As long as you’re careful about what you eat and drink and how long you spend in the sun, you shouldn’t have any major health problems in the Philippines. Hospitals in cities and even in small towns are generally of a good standard, although health care is rudimentary in the remotest barrios. Anything potentially serious is best dealt with in Manila. Doctors and nurses almost always speak English, and doctors in major cities are likely to have received some training in the US or the UK, where many attend medical school.
For a full list of hospitals in the country and a searchable database of doctors by location and speciality, check w ww.rxpinoy.com. There are pharmacies on almost every street corner where you can buy local and international brand medicines. Branches of Mercury Drug, the country’s biggest chain of pharmacies, are listed on whttp://www.mercurydrug.com.
If you are hospitalized, you’ll have to pay a deposit on your way in and settle the bill – either in person or through your insurance company.
Food- and waterborne diseases are the most likely cause of illness in the Philippines. Travellers’ diarrhoea can be caused by viruses, bacteria or parasites, which can contaminate food or water. There’s also a risk of typhoid or cholera – occasional cases are reported in the Philippines, mostly in poor areas without adequate sanitation. Another potential threat is that of hepatitis A. The authorities in Manila claim tap water in many areas is safe for drinking, but it’s not worth taking the chance – stick to bottled water.
Dengue fever, a debilitating and occasionally fatal viral disease, is on the increase across tropical Asia. Many cases are reported in the Philippines each year, mostly during or just after the wet season when the day-biting mosquito that carries the disease is most active. There is no vaccine against dengue. Initial symptoms – which develop five to eight days after being bitten – include a fever that subsides after a few days, often leaving the patient with a bad rash all over their body, headaches and fierce joint pain. The only treatment is rest, liquids and paracetamol or any other acetaminophen painkiller (not aspirin). Dengue can result in death, usually among the very young or very old, and serious cases call for hospitalization.
In the Philippines malaria is found only in isolated areas of southern Palawan and the Sulu archipelago, and few travellers bother with anti-malarials if they are sticking to the tourist trail. If you are unsure of your itinerary it’s best to err on the safe side and consult your doctor about malaria medication. Anti-malarials must be taken before you enter a malarial zone, and note that resistance to chloroquine, one of the common drugs, is a significant problem in Mindanao and Palawan.
To avoid mosquito bites, wear long-sleeved shirts, long trousers and a hat. Use an insect repellent that contains DEET (diethylmethyltoluamide) and – unless you are staying in air-conditioned or well-screened accommodation – buy a mosquito net impregnated with the insecticide permethrin or deltamethrin. In the Philippines mosquito nets are hard to find, so buy one before you go. If you are unable to find a pretreated mosquito net you can buy one and spray it yourself.
Leeches and rabies
If you’re trekking through rainforest, especially in the rainy season, there’s a good chance you’ll encounter leeches, blood-sucking freshwater worms that attach themselves to your skin and can be tricky to remove. If you find a leech on your skin it’s important not to pull it off because the mouth parts could be left behind and cause infection. Use an irritant like salt or heat from a cigarette or match to make the leech let go, then treat the wound with antiseptic. You can guard against leeches in the first place by securing cuffs and trouser bottoms. Climbers in the Philippines say rubbing ordinary soap with a little water on your skin and clothes helps keep leeches at bay.
Stray and badly cared for dogs are everywhere in the Philippines, and rabies claims about eight hundred lives a year. The stereotype of rabid animals being deranged and foaming at the mouth is just that; some infected animals become lethargic and sleepy, so don’t presume a docile dog is a safe one. If you are scratched or bitten by a stray dog, wash the wound immediately with soap and water, then get yourself to a hospital.