The author, with instructors from a paramedic school in the Philippines.

By Antonio Graceffo

For more than six years, I have been working in tribal areas all over Southeast Asia as a journalist. Whenever I go into these villages, I always wish I had more medical training so I could bring the people direct aid aside from being their voice, telling the world about their plight. Since October of 2007, I have been working inside Shanland, Burma, where the Shan, an ethnic minority, is under threat by their own government.

After a near brush with disaster on the border, I decided it was time for me to get medical training. At times, I know that I am the only foreigner inside of Shan state and there isn’t even one qualified doctor or nurse. There are some dedicated Shan “nurses” who received training from an extremely kind and competent doctor named Dr. Cynthia, who has been doing aid work on the border for years, but there is no permanent staff with formal medical training.

It would be good to have general clinical knowledge, like a doctor, in Shanland to be able to diagnose and treat common illnesses. In observing a medical volunteer team that recently came into Shanland, I saw the most frequent ailments were malaria, upper respiratory infections, and skin infections. Dental care is nonexistent and the kids all need a bunch of fillings and extractions. During combat scenarios, the medical practitioner needs to possess the skills of an army medic and should know what to do to stop bleeding. He needs to be a surgeon to remove bullets. And he needs to know how to do amputations for landmine victims.

Basically you need every medical skill imaginable.

In addition to the clinical work, there are backpack teams that trek for months at a time into the jungle, bringing medical aid to remote villages in the conflict zone. You also need to provide security for yourself and your patients.

So you need to be a Rocky/Rambo green beret and an Olympic athlete. It’s a tall order.

Recently, I realized the Burma conflict didn’t only spill over into sunny Thailand. There is a large number of undocumented refugees in Bangladesh as well. And no one is helping those people. For a medical service adventurer, the Thai side could be a practice for the real adventure of going into the Chittagong Hills of Bangladesh.

One step at a time
The obvious first choice was to return to the US and get trained as a paramedic. But the cost was in the tens of thousands of dollars. The only place in Asia where they have US-style training programs, in many fields, is the Philippines.

My kuntaw teacher, Master Frank, used to be a military paramedic and later a professional paramedic in Saudi Arabia. I called him and asked if I could come stay with him while I looked for a program. Before I landed, he had already enrolled me in a school.

The school is run by Aiden Tasker-Lynch, executive director of the Philippine Society for Emergency Medical Technicians. He is a great Irishman who really cares about EMS and works tirelessly to get programs installed in the Philippines. He told me that in Manila, less than 10 percent of emergency (911) calls are even responded to. And outside of the capitol, the percentage approaches zero. Some of the medics in these services have been through a ten-day EMT program. Others have had no training at all.

Aiden’s program for EMT basic is a full-time, forty-hour-a-week program for seven weeks. This is the program I have enrolled in. The course is recognized everywhere in the world for licensing. In fact we can get automatically dual-licensed for Australia. For US, we would be required to get an additional exam, given in America.

Aiden seemed very moved by the stories about Burma. Because I have little or no actual income, my studies being funded through donations, he gave me a significant discount; otherwise I couldn’t afford to study. By helping me study, Aiden is helping the people of Burma. In a strange, roundabout way, getting this discount from a Philippine school means the Filipinos, who suffer from their own problems, are now helping the people of Burma, who are in many ways worse off. It was a karmic empowerment: Southeast Asians helping other Southeast Asians. I was just a conduit.

EMT is a single course. Paramedic is a series of advanced courses and certifications that one does beyond the EMT. As Aiden understood that I needed as much education as possible, he suggested I do the whole program and promised to get me some practical experience in an emergency room in Manila.

“How long does it take to get through the whole program?” I asked.

“I don’t know,” answered Aiden. “When Filipinos finish the course and are qualified for overseas employment, they leave.”

The economy of the Philippines is so bad that more than 20 percent of the population is working abroad. In Qatar alone, nearly 30 percent of the population is Filipino. Many of the guys in my course grew up in Qatar and now attend the Filipino school.

Master Frank told me about his time working in Saudi Arabia: “My wife and I could have saved more, but she had two sisters, and I promised to pay for their education.”

In more than ten years of teaching the EMT course, not one Filipino had remained behind to continue advanced studies.

“I was hoping to build up the overall level of the paramedics in the country,” said Aiden, “but they all leave.” Aiden was quick to add, “You can’t blame them.”

Aiden fought with the employers in the Middle East to recognize the high level of training he had given his EMT. As a result, they command salaries of up to $2,500 a month, plus accommodation. This is the equivalent of more than three years’ income for many Filipinos. Said another way, a Filipino EMT working for one year in the Middle East will earn more than the lifetime income of a relative who stays behind in the Philippines.

My classmates are great, and we really get on well, but none of them understands me. I am the only poor American they have ever met. I think the US government should pay me because meeting me destroys their hopes of streets lined with gold.

I live in a student apartment, a concrete cell with a bunk bed and no other furniture. I even had to buy my own mattress for the bed. Master Frank gave me a hot water maker so I could make coffee. I share the bathroom with six people. There is no shower; we take cold bucket showers, but it has a Western toilet. It is awful but cheap (about US$100), and it is right next to the school. Master Frank helped me find the apartment and it has the number one attribute he was looking for–it is safe.

The guard sleeps in the room right next to me. He is kind of small, so if there is trouble I will do my best to protect him. For all its shortcomings, I am grateful for this room that allows me to continue my studies.

My classmates spend a lot of their time talking about how they hope they can work in the Middle East, America, or Australia to earn money.

“Why are you working in Burma?” they ask. “You could get more working in Iraq.”

Yeah, but people in Shanland need help. Of course, now I also need help, so it is sort of a wash.

Of my 27 classmates, 19 are RNs; a few are respiratory therapists, physical therapists, and nursing students. This particular paramedic program is the only professional education program of any kind in the Philippines, which is recognized abroad.

The Filipinos are very hardworking and I have a huge respect for my classmates. You can’t keep them down. A Filipino doctor can’t usually work as a doctor in the US, so they work as nurses. If nurses can’t work as nurses, they work as EMTs. Basically, any Filipino you hire to work for you in the US is probably way overqualified for the position.

One guy, my friend Mike, put himself through nursing school by working at a call center. One of the best-paying private sector employments in the Philippines is the US call centers. Credit card companies and other big corporations have outsourced their 800 numbers. So when you call to ask about the warranty on the new Maytag that you bought, you are calling Manila. But instead of talking to a brain-dead trailer-trash kid in Arizona who couldn’t get another job, you are talking to a college graduate who has been through a lengthy selection process.

Eighty percent of Filipinos earn less than $2 per day. The call center workers earn between $500 and $700 per month. Mike graduated from his nursing class with flying colors, took the board exams, and earned one of the highest scores ever. But employment opportunities in the Philippines are so bad, so he is trying to go to the USA and work as a paramedic. Possibly while he is there, he can take review courses and take the nursing board exam in America. If he makes it, he will be one more Filipino with about two to three years’ more education than his American counterpart.

Manila, or at least Cubao where I live, is loud, dirty, and dangerous. So it is not the nicest place I have ever lived. But my classmates are great. Filipinos in general are funny people who try to have fun in the face of adversity.

On the first day of classes, Aiden said that in the USA, EMT basics go to work with experienced paramedics. They learn on the job and then attend additional training classes. But for his graduates, he knew that this was not the case. They would walk out of the school and into a job where they were most likely the best-trained person there. As a result, he holds the EMTs to very high standards.

His next comment shocked me with its candor. “When you arrive at your overseas job, they will think that you are less qualified than a white man.”

I was shocked. We could never say this in the US. But Aiden continued, and his point became clear. “Those people have a colonial mindset, and so do you. They believe the white man is better qualified. And so do you! Over the next seven weeks, we need to change your attitude. You are more qualified than they are and you are better. You need to believe that.”

After only a few days with these young people, I believe Aiden. There are probably very few people anywhere in the world whose families sacrificed so much for their children. Who knows what the family had to give up to pay the tuition and accommodation for these bright kids who have come from every corner of Luzon and every island of the Philippines. Very few people would work so hard just to take a job that they are grossly overqualified for and will take them away from their families for years.

Yes, I can say with no reservation, the Pinoys are better.

Antonio Graceffo is an adventure and martial arts author living in Asia. He is the host of the Web TV show, Martial Arts Odyssey. Currently he is working inside of Shan State, documenting human rights abuses and doing a film and print project to raise awareness of the Shan people. His videos about martial arts, Burma, and other countries are available here.

Antonio is the author of four books available on Amazon.com. Contact him by e-mail or visit his Website. He is self-funded and seeking sponsors. If you wish to contribute to the “In Shanland” film project, you can donate through Paypal, through this page.