Week 7

Hello everyone!

Link to pictures https://drive.google.com/drive/folders/1ZFaHtHUao5P8qhoFox3a8UXNnJDKxiYk?usp=sharing

This week Faith and I had our last rotation at the ER department. i was excited about this week because I work in the ER department back home in the US so i wanted to compare the differences between the 2 places.

the ER here had only 7 beds. 3 regular little rooms, a trauma room, a resuscitation room, an isolation room, and a critical room. I’ve noticed that the majority of the people that came in were people with animal bites. when you get an animal bite you have to get a rabies shot and then 4 shots spread out over some time after the initial one, so most people came in for their routine rabies shot and faith and i helped out with that a lot. we only had 3 days in the ED because of our trip to Japan so we didn’t see a lot. on Friday, the ER had no patients, so we went over the medical school that is next door to the hospital and we gave out Covid booster shots to the hospital staff. this took mostly the whole day, and it was cool to give a bunch of injections but pretty much every person that came in asked faith and i the same questions and right after we answered them in English, they would ask the exact same question to our supervisor in Tagalog (their language) but that happened pretty much everywhere we went. we also met a bunch of nursing students in the vaccination room, and we went out to lunch with them too.

over the weekend faith was not feeling good so I went by myself to Los BaƱos and visited the IRRI group. on Friday night we all met up with some of the IRRI groups lab group and went to a karaoke place. on Saturday we took a day trip to Tagaytay to see the taal volcano again and we also went horseback riding.

although this week was our last rotation week at work, we still have our big case study presentation on our patient from the general ward. we will present this coming Thursday to the group of supervisors and that will be our last day of work. we will have 4 days after that to do whatever we want before our flight on august 1st. we are about to be in a typhoon right now so it has been raining pretty much nonstop here so we cannot do much in terms of going outside because we will get soaked in just a few seconds.

see you next week!

Week 6

Hello Everyone!

Link to pictures https://drive.google.com/drive/folders/1ZFaHtHUao5P8qhoFox3a8UXNnJDKxiYk?usp=sharing

This week faith and I started our operation room rotation. The OR rotation consisted of us observing different surgeries, learning about the different instruments, and finally assisting the surgeons during surgery. This week there was about 5-7 surgeries per day which was super fun to watch. it would be a lot to name every single surgery we watched but the most interesting ones were several C-sections, a couple total hysterectomies, a total hip revision, lap chole, live birth, total mastectomy, total thyroidectomies, removal of abdominal tumor, removal of pancreatic tumors, and lower anterior rection surgery.

The differences that I have seen between surgery in the Philippines vs back home is that since they have low staff here, they have nurses do all jobs in the department. All nurses are trained in first assistant, instrument assistant, pre and post anesthesia care in all patients (neonatal to geriatric), and cleaning the OR after surgery. All of the surgeons and anesthesiologists were really nice and wanted us to learn and know what we were seeing.

after the whole week of surgeries, faith and I had an earlier shift on Friday because we planned to use our 4-day weekend to go to Japan from Friday to Tuesday. So late Friday night we got on a plane with hunter from the FNRI group and we flew into Tokyo and landed on Saturday morning. the plane tickets were a lot cheaper from the Philippines than they would be if we flew from the US. on the first day in Tokyo we explored the city and took the train to the more city like area called Shinjuku. Japan was really clean and very quiet, which was a big difference from what the Philippines is like. we ate lots of sushi and ramen in Tokyo.

the next day we all want to Harajuku, which is another citylike place, that’s where we went to all of the shops and different tourist areas like the famous dog statue called Hachiko Shibuya and the Shibuya crosswalk which is the most used crosswalk in the world. that night we went to a park by the Tokyo bay and watch a sea lantern festival (thinking it was a sky lantern festival) for the national holiday in Japan called Ocean Day (Umi no hi).

on Monday which was our last full day in Japan we took a bullet train to Kyoto which took about 2 and a half hours, and we went shopping, ate some good food, and hiked up a trail up a mountain to go to a monkey park to watch and feed some monkeys. later that night we went back to tokyo and went to a pachinko place which is like Japanese gambling, hunter won $350 after putting in $7 and listening to a worker who was telling him what to do.

on Tuesday we only had time for breakfast and then we went back to the airport and flew home. next week at the hospital faith and i will be in the ER department for our last rotation.

Week 5

Hello everyone!

Link to pictures https://drive.google.com/drive/folders/1XILkcAxZZT_mYjEGEdhA5v9mY7dvwWPU?usp=sharing

This week at the hospital faith and I were in the ICU Department. The hospital really only has the general ward and the ICU Department, so for the patients that would normally be in the PCU at home, they would go to the ICU here. also. due to low staff. we were told that out of the 7 ICU rooms they could only fill five of them because they didn’t have the staff and equipment at the time. They have one I see you very reserved for NICU patients, which they get from time to time.

During our time in the ICU. Faith and I, where each assigned a specific patient to. take vitals in chart and administer medication throughout the day. During this time, I was able to insert an NG tube. which is a tube that goes through her nose and down into the stomach and we used that tube to give the patient the patient liquid food so they could keep their energy up.

During this week, patients were constantly getting discharged from the ICU at. one point there were no patients at all. So during that time, faith and I were sent to that OR to watch some more surgeries. At this point, I can’t even name what surgeries we watched and when, because there was so many. But I’m pretty sure this week we watched a total hysterectomy. which is the removal of the uterus and they also removed both the. fallopian tubes and one ovary., I thought it was cool that they left part of the second ovary inside the patient because She was 33 years old and if they were to take out the whole second ovary, The patient would go into early menopause.

During this weekend, faith and I flew to El Nido, Palawan, which is an island in the Philippines with lots of beaches and beautiful scenery. All 12 of the interns here in the Philippines met up and stayed at the same hostel in El Nido. we also all went island hopping which is where you get on a boat with some tour guides and they take you to different islands and beaches in the Philippines. during our island-hopping tour, we went swimming, played some beach volleyball, did some snorkeling, and rode on a kayak through the huge mountains in a lagoon.

El Nido was super nice and i got super sunburnt. after the island hopping, a few of us went and got dinner at a nice Thai restaurant and then went to a place where we heard some live music. after that we walked along the beach and at that point it was super late, so we went home. Faith and I chose not to use our 4-day weekend this weekend, so we had to fly back to Santo Tomas on Sunday so we could make it back to work on Monday where we will be starting in the OR department.

Week 4

Hey everyone!

this week at the hospital Faith and I were in the general ward. The general word is where patients go when they get admitted for a couple days at the hospital. During our time at the ward, We were given a patient to perform a case study on and present it at the end of the month. Our patient had diabetes Hodgkin’s lymphoma and hypertension. Our case study consisted of her medical history, her family history, all the medications she was on, and the care plan for what the doctors and nurses should do as she is at the hospital and after as well. We pretty much worked on our case study the entire week while going into the patient’s room and asking questions relevant to the study.

Something I have noticed about the general ward here is the patient’s need a lot less care from the nurses and other staff while they are in their room. I think the reason for this is because in the Philippines family is a great value, so many of the older patients that would normally need help from staff or nurses receive that help from their younger family members or friends. The workload in the general ward is still high and I think that can be accredited to the paper charting. I feel like if the hospital is charting was fully online like most hospitals in the United States, it would be easier for the nurses to quickly document and provide care for these patients. Though I am told that this hospital is moving to more online charting and stuff but it has to take time.

Over the weekend, Hunter and I decided to travel about an hour NE to Los Banos and visit the International Rice Research Institute interns. Once we got there, they took us to one of their favorite dinner places and showed us around the town’s close by. The International Race Research Institute He’s a big deal in the Philippines, I know this because our grab driver was taking pictures of the inside of the gated area because he said he’s never been there before and it’s amazing to him. After dinner with the other interns, we walked around town, and they showed us some of the friends they had made in the Philippines and what they do on a daily basis

That pretty much sums up all of this week, faith and I will Present our case study on July 27th, our last day at the hospital.

Week 3

Link to pictures https://drive.google.com/drive/folders/10rmcYIC-CbUXi8vjJQjyTNOiVrddcGjL?usp=drive_link

This week for work faith and I were in the hemodialysis department. Something we noticed about the hemodialysis department is how many patients they have. St. Cabrini has only 100 beds and 20 of those beds are for hemodialysis patients, and they have three sessions of dialysis every day. in fact, CKD (chronic kidney disease) is the highest cause of death in the Philippines. the reason for this is because of their diet, drinking, and smoking. Much of the food here in the Philippines has a high amount of sodium in it which over a long period of time, causes kidney damage.

at the dialysis department, Faith and I started off learning how the dialysis machines are prepped for each patient. something we noticed is that each patient has a dialyzer which acts as a filter for the blood of patients with kidney damage. in the US, the dialyzers are disposable but here in the Philippines, they hand clean them after each patient use, and they throw them away after 10 uses. i was taught how to clean them and basically water is shot through the filter and then we used a toothbrush to clean the sides and finally the dialyzer gets filled with an antibiotic and left there until the next time that patient needs dialysis (usually 2-3 days).

towards the end of the week faith and I followed around some of the nurses and learned how to canulate the patients, which is basically inserting 2 big needles (15G) into their fistula so their blood can get taken out, filtered, and replaced. they let faith and I canulate some patients and also give them a subcutaneous injection to increase their hemoglobin which gets low due to the dialysis treatment. This week at hemodialysis was different than the other departments because we didn’t always have something to do. most dialysis treatments are 4 hours long, so while each patient was receiving their treatment we pretty much just waited until it was time to unhook them and get ready for the next patient.

after work on Friday, Hunter, one of the FNRI interns came down from manila to spend the weekend with us. on Friday night we all went to the neighborhood where we met a bunch of people and watched some live music. Afterwords, we followed some people we met to what they called “the best club in town” and while we were there, we met a ton of other people and they all wanted to take a picture with us. there was karaoke and a ton of music.

on Saturday, all three of us planned to Tagaytay which is a touristy town west of us and while we were there we went to a “sky ranch” which is pretty much an amusement park, but it was on a cliff right next to the Taal volcano. which is the most active volcano in the Philippines. the park had a big Feris wheel and behind it we could see the volcano emitting sulfur. after the sky ranch, we went to a really nice steakhouse that overlooked the water and after that we rode a trike for an hour all the way home.

on Sunday the three of us went to a mall in Calamba which is like 30 minutes away where we ate at a Korean BBQ restaurant and made our own food at our table. After the BBQ all three of us got a Filipino massage. from there Hunter went back to manila and faith and i got ready for next week where we will be at the general ward preparing for a case study that we have to present in front of the whole hospital faculty.

Week 2

Hello everyone!

Here is the link for the pictures I have taken so far on my trip. https://drive.google.com/drive/folders/1ZFaHtHUao5P8qhoFox3a8UXNnJDKxiYk?usp=sharing

This week started with Philippines Independence Day, which was on June 12th, so we did not have any work. Faith and I took that day to go do our laundry and walk around and explore different places in Santo Tomas. On Tuesday and Wednesday at the hospital we were in the chemotherapy unit in the hospital where we first observed how everyone functioned and then eventually helped out and did some work.

In the chemo department they have a different number of expected patients each day depending on when the doctors say it is alright for the patients to have chemo. from what i gathered and was told, before each patient gets their chemo, the doctor is called, and they have to confirm which patients get which medicines. on Wednesday they had over 20 patients expected to come in and receive treatment which is a lot because they only have around 8 chairs and each patient stays there anywhere from 1-4 hours. what typically happens is patients come in and get their vitals checked and then have a seat in a recliner type chair. a nurse then comes around and inserts an IV which is how they get their treatment (I didn’t see any patients that had any ports or picc lines), while the nurses call the doctor to confirm the treatment, there is a pharmacist in the back that has a list of meds to infuse into some IV fluids and she makes them right then and there. when everything gets confirmed then patient then sits in their chair while their IV drip of chemo treatment runs and that’s pretty much it.

I spent most of the time in the back with the pharmacist because they knew I was a BioChem major. while I was in the back, the pharmacist would tell me the medication concentration and fluids needed and I would have to prepare everything. most medication comes in a powder form or a liquid form with a concentration different than what the patient needs so it was my job to calculate the dilutions and amount of liquid needed for each patient, and then eventually mix up what I need and send it out. some types of medication runs for 1 hour and others run for 2 hours, and also some patients get multiple kinds of treatments so those people end up staying in the unit for a while. something i found interesting is that the chemo drugs that contain platinum, needed to be shielded from light so we had to cover the IV bags while they were being administered.

on Thursday there were no patients in chemotherapy so Faith and I decided to go visit the OR and see if we could watch anymore surgeries. we ended up watching an AVF surgery which is a surgery where you connect the side of a vein to the side of an artery in your arm. the reasoning for this is for patients who are in kidney failure and need hemodialysis. the blood from the artery will move over to the vein in that specific area and that in turn makes the vein bigger and a gives more adequate access to the bloodstream. in the middle of this surgery there was an earthquake with a magnitude of 6.5 which is pretty big from what I’ve heard. when the earthquake happened i initially thought the patient who was getting the surgery was seizing or something and then when i looked around i saw everything in the room was shaking and wobbling. everything ended up being okay, but it was crazy to witness. Later that day we also watched a total thyroidectomy which is a surgery where a patient gets their thyroid taken out due to hyperthyroidism or thyroid cancer. this was a pretty long surgery (around 3 hours) and in the middle of the surgery, the power in the hospital went out, and until the hospital switched to their generators, everyone in the OR took out their phone flashlights and pointed it at the patient’s throat so the surgeon could see.

Friday was more of the same chemotherapystuff but since there wasnt many patients we were done by lunchtime. it was a nurse on the chempotherapy units birthday so they threw a suprise party for her and someone brought in a whole pig which they called lechon and we ate it (see the picture), we also had cake with Ube flavored custard inside it which was very good. after lunch faith and i went to the OR again because that’s our favorite place and we watched a lap chole which is the removal of the gallbladder using a laparoscope which is like a less invasive surgery where only a couple incisions are made and the surgeon uses a camera and some tools connected to a tube to remove the gallbladder from inside the patient without seeing what’s going on from the outside. right after that, i was asked if i wanted to assist in a surgery which was an excision of a mass in someone’s back. I was basically the person that hands the surgeon the tools whenever he asked for them.

right after work faith and i went straight to get on a bus and head to manila to visit the Wesleyan students who worked in the Food and Nutrition Research Institute. they were living in a gated off complex of condos which was really nice, with a pool and basketball court. we spent the whole weekend there and on friday night we went to this penthouse/rooftop restaurant which looked really fancy but was actually pretty cheap compared to the US. it was on the 21st floor of a tall skyscraper and the food was crazy good. i had stuffed chicken wings with sirloin in the middle. from there we left and explored the town and visited a bunch of places that played some good music. on Saturday all of us spent the day shopping and swimming and just chilling outside. today faith and I went home and realized that we can Grab (doordash) food to our apartment for like $4 for 2 people so we will be doing that a lot now.

next week faith and i will spend the week in the hemodialysis unit which I am excited for because the nurses seemed really fun, and they said they’d let us do a lot of things, so I am excited.

Until next week!

Week 1

Hello Everyone!

Before I start, this is a link to the pictures that I have taken in the Philippines https://drive.google.com/drive/folders/1ZFaHtHUao5P8qhoFox3a8UXNnJDKxiYk?usp=sharing..

I have just completed my first week of the 2023 Freeman Asia internship and am writing this blog to share what I have done. In order to get to the Philippines, we had 2 flights scheduled, the first one was to Abu Dhabi, and it was 13 and a half hours long. Before our next flight we had a 16-hour Layover, so we took that time to explore the city. The first thing I noticed about Abu Dhabi was how hot and humid it was, and also how easily it was for me to get sunburnt. In Abu Dhabi, a few of us visited the Sheikh Zayed Grand Mosque which is one of the world’s largest Mosques.

After our Layover, we had our second flight to Manila which took only 9 hours but since not everyone flew from Chicago, we all waited in the Manila airport until everyone’s planes landed. From the airport we were all taken to Los Banos where we would sleep and have a culture/language orientation before we all split off to go to our separate places. During the orientation, we learned some common Tagalot phrases that we would probably use during our time here. Pretty much all of the Filipinos I have met speak a good amount of English but trying to learn their language doesn’t hurt. Before we all split off into our separate groups, we had one last dinner together at this one restaurant where we tried many Filipino foods. After dinner, Faith and I were taken to our Apartment in Santo Tomas, Batangas.

The next day was our hospital orientation where we were driven to St. Frances Cabrini Medical Center and learned about the different parts and what we would be doing for the next 2 months. During our time at Cabrini, faith and I will be working in different departments throughout the hospital. This past week we have kind of been jumping around but starting this Tuesday (Monday is Philippines Independance day) we will be working in the chemotherapy department. the week after that we will be in the hemodialysis department followed by the emergency department, intensive care unit, operating department and finally the general ward (medical/surgical unit). We were also informed that we will have to write a case study while we are here and present it to some of the nurses. This past week Faith and I spent most of our time in the general ward, but when things got slow, we moved up to the operating department where we inserted IVs on patients and also observed some colonoscopies and also a C-section of a premature baby.

At home I am an ER tech at Carle BroMenn Medical Center, so I have taken note of some major differences that I have seen between hospitals. The first thing I have noticed is that Carle is pretty much fully online when it comes to charting and patient care, while at Cabrini they are trying to get to that at some point but for now they use a lot of paper for their charting. While charting on patients I learned that here, some things should be done in pen while others in pencil, this is because if something about a patient change like their diet or their status, it gets erased and rewritten on the same sheet of paper. another thing i have noticed is that all IVs get placed in the hand, no matter how nice an AC vein might look. Their reasoning for this is because if a vein blows, you can just work up the arm, and also so they can pull any needed blood samples from the AC. I believe the final thing I noticed is how many surgeries they have scheduled each day. For a hospital with 9 ER beds and around 7 ICU beds, they from what I’ve seen, do over 10 surgeries a day. Cabrini hospital is a private hospital so things will cost a little bit more than a public one. But while looking at the prices and billing of some patients i saw a big difference. For an IV insertion the cost in USD equates to $3 and for a private bed (Room with bathroom and TV) in the general ward it equates to $40 a night while a semiprivate one (room without TV) is around $25. The prices in the US for these types of rooms are thousands of dollars per night.

Some things I noticed about the Filipino culture that is different from the US is that everyone is very happy and smiles a lot. Many of the Filipinos we have talked to have been very helpful and nice, for example, when faith and I went to the mall, we bought a blender and the worker insisted on carrying this blender to the checkout counter for us. Filipinos also are very fond of Americans, Faith and i have only been here for a week and just about every person we pass waves and says hello and sometimes even asks us for a picture. We have also started to ask everyone who wants a picture with us, if we could also have a picture with them.

This is the end of my week 1 blog, I’m excited to see and experience more of the Filipino culture!

Also… it rains A LOT here, while I’m typing this blog, I cannot hear my music because of how loud the rain is hitting the roof. they did tell us that it is the middle of the rainy season because of a monsoon so that could by why….


Hello everyone! This is my first blog for the 2023 Freeman Asia internship that I will be apart of! I will spend my summer working and contributing my skills and knowledge at St. Frances Cabrini Medical Center in Santo Tomas, Batangas and I am very excited for what this experience will bring!