the PNA

Out of all the hospitals we visited over the 5 days I think the one that has stayed with me the most was San Juan de Dios Educational Foundation, Inc. Hospital. It is actually a private hospital and is in pretty good nick as a result but that wasn't the impressive part. As we visited departments and I spoke to nurses it quickly became apparent that research is a huge part of the day to day routine here. For example, in the ICU the nurses received complaints about patients not getting their medication in a timely manner. 5 years ago they started to look at this in more detail and on the day I arrived there was a list of 17 conclusive reasons why patients medications are late (illegible hand-writing, unclear instructions from doctors, out of stock in pharmacy, paperwork not completed correctly as just a few examples). They are listed out and each nurse must put a notch beside the relevant reason if there is a delay with meds on their shift. They are systematically working their way through the issues that cause this problem and trying to come up with solutions for them one by one. My favourite is the name and shame method for illegible writing from the repeat offending doctors!😂 It's working though as there has been a notable decrease in patients waiting for medication and subsequently a decrease in complaints.

With Rodolfo Borromeo (right), Director of Nursing & some of the nursing staff in San Juan, a hub of nursing innovation & research

The best bit about it though is that doing research as part of their daily routine is totally normal to these nurses. If there is a problem, look into it. Investigate it, write it up, publish it. It's brilliant to see nurses so enthusiastic about further learning and research and to be contributing so much to their patients and departments at the same time.

San Juan wasn't a flash in the pan though. Several of the hospitals and Universities (most notably Arellano University and the University of the City of Manila) had shelves upon shelves of research bound and published by current nursing staff, students and alumni. I've never seen anything like it! The topics varied hugely as well, from research on mental health to diabetes to community care to HIV.

With the head of the nursing faculty in Arellano University and members of the faculty

Styling it in my Arellano University tshirt!

Rodeo and I also visited the Niners centre in Manila, so called because the guys who set it up all got 9.0 across the board in their English language tests back in the day so are seen as the go to people if you want to do well. It was a really interesting visit actually as there were a few gaps in my knowledge especially when it comes to the difference between the IELTS and OET. I had thought that once the OET (the occupation focused English test) was rolled out the IELTS would become obsolete but that's not the case. The OET is only for health care professionals, there's no equivalent for other professions so the company still sees a lot of people come through who are married to nurses or related in some way and wish to go to the UK or Ireland with them but have to do the more difficult test because they are an engineer or architect, not a nurse. The more I learn about the immigration process the more complicated it sounds!The ones who do make it over have certainly earned their VISA by the time they get there!!

Rodeo & I with Ervin, president of Niners

Also, a week can't go by without a little bit of drama can it? There was a typhoon out over the Philippine Sea which didn't make landfall thankfully(!) but did cause a bit of a cyclone and some serious flooding all around Manila. I had a few days between working in Manila and Cebu and had planned to bus it down the Eastern Visayas through Tacloban and finally arrive in Cebu. Due to the flooding (and risk of landslides that everyone and their mother kept telling me about) I was talked out of that plan and flew to Cebu from Manila yesterday morning after a few extra days weather watching out of my hotel window. That in itself wasn't loads of fun - I don't like flying at the best of times, flying in storms is pretty high on my list of activities to avoid! But all's well that ends well, the weather in Cebu is hot and sunny which is a nice change from hot and torrential rainy!

Bit bizarre seeing this first thing in the morning!

I met Janice from the Cebu office this morning and we crack on with our visits tomorrow. 

Oh and another bizarre thing that I love here - Irish bands are big! And not in the everybody knows who Bono is kind of way. Boyzone, Westlife and the Script are constantly on the radio and EVERYONE I have met loves the Corrs! It is literally amazing to have random Filipinos singing Corrs songs at you on a daily basis! No B*Witched though, which is disappointing. I obviously have some non-nurse related work to do.

To summarise, it's been a busy start, the weather has been terrifying but then lovely, nurse research here is amazing and the people are some of the friendliest and nicest I have ever met. Although I really can't get used to being called Miss Kate and ma'am all the time - feel like I'm turning 80 next week rather than 30! 

Last week of my twenties spent in sunny Cebu and a visit from Gareth, laden down with gifts (obvs), to help me celebrate to look forward to. Even I can't find anything to complain about today and that's saying something!😊

Slán

Kate

Easy as one-two-three

So, I'm a bit late with the blog this week. The main reason is that since finishing the last one I had 2 days in Zimbabwe, flew to Dubai for 4 days and have now just arrived in the Philippines. To say I'm confused is an understatement - I think it was probably at it's worst when I was buying tea in Dubai airport and the guy behind the counter asked where I was flying to. Cue me looking at him blankly for a full 10 seconds and then finally admitting I couldn't remember!😂
But I'm getting ahead of myself, my last few days in Zimbabwe were as dominated by the election as the previous week had been. I had originally planned to leave at the weekend and only spend a day in Dubai but as I didn't seem to be achieving much I decided to bring my trip forward by a few days and have a bit more time to spend there. Turned out to be a good idea as protests and riots kicked off in Harare the night before I left due to the results coming out so getting approval to visit anymore hospitals was definitely gone out the window. When I changed flights in Ethiopia and saw the scenes in Zim, that the army had been brought in to use water cannons and tear gas on protesters and, at that time, at least 1 person was dead it was a serious reality check. I had literally been walking down the street flashing across the screen with Jackie the day before enjoying my last day in Harare. What a difference a day makes.
Thankfully everyone I know there and stayed with are all fine and things seem to have calmed down slightly as people get on with their day to day business but the future is uncertain for Zimbabwe at the moment. I hope things can be turned around, the normal people who carry the heaviest burden day to day need something to change for the better and give them some hope for a future of economic stability.

Jackie (right) & her family who I stayed with in Harare

Last Thursday I arrived in Dubai. I was always going to be stopping off there on my way to the Philippines but had decided to try and squeeze a bit of work in on the way. I did this with the help of Laura and Hayley who both work for Healthperm, a recruitment agency who work with our Trust. Hayley set me up with my contacts for the Philippines (life saver, thank you!)and Laura had the bright idea of visiting their office in Dubai on my stopover. I met Angela from the Dubai office on Friday morning and, after a little tour, we went to meet the team.

Angela from Healthperm & my Arabic coffee with dates!

The major problem I have come across so far on this journey is nurses failing the English language test (IELTS) to gain entry to the UK. Everywhere I have visited so far the nurses have said the same; either they have failed at least once already or they want to come to the UK but are afraid of failing the IELTS. You also have to pay to do it which is a huge barrier especially if you have to repeat it. And before you start to think why would we even want these nurses if they can't speak good enough English to pass the test, their English is better than mine. The problem with this test is that it can ask them anything and I mean anything. There are questions about rock formations, Inuit populations in Canada, the solar system. It doesn't ask them a thing about nursing! In the Dubai Healthperm office the team basically help future recruits to prepare for the test and other assessments. They do lectures, 1 on 1 lessons, weekly mock exams, whatever it takes to help these nurses achieve the level 7 (in Ireland you only have to get 6.5 which is what it was in the UK until recently). There is a new test which is occupation focused that is being rolled out which makes so much more sense but for now the IELTS is the only one that matters. Angela and her colleague Mark both carry out the lectures and are trained nurses themselves and the enthusiasm from both of them for their jobs is incredible to watch!
I was so glad I had extended my time in Dubai as it meant spending a whole day with Angela (who is amazing) and the team rather than a few rushed hours between flights. I also got to meet a group of hopeful recruits come in for orientation and a presentation on what the company delivers. Most people in the group were keen to move to the UK or Ireland but that is a long way off for them at the moment - one nurse I spoke to, from Pakistan, had perfect spoken English and has failed the IELTS 3 times! It's a real uphill battle for overseas nurses.

Future recruits (we hope!) in Healthperm, Dubai

I'm now in the Philippines but will save what I've been up to here for my next blog as I'm in danger of confusing myself let alone anyone else at this stage! Needless to say it's hot and humid (but Dubai was 40 degrees and fairly heavy so I've had some good prep!) and Manila is a bit mad! I've had a jam-packed few days here, with little sleep as I think jet-lag (or all the travelling) has messed me up so I'm a bit of a zombie at the moment!

Although I have to say one thing about Manila so far. Hilariously, every group of nurses I've met think I am visiting from Notting Hill! It's bizarre, it never even occured to anyone in Zambia or Zimbabwe and it's been constant here! Also, HUGE confusion when I tell them where I live and they excitedly go 'Oh, the movie!' - at first I'm surprised they know about it! That doesn't last long (You know it!? Ugh, Kevin Costner. But, Alan Rickman!! Am I right!? Amazing! God, I can't believe he's dead. And he was so young. Did you know he only starred in his first movie when he was 41??). It took much miscommunication and accent figuring out for me to realise that they all love Hugh Grant and Julia Roberts and tiny travel bookshops and I'm pretty sure they are all still none the wiser as to what 'Robin Hood: Prince of Thieves' is but I think everyone now knows how I feel about Alan Rickman which is obviously the most important thing. Point being, you have never seen disappointment until you've explained to a room full of excited Filipino nurses that you live in the land of 'Ey up me duck' and being mardy instead of posh London. But hey, you can't win 'em all!

Third country of the week!

Another week of visits and adventures in Manila so we will see where that takes me, at least I'm staying put in one country for a while! Although, that reminds me, I need to go do my ESTA!

Slán libh

Kate