As a young specialist I applied in 1984 for a six -week medical mission with "Doctors for the 3.World", which at this time, was a fairly new humanitarian NGO.

There were two places to choose from: Manila, Philippines and Mumbai, India. Since I did not really mind either place, they sent me off to Manila.

My annual vacation plus days off made exactly 6 weeks. I payed half of the plane fare myself (the NGO was not very rich) and on the way to Manila I got to know the two other personable and competent  members of the team: Dr. Hubert Hayek, radiologist for children from Wilhelmsstift, Hamburg and Dr. Thomas Schairer, dentist from Freiburg.

We were accomodated in a small house with three rooms, which had been rented by the organisation right in the middle of Tondo. Tondo at this time was supposed to be one of the most disgusting and dangerous slum areas of Southeast Asia. Taxidrivers refused to bring you there, after it had turned dark. But a lot of cheerful kids were playing in the street, there was happy loud music and noise everywhere. Other than that you could see garbage in every corner, rubbish-strewn channels, miserable living quarters consisting of small huts made from sheets or any other material, people could lay their hands on.

The Canossian Health Care and Social Center was our base. It was run by the Canossian Sisters of Charity, downright unbelievably happy, committed and energetic women, who were day after day bracing themselves against misery. This is where we held doctor's consultations,  examined our patients, gave out prescriptions, counseled and were well aware of our inadequacies.

80% of our patients were children. Their main problems were mostly worms, easily recognizable by the distended bellies, malnutrition, diseases of the skin and respiratory ailments. Sometimes we also had to stitch up lacerations, cuts or treat abscesses etc. We also saw quite a lot of goiters in grown-ups. Up to then  I never had first-hand experience with tuberculosis before: here, due to circumstances of life, it was a persistent companion. And what could we have done about it? Neither could we change social and hygienic standards, nor was it possible to implement systematic therapy. It was depressing.

Twice a week the sisters packed cases with drugs, surgical instruments and dressings and off we went to the "Smokey Mountain", a gigantic dumping ground in Tondo, filled for more than 40 years with the leftovers of a metropolis.  Around 30.000 people, among them many, many children, earned a meagre living by selling bottles, paper, cardboards or parts of metal etc. to traders, who could still make use of it. Billows of smoke caused by fermentation and oxydative processes gave "Smokey Mountain" it's appropriate name. Additionally soot and smoke from places which served to produce coal in a primitve manner out of pieces of wood. Bitter and rotten smell everywhere.

The pathetic huts made of whatever could be used conveyed a pitiful sight. Children in ragged t-shirts and shorts, many bare-footed, covered with filth and skin diseases were - like the grown ups - busy with picking up exploitable material. But all the same: kids were laughing, curious and merry.

In front of our public "medical office" consisting of a table and two chairs, a never ending queue of mothers with small children was lining up. With the help of our nurses we inquired about health problems, examined, stitched up wounds, opened up abscesses, distributed antibiotics, cough syrup, pain killers, consoled as good as possible. At the end of the day we were exhausted and once again I was feeling very helpless. The proverbial drop on a very hot stone.

The children of Tondo owe a lot to Dr. Hubert Hayek. It was him, who initiated a vaccination program with great enthusiasm, which outlasted our mission for a long time, since our successors in Tondo were continuing the effort.

The workload of our dentist Dr. Thomas Schairer cannot be overestimated. In my opinion he saved and pulled more teeth than ever before in his career. As far as I know he is still working in the Philippines in his vacation.

In 1995 under president Fidel Ramos, the dwellings of the residents of Smokey Mountain were vacated by force and subsequently destroyed. Consequently most people were deprived of their means of existence. Only half of the houses, the slum dwellers had been promised as compensation were built and promised income opportunities did not materialize.

Greenery was planted on  this mountain of refuse but on most parts you will see the wretched huts again. In the meantime other trash dumps have opened in Tondo. Making use of the excretions of a Metropolis of something between 12 to 15 million is still going on. It is estimated that up to 50% of the inhabitants of Metro-Manila are living under slum conditions.

One day we visited Tala, a leprosy village not far from Tondo. Leprosy is not very contagious and can be treated efficiently nowadays. The cause of this infectious disease is always poor hygiene and weakness of the immune system due to malnutrition. It was the first time that I came into contact with this affliction which is more or less eradicated in Europe. But here all stages were to be seen, up to advanced disfigurations of face and limbs.

Owing to the tireless work of Dr. Otto Paulischek, physician from Krefeld, the leprosy village even today gets generous support. Dr. Paulischekis is one of the earliest members of "Ärzte für die 3.Welt" and well over 90 years.

Another trip lead us to Salapandan, a small village in the northern province of Abra. I will never forget travelling through this impressive landscape and probably around 200 patients ervery day queuing up  in front of our improvised "doctors office". Without our English speaking nurses we would have been totally helpless. In the evening we were invited to a festive meal, singing and dancing.

The island of Palawan can be reached by plane from Manila in one hour and was our last destination. Having arrived in Puerta Princesa, the capital of Palawan, we were confronted - and not for the first time - with the imponderabilities of the Philippine health system. Obviously the administration had let it be known everywhere, the German doctors would operate on anyone, who turned up at the hospital. So we were awaited by a big crowd, patients wishing for alleviation and healing. Being totally unprepared for this request and since there was not even a surgeon among us, we could not comply of course. The gouverneur bid to an opulent meal, held out the prospect of more relaxing days to come - which we declined. There were only a few drugs in the pharmacy of the hospital - a chapter of its own, because most medication ended up in the pockets of those sitting next to the source and were eventually handed out to relatives or sold privately. So, with the generous help of the bishop and our own money we bought what was necessary in the local pharmacy, were allowed to use the bishops car and were on our way to a small village, where no physician had been sighted for ages. We received a warm-hearted welcome and tried to do our best.

It is difficult to summarize all those impressions:
anyway I humbly and pensively returned to the sophisticated operation theaters of my hospital.

In 1985 I privately undertook a journey to the Philippines again and worked part of my holiday in the Canossian Health Care and Social Center.