surgery in the philippines, cost, procedure
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Having a surgical procedure done in the Philippines

I’m kind of shocked when I hear the surgeon answer his phone. Here I am under an operating cloth with a huge wound on my head he was stitching and I can feel the anesthesia wearing off. The soft throbbing of the wound becomes more and more severe as I hear him talk (sige, sige…….blabla….sige…..blabla)

When he sticks in the needle to continue I shudder and he asks if I’m okay. He decides to a new set of anesthetic. I shudder again, the needle movements hurt like hell.

I am in Silliman Medical Centre, Dumaguete, Philippines. I have a cyst by the size of a golf ball removed from the back of my head. Wearing a helmet and the rubbing of the helmet, made it grow from a pea-size cyst to a giant egg, stretching my skin and becoming infected.

On the phone is Doctor Alfeche the 3rd, according to the medical bill his assistant will hand me later.

I visited his office the day before, and he was quite certain it was a cyst that urgently needed to be removed. Will tomorrow at 9 o’clock do? Oh, hell, why not, it has been bothering me for so long. Maybe it is time to let go of that ugly lump on my head.

So 8.30 we arrived at the new building for OPD patients and daycare treatment. State of the art operating rooms, so I’m told. The receptionist tells my son who is accompanying me that we have to go to the business office in the main building first. We have to register and make a downpayment.

There is a cue. We ask the guard and tell him we have a procedure scheduled. He puts us in front of the cue.
The downpayment is 1000 pesos, and the whole registration thing is as inefficient as it can be. I have to write down my personal details (name, date of birth, gender, age, address, and phone number) on a piece of paper. All that information is also on the papers the woman behind the desk has to process. But still…..After 3 years dealing with Filipino efficiency, you don’t ask anymore, you just do. As do you answer all the questions asked afterward (name, age, date of birth, contact number) You don’t even mention that you just wrote that down.

I step in the line at the cashier and pay my downpayment and get an OPD-er clearance.

Back to the building with the operating rooms.

I am asked to sign a clearance that I want to be operated that day by that doctor. And I am invited into the sterile area. My son is not allowed he is not sterile the nurse tells him. I try not to laugh. This is exactly why I hesitated to have this procedure done in this country, in this type of hospital. The contradicting reasoning on matters. Sterile is sterile and dirt is dirt, I am dirty too as I enter the sterile zone, and how about the phone in the Operating room? Cellphones are known to be the greatest source of germs on earth. So WTF??

Why is he taking a phone call in the middle of my surgery?

I have seen too many rural clinics that were downright filthy, and even larger hospitals that had blood on the walls of previous visitors and toilets so dirty that you were afraid to even go there. No means to wash your hands or disinfecting them while the wards are cramped with diarrhea patients.

Anyway, I enter the state of the art operating theatre in a freshly washed operating gown, and sterilized slippers. And it looks almost like I remember from the Netherlands I think. Clean, crisp, the smell of fresh paint is still in the air. It looks good, except for the leaking from the roof.

The contradiction in sterile starts again with the pre-opp preps, my hair needs to be cut, on the operating table, while wearing my gown. I try not to think too much and to let go of my fear and trust more.

But when the doctor took his phone call I made the decision to get some antibiotics, just in case my wound starts to infect.

The care is excellent, nurses are kind, caring, there is no rush. I get plenty of time to recover slowly after the 1-hour procedure, and they ask frequently how I am doing during the procedure itself.
The equipment used comes from sterile packages and is all new. Only the cart with syringes and clothes looks odd, a wooden thingy definitely manufactured by the carpenter next door. And difficult to keep clean I figure. But everything is new. I do not have to face all this in a year or so. And it is only a minor procedure, I reassure myself.

I still remember the emergency room on Siquijor. A very qualified doctor, but the mess, the floors the dirt in the corners, the absence of the right equipment. But the medical care was free there. Here I have to pay.

The bills are less than the doctor estimated. That is always nice, even in a country where medical care is only a fraction of what one should have paid ‘back home’.

I looked up the prices of my procedure in the Netherlands and the simple surgery on a tumor or cyst would cost between 287 euro and 1400 euro depending on the hospital. The clinic visits around 250 euro.

When I am allowed to sit and take off the operating gown I get washed, my neck, face, hair, all is rinsed down with a wet cloth and freshwater. I get all the bandages I will need in the coming days and they ask me if I want to see the cyst, for it is so cool? Maybe take photos?

I thank them without even glancing in the direction of the horrid bloody thing that was on my head for 2 years. I am afraid I will throw up. The doctor carries it outside. Later my son tells me he showed it to him, holding it in his hands in a waiting room full of excited Filipinos that loved to see my cyst. It was not cancerous he told my son, no need for a biopsy.

I will never understand the Filipino desire for gruesome pictures of deceased family members’ operation scenes and removed body parts. Look on an average Filipino Facebook timeline and you see such horrors. they love blood, bloody scenes and miracles. And they are so easy to believe stories. I know for sure if I told them the cyst was caused by my shampoo, or that I had brain surgery about an hour ago and I did not want to pay for a room, when they ask about my dressing on the head, they believe me.

We are off to the main building again. A bunch of paperwork in our hand. Lucky for me the state of the art new building has a “Tea leaf and Coffeebean’-shop, So I sooth my edged nerves with a double espresso before cueing up to pay the bills.

Total costs:

Consult with the doctor 300 pesos (5 euro), he gave a full explanation of the procedure and an estimate of the total costs
Operating room 4,258,13 PHP (70 euro)
Surgeon 7,500 PHP (125 euro)

I have to have the stitches removed after 2 weeks, that will probably cost some more. And a checkup after 1 week.
But with everything medical in this country: it is all up to you. If I don’t show up for the checkup he will not be upset and he can’t be bothered if I do not get the medication prescribed.

Make sure you check your bill. Like for me, they wanted to do a biopsy while I was in the operating room, while he already told my son there was no need for one. Saved me 2,500 pesos when I told him I did not want a biopsy.
I heard of patients that were charged for a room while laying in the corridor, let them remove the room from the bill, after all, here you only pay for what you use.

Same with medication: google! WebMD gives excellent information over the medication prescribed and that will give you a clear idea of what risks you take taking them.

General tips when visiting a hospital or dentist in the Philippines

  • Search the internet for symptoms and what possible procedures and medication are given, so you can ask the right questions
  • Check with the local hospital if they can treat it, if you do not trust it, look for hospitals nearby. I refused to have the cyst removed on Siquijor, I’m sure the doctor there could have done it, but the lack of hygiene and the doctor’s attitude bothered me
  • Take time, visiting a doctor in the Philippines is a time-consuming process. He will not show up or too late, sometimes even the assistant doesn’t know where he is or if he/she will come in today. I sometimes wait for half an hour for my dentist to show up. And the waiting rooms in hospitals are first to come first serve. And you may have to visit multiple desks and offices in multiple buildings to pay bills and get registered.
  • Is the offered check-up or procedure really necessary for the symptoms you come to consult about? I know of people that come in with a sprained ankle that get a brain scan scheduled, (you may have bumped your head while tripping! And we are so proud we have a scan!!)….nonsense, and it will be on your bill.
  • Ask for alternative options, especially at the dentist’s. (In a country where many people are poor, there is a cheaper solution, trust me!)
  • Ask for a price explanation if they do not give you one during making your estimate, keep in mind: so many hospitals, so many different prices. They will not be offended when you go for a second opinion, or have your lab work done elsewhere where it is more affordable.
  • Ask the doctor what he will do during the procedure and draw you pictures, this way you can check afterward if he knows what he is talking about. The first doctor looking at my cyst at a rural clinic wanted to ‘pop’ it. (No way José, that is not how you treat a cyst!)
  • Always ask the doctor or the Pharmacy if there is a generic brand available, that can save you sometimes more than 1,000 pesos for the same medicine.
  • Never buy the (general) medication at the Hospital Pharmacy, you will pay a lot less if you go to any well-stocked pharmacy in town. Specialized medication might not be available when you ask for it, they will have to order.
  • Use your common sense. Why did you get the medication? Is it really necessary? They prescribe antibiotics here like it were vitamins. And there are a lot of (not FDA Approved, yet already listed) experimental medicines here to be tested outside the US. Make sure you know what you are taking and what for.


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