A FILIPINO DIES IN KOSRAE

I am very thankful that in accepting Kosrae as a place of work, the body of work experience that I have gone through is helping me a lot. My education at UP has provided a lot of clinical experience to look into different medical cases. On the other hand, my residency training in general surgery in the Philippines and my fellowship in Bologna, Italy had helped me a lot on how to manage the best possible way for a patient. Being in an island where there amenities are lacking, my rural oriented type of training has boosted my adjustment and adaptation in the area. My highly technical training in Italy had given me better techniques and surgical savvy.

Even, my masterals in management at the University of the Philippines have come in handy in this intercultural exchange and interaction. Having been grounded in organizational behavior, I was able to get to mainstream Kosraean life easier because adjustment and respect for culture had become a learned behavior in my case. Although, I get picky at times when I feel that my intelligence is assaulted but I simmer down at once because I know I am here to work for them.

I am so thankful that I have met well-meaninged countrymen here. I can share with them my thoughts and feelings. And it is productively interactive. I am thankful that I have met and interacted with the best of what our country can be proud of – the Filipino. Although, we are of different persuasions, I found them very supportive. Their contribution to Kosraean development can’t be faulted.

The death of one long-staying Filipino worker in Kosrae who had married and have joined mainstream Kosraean life showed the camaraderie and solidarity of the Filipino community in Kosrae. They made the coffin for Mang Bing Soriano. They conducted a catholic service during the wake and they sang songs of praise to God. Some helped in the cooking and during the burial; they were in full force as they prepared the graveyard for Mang Bing. Burial practices in Kosrae are very much different compared to the Philippines. For one, there are no embalming services; hence, they will have to bury the dead within 24 hours. There are no common cemetery grounds; therefore, they bury their dead in their front or backyard.

The life of Mang Bing is a story in itself. But suffice to say that it is full of joys, pain and more pain as he approached the twilight of his years. Having no child from his marriage to the Kosraean woman and only an adopted child to call his own, Mang Bing’s last days were really crucifying. He looked back to the olden days and he remembered his family back in the Philippines. But he can’t turn back the hands of time. Death is in his doorstep. We can only offer prayers for him and wish that we learn a lesson or two concerning his life story.

THE SURGEON GETS BUSY

On the 20th of July, it would be my 6th month here in Kosrae. And if you notice, there was a lull of about three months from the last writings I had in my blogspot. Practically, I got immersed in work and for one thing it is dizzying pace. I consider it as such because surgery work had been very busy. I am always confronted with the diabetic foot gangrene – operations ranging from simple debridement, disarticulation to below the knee amputation. It is often a long and arduous treatment process. If you do simple debridement or disarticulation, you still have to contend with the long process of waiting for the wound to heal. And sometimes during the waiting time, the patient ends up saying goodbye to the foot that they want to preserve. Conservative management is sometimes a frustrating treatment option . Sometimes, trying to preserve the foot upon the request of the patient becomes the radical option because one may think that the simpler option is just doing below the knee amputation.

BKA sometimes I feel is a way out for me and my patients. Yes, one may find it that way. The gangrenous infected stump is severed from the body. One may think it is easy as that and that’s it. But still, we have to contend with a lot of possible problems knowing fully well that these are patients who have poorly controlled glucose levels and have other complications, hence wound healing is poor. We encounter stump failure – wound dehiscence, wound infection and sometimes ascending gangrene. Just recently, we operated on a patient wherein we found out that she had a large thrombus in the leg. On the other hand, another presented with very sclerotic blood vessel. Ascending gangrene on the other hand is a very catastrophic complication as an operation above the knee amputation may be inevitable.

Diabetes mellitus is said to be a lifestyle disease among cosmopolitans. But I feel that among Kosraeans, it is a hereditary disease and it is very much associated with Syndrome X - high glucose, obesity, hypertriglyceridemia or hypercholesterolemia. And since this disease is fairly common among the Pacific Islanders and in one report has reached epidemic levels, it is as if, the islanders consider it as a part of their lives.

It is very unfortunate that there is no system for physical and occupational rehabilitation in the island. When they get to have BKA or any amputation for the matter, due to the physical disability the patient’s are terminated from work on medical grounds. When in fact, a lot of these patients can undergo rehabilitation – fitted with prosthesis, trained to walk like any normal people do – they can live a relatively functional life. If amputees can climb Mt. Everest, then why cant the diabetic patients with BKA in Kosrae. The government must look into the feasibility of hiring a physical therapist and an occupational therapist for the island state of Kosrae.

But unfortunately again, another problem is compliance. Most cases I saw would come back with another lesion on the previously unaffected foot. It becomes a source of frustration for a clinician like me who labored in saving a gangrenous foot from amputation and would find out that in the next follow-up, the other foot is affected. I wonder how our public health counterparts are doing regarding prevention and control of the disease. With data coming in, it should be a cause for concern because it has reached epidemic proportions already.

Of course, I would not just be busy with diabetic foot alone. There are a good number of cases in orthopedics. And this is very common to see in a cross-section of Kosraean society. I am not an orthopedic specialist. I only had some months of rotation in orthopedics. In medical school, our class monitor called my attention for almost a failing grade in orthopedics and I loathe the subject because I feel it is the carpentry of medicine. Pardon the pun. I don’t intend to offend the great orthopedic surgeons whom I have learned from. I could only smile in retrospect as I am faced with a good number of cases from clavicular fractures, shoulder dislocations to humeral, radio-ulnar, femoral and tibial fractures. Add to this are hand and foot fractures. Doing the casting and reduction takes a lot of strength. More so, when removing the cast, you need extra strength again. I told myself, I have to go to a body building gym when I get back for my 6 weeks vacation. Orthopedics has always been a challenge to me. Although not a favorite subject and rotation, I am always confronted by these cases and I have to face up to the challenge – by reading and applying what is needed to the patients. For complicated cases, I have to refer them off-island for further evaluation and management.

Of course, we are also confronted with an iota of the usual common surgical cases – appendicitis, hernia, exploratory laparotomy for acute abdomen cases. Since the Ob-Gyn specialist has not arrived yet, I still do the operations related to the specialty. It is here hoping that my load becomes lighter when the specialist arrives from the Philippines soon.

In all these cases from emergency to elective operations I deal with the patients with the best possible way. My being a perfectionist is both an advantage and a disadvantage. Advantage because we aim for the best if not an excellent quality care. Disadvantage because I am easily unnerved if things do not go my way. Although I must accept that there are inevitable things that happen like complications, most especially in a setting where poor compliance is more of a norm rather an exception to the rule and the limitations faced by the health system here in Kosrae, I do still try to make the best out of it under the present circumstances. I am glad that my efforts are greatly appreciated. Public feedback is very favorable it makes my heart leap with joy. I savor the appreciation of the people and they are enough to perk me when the flagging feeling – feeling of longingness, homesickness and boredom sets in. I feel I am not lonely but I feel I long for the people I love. These are some of the things you sacrifice when you make the decision of leaving some love ones behind.

THE KOSRAE IN MY MIND

Although January 19, 2006 is the first official day of the commencement of my work in the State Hospital, January 23, 2006 was my first formal day in work. Since I only have a 32-hour work week, then my work is from Monday to Thursday 8am-3pm and Fridays 8am-2:30pm. Then I get to receive calls from the hospital for referrals. I am also scheduled for standby duties.

My first formal day in work constituted a courtesy call with the Director of Health Services. An orientation was done and we discussed my concerns. Then the Director assigned Bob Sigrah to take me around. First stop was the Social Security Office where I registered and got my number in no time. Then we proceeded to the Immigration office where I registered and got my Alien Registration card. Then we went back to the hospital where I went to the office of the health insurance and again registered there. After all of those registration things, I was off to the operating room for another surgical exercise.

I began to fully understand why the people in Kosrae are wondering what keeps us from being deployed the earliest time. Well take note of this:
1.) Getting a schedule at the US Embassy may take months to wait. Even if you apply for an early schedule, the most of the waiting time would be 2 weeks to one month. The release of your visa if approved takes about 2 to 7 days. What if your papers are placed under administrative processing? In my case, it took three months of waiting for that proverbial visa. One of the reasons for this really is the increased number of Filipinos applying for that famed U.S. Visa. One can just see the long line of people in front of the Embassy as early as 4AM.

Take the case of Micronesia, the schedule in Ponphei is from Tuesdays and Thursdays between 2pm to 4pm. Once a visa is approved for you, you are to wait for an hour for the release of the visa.

2.) I am also reminded when I have to register for my SSS number in the Philippines. I had to follow a long line of applicants and have to wait for quite a time. In Micronesia, it just took 10 minutes and off I went to the immigration where the issuance of my immigration took the same number of minutes just like the SSS card.

What made the difference? Well, those offices I have mentioned in the Philippines have to serve the needs of at least 80 Million Filipinos. And a big percentage of these people either want to go to the United States to immigrate or to visit. Compared this with Kosrae, it has only about 9000 population to date and not is everyone is in the working force. Well, talk about population control. My own municipality alone, the town of Aringay, La Union has around 35,000 people at that. It has 24 barangays. Kosrae has 4 municipalities and yet it has that much people only.

Kosrae in my mind is like the Bahamas. Hence, you could see the picture of Nassau, Bahamas in the picture. But basically Kosrae is an untouched island with its natural beauty emanating. Everything seems easy in Kosrae because of the simplicity of their system. Everyone seems knowledgeable about people because of their few numbers. The moment I landed and reported to the immigration , the person at the immigration already knew me and handed me my working permit. By the time I arrived from work, almost everyone knew me. By the time I conducted my outpatient clinic, they knew I am the new doctor. By the time I did my first surgical operation, the island knew that the new surgeon did an operation for a ruptured appendicitis. The island of Kosrae, being a State is not just a State, it a community in itself where people practically knows everyone. People almost have all blood relationship with one another. Kosrae connotes simple living. Kosrae connotes idyllic life. Kosrae connotes man’s simple living in relation to the bounties that nature can provide.

In contrast, the Philippines which is said to be lagging behind in the economic arena compared from its Asian neighbors is much far far ahead that Kosrae or say Micronesia. But here in Kosrae, there seem to be a general acceptance of the simple life that they have. In the Philippines, people aspire for more. People are caught in the web of satisfaction and dissatisfaction. Why so? This is because of social injustice. There seem to be a feeling of the widening gap between the rich and the poor. Add to this is the continuous political bickering that the country is constantly being barraged with. Furthermore, the pervading ineptness in the bureaucracy has constantly stifled economic progress in the country.

THE PARTY

I was introduced with the mainstays of the Thurston Barracks. Why it is called Thurston barracks? Well, in here lives the Filipino workers in the construction company of Mr. Thurston. They showed me warm camaraderie during that time. They know how I felt and how I probably reacted to Kosrae as a place to work in. They had only good words for this place that had become the source of their of their livelihood. Sooner, I will find out that a lot of things were true to what they are saying. And sooner too, that in the final analysis, I could also feel their longing for their families as they are afar and that if they take the chance to go home to the Philippines, they also take the probability of not coming back again to Kosrae.

I have met other Filipinos. The engineers, the acocuntants, the teachers and the like. They too have their stories to tell. But the common denominator is that they want to make your stay in Kosrae the best possible way. And what is a party without the usual drinking? Well, the San Miguel beer was conspicuously absent. It was not available here in Kosrae. They had to settle with the Budweiser. In my case I was offered red wine and of course the Budweiser. Then, just like any Filipino party for that matter, there is the singing through the videoke. The Filipinos never run out of things to make themselves happy despite the stinging pain of homesickness in a faraway land.

The picture that I got from the blogspot of the Kosrae Filipinos is not situated in the Thurston barracks. I do not pictures yet. But in the next few months, I would be posting you the authentic pictures that I got. I have yet to buy a digital camera you know. But this is the house of Engr. Gerry and Susan Protacio. I had dinner with them the Sunday thereafter. But the people in the picture are basically the people that I have met and interacted with during the first days of my life in Kosrae. (Thanks to Kosrae Aggie for the picture)

THE DAY ISNT OVER YET

January 20, 2006 7pm

After resting quite a while, a knock at my door was heard. I saw Dr. Ocfemia at the door inviting me for the gathering of Filipinos at the Thurston barracks. Although tired, I obliged since it is an opportunity to meet the Filipinos in Kosrae and I need to meet Mr. Fred Jacla, a provincemate for whom some were sent to him by his wife.

We went to Leandro’s place (the surveyor-engineer and the computer wiz of the Filipinos here) first and there I met Bong and Edna Martinez. I also met Atong and Liza Calma. They have told me that they have been in Kosrae for quite a number of years already. At Leandro’s place, I also met Mr. Fred Jacla and I told him the medicines that were sent through me were at the apartment.

Then Dr. Toy (the nickname of Dr. Ocfemia), took to me the Thurston barracks and introduced me to the Filipinos in the place. They gave me a warm welcome. After some talks, and introduction, Dr. Toy brought me to Island Café and had dinner - my first dinner here in Kosrae. The interaction among the Filipinos was not that much that night as they can feel that I was tired from the trip.

The Jet Lag. The jet lag soon affected me. I was able to get some sleep only to wake up at 2 o'clock in the morning. It is only 11 pm in the Philippines. But what really affected me really is travelling at 11:10 pm and arriving supposedly at 4:40AM in Guam. In reality, Guam is 2 hours advance than in the Philippines. So id we take the real time that I travelled, it is only 3 hours and 30 minutes. Then we waited for 4 hours for our trip to Central Pacific which moves us more to another hour advance. I knew this would happen to me but the hastiness of the travel did not give me the chance to bring along my Melatonin capsules. Melatonin is the one I use to set my time clock. Back to waking up at 2 o'clock in the morning, it was not until 4AM that I was able to fet to sleep only to wake up again at 6:30AM. Dazed and still feeling like a wilting vegetable, I woke up as I cant get to sleep anymore. It was then that around 8:00Am, Dr. Toy knocked at my door and told me that there was a referral from the hospital.

The Hospital Referral. Dr. Toy and I went to see the patient and I assessed it and it was an acute appendicitis. We scheduled him for Emergency Appendectomy. I had a patient who is 27 years old, burly and really with those fatty blebs underneath. I thanked God, I saw someone who is larger than me. (Laugh out loud.) We had the operation at around 11:30 in the morning and assisting me was Dr. Carolee Masao and Lorentha Mongkeya the OR nurse. It was a ruptured appendicitis I found out and have to wash intraabodminally. I also washed the incisional wound and yet, the wound developed subcutaneous abscess. My life as a surgeon had started in the Kosrae.

THE TRIP TO KOSRAE

After waiting for 4 hours at the Agana, Guam International Airport, I was off to Kosrae. The first stop into Micronesia is into the Island State of Chuuk. After some 45 minutes stopover, we were off again to the Island State of Ponphei. Ponphei is the capital state of the Federated States of Micronesia which are Yap, Chuuk, Ponphei and Kosrae.

There were just drizzles in Chuuk and Ponphei but when the plane was approaching Kosrae, the rains have become maddening. There seem to be storm over Kosrae. I started praying because I noticed that the plane did not touch down during the first attempt. We were back 3000 feet above. Then I heard the pilot telling us that because of the strong rain and zero visibility, he did not attempt to land down.

I was uttering my prayers that. Again......the question is........am I really destined to go to Kosrae that even the weather does not life to cooperate during the landing of the plane? Well, on second attempt however, we finally landed.

As I descended the plane, we were ushered to the immigration area. The immigration officer did seem to know me at once. Of course, there was my working permit waiting for me to be issued at the immigration booth.

As I was waiting for my luggage, I read the posters on the wall. Kosrae is quite strict about plants and other vegetation coming in. The government of Kosrae is quite strict in the implementation of this law. They do not want their ecology destroyed because of foreign vegetation coming in.

I was met by Kun Mongkeya, the Administrative Officer of the Hospital and Dr. Nestor Ocfemia who is the Filipino anesthesiologist in the hospital. I was happy to note that the person that I would be working with in the operating room would be a Filipino.

The airport was quite far from the main town. As we traversed through the well-asphalted road going to the main town, I appreciated the lush vegetation around and the view by the sea. Kosrae is a place still untouched by the grandeurs of city life.

I was taken to my new place. A bungalow type of a house with the barest essentials. I thought of how I could manage in the place. It is quite large for my existence. A very big master's bedroom. Another empty room and a sala that is so large. The dining room and kitchen however were quite within my personal standards.

The owner of the house, Presley took me out to buy some things that I needed and after that he gave me the keys to the house and off I went to sleep after an almost sleepless trip.

Finally, I have arrived in the State of Kosrae, Federated States of Micronesia on January 20, 2006 at 2:26pm.

GUAM

Whenever we travel into a new place, we get all the nervous feeling. We had a very good meal during the flight. I was just thinking that the little boy who sat in the seat that I am supposed to be sitting on slept during all the three and a half-hours going to Guam. It was very unfortunate that I did not talk with my seatmates at that time. My mind was concentrated on the fellow who told the flight attendant that he will be alighting in Chuuk. So this guy is going on the same flight like me going to Micronesia. I told myself, I am going to tail this guy when I arrived in Guam.

Now the old woman. This woman is from Baguio and that she had relatives in Aringay, La Union, my hometown. And this woman had in fact relatives who are also my relatives. O my, the world is so small. Unfortunately, we were only able to talk in so little time because it was almost touched down when I made the chance to talk to her by commenting that it was so good to see the little boy having straight sleep during the flight. In my case, it was not.

The flight is supposed to be three and half hours. So time would have been in Guam as 2:30AM. But the time in Guam is around 4:30AM. They are 2 hours advanced in relation to the time in the Philippines. The airport is Guam is a very beautiful one. Remarkable indeed. And Guam during dusk is very beautiful with all the lights around. It is so nice to see that there are a lot of Filipinos working in the stores within the airport. Guam is a cosmopolitan area. I need to remark this because it is a great contrast with the island state of Kosrae.

As I was telling awhile, I tailed the man who would be travelling in Chuuk. Then I started conversing with him as we neared the immigration area. The immigration area was very systematic. When they ask us where we go and they checked on our fingerprints and faces, off we go to the transit area. Again we were whisked and checked again.

I began conversing with the Filipino who is working in Chuuk and he is from Echague Isabela. It was very unfortunate that I lost recall of his name. Then he introduced another fellow to me who happened to be a doctor-internist at the Chuuk State Hospital. It was nice talking to Dr. Galindez because at least I had a working idea of what it is to work in Micronesia.

CHAPTER 5 : THE KOSRAEAN EPISODE

INTRODUCTION

You might be surprised why I placed the title of this missive as Chapter 5 - the Kosraean Episode. Well, Kosrae, one of the island state of Micronesia is now my home for the next three years. Whatever that would happen to me here, whether I would extend for the next 12 years of the rest of my working days remains to be seen. But that would be jumping too soon. We have not started yet on why I called this Chapter 5.

Well, if I would write my biography I would say, Chapter 1 refers to my birth and growing up years. Chapter 2 refers to my school days from the elementary to my college of medicine years. Chapter 3 would stand for my training and work days until I had my fellowship training in Italy while Chapter 4 would be the part where I had a life of my own.

So much about those chapters in my life. But I would like to tell you the story about how I got here in Kosrae.

JOB HUNTING

After almost 9 years of having a life of my own. I practiced surgery in La Union, I taught paramedical courses to physical therapy, nursing and graduate students, I worked as an occupational health specialist in two electrical plants in the province, I dabbled as a legislator in my hometown Aringay and showed passion for beauty pageants, I had my share of relationships and had it sealed with passion and love, what more could I ask for?

For all those 9 years, I had my ups and downs. Both professionally and personally. Until such time that I thought I woke up on the other side of the bed, holding 3 credit card reports, so many bills on my hand and I looked at the walls of the apartment I am renting. I asked myself, are these awards commensurate to the lifestyle I am having now? I may have been professionally satisfied but I am broke. As in. I may be earning a lot but almost all of my earnings are have been going to the payment of my loans and day to day expenses. I have to make a decision.

Vouyed by the feeling of depression and exasperation, I went to some kind of a different high. I enrolled in a Masteral Course at the University of the Philippines Baguio. I was definitely on a new high as I garnered very good grades. However, on the side, I was applying to different jobs abroad. I was called by different agencies but there seem to be no luck at all. One time , as I was surfing the net, I saw that they needed general practitioners to the Marshall Islands. I got all the details of the job and decided that on that fateful September 18, 2005 I will be filing my application for the job. I know that my qualifications are much greater than what the job requires but because I was contemplating of doing a career change, I applied for that job. I applied for the job in the morning and in the afternoon at around 3:00 PM, Miss Tess Talagtag, called me in my cellular phone asking me if I would consider a job of a surgeon in the Island State of Kosrae in Mincronesia. Well, it is a job so why not? Besides, I am trained surgeon. So I was scheduled for an interview at 10AM the next day, Thursday.

The Interview. I arrived early that Tuesday morning. I was still all alone waiting for the interviewer. I was even telling myself that I hope all other applicants would not come. They told to just wait because the interviewer would be late. One by one all the other candidates arrived. Then I saw one doctor who arrived with an imposing personality. Tall, good looking and young. Having been a manager of our department, I know whom I am looking for. I told myself, this candidate would be taken in. True enough, he was the one chosen by the employer.

By a stroke of luck, the prospective employee did not accept the position because her wife is on her 6th month of pregnancy, higk risk at that because of 3 miscarriages in the past plus the fact that there are no OB-Gyne subspecialist in the island. And then, she can not go home to deliver in the Philippines during the month of her expected date of confinement. I was called and was asked whether to accept the offered contract. I accepted the job although it hurts me that I was only second choice. Although I know the reasons why I was not the first choice. First, because of my age. I will be turning 45 that September 23. Second, I am single and the thought of rooting down in the place would far-fetched. Thirdly, the interest on the first choice was grounded also on the fact that his wife is an internist and could be possibly employed by the hospital.

The Commencement of my Travails.

Visa Schedule. Problems started to crop up later because, it did seem that the Department of Health Services did not know how the Philippines operate in terms of visa schedule and all other stuff. I reported to the POEA to sign the contract that would be sent to Kosrae. We scheduled my visa interview with the US Embassy and the earliest schedule that they would give would November 16, 2005. My employer asked if it could be moved earlier because they wanted me to be in Kosrae on October 11, 2005. But how could I be in Kosrae during that date when the earliest schedule that they could allow me for the interview would be October 12, 2005.

Visa Interview. The visa process went on as scheduled and smoothly as it could be. I was assigned at Window 8. An American consul about 35 to 38 years old interviewed me. The interview was going smoothly well and he told me he will be issuing me a transit visa to Guam enroute to Kosrae, multiple for 3 years. But on one count when I ask how long would the release of my visa be, he started doubting then he started doing something in the computer and he asked some validating questions which I answered in the negative. Then the consular officer told me he can not issue me a visa now. He asked for my papers, the original papers for them to study. Apparently, they have placed me on administrative processing. I wanted to protest. I told them that I would only be transiting in Guam but to no avail. My fate has been sealed to wait. I ask him how long will the process go, I just got an answer telling me I do not know.

Administrative Processing. I was given a green paper wherein there is an area that is checked that my application for a non-immigrant visa is being placed under adminsitrative processing. And that would mean they would be reviewing my papers for a period of 2 weeks and more and that if after one year, I would need to apply again if I am interested. I felt so down. I felt my hopes of a career change will not be possible anymore. I have heard a lot that people who were placed in administrative processing have to go through a lot of waiting time. The POEA Account Executive, Salve Untalan for the State of Kosrae Department of Health Services advised me that we are going to wait and that everything will come to pass. The employer wants me to be in Micronesia the soonest possible time. Then he wrote that he can not wait for the US transit visa anymore, he advised me that I take another route. That of Manila to Brisbane, Brisbane to Majuro through Solomon Islands and Nauru and then from Majuro to Kosrae. I was already able to acquire a transit visa to Australia because there would be a lay over of 18 hours in Brisbane. No visa issuance is only given to those staying in Australia in less than 8 hours. I was to have my trip on November 26. I would be arriving in Brisbane around 8AM on November 27. At 2AM of November 28, I would be taking an Air Nauru flight off to Majuro. I would be having an overnight in Majuro and on November 29, I would be taking a Continental Air that would take me to Kosrae. Everything was ready. I already had my reservation. Then the call.

US Embassy Call. I was called by a staff of the US Embassy that I will be re-interviewed. I have to bring the green colored document that was given to me and to bring my passport on November 22, 2008. On that fateful day, I came face to face with the consular officer that put my papers on review. He told me that the Embassy had received a lot of letters from Micronesia asking when will the US transit visa be released and telling them that my presence in the hosptial is badly needed because the surgeon that I am replacing has been out of the island state. The consular officer had apologized it has to go this way and he had some couple of questions to ask. Had I lived somewhere in Tarlac? Had I lived somewhere in Clark or in Subic? I had an inkling that the problem would be someone who went to the United States who is my namesake and had some legal problems in the process. The consular officer after asking me those questions told me that the visa would be released in 1 to 2 days if within MetroManila and 3 to 4 days in key cities and 5 to 7 days in all other parts of the country.

Washington DC Clearance. The waiting time is not over yet. It had been more than a week already and my US transit visa had not been released. I was already aghast what was the problem. I wrote to my employer that my visa was not yet released and I do not know what is the problem. The POEA also wrote a letter and I was informed through telephone that there is still no clearance from Washington DC about the release of my US Transit visa. I just felt that there seem to be an unseen force that does not want me in Kosrae. The waiting time is killing me.

The Threat of Losing the Job Offer. On December 18, 2005, Mr. Arthy Nena, the Director of the Dr. Arthur Sigrah Memorial Hospital, the State Hospital where I will be working as a Surgeon wrote to Salve that I have to be there in Kosrae on December 23, 2005. If would not be able to make it, then they would be looking for a replacement. Miss Salve Untalan forwarded the message to me to my email and that message clearly shattered me. I have resigned from my job and that I am ready to leave the country as long as the transit visa would be released. But that eventuality does not seem to be clear. In the event that this would happen, I would need to have a fallback. I assessed the situation. I can not go back to my former jobs. I can not go back to teaching again since the loading for subjects takes it in a semestral basis. It is midway the semester and they just cant get me in the middle of the semester. I had to have other fallbacks.

The director of the hospital also wrote me a letter asking for the status of the release of the visa. I just cant tell him anything concrete. I told him I could not enjoy the holiday seasons because of the threat of not getting the job. He thanked me for writing him back and despite of what is happening we should enjoy the holidays.

Compounding problems. My bills that arrived. And I was surprised, I was considered to be in default of payments for my Mastercard. I have to pay all the bills amounting to P40,065.00. With no viable economic alternative to pay for this bill, I was dumbfounded during the holiday seasons until the new year. I did not know how I went along this financial crisis and luckily and surprisingly, I was able to raise the amount to pay for that one time bill. It hurt my pockets but I considered it a miracle.

The Miracle. The year 2006 came without a bang in my case. It was a lonely year with no viable occupation at hand. I gave myself until the 15th of January that if I can not have my US Transit visa, I will write a letter to the hospital director that they consider other applicants already. On January 6, 2006, a staff from the US Embassy called me up asking me to pick up my passport/visa since clearance from Washington has already been released. I told them that I have paid the courier fee for delivery hence, it was sent through the courier. January 14, 2006, a delivery man from Delbros delivered my passport/visa at my home in Aringay. I examined the issued visa. In it is an annotation that stated: Hit considered. Not the same person. All along I have suspected that it is the problem why they have put application through administrative processing. What an unlucky name. Anyways, on both ways, it is a miracle that I was still given a transit visa after 90 days of waiting. It is also a miracle that the name I carried is a very common one and that many people would love that kind of name.

No Travel Authorization. My ticket which had been booked for quite a time had been rescheduled on January 17, 2006 for my flight to Guam and on January 18, 2006 my flight to Kosrae. Everything went fairly well until I have gone to the check-in counter. They examined all my papers. The land crew of Continental Airways asked for my work permit. I showed them the scanned copy of my permit. I told them that the original copy of my work permit will be issued to me at the Immigration of Kosrae. The crew told me that the one I am carrying is not valid. There should be coordination of the Continental Office of Kosrae with the Manila office that I would be allowed to board with those conditions. Apparently, there was none. After some exhausting and tiring waiting time and asking help from the Labor Assistance Center (note that I am an OFW no), nothing happened. I was advised that if I pursued to board the flight, I need to purchase a return ticket to the Philippines because in any case that they would let me return, I have a ticket for that. I did not take the risk.

My Jetsetting Ways. I decided to go home to La Union. Went back to the daily grinds of life. At around 10:30AM, I received a call from Salve Untalan telling me that I am to fly to Kosrae on Thursday night at 11:10 PM. So I have to be in the airport at 7:00PM. This time everything went fine. I was off to Guam. After a 4-hour stopover at the Agana, Guam Airport, I was off to Kosrae.