From information to knowledge

From information to knowledge

Updated 09:39pm (Mla time) Oct 28, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 29, 2004 issue of the Philippine Daily Inquirer


THINK of the country's top corporations and you usually think of oil companies, utility firms, banks, and food manufacturers.

For the last three decades or so, these companies have indeed been consistently among the leaders in business. But the BusinessWorld newspaper's latest yearbook on top corporations in the Philippines, released on Wednesday, reveals a major change, with information technology firms now dominating the economic scene.

For purposes of comparison, look at the 10 leading companies in 2000, based on total sales: (1) National Power Corp., (2) Manila Electric Co., (3) San Miguel Corp., (4) Petron Corp., (5) Texas Instruments Philippines Inc., (6) Pilipinas Shell Petroleum Corp., (7) Philippine Long Distance Telephone Co., (8) Caltex Philippines Inc., (9) Nestlé Philippines, (10) Ayala Corp., (11) JG Summit Holdings Corp., (12) Philippine Airlines, (13) Zuellig Pharma, (14) Coca-Cola Bottlers, (15) Mercury Drug, (16) Philippine Associated Smelting and Refining Corp., (17) RFM Corp., (18) Procter and Gamble Philippines, (19) Unilever Philippines, and (20) Purefoods Corp.

For 2003, which was the focus of BusinessWorld's yearbook, we have the following leading 20 companies: (1) Texas Instruments Philippines Inc., (2) Toshiba Information Equipment, (3) Manila Electric Co., (4) National Power Corp., (5) Petron Corp., (6) Pilipinas Shell Petroleum Corp., (7) Philippine Long Distance Telephone Co., (8) Caltex Philippines Inc., (9) Nestlé Philippines, (10) Globe Telecom Inc., (11) Smart Communication Corp., (12) San Miguel Corp., (13) Philippine Airlines, (14) Mercury Drug, (15) Panasonic Mobile Communications, (16) Philips Semiconductors, (17) Fujitsu Computer Products, (18) Metropolitan Bank, (19) Coca-Cola Bottlers, and (20) Hitachi Global Storage Technologies.

Note that eight of the top 20 companies are involved in information technologies, six of them as manufacturers of semiconductors and computers, and two (Globe and Smart) involved in mobile phone services.

Loose change

Does all this mean that we've made it into the information age, and that IT is going to be our major engine of growth?

Not quite. As I pointed out in this column last week, our role in the global IT world is still one of consumers (for example, of cell phones) and of providing cheap labor, whether to assemble electronic products and computers, or as workers for outsourced information activities such as call centers.

Excuse me as I rattle off a few figures, which are necessary for us to get a clearer perspective in relation to IT. Let's first look at Texas Instruments' gross revenues in 2003, which came to P159 billion. At P55 to the dollar, that is about $2.89 billion.

Awesome? Not really. In 2000 (the latest year for which I could get international figures on Asian companies), the largest Asian manufacturer of information equipment, Hitachi, had total sales of $70.24 billion, which is more than 20 times the Texas Instruments Philippines figures. Hitachi, you will notice, also ranked 20th in the Philippines, but its revenues here, from assembly activities, came to a mere $541 million, loose change really.

The second-largest Asian IT company, Toshiba, had 2000 sales totaling $50.472 billion while its 2003 revenues in the Philippines, for assembling products, came to $2.618 billion. Similarly, Fujitsu, the third largest Asian IT company, had sales of $46.133 billion in 2000 while its 2003 revenues in the Philippines came up to $627 million.

Value added

My point is that there's a world of a difference between manufacturing and assembling. We have remained content with assembling products for multinationals while our East Asian neighbors, in allowing the companies to use their cheap labor in the past, also insisted on a transfer of technology. Even more importantly, these countries poured in huge investments into education, developing basic and applied sciences to produce a large corps of IT professionals and scientists who are truly catapulting East Asia into the global IT market.

Acer is a case in point. A few years back most Asians had never heard of the small Taiwanese computer manufacturer. By 2000, Acer was the 15th-largest IT manufacturer in Asia, with sales reaching $5.662 billion, double Texas Instruments Philippines' revenues in 2003.

Today, China, India and Singapore are following the example of Japan, South Korea and Taiwan, starting out with joint ventures and imitation of the big players' products, but with value added through all kinds of innovation. In last week's column, I mentioned how India developed its own hardware and software to canvass 450 million votes within a few days. Easily, in a few years, the Indians can export their technologies to the United States (and maybe assure more honest elections than the one in 2000, where computer glitches resulted infamously in Bush's victory).

Yesterday's Inquirer had a local call center spokesperson claiming their sector will bring in $689 million in revenues in 2004. But I've also mentioned India, which still has a major share of the outsourcing industry, sees the call center as generating loose change compared with software development. Last year they generated $9.2 billion from software exports.

Knowledge workers

We need a major shift in the way we are to move forward and compete in the global IT market. It would help if we start and recognize our potentials not just as end-consumers of IT but as knowledge producers and knowledge workers.

Our much-touted assets -- relative fluency in English and high educational attainment -- need to be tapped in a way that we are able to process knowledge, for ourselves and for the world.

I could cite other examples of knowledge production that's needed. Most of our Southeast Asian neighbors now have their own electronic dictionaries, as they try to get more people to master English. We could use such dictionaries, as well as other products like Filipino spell-checkers.

We need more role models like Niel Dagondon, who developed Anino, a computer game that takes off from local folklore. That is an example of a value-added product that draws on what we have. The market is there, locally as well as internationally.

Knowledge doesn't have to be packaged only as electronic products. "Old fashioned" books are still badly needed. The recent expos‚s about inaccuracies in our textbooks are an indictment of the way we have neglected knowledge production. Given an educational system where textbooks mangle information, should we be surprised that Mercury, the country's 14th largest corporation, produced a calendar two years ago showing a mosque with a caption identifying it as "a place where Muslims worship Mohammed"?

If we are to "sell" ourselves to the world, as a hub for information technologies, we need to go beyond technical skills and show we appreciate our own store of knowledge, and our ability to think critically and creatively. Then maybe in a few years we'll find more Filipino firms, rather than multinationals, among our top 20 corporations.

From Paris to Greenhills

From Paris to Greenhills

Updated 00:59am (Mla time) Oct 27, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 27, 2004 issue of the Philippine Daily Inquirer.


TWO series of unfolding events in France and in the Philippines won't make it into front-page headlines but their outcomes can affect the lives of many people, for decades to come.

In France, effective Sept. 2, the government has banned the use of "overt" religious symbols in public schools, including Muslim headscarves for women (“hijab”), Jewish skullcaps and large Christian crosses.

In principle, the French ban is meant to uphold secularism, but it is clear that the move, goaded on by the far right National Front party, is mainly targeting Muslims, with the argument that the headscarves represent Islamic fundamentalism (read terrorism).

Here at home, we also have a small storm brewing in the Greenhills district in San Juan, Metro Manila. I am referring to the opposition by some Greenhills residents and shop owners to the proposal to put up a musallah or Muslim prayer room in their shopping center. A resident told ABS-CBN news that a prayer room would turn Greenhills "into a haven of squatters, robbers and, worse, terrorists," claiming this happened in Quiapo and Taguig after mosques were built there.

Secularism

There is one stark similarity between the ban in French schools and the opposition to a “musallah” in Greenhills: bigotry, mainly targeting the Muslims and invoking the threat of terrorism. But there are differences in the way the prejudice is disguised.

In France, the ban on "overt" religious symbols invokes the principle of secularism, which the French have insisted on since the French Revolution in the 18th century. The Roman Catholic Church had been identified with the oppression of the French aristocracy and so secularism was intended to end the domination of the Catholics over the state. There was, too, the influence of the French enlightenment philosophers Voltaire, Diderot and Montesquieu who saw religion as divisive and intolerant.

The French debates have relevance to Filipinos. We also subscribe to the separation of Church and State. Last year, University of the Philippines president Francisco Nemenzo issued a memo reminding the faculty that the university, as a state institution, needed to remain neutral when it came to religion. Specifically, he pointed out, classes and other official functions were not to start off with a prayer or invocation. The memo came as a result of a law student's complaint that one faculty member had been starting her classes with a Catholic prayer.

I wrote about that memo some months back, expressing my agreement and arguing that it's not just in state universities but in any institution used by the public (for example, hospitals) where we need to maintain secularism, not in opposition to religion but, precisely, as a way of respecting religious freedom and the diversity of faiths.

Having said all this, I would disagree with the French government ban, which is so clearly instigated by a lack of understanding of the so-called religious symbols. First, a headscarf isn't going to stoke the flames of Islamic extremism any more than a large cross on a necklace would fan Catholic fanaticism.

Second, the French ban fails to see that the so-called religious symbols actually transcend faith. The “hijab” isn't just an expression of Islam; in fact, some of those who oppose the “hijab” see it more as a symbol of the oppression of women. Yet, Muslim women themselves will explain that the veils have many meanings, including an expression of one's identity. One Muslim woman anthropologist has even described the “burqa,” which covers the entire body, as "portable seclusion," giving a sense of protection from intrusive eyes, including those of religious conservatives. Underneath the “burqa,” Muslim women have been known to use cosmetics and wear high heels!

It's not surprising the French are now caught in a quagmire because the ban on religious symbols has been interpreted by one school to extend to Sikh turbans. Last week, when one school banned three Sikh boys from using their turbans, the parents brought the case to court. Again, there is a lack of cultural competence here, the inability to see the turbans not just as an expression of the Sikh religion but of a Sikh ethnic identity.

Religious apartheid

The issue then is one of cultural liberty, which the United Nations defines as the ability to practice one's own religion, to speak one's language, to celebrate one's ethnic heritage, "without fear of ridicule or punishment or diminished opportunity."

"Diminished opportunity" are the keywords here. In the Greenhills controversy, some Christians argue that a Muslim prayer room is inappropriate because the area is largely Catholic. But we forget that there are some 400 Muslim traders in the Greenhills Shopping Center. Islam requires prayer five times a day and the Muslims in Greenhills have been doing this in an empty space at the side of a building, a stone's throw away from a large Catholic chapel. A musallah would allow Muslims equal opportunities with Catholics to practice their religion in a more decent, secured space.

This is why I've always argued that the University of the Philippines, despite its secular nature, must provide at least a “musallah” for its Muslim students, simply because we already have Catholic and Protestant churches within the campus.

Of course, the best solution to all this -- whether in Greenhills or on University of the Philippines campuses -- is to have ecumenical rooms or buildings where people of all faiths can worship and reflect. You see such rooms in the world's major airports, a testimony to the multicultural age we live in.

Muslim traders are now found in the country's major urban centers and I've always felt their businesses are a good thing, a chance for Muslims and Christians to interact. I've talked with both Christian and Muslim business people in Greenhills, Quiapo, Baguio and they generally agree they are able to co-exist peacefully.

The absence of a “musallah” in Greenhills will only reinforce the tendency of Muslims to retreat into ghettos, practicing their faith apart from Christians. We are in a sense creating religious apartheid (an Afrikaans/Dutch word that means apart-ness), imposing our own mental “hijab” on our Muslim brothers and sisters and keeping them mysterious, forbidding and threatening.

How do parents in France, and in the Philippines, explain to their children why there is this religious apartheid? At best, the next generation will shrug this off as ignorance. It could be worse though, as religious extremists capitalize on this apartheid to prove how religious minorities are persecuted. The next generation may yet reap a bitter harvest from our intolerance and bigotry.

Outsourcing: boon or bane? (2)

Outsourcing: boon or bane? (2)

Updated 01:20am (Mla time) Oct 22, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on Page A15 of the October 22, 2004 issue of the Philippine Daily Inquirer


OUTSOURCING has been described as a sunshine industry in an otherwise bleak Philippine economy. Last Wednesday, I described the many lucrative opportunities offered by major outsourcing activities contracted out by Western companies to the Philippines -- call centers, software development, medical transcriptions and cartoon animation.

But I warned, too, that if we are to tap the full potential of these outsourcing activities, we need to be more aware of the history of outsourcing, and its advantages and disadvantages.

Outsourcing is, after all, only the latest phase in the development of global capitalism. In the 1970s, as multinationals faced rising factory labor costs in their home countries, many moved their production facilities overseas (sometimes called runaway shops) to use cheap Third World labor. In this 21st century, with the explosion of information technologies, the multinationals are looking into the use of these technologies to outsource customer servicing, office accounting and other routine office procedures to the Third World.

How do we stand to gain, or lose, from all outsourcing?

Global coolies

It helps to start by looking back at our experiences with the "runaway factories," mainly garments and electronics firms that now form the backbone of several of our export processing and industrial zones.

Yes, the products of these multinational firms are now among our leading export items. And yes, we did see, and continue to see, the creation of jobs, often paying fairly good salaries based on local standards. Just to give one example, electronics firms in Laguna province can offer something like P10,000 a month to a factory worker. For the many young women from rural Southern Tagalog provinces who flock to Laguna, that is a windfall, enough to support parents and younger siblings.

But there's another side to this. These factories have in a sense stifled local industries. Local textile and garments firms, for example, have been practically wiped out, unable to compete with the multinationals, unless they themselves become subcontractors.

In the area of electronics, I always have mixed feelings seeing some gadget sold in an American or Japanese store labeled "Assembled in the Philippines." Note "Assembled," rather than "Made in." Unlike Taiwan, South Korea and now, China and India, we've always been content to be global coolies, doing the menial jobs of assembling different components, many produced in other Third World countries, into a finished product.

We welcomed these firms thinking of the jobs they'd create, but forget that capital moves into areas where the skills that are needed are cheapest and most docile. We're vulnerable, as the multinationals move out of the Philippines to countries like China and Vietnam.

Hype versus realities

Never mind, we tell ourselves, we have a stable niche with call centers, because, together with India, we have the English proficiency and fairly high levels of formal educational attainment needed to deliver many of the required outputs.

But there's a danger here that we become complacent, believing the hype in the mass media and in the local grapevine about the opportunities in outsourcing. Last month, I met someone I'll call Ana, an ambitious young woman who had come to Manila from Polomolok town in the southern province of, South Cotabato, lured by the prospects of becoming a call center operator. Ana was setting aside two years of college courses in engineering and a six-month caregiver course after hearing about the wonders of the call center world, with salaries supposedly running up to $800 a month. Why work overseas when you could earn that much here?

Manila proved frustrating for Ana, with one rejection coming after another. Ana hadn't realized, as with many other call center hopefuls, that last year there were only about 20,000 "seats" (job positions) available. Even with projections of 40,000 seats this year, this is miniscule compared with the number of jobseekers. Outsourcing Digest cites a recent study by the Contact Federation of the Philippines finding that only two or three out of 100 applicants qualified for call center jobs. The reason? You need not just proficiency in English but the potential to get "accent training" so you can be understood by American clients. It's not surprising most of those accepted come from the University of the Philippines, Ateneo de Manila University and other upper-class private schools.

And the salaries? P12,500 to P17,000 a month is a more realistic starting salary, overtime included. Sure, that's about what an instructor gets at the University of the Philippines, but certainly a long way off from the $800 figure being bandied around.

Learning from India

My fear is that we will again remain content as global coolies, deploying University of the Philippines graduates to handle menial jobs. Call centers moved to the Third World not just because our labor was cheaper but also because Americans and British young people were leaving their jobs after a few weeks, totally bored by the routine.

We might want to learn from the Indians, who see outsourcing as part of a larger industrial development plan. Whether call centers or software development, many of these outsourcing firms are situated in Bangalore, India's "Silicone Valley," where they become part of a larger plan to develop India's own information technology sector.

Not surprisingly, the Indians have developed homegrown technologies for local needs, from hand-held equipment to be used by farmers to computer technologies that electronically canvassed some 400 million ballots during their last elections within a few days. Call centers, the Indians know, generate loose change compared with software development. Last year, their software exports raked in $9.6 billion.

The Indians have a National Association of Software and Service Companies (Nasscom) that is able to negotiate on the global market. When American politicians began grumbling about how outsourcing was taking away jobs at home, Nasscom warned them that without outsourcing, the US economy would be in even more dire straits.

Nasscom conducts studies of the world outsourcing market, trying to figure out what niches are available for India. Rather than feeling threatened, for example, by China, a major competitor for software development, they're talking about joint ventures. Similarly, the Philippines is seen less as a threat than an opportunity, with at least one Indian human resource company, Daksh, already investing in the Philippines' call center industry.

Why the difference in approaches? India has always adopted a nationalistic but pragmatic stand in relation to industrial development, bringing in the multinationals but negotiating with them with domestic priorities in mind. We lacked that foresight many years ago when we invited in the runaway factories. It may not be too late yet when it comes to outsourcing.

Outsourcing: boon or bane? (1)

Outsourcing: boon or bane? (1)

Updated 10:41pm (Mla time) Oct 19, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 20, 2004 issue of the Philippine Daily Inquirer.


ABOUT two or three years ago, I first wrote about the potentials of cashing in on the needs of US companies for software development, which they had started contracting out (thus the term "outsourcing") to Third World countries, mainly India, the Philippines and China.

While I knew outsourcing was going to grow rapidly, I didn't realize it would do so at such a rapid pace, and that besides software development, the explosion would cover areas such as call centers. Today, there are some 8,000 Filipino firms engaged in outsourcing activities.

No doubt, there are many potential benefits in outsourcing, but if we are to maximize the gains, we should understand how outsourcing came about in relation to global capitalism, its advantages and disadvantages, and where we are today in this global market. It's also important that we look at the situation soberly, separating the hype from realities.

To do this, I checked different Internet sites but I will be mainly using figures from the Internet site of Offshoring Digest, which examines trends and prospects in outsourcing.

Call centers and software development

Call centers account for the biggest chunk of outsourcing revenues in the Philippines. The call centers are actually customer service units, the "operators" responding to questions from consumers. Thus, someone living in the States who has encountered difficulties operating a new MP3 player from an American multinational can call a toll-free number to get advice. What the US-based customer may not know is that the customer service representative, speaking with a mild "foreign" accent, is actually based in Manila.

In 2003, there were 20,000 "seats" (job positions) generated by Philippine-based call center firms, and that number was projected to double in 2004. Total revenues were said to have reached some $200 million in 2003. Some P10 billion has been invested to set up over 60 call center firms.

I could not find revenue figures for the other outsourcing segments, but I suspect software development comes in a close second to call centers. Offshoring Digest says there are some 10,000 software developers in the country, about 10 percent of our total number of IT professionals. These developers work for some 200 firms.

Medical transcriptions and animation

Less known than call centers and software development is the market for medical transcriptions, which involves medical reports, discharge summaries, therapy and rehabilitation notes, chart notes and other clinical reports. Under US laws, a doctor or a medical institution will not be paid their fees unless they have filed full medical reports, mainly documenting doctor-patient interactions. Doctors routinely tape their observations, which then have to be transcribed.

There are about 20 medical transcription firms in the Philippines. I could not find total revenue figures for these firms, but Offshoring Digest says that one firm alone, Philippine IT Offshore Network, had a $2.5 million contract with Health Partners, a US health maintenance organization. Under the contract, Piton will provide some 100,000 lines of medical transcription per day, to increase to 250,000 to 350,000 lines within the first year of the contract.

What human resources are required here? Apparently, a good transcription worker can provide up to 1,000 lines per day at a 98 percent average accuracy rate. They need to be able to provide transcripts within 24 hours; for emergency cases, the output has to be delivered within three to six hours. It's intensive work, and requires a familiarity with English medical terms.

We move now to animation production, which involves a handful of firms. Filipinos mainly do two-dimensional (2D) animation, the more traditional drawing and painting such as what we see with many Walt Disney classics. We've started to compete for the market for 3D animation, which includes computer-generated images, but the high cost of software for such production has limited local firms from getting its share of the market.

Runaway factories

Outsourcing has many exciting potentials, but let's not forget that all these new industries only represent the latest phase in global capitalism.

Labor costs in the United States and other developed countries have always been much higher than in Third World countries, which is one reason we keep losing so many Filipinos seeking greener pastures in countries like the United States, Canada and Australia.

Business people are always looking for ways to maximize profits, mainly by keeping production costs, especially labor, as low as possible. Using cheap migrant labor still comes out expensive, so in the 1970s, we saw the phenomenon of "runaway factories," where American multinationals began setting up shop in Third World countries to take advantage of the lower labor costs. It started with factories across the United States' southern border, in Mexico, but eventually spread to other countries. The Philippines was one of the countries that hosted these factories, mainly those producing garments and electronic components.

The development of information technologies in the last 30 years introduced new opportunities for global capitalism. We plunged into an information revolution, with businesses discovering that profits were to be made not just in the production of material goods but also in the packaging and dissemination of knowledge and information.

Outsourcing was inevitable as the rapid and efficient flow of information and knowledge became more and more important. Note that some aspects of this flow of information and knowledge are part of a continuum of earlier global capitalism. The call centers, for example, are there to provide customer support for products that, although sold by an American multinational, were probably assembled in China, with parts from the Philippines, Mexico and Malaysia.

Note, too, that there's a whole "generic" field of business process outsourcing (BPO), where a US-based firm will contract a Third World group to handle all kinds of information and data tasks. Outsourcing Digest reports that there are 53 registered BPO operators in the Philippines handling "business data processing, database management, finance and accounting services, insurance claims processing, logistics management, human resource administration, and sales and marketing."

In so many words then, there's more to outsourcing than call centers, software development, animation and software development. On Friday, let's see how we can use all this information to maximize the benefits that we might want to reap from outsourcing.

Medical tourism?

Medical tourism?

Updated 00:22am (Mla time) Oct 15, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 15, 2004 issue of the Philippine Daily Inquirer


"HOSPITAL sets sights on Manila," read the headline.

I wouldn't have given the article too much attention except that it appeared in The Nation, an English-language daily newspaper in Bangkok. The article, which came out last week, disclosed that Bumrungrad, one of the largest hospitals in Thailand, was planning to invest some $9.2 million in Asian Hospital and Medical Center in Manila’s Alabang suburb, representing a 40-percent stake in the Filipino hospital.

Because of frequent trips to Thailand, the name Bumrungrad was familiar. I knew it was a major player in Thai medical tourism, offering all kinds of medical packages for foreigners. Could Bumrungrad's move with the Asian Hospital be part of an expansion of its medical tourism package into the Southeast Asian region?

What does this mean for the Philippines' own plans for medical tourism? Maybe even more crucially, do we want to compete for this emerging niche in the global market?

Executive health packages

Let's look first at what medical tourism is all about.

Until fairly recently, people looked at Third World countries and its hospitals as inferior imitations of those in developed countries. Western expatriates as well as wealthier Third World "natives" would fly to the United States for something as simple as an executive check-up, having very little trust in local hospitals or doctors.

In the past 30 years or so, the costs of health care have soared in developed countries, especially the United States. Americans and, to some extent, the British, Canadians, Australians began to look for ways to reduce these expenses. Certain services and procedures in American hospitals are now being contracted out to Third World countries, from transcriptions of medical records to the reading of X-rays.

With medical tourism, the patient is literally "outsourced" -- packed off and sent to countries like Thailand on executive packages that offer, besides the medical services, all kinds of services. Bumrungrad's website offers perks like "roundtrip airport transport, welcome massage, cell phone, half-day Bangkok orientation tour, two round trips to hospital with hospital outpatient registration and process orientation plus 24/7 assistance for your entire stay in Thailand"!

The Bumrungrad website lists rates for some medical services. Need a coronary angiogram? That's about $3,000, including two nights in a single room. An elective Caesarean section? That's about $1,000, including four nights in a single room. Breast augmentation with smooth saline implant costs about $2,000, including one night in a single room.

Plastic surgery is actually quite big in Thailand. When you land in Bangkok's airport, the free maps carry many ads of clinics offering these procedures. One map I got, for example, had an ad from Bangmod Hospital offering breast implants, abdominoplasty (tummy tucks), liposuction, face lift, double eyelid surgery, nose implant, laser skin resurfacing and ... sex reassignment surgery.

These rates are very low compared to what you'd pay in the United States, Europe or Australia. As Bumrungrad's hard sell goes, the savings from one root canal performed in Thailand actually gives you extra money for a luxury vacation. Their website has this blurb that pretty much summarizes the business of medical tourism: "We can schedule shopping excursions, river tours, ancient site tours, trips to nearby beaches ... all around your medical appointment schedule."

Faith healers

The Philippines probably beat other countries to this idea of medical tourism bit many years ago. I recall how in the 1970s, faith healers like Tony Agpaoa were already offering tour packages for people coming in from Europe and Japan who wanted the faith healers' services. Agpaoa even had his own little hotel in Baguio City so patients didn't have to look for their own accommodations. The faith healing packages eventually went into decline, and last I heard, it was our faith healers who were going to Eastern European countries to do their road-show healing.

Earlier this year, then-secretary of tourism Roberto Pagdanganan announced that the Department of Tourism was teaming up with the Department of Health, specifically the Philippine Institute of Traditional and Alternative Health Care, to promote medical tourism. At that time, he said only the St. Luke's hospital had been accredited for their program but Asian Hospital, Capitol Medical Center, and Medical City had also applied.

So, do we want to pursue this medical tourism track?

I think there's potential here. Some of our hospitals, and health professionals, can match those in the United States; after all, we've been exporting our doctors and nurses there for 50 years now. Our medical and nursing curricula are certainly tougher than many of our neighbors' in Southeast Asia. Who knows, maybe medical tourism can convince a few more Filipino health professionals to stay rather than migrate.

On the "tourism" side, we do have a long way to go. It's hard to compete with our neighboring countries' tourist attractions, given their edge of a few hundred years with temples and palaces. On the other hand, we do have lots of untapped potential, with our nature spots and, of course, we do have an edge in terms of greater fluency in English, which is so important for a service industry of this type.

Reservations

I do have my reservations about medical tourism. My main concern is that it might distort our priorities. Just look at our flight attendants and the way they smile and kowtow to foreign flyers, constantly asking them if they need anything. Compare that to the scowl that greets you, a mere fellow Filipino, if you have the temerity to ask for water. Bring that kind of discrimination into our entire health care system and you can imagine what could happen.

I worry, too, about the bandwagon effect of every hospital trying to get into the act. If quality is not maintained, our medical tourism program could be shot down even before it takes off. All you need is a few well-publicized complaints of botched medical procedures from the visitors and we're finished.

Remember, too, there's the "tourism" angle to this. A foreign patient may be totally pleased with the medical services, but if he or she is mugged while out on a shopping trip or overcharged at some tourist trap, then they're likely to discourage friends from coming here.

We should be realistic though. Medical tourism isn't going to bring in huge revenues. Neither will it save our health care system from its present dismal state. But if we get our priorities right, medical tourism could help somewhat to serve the needs of Filipinos, with revenues derived from it going back into improving equipment and services and, in a sense, subsidizing costs for indigent patients.

Food politics

Food politics

Updated 02:13am (Mla time) Oct 13, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 13, 2004 issue of the Philippine Daily Inquirer


THE ONGOING controversies around hunger in the Philippines and the government's proposed food coupons should remind us how political food can be.

There's a sense of déja vu to all this, evoking ominous memories of hunger during the Ferdinand Marcos dictatorship and how the regime reacted. I say ominous because hunger is something you usually associate with dictatorships and failed states.

We tend to associate hunger with pictures of starving infants with bloated bellies. You do get such children in hospital wards but by and large, hunger in the Philippines isn't quite as blatantly visible. Which actually makes it more dangerous because we don't see the thousands of children who are actually slowly being wasted away by hunger, or by adults whose poor diets are eventually going to make them pay a terrible toll with all kinds of chronic illnesses.

Invisible hunger

About two weeks ago, I wrote about a GMA Network "Imbestigador" documentary that featured faces of Philippine poverty, with one segment focusing specifically on hunger. There were the usual scenes of households whose meals consisted of instant noodles. Others supplemented the instant noodles with a small pack of junk food. There was footage of market vendors giving away leftovers at the end of the day. Again, our comfortable upper classes rarely see this aspect of hunger in the Philippines.

The "Imbestigador" documentary missed out on other faces of hidden hunger, such as the ways poor Filipino mothers have to scrimp on the nutrition of their infants, and the malnutrition that results from these practices. For example, I have seen babies being bottle-fed with diluted condensed milk, which gives them a typical "moon-face," an illusion that the baby is well fed when it's actually under-nourished from an all-sugar diet.

It took the cold statistics of a recent Social Weather Stations survey to remind us that about one of every seven Filipino households had nothing to eat at least once in the three months before the survey. In Mindanao, this went up to as high as 23 percent of households, and I can imagine that in more remote areas of the island, the incidence may be even higher.

Nutribuns

The response of the Gloria Macapagal-Arroyo administration was swift, with orders to issue food coupons. The response only showed that the President and her advisers do recognize what a volatile situation we have in our hands. People going to bed hungry is the stuff that makes for more “people power” uprisings.

But the food coupons, which could cost taxpayers up to P6 billion, are ill advised. They again betray the administration's penchant for political dole-outs. The food coupons will do little to reduce hunger, and may in fact cause more harm in the long run.This use of food as a political tool isn't new. Imelda Marcos did this as well, through her many nutrition projects. In retrospect, the projects weren't too bad. There were attempts to educate the public about low-cost but nutritious food. For example, powdered “dilis” (a kind of fish) was rightly promoted as being a source of iron and protein. There were contests for schoolchildren, nutrition quizzes, oratorical contests, to get the young to extol the virtues of nutritious foods. (Remember the TV commercial "Ako si ampalaya, bow" [“I am bigger gourd”]?)

Alas, some of the projects didn't quite consider existing cultural concepts about food. The status-conscious Filipino thought, and still thinks, food has to be expensive to be nutritious. “Dilis” was too lowly. Worse, there were government nutritionists who tried to promote alternative foods that could be found growing wild in backyards, for example, “gulasimang bato.” Alas, people complained, that was food you gave to pigs, not to people.

Imelda Marcos' nutrition projects also involved dole-outs, the most well known being nutribuns, which were specially fortified bread. She personally gave out some of these nutribuns in her sorties, thinking this would gain her political mileage. Again, the public response wasn't always what she and her advisers expected. Word spread that these were old, stale bread, and they were quickly re-christened "Nutri-amag" [nutritious mold].

The Marcos dictatorship tried to use food as a political tool, and didn't realize that people would respond by criticizing the food programs. People weren't just cynical about the nutribuns and the messages about “ampalaya” and “dilis.” They were putting down the conjugal dictatorship.

In the last years of the Marcoses, the “mosquito” protest press began to expose the faces of hunger that the dictatorship had tried to suppress. Magazine covers showed infants and children who looked like they were from famine-stricken areas in Africa but, as it turned out, were from our own backyards. The fancy nutrition programs couldn't tackle the root causes of hunger: the plundering of government coffers and mismanagement of governance in general.

Ending the dole-outs

The Arroyo administration needs to learn from the Marcos era. On all counts, dole-outs never work for the poor. They are stopgap measures and yet, like all freebies, create a dangerous demand. The poor will appreciate the food coupons to some extent, but not in any significant way. Now if the government runs out of money to support the food-coupon scheme, you can expect uproar.

Doling out food coupons does not necessarily mean less hunger. Given the dismally low levels of nutrition awareness in the country, food coupons may only mean more instant noodles and junk food. I've seen it time and again when I give food allowances to household helpers and let them choose what they want to buy from the markets. They come home with cheap cuts of pork, chicken, lots of instant noodles, snack foods, soft drinks and, of course, packs of monosodium glutamate and bullion flavor cubes. Rarely will they get vegetables, fruits or fish.

Our P6 billion would be put to better use if it were allocated for community financing schemes. Many years ago when I worked with Dr. Mita Pardo de Tavera (a former social welfare secretary) and her NGO in an urban poor community, we had a micro-financing community revolving fund that gave out loans for mothers to put up small stores and food stalls. To be able to get a loan, the women had to agree not to sell cigarettes, alcohol or junk food. They were also taught to prepare simple but nutritious meals, and as they served these meals, they were able to talk about good nutrition.

I remembered that community project while watching the "Imbestigador" documentary on poverty (they featured a woman food vendor providing meals at P10 each to security guards and other low-income employees). Support for such initiatives may not be as politically dramatic, but they will go a longer way in helping people help themselves in the war against hunger.

Binge drinking

Binge drinking

Updated 01:05am (Mla time) Oct 08, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 8, 2004 issue of the Philippine Daily Inquirer


NOTICE how in both English and Tagalog we use innocuous words to describe alcohol intake: "drinking" in English and "inuman" in Tagalog. Yet alcohol is a powerful chemical, with effects on the body that you can feel within a few seconds after you take it in.

Almost as quickly, society takes over, telling us what we can and can't do as we take in more alcohol. In many societies, like our own, drinking "authorizes" us to let our hair down. Women are allowed to become more talkative, to laugh more loudly, even to flirt. Men, already usually loud, become boastful and as the night wears on, the alcohol intake again authorizes other behaviors, including the sexual.

When is it bingeing?
In recent years, medical researchers have become more and more concerned with binge drinking, for which they've even elaborated a definition: drinking that brings blood alcohol concentration to 0.08 percent, meaning at least 80 milligrams of alcohol for every 100 milliliters of blood.

Big help, huh? As if we went around with chemical sensors to tell us how many milligrams of alcohol there is in our blood.

The Aug. 21 issue of New Scientist, a British magazine, translates the medical gobbledygook and explains that, on average, males taking in five or more "standard drinks" or females taking in four or more "standard drinks" in two hours sends blood alcohol soaring to that 80 milligram level.

And what's a standard drink? It can be a small glass of wine, one bottle of beer or a splash of Russian vodka. For Filipinos then, the index would be beer bottles: taking in five or more in two hours could be binge drinking. But don't forget that many Asians don't break down alcohol very well in the blood, which means we get intoxicated more quickly. I'd suspect maybe even three beers in two hours could be problematic for many of us.

Drinking to get drunk
Besides giving actual figures on numbers of alcoholic drinks, the New Scientist offers an even more simple definition of binge drinking: drinking to get drunk.

I can imagine some people asking, but isn't that why we drink in the first place? Ah, we forget that there's social drinking, which is usually meant to be in great moderation, as we do in family gatherings. There's even drinking for health, like a glass of red wine a day, taken leisurely.

Binge drinking is different. It's "pathological" because it invites many problems. The rapid increase of blood alcohol levels can lead to accidents. In the year 2002, it was estimated that 15,000 Americans died in vehicular accidents, following binge drinking.

Binge drinkers, often college students, are more likely to get involved in brawls ("rumbles" in Taglish), sexual assaults and vandalism. Frequent binge drinkers among students also find their academic performance affected. Which should not be surprising since alcohol hits the brain. Even during one binge drinking session, drinkers have been known to pass out. People mixing drugs with binge drinking can even die from cross-reactions, as we've seen with quite a few celebrities. The research also shows that brain damage due to binge drinking can be worse with younger people.

Drinking affects our judgment, not just in driving but for other decisions. When drunk, people are more likely to get into unsafe sex, ending up pregnant (or getting someone pregnant), or picking up some sexually transmitted infection, including HIV/AIDS.

Why drink to get drunk? There's the "fun" element, what young people describe as going for a "gimmick." It's part of barkada (peer group) bonding, mixed with machismo values of proving one's masculinity. This is more likely with young people, but I've noticed in the Philippines that it's actually older male barkada (and sometimes people in middle age) who binge. The reason is simple: young Filipinos just don't have the money to binge.

For others, binge drinking may be a response to problems. But the alcohol does nothing to help overcome those problems. Alcohol adds to the depression and, paradoxically, it complicates problems because with binge drinking, the high levels of alcohol actually suppresses REM (rapid eye movement), making it more difficult to sleep. So you're drunk, nauseated, trying desperately to forget a problem which nags you even more incessantly because you can't sleep. If you finally dose off, it'll be for short sleep. You wake up with a hang-over, and the problem looming even larger.

Fighting binge drinking
The research on binge drinking has produced a lot of interesting information. Scientists now know that men are more likely than women to binge, this being of course a matter of culture and gender. As societies become more accepting of women drinkers, you might expect to see more women binge drinkers.

The research also shows that the earlier one starts to drink, the higher the chance of becoming a binge drinker later. And if one does start bingeing early in life, that bingeing is more likely to continue later in life.

Like cigarettes, controls on alcohol consumption should start with young people. We need to rethink all those advertisements glorifying alcohol, especially when it's associated with a night out with the barkada.

Alcohol is also too cheap in the Philippines, encouraging more binge drinking. Notice how in beer houses they put the entire crate next to a table, almost as a way of letting people know that the barkada intends to finish at least one crate. Beer prices in the Philippines are among the lowest in the world but even then, it can be a bit too expensive for low-income Filipinos, who then turn to even cheaper alternatives such as local gin, vodka or rhum.

The potential problems that come with drinking in general need to be part of health education in schools. Besides binge drinking, young people should be able to identify "bending," where someone spreads out heavy drinking over two or three days. And then, too, there's chronic drinking, for some on a daily basis, until the liver gives up. Cirrhosis is among the 15 leading causes of death among Filipinos.

People should be taught to know when to stop. In English, there are various terms used to describe intoxication: "feeling tipsy," "woozy," "drunk," "very drunk." We should look at our terms: "may tama" (early stages, where alcohol's hit is felt), "medyo lasing," "lasing na lasing," "lating na lating" (when the drinker can't even pronounce lasing), "windang", the last a slang term meaning "wala na" (there's nothing left, good night). Unfortunately, people don't usually want to admit they're "windang" and stop drinking. So the binge drinking can go on and on, until trouble erupts.

We learn to binge through the barkada; the barkada should also be a channel for teaching each other when to slow down, when to stop.

A sordid and painful tale

A sordid and painful tale

Updated 09:45pm (Mla time) Oct 05, 2004
By Ambeth Ocampo
Inquirer News Service



Editor's Note: Published on page A15 of the October 6, 2004 issue of the Philippine Daily Inquirer


NEWSPAPERS are often described as "history in a hurry." Today's current events become tomorrow's history.

Whenever I read old newspapers, some from as far back as the late 19th century, it is natural to compare and contrast them with the papers of today. For example, we all learn about the Reform or Propaganda Movement in school, and our textbooks emphasize the efforts of the fighting newspaper La Solidaridad. The bylines in this newspaper are like a roster of heroes: Jose Rizal, Marcelo H. del Pilar, Graciano Lopez Jaena, Antonio Luna and Mariano Ponce.

When I first came face to face with an actual copy of Solidaridad, I was surprised, and somewhat disappointed that it wasn't a daily and wasn't broadsheet. It wasn't even the size of a tabloid. By today's standards, the fortnightly Solidaridad would be considered a newsletter. This simple experience made me realize that reading historical sources requires shifting gears, that you take the past on its own terms and not read about the past with the hindsight, bias and comfort of the 21st century.

Aside from physical size, of course, there is the editorial slant. Why are some articles printed and others rejected? Why do the articles sound the way they do? Evaluating content is something we do for any newspaper new or old, but reading the Inquirer today makes me wonder what a future historian will see and say about our times. What will future historians make of the explosive (I would say, libelous) Gretchen Barretto interview in the Inquirer last Saturday? If it is any indication of readership that crosses boundaries, my jaded, 79-year-old father, who isn't interested in show biz or society gossip, recommended that I read it after one of his golf cronies told him that expatriate Pinoys who read the Inquirer on the Net got the news even before we get our newspapers here in the Philippines. I only read the paper on Monday because I spent the weekend in Odiongan, Romblon, where I had no television and newspapers to distract me from a reading seminar I participated in.

While I have always had a nose for scandal in history, I find that the primary sources are often discreet, the secondary sources silent on things that make our heroes human: Juan Luna murdering his wife and mother-in-law in a jealous rage; Jose Rizal and the women he left at every port he visited; Gregorio del Pilar and the different letters and perfumed embroidered handkerchiefs found on his body in Tirad Pass, etc. When there is little or no material, the historical vacuum can be filled with malice and conjecture: Apolinario Mabini and the sexual cause of his paralysis; Antonio Luna leaving a bag filled with revolutionary funds with a certain Ysidra that became the source of the Cojuangco fortune; Andres Bonifacio having a love-child in a place appropriately called Libog, Albay; Rizal's one-night-stand in Vienna that resulted in Adolf Hitler. Unlike urban legends that have a strand or semblance of truth somewhere, historical myths are more enduring. The more outrageous and the crazier the story the more people want to believe it, like that yarn about Rizal being the father of Hitler.

Reading the Gretchen Barretto interview made me wish journalists were more forward a century ago so that we would not be left guessing. For example, the closest we can get to Gretchen's plight (real or imagined) is Josephine Bracken who was not accepted by Rizal's family, with the exception of one or two sisters. After Rizal's death, she sued Teodora Alonso claiming that the family cheated her of her inheritance that included all of the Juan Luna and Felix Resurreccion Hidalgo paintings in Rizal's modest art collection, the library he left in Hong Kong in the care of Jose Ma. Basa, and some cash. She gave two interviews to the Hong Kong press in 1897 regarding her military exploits in Cavite that are quite doubtful. Not much is said about the cold shoulder treatment that she mentioned in a letter dated Aug. 13, 1896. Rizal was en route to Cuba from Dapitan, he had a stop-over in Manila but was not allowed to disembark so Josephine tried to send all of her lover's bilin that included lansones, collars, cuffs, mangoes, cheese etc. In this rather sorry letter she wrote:

"...Ah! My dear I am suffering a great deal with them [Rizal's family] in Trozo, it is quite true they ought to be ashamed of me as they say in my face & in Presenance (sic) of Sra. Narcisa & their children because I am not married to you. So if you heare (sic) that I don't go to Trozo any more, don't be surpized (sic)...If you go to Spain [and find] any one of your fancy you better marry her, but deare heare (sic) me better marry than to live like who we have been doing. I am not ashamed to let people know my life with you but as your dear Sisters are ashamed I think you had better get married to some one else. Your Sister and your Father they are very good and kind to me."

Earlier Rizal had written a letter of introduction for her stating that he wished that she be treated well as he cared for her.

We will never know what Rizal's mother thought of Josephine because she was not interviewed by the Inquirer, but from various pieces of correspondence we try and piece together a sordid tale that was too painful to record in the 19th century but comes so easily in our time.

A different Santo Nino

A different Santo Niño

Updated 00:46am (Mla time) Oct 01, 2004
By Michael Tan
Inquirer News Service



Editor's Note: Published on page A15 of the October 1, 2004 issue of the Philippine Daily Inquirer


THE SANTO Niño (Holy Child) is a quintessential Filipino Catholic icon, much loved and venerated, a little boy vested with the most extraordinary of powers. To be able to heal, many faith healers go into trances, their voices transformed into that of a little child to signify that the Santo Niño has taken over. Mothers pin Santo Niño medals on babies to protect them from illnesses and from harm in general. And what Filipino Catholic home would be complete without at least one image of the Santo Niño?

I know there's an entire coffee-table book produced on the Santo Niño in the Philippines but I haven't been able to get a copy, so I don't know how they explain this image's popularity. My hunch is that God, as God the Father, and Jesus still remain distant for many Filipinos. Too alien (especially God the Father, who looks too much like the Spanish friars), too male. When the Filipino needs succor and comfort, the gentle Virgin Mary and the innocent Santo Niño are so much more approachable. Note how Filipino mothers instill this love for the Santo Niño early in life, instructing children to pray to "Baby Jesus."

A plethora of Santo Niños

The Santo Niño comes in many versions: fair-skinned or dark-skinned, in simple or elaborate clothes. Perhaps reflecting my own personality and lifestyle, my favorite is the “Santo Niñong Gala,” the vagabond Santo Niño looking like a hobo, complete with a stick and a bundle of clothes, always on the road.

Gay couturiers love the Santo Niño, designing the most elaborate costumes for their statues, which are then paraded with other images when there are neighborhood religious activities, in a kind of fashion show.

The Santo Niño's popularity stems in part from its ability to be "adopted" by anyone, simply by changing its clothes. It's not just gay couturiers who love the Santo Niño, your epitome of machismo, soldiers and police, also have their Santo Niños perched on an altar and looking over their shoulders, decked out of course in the proper uniform.

Government offices also constantly violate the constitutional separation of Church and State by displaying their own versions of Santo Niños, although I have to say I have not seen these Santo Niños decked out according to the agency's work (e.g., dressed as a doctor for the Department of Health).

I've noticed Santo Niños are also very popular in beerhouses, bars and, well, what have been referred to euphemistically as "bahay aliwan" [houses of pleasure]. No, those Santo Niños aren't dressed, or undressed, for the occasion.

In several church courtyards here in Manila, vendors hawk a “Santo Niñong Hubad” -- yes, a naked Santo Niño, anatomically correct but physiologically not quite right. Let me explain that for lay people: yes, the anatomy can be correct, but what they tried to get the correct anatomy to do, for an infant, wasn't exactly possible.

Mind you, this naked Santo Niño now comes in different versions. I've seen at least four different ones. A tiny one, about 1-1/2 centimeters high, which you can carry in your wallet or put under your tongue (more on this later). This image has two other larger versions. Then there's also one where Baby Jesus is on the palm of a hand.

Custom-made functions

What powers does the Santo Niñong Hubad have?

I've always felt religious beliefs and practices are very malleable, adjusting to people's needs. Ask the Santo Niñong Hubad vendors what the little statues do and they'll tailor their answers according to who's asking.

If it's a woman who inquires, they'll say the image brings good luck, especially the Santo Niño on a palm. If it's an older woman asking, the vendor is likely to suggest that carrying the Santo Niño around helps to keep a marriage intact.

Now if the prospective buyer is a male, vendors will give you that inscrutable smile. To me, they gave the standard generic reply, "Suerte" [Good luck]. I'd heard of other more powerful functions of the Santo Niñong Hubad and asked if it is a “gayuma,” a love charm. The vendors were mum. I guess I just looked too academic to need such talismans.

The first time I heard about the Santo Niñong Hubad, I did ask Tita Gilda Cordero Fernando, an authority on Filipino popular culture, about it and she scoffed, "Goodness, that's been around for many years. You're supposed to swallow it."

Swallow? Maybe the earlier versions were, well, edible but the ones they sell now are metal ones, and I'd definitely advise against swallowing it. It can be quite awkward explaining to the doctors in the emergency room what they need to fish out of your gut.

Anyway, the mystery of the Santo Niñong Hubad persisted. I bought a few, distributed them to my mother and aunts (one of whom brought it to her parish priest to bless, which he declined) and continued to ask around.

Until one day I showed it to the father of my partner, a crusty working-class super-macho male if there ever was one. He smiled and said it was "mabisa," very effective. A man of few words, he elaborated a bit about putting the image under your tongue and thus armed, anyone you whisper sweet nothings to would not be able to say no.

The next week when we met, he slipped a piece of paper into my hand and told me to follow the instructions carefully. "Buhayin mo," he grunted.

It was chilling: He was telling me to bring the image to life first, before it could work, and he had just passed on prayers and incantations to use for nine Fridays in a row.

Bared, dared

Our many Santo Niños, not just the Santo Niñong Hubad, tell us so much about Philippine society. I've mentioned how maybe the child Jesus is so much more approachable. Maybe, too, that's why the Santo Niño is so popular in government offices, displayed to radiate some kind of continuous absolution. I once had to go through Customs to claim a shipment of books and was struck by the many Santo Niño statues in the offices. Why, nearly every desk had one. Then it occurred to me, as I ran the gauntlet of numerous Customs officials signing clearances, that their desk drawers were all open, presumably to receive bribes, oops, I meant heaven's blessings... and the Santo Niño's forgiveness.

And the Santo Niñong Hubad? Who knows? My partner's mother claims, tongue in cheek, she was a "victim" of this Santo Niño and her husband's lethal whisper while my partner's father, when he gave me the piece of paper, warned me, "Don't ever teach this to my son. He knows too much already."

I don't believe in the occult so I've filed the spells away, together with the Santo Niñong Hubad images. We get the partners we deserve and whether they stay or not depends not so much on naked Santo Niños under our tongue, than on how we use our hearts and our minds.

The naked Santo Niño bares Philippine society, daring us to think about all our existential anxieties around love and marriage and life itself.