SLEC 2020 experience

[user555 196]

My wife went to SLEC today at 7:15 AM and was given the number 50. 49 people had already arrived. 

 

The guard wanted to see her passport, a photocopy of passport bio page, 4 pieces of her 2x2 visa photos with her name at the back, and a copy of the NVC letter with the case number. She did not have an interview scheduled yet. It was ok with him. She went through the welcome area for biometrics, and then she went to pay. She did her x-ray, blood draw, urine test, and physical exam. She said everyone was very friendly. There were a lot of children there too. She was surprised that on one of the forms, she had to list a close relative that lived in the States (not the petitioner). She just left that blank. She waited for the doctor, and she was number 35 in line by now. She changed into her gown and the doctor just pushed on her stomach, checked her neck and limbs, and asked about some general health questions. 
She went to the US counter but was told her x-ray was unclear so she had to do 3 days of sputum tests (check for TB) and then wait for 2 months to see if the bacteria grows from the sputum samples. She asked for a copy of the x-ray, but they refused to provide her with one. There were at least 2 other women who had to go through sputum testing as well. 

 

She was done by 11 AM.

 

Here are my two complaints. 

1. The US doesn't really care about TB that much. If they did, they'd have foreign university students, migrant workers, and tourists also take a TB test. Also, how many illegal immigrants that cross the border or claim asylum are checked for TB? How many tourist visa holders who overstay their visa for years are checked for TB? The US allows millions of these visa holders to come into the country every year and risk spreading the bacteria. I read several case studies on the CDC's website where they analyze this and are like, "Oh well! All we can do is contract tracing after TB is already detected on US soil!" 

2. Why is SLEC still using an old TB testing method for adults? They use IGRA for kids aged 2-14 and the result is available within 24 hours. SLEC increased the fees for adults in 2017, kept the old method of testing, and only allow kids to have IGRA. It baffles my mind. IGRA is far superior to a sputum test. The higher fee adults pay does not benefit them one bit! Adults pay for kids' tests. 

 

Edited September 29, 2020 by user555

[Lucky2Lucky 2,526]

27 minutes ago, user555 said:

My wife went to SLEC today at 7:15 AM and was given the number 50. 49 people had already arrived. 

 

The guard wanted to see her passport, a photocopy of passport bio page, 4 pieces of her 2x2 visa photos with her name at the back, and a copy of the NVC letter with the case number. She did not have an interview scheduled yet. It was ok with him. She went through the welcome area for biometrics, and then she went to pay. She did her x-ray, blood draw, urine test, and physical exam. She said everyone was very friendly. There were a lot of children there too. She was surprised that on one of the forms, she had to list a close relative that lived in the States (not the petitioner). She just left that blank. She waited for the doctor, and she was number 35 in line by now. She changed into her gown and the doctor just pushed on her stomach, checked her neck and limbs, and asked about some general health questions. 
She went to the US counter but was told her x-ray was unclear so she had to do 3 days of sputum tests (check for TB) and then wait for 2 months to see if the bacteria grows from the sputum samples. She asked for a copy of the x-ray, but they refused to provide her with one. There were at least 2 other women who had to go through sputum testing as well. 

 

She was done by 11 AM.

 

Here are my two complaints. 

1. The US doesn't really care about TB that much. If they did, they'd have foreign university students, migrant workers, and tourists also take a TB test. Also, how many illegal immigrants that cross the border or claim asylum are checked for TB? How many tourist visa holders who overstay their visa for years are checked for TB? The US allows millions of these visa holders to come into the country every year and risk spreading the bacteria. I read several case studies on the CDC's website where they analyze this and are like, "Oh well! All we can do is contract tracing after TB is already detected on US soil!" 

2. Why is SLEC still using an old TB testing method for adults? They use IGRA for kids aged 2-14 and the result is available within 24 hours. SLEC increased the fees for adults in 2017, kept the old method of testing, and only allow kids to have IGRA. It baffles my mind. IGRA is far superior to a sputum test. The higher fee adults pay does not benefit them one bit! Adults pay for kids' tests. 

 

Seriously?!!? The US has under 10,000 cases a year and we'd like to keep it that way. NO vaccines are REQUIRED for a person to visit the United States- you really think people on a tourist visa should be required to have a TB test or receive vaccines in general? Imagine the uproar- people are freaking out because the government wants to make sure you can financially sponsor your family member- imagine if EVERY SINGLE PERSON who wants to enter the US needs this clearance?!! If someone overstays their visa or crosses the border without inspection it's not the USAs fault these people have gone under the radar and can spread diseases- but why should we knowingly allow someone TB positive or suspected come to the US? Additionally if the US didn't care about TB then please tell me why as a health care provider I have to get tested EVERY year?!  

[Hank_ 9,174]

1.   Cases of TB have risen in the USA,  the Philippines makes the Top Ten list for countries with TB ...  'nuff said there.

 

 

2.  IGRA is not "far superior", it is used with children to avoid the x-ray, when possible.  The 60 day sputum test IS still the more accurate.   The IGRA test is uses for children day 1, if the result is positive they must complete an x-ray and if there is any "issue" they will complete the 60 day sputum.  SPUTUM still rules.

 

 

SLEC has to follow guidelines established by CDC

[user555 196]

 

  

1 hour ago, Luckycuds said:

The US has under 10,000 cases a year and we'd like to keep it that way

Tuberculosis has dropped in the US, but during the past twenty years, the number of cases has gone up and down. In 2011, the US had over 10,000 cases. From 2013 to 2014, there was a slight increase in the number of cases. By screening other travelers, the US could dramatically reduce this number. 10,000 is too much. I don't know why you want to keep the number that high. I'd rather have a much lower number.   

 

18 minutes ago, Luckycuds said:

you really think people on a tourist visa should be required to have a TB test or receive vaccines in general

In 1989, the CDC created the goal to eliminate TB from the US. Their latest goal is total elimination by 2050. If the US is really concerned about preventing the spread of TB on its soil, screening other travelers would be a major step in the right direction. I didn't mention anything about other vaccines. If you want to create another thread about that, please do. I am only talking about tuberculosis coming into the United States.

 

I'm not talking about finances. I'm talking about the spread of tuberculosis on US soil. If the US is really serious about stopping the spread of tuberculosis and reaching their goal, they know what to do. 

 

There may be a newer study, but from 2001-2008,  "of the 11,500 estimated TB incident cases, 41.6% (4,783) occurred among immigrants and refugees, 36.6% (4,211) among students/exchange visitors and temporary workers, 13.8% (1,589) among tourists and business travelers, and 7.3% (834) among Canadian and Mexican nonimmigrant visitors."

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0032158

 

57.7% of TB cases came from tourists, temporary workers, foreign exchange students, and Canadian and Mexican nonimmigrant visitors. The rest came from immigrants and refugees who were supposed to have already been screened for TB. 

 

 

1 hour ago, Luckycuds said:

but why should we knowingly allow someone TB positive or suspected come to the US?

The US knows that some tourists, temporary workers, foreign exchange students, and other nonimmigrant visitors have tuberculosis. They just don't check for it. That is worse. You just said it's not the USA's fault if someone overstays a visa and has TB and spreads it. So is it not the USA's fault for not screening other nonimmigrant visitors? Whose fault is it? I think it's ok for people to get tested for TB to go to the US. 

 

That's great that you're tested every year. I'm talking about tuberculosis coming into the United States from tourists, temporary workers, foreign exchange students, and other nonimmigrant visitors. Let's stay on track. 

[flicks1998 1,044]

22 minutes ago, Hank_ said:

1.   Cases of TB have risen in the USA,  the Philippines makes the Top Ten list for countries with TB ...  'nuff said there.

 

 

2.  IGRA is not "far superior", it is used with children to avoid the x-ray, when possible.  The 60 day sputum test IS still the more accurate.   The IGRA test is uses for children day 1, if the result is positive they must complete an x-ray and if there is any "issue" they will complete the 60 day sputum.  SPUTUM still rules.

 

 

SLEC has to follow guidelines established by CDC

I dont doubt the seriousness of TB etc, however if the US was serious in this, they would stop using SLEC.  The corruption runs from top to bottom and this has been brought to the attention of the Embassy in Manila multiple times by myself as well as many others and it was all ignored and this is over a multiple year period.  The corruption starts from the guard who stands outside, through to the doctors.  The medical exams in themselves are a joke and most Filipinos will tell you that the medical exam they take to get a job in the Philippines are much more stringent and thorough.  None of this is hearsay, I have seen and experienced the extensive corruption myself.  I do know that payoffs to doctors have occurred, test not being done but marked as if they were, etc etc etc  And this isnt just a US problem, its the other countries who also use SLEC.

 

Again, I understand TB is serious, but using SLEC is the wrong decision.  But what are the alternatives?  Not much.  Maybe make it the Makati Med Extension Center for a certain contract period and see if that helps, but for all of this you would need other governments to agree as well.  No easy task and thats probably why a blind eye has been turned to the debacles there.  

Edited September 29, 2020 by flicks1998

[user555 196]

27 minutes ago, Hank_ said:

IGRA is not "far superior",

I should have said that IGRA is far superior to the radiologist trying to interpret someone's x-ray and then deciding to require a sputum test. IGRA is superior to the TB skin test (TST). If the TST or IGRA are positive, then the sputum test should be the final factor. 

Edited September 29, 2020 by user555

[Allovertheworld 355]

2 hours ago, user555 said:

 

Here are my two complaints. 

1. The US doesn't really care about TB that much. If they did, they'd have foreign university students, migrant workers, and tourists also take a TB test. Also, how many illegal immigrants that cross the border or claim asylum are checked for TB? How many tourist visa holders who overstay their visa for years are checked for TB? The US allows millions of these visa holders to come into the country every year and risk spreading the bacteria. I read several case studies on the CDC's website where they analyze this and are like, "Oh well! All we can do is contract tracing after TB is already detected on US soil!" 

 

 

Had a buddy her on a work visa, Brought his wife from Philippines.   He works for Nokia and has worked all over the world.  I don't know the visa process but they had been in USA for a few years and she decided to get a greencard and she had to do medical in the USA.  Lo and behold she had TB.   

 

This chick worked at WalMart at the counter and I suspect she was a former GRO girl who went abroad to earn money, and she couldn't stay away from the nightclubs in the USA and she was married.

 

I frankly was pretty peeved, since she easily could of gave me or my wife TB.  She quarantined for a few days during treatment, not as long as she was supposed to.  I called the county health department and reported her, they said there was nothing they could do to her to make her stay home.

 

 

[Allovertheworld 355]

21 minutes ago, flicks1998 said:

I dont doubt the seriousness of TB etc, however if the US was serious in this, they would stop using SLEC.  The corruption runs from top to bottom and this has been brought to the attention of the Embassy in Manila multiple times by myself as well as many others and it was all ignored and this is over a multiple year period.  The corruption starts from the guard who stands outside, through to the doctors.  The medical exams in themselves are a joke and most Filipinos will tell you that the medical exam they take to get a job in the Philippines are much more stringent and thorough.  None of this is hearsay, I have seen and experienced the extensive corruption myself.  I do know that payoffs to doctors have occurred, test not being done but marked as if they were, etc etc etc  And this isnt just a US problem, its the other countries who also use SLEC.

 

 

I have always suspected corruption runs deep at SLEC

 

The building itself looks seedy to me

[Lucky2Lucky 2,526]

46 minutes ago, user555 said:

 

  

Tuberculosis has dropped in the US, but during the past twenty years, the number of cases has gone up and down. In 2011, the US had over 10,000 cases. From 2013 to 2014, there was a slight increase in the number of cases. By screening other travelers, the US could dramatically reduce this number. 10,000 is too much. I don't know why you want to keep the number that high. I'd rather have a much lower number.   

 

In 1989, the CDC created the goal to eliminate TB from the US. Their latest goal is total elimination by 2050. If the US is really concerned about preventing the spread of TB on its soil, screening other travelers would be a major step in the right direction. I didn't mention anything about other vaccines. If you want to create another thread about that, please do. I am only talking about tuberculosis coming into the United States.

 

I'm not talking about finances. I'm talking about the spread of tuberculosis on US soil. If the US is really serious about stopping the spread of tuberculosis and reaching their goal, they know what to do. 

 

There may be a newer study, but from 2001-2008,  "of the 11,500 estimated TB incident cases, 41.6% (4,783) occurred among immigrants and refugees, 36.6% (4,211) among students/exchange visitors and temporary workers, 13.8% (1,589) among tourists and business travelers, and 7.3% (834) among Canadian and Mexican nonimmigrant visitors."

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0032158

 

57.7% of TB cases came from tourists, temporary workers, foreign exchange students, and Canadian and Mexican nonimmigrant visitors. The rest came from immigrants and refugees who were supposed to have already been screened for TB. 

 

 

The US knows that some tourists, temporary workers, foreign exchange students, and other nonimmigrant visitors have tuberculosis. They just don't check for it. That is worse. You just said it's not the USA's fault if someone overstays a visa and has TB and spreads it. So is it not the USA's fault for not screening other nonimmigrant visitors? Whose fault is it? I think it's ok for people to get tested for TB to go to the US. 

 

That's great that you're tested every year. I'm talking about tuberculosis coming into the United States from tourists, temporary workers, foreign exchange students, and other nonimmigrant visitors. Let's stay on track. 

There were 8,920 provisional TB cases in the US in 2019. One is too many but the lower the better. Your argument doesn’t make sense- you are upset that your wife needs to be retested for TB and delays her immigration to the US yet wants everyone who enters the US to get tested. Which one is it?! The US doesn’t “know” visitors are infected- you can’t “know” without proof. It is completely ridiculous and unrealistic to think everyone that enters the US should have proof of being tb negative as the only way that the US can show they “care” about tb.

[user555 196]

16 minutes ago, Luckycuds said:

you are upset that your wife needs to be retested for TB and delays her immigration to the US yet wants everyone who enters the US to get tested.

I don't know how you came up with your interpretation about my case, but it is inaccurate. I am ok with testing immigrants. I want testing for everyone. The US only tests some people that travel to the US. Why don't they test everyone for TB? By looking at the data, the US knows where TB comes from. The majority of TB cases didn't magically occur from people born in the US. TB came to the US from non-US born travelers. So even though you have a hard time understanding that the majority of TB carriers come from outside of the US, the data is clear that it does. What part of that quote from the research article didn't you understand? You can have your opinions, but I will stick with the facts. 

[Hank_ 9,174]

2 hours ago, user555 said:

I should have said that IGRA is far superior to the radiologist trying to interpret someone's x-ray and then deciding to require a sputum test. IGRA is superior to the TB skin test (TST). If the TST or IGRA are positive, then the sputum test should be the final factor. 

 

Yet the next step after a positive IGRA is an x-ray.    

[Carpe Vinum 2,327]

1 hour ago, Hank_ said:

 

Yet the next step after a positive IGRA is an x-ray.    

It seems like every six months we go through this TB bruhaha. Nobody really likes St. Lukes but those of us with some experience in the Philippines would like to know what the alternatives are. It's about as good as your going to get there. Also, I have never had to pay a bribe for anything in the Philippines. Now, ask me about Ukraine and Russia and we could talk for a while)

[Allovertheworld 355]

4 minutes ago, boris64 said:

It seems like every six months we go through this TB bruhaha. Nobody really likes St. Lukes but those of us with some experience in the Philippines would like to know what the alternatives are. It's about as good as your going to get there. Also, I have never had to pay a bribe for anything in the Philippines. Now, ask me about Ukraine and Russia and we could talk for a while)

I have never had to pay a bribe either.

 

But I have slipped some cash to officials to make things happen or get some things done.

[Hank_ 9,174]

19 minutes ago, boris64 said:

It seems like every six months we go through this TB bruhaha. Nobody really likes St. Lukes but those of us with some experience in the Philippines would like to know what the alternatives are. It's about as good as your going to get there. Also, I have never had to pay a bribe for anything in the Philippines. Now, ask me about Ukraine and Russia and we could talk for a while)

Ain't that the truth ..   

[payxibka 10,045]

39 minutes ago, Allovertheworld said:

I have never had to pay a bribe either.

 

But I have slipped some cash to officials to make things happen or get some things done.

Bribe:  to persuade (someone) to act in one's favor by a gift of money or other inducement.