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random musings from the Philippines

Trying out adlai, a local alternative to rice for Filipinos

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In the Philippines, no meal is complete without rice, our main source of carbohydrates. Filipinos are so addicted to rice — white rice in particular — that most of us treat dishes of other carb sources, such as pasta or ramen, as just “snacks”. Some even pair other carbs like pancit as the ulam to their rice!

I’ve long been wanting to reduce my white rice consumption, as research has shown that too much intake of white rice, with its high glycemic index, is “associated with a significantly increased risk of type 2 diabetes, especially in Asian…populations” (Hu et al, 2012). I once tried to quit rice cold turkey, but obviously that didn’t last long (lol). I tried substituting with potato, but it still felt kulang. Same with corn. One alternative I tried that felt as filling as rice was quinoa, a pseudocereal native to South America, but it’s an outrageously expensive imported product (PHP 800+ for just a 26-oz pack at Healthy Options).

So when I heard about a supposedly healthier rice substitute that is grown locally called adlai, my interest was piqued. Adlai — also known as adlay, Chinese pearl barley, coix seed, hatomugi, or Job’s Tears — is a gluten-free “heirloom” grain that belongs to the same family as rice and corn. Although it’s only just starting to become widely known in the country, apparently the Subanen tribe of Zamboanga has long been cultivating adlai as their staple food.

Last week, I bought a pack of adlai online from The Hineleban Store. So how does it stack up?

Hineleban Adlai

  • Cost. Adlai is more expensive than local black rice, but definitely more affordable than quinoa.
  • Health. Adlai has a lower glycemic index than brown rice (Lin et al, 2010).
  • Nutrition. According to the Bureau of Agricultural Research (BAR), adlai contains more carbs, fat, and protein and provides more energy (calories) than rice or corn. (There are some lifestyle blogs that claim adlai is low-carb and low-cal compared to rice, but I’m more inclined to believe BAR than them.)
  • Taste and Satiety. These are subjective, but I like the taste of adlai better than quinoa. Its texture also felt close to rice, unlike corn or potato. It also felt more filling than rice; I consumed only around 1/3 cup of adlai per meal.

Cooked adlaiI’ve been eating adlai instead of rice for a week now, and so far haven’t experienced any rice withdrawal symptoms (lol). I can definitely see adlai as a viable alternative to rice for Pinoys; the barrier is its hefty price tag because of low supply. There was a push by the Department of Agriculture for more adlai cultivation by local farmers, but it seems to have petered out. Here’s hoping they actively promote adlai farming again so its price would go down.

Review: The Hineleban Store (hinelebanstore.com)

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I’ve been hearing a lot lately about a healthier rice alternative that is grown locally here in the Philippines called adlai (also known as adlay, Chinese pearl barley, coix seed, hatomugi, or Job’s Tears). Eager to try it out, I searched for adlai online and found only a few specialty stores that carry it.

One of these shops is The Hineleban Store, which sells adlai farmed by indigenous communities in Bukidnon. At first I was hesitant to buy from the site because it’s not even secure:

The Hineleban StoreFor an online store in this day and age, not using HTTPS is just plain lazy. Still, I went ahead and made an account (using an alternate email address) because among the few local online shops that carry adlai, The Hineleban Store sells it the cheapest at PHP 250 for a 1-kg pack. All the other shops are selling it at PHP 300+ per kilo. They also accept cash on delivery, which is good — there was no way I was entering sensitive credit card information on an insecure site.

So I placed an order, got a confirmation email, and logged out of the site. After a week of no order updates, I tried to log in to the site again. Lo and behold, I couldn’t. I tried to reset my password, but it didn’t work in Chrome or Firefox. Finally it worked in Safari, but upon logging in I found that the order is still “Processing”.

At this point I simply gave up. So I was surprised when the adlai arrived nearly two weeks later, as I had nearly forgotten about it.

TL;DR: The site is insecure and very buggy, but it’s legit. You will eventually receive your order. Points for improvement:

  • Get an SSL certificate. Seriously, plain HTTP doesn’t cut it for an e-commerce site. Even this site, which is just a blog, uses HTTPS.
  • Hire a better WooCommerce developer, or just switch to Shopify. Buggy password reset, no shipping confirmation, no tracking number — right now it’s just not up to par. Even after the order arrived, it’s still marked “Processing” on the site.

How to apply for a Social Security number (SSN) for an infant at the US Embassy in the Philippines

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Social Security card issued by the Social Security Administration (SSA)In my previous post, I wrote about our successful application for a Consular Report of Birth Abroad (CRBA) and US passport at the US Embassy in Manila for our infant child. With CRBA and passport in hand, my husband and I then applied for our child’s Social Security number (SSN).

The process was quick and easy, because unlike in some other countries, the US Embassy in the Philippines has a Federal Benefits Unit (FBU) onsite that provides Social Security services. Personal appearance is also not required for children under 12 years old.

This guide is based on our infant child’s application; additional documents and personal appearance are required for children who are 12 years of age or older.

1. Prepare the requirements

Present the original documents. There is no need to photocopy them; the FBU personnel will make the copies themselves.

  • Child’s Consular Report of Birth Abroad (CRBA)
  • Child’s unexpired US passport
  • Unexpired passport of the parent who will sign the application
  • Application for a Social Security Card. There are two forms available; fill up and sign only one. Both are fillable PDF files, so type in your answers before printing your preferred form on US Letter (8.5″ x 11″) paper. There is no need to print out the first few pages of instructions; just the last page (the actual form) will do.
    • Form SS-5 (for US address) – card will be delivered to US address within two weeks
    • Form SS-5-FS (for non-US address) – card will be delivered to Philippine address within five months

2. Go to the embassy


The FBU is open on weekdays (except during US and Philippine holidays) from 8 am to 3 pm. There is no need for an appointment. A few tips:

  • Arrive before 1 pm. The FBU staff can only access the system until 1 pm. If you arrive well before that, they can process your application immediately and have the SSN ready the next business day. If you arrive after 1 pm, they will still accept your application, but will process it the next business day.
  • Leave electronic devices behind. Cellphones and the like are not allowed inside the embassy.

3. Wait for the card to arrive

A week after we submitted our application, the Social Security card arrived in the mail in the US. If you choose to have it delivered to the Philippines, don’t fret — although you may have to wait for up to five months for the physical card, the actual number will be available within two business days.

If you want to know the SSN right away, provide the FBU staff with your local mobile number. They cannot divulge it over the phone for privacy and security reasons, but they will call to inform you if the SSN is already available. The parent who signed the application form can simply present his/her valid passport and the child’s valid US passport to the FBU to get the SSN.

How to apply for a Consular Report of Birth Abroad (CRBA) and US passport at the US Embassy in the Philippines (updated August 2020)

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Consular Report of Birth Abroad of a Citizen of the United States of America (CRBA) or Form FS-240

Update July 2018: With CRBA and US passport in hand, my husband and I then applied for our child’s Social Security number (SSN). Click here to read about our experience at the US Embassy in Manila.

Under US law, a person born outside the United States to an American parent and a foreign parent in wedlock acquires US citizenship at birth if, prior to birth, the American parent was physically present in the US or its outlying possessions for at least five years, two of which are after the age of 14.

My husband meets this physical presence requirement, and so thanks to him, our child is also a US citizen. To make it official, we applied for a Consular Report of Birth Abroad of a Citizen of the United States of America (CRBA) and US passport for our child at the US Embassy in Manila.

The process was surprisingly quick; we received our child’s CRBA and passport less than a month after mailing in our application. My tips for a smooth process:

  • Fill up all forms correctly
  • Ensure all documents are complete
  • Present a lot of evidence
  • Both parents are present during the interview

We did all of the above and were approved immediately. On the other hand, we saw several families who were sent home during pre-screening because of incomplete requirements or insufficient evidence. One family, who came without the US citizen parent, was even told to undergo DNA testing.

This guide is based on our infant child’s application; additional documents are required for school-age children and children born out of wedlock, or if one parent or both cannot attend the interview.

1. Prepare the requirements

Click here to download the latest checklist (updated January 2020). Prepare one (1) photocopy each of all documents and completed forms. Do not mail the original documents.

  • Passport photos. Submit three (3) identical pictures each of the child and parents. Click here for photo guidelines and samples.
  • Application for Consular Report of Birth Abroad of a Citizen of the United States of America (Form DS-2029). Click here to download. It is a fillable PDF file, so type in your answers before printing it on US Letter (8.5″ x 11″) paper. Do not sign. Ensure that you provide a working email address, as the appointment letter will be sent there. Also include a local Philippine telephone number.
  • Certificate of Live Birth of applicant issued by the Philippine Statistics Authority (PSA). You can easily get a copy online from PSA Serbilis. Don’t bother to apply if the PSA copy is not yet available; the copy from the Local Civil Registry Office (LCRO) will not suffice.
  • Growing-up photos of applicant. The more pictures, the better. It is best to submit photos of the child together with both parents, spanning from birth to the present. Personally we printed 20 pictures, each labeled with the date and our child’s age on that date.
  • Evidence of American parent’s citizenship. The US citizen parent may present any one (1) of the following:
    • US passport
    • US birth certificate
    • CRBA (Form FS-240)
    • Certificate of Citizenship
    • Certificate of Naturalization
  • Identification document of Filipino parent. The Filipino parent may present his/her passport. If s/he has no passport, s/he must present two (2) other digitized government-issued IDs.
  • Evidence of American parent’s physical presence in the US. This is important; the application will be denied if the US citizen parent cannot conclusively demonstrate that s/he fulfills the residence requirement. Present as much hard evidence as possible, including old passports, school transcripts, Form W-2s, and medical treatment records. Military members or veterans can also submit a Statement of Service or Report of Separation (DD Form 214). Time abroad counts towards residency only if it was:
    • as a member of the US armed forces in honorable status
    • as an employee of the US government or other qualifying organizations
    • as a dependent unmarried child of any of the above
  • Certificate of Marriage of parents issued by the PSA. You can easily get a copy online from PSA Serbilis. The copy from the LCRO will not suffice.
  • Evidence of mother’s pregnancy. The more evidence, the better. Personally we presented the following:
    • ultrasound reports with images (sonograms)
    • 20 pictures of myself while pregnant, each labeled with the date and location
    • hospital billing statements and receipts
    • hospital certification of confinement for myself and our child
  • Evidence of parents being in the same location at the time of conception. We presented boarding passes along with our passports.
  • Evidence of parents’ relationship prior to conception. The more evidence, the better. Personally we submitted 20 pictures of the two of us together, spanning from the start of our relationship to just before our child was conceived, including several from our civil wedding. My husband and I like to travel, so we presented more boarding passes along with our old passports.
If you don’t have enough evidence to establish filiation of your child, fret not. There is always DNA testing, which is the last resort because it’s expensive and time-consuming. However, do not initiate DNA testing unless recommended to do so by the consular officer. Click here for more information on this option.
  • Application for a US Passport (Form DS-11). Click here to fill out the form online. Download and print the resulting PDF file on US Letter paper, but do not sign.
  • Declaration of No Social Security Number (SSN). Click here to download (embedded below). SSN is a required field in Form DS-11. Obviously our child doesn’t have one yet, so we entered all zeros in the field as instructed and submitted this signed declaration.
Declaration_of_no_SSN

 

2. Send the application

Arrange the photocopies of the requirements in the above order and mail, along with the signed checklist, via courier to the following address:

EMBASSY OF THE UNITED STATES OF AMERICA
CITIZENSHIP AND PASSPORT UNIT
AMERICAN CITIZEN SERVICES
CONSULAR SECTION
1201 ROXAS BOULEVARD
MANILA 0930

3. Wait for the appointment email

A few days after we sent the package, we received the appointment letter in the email address we indicated in Form DS-2029.

4. Prepare for the interview

A few tips:

  • Ensure all original forms and documents are complete. Arrange them in the same order as the checklist, then place inside a waterproof plastic zip envelope for protection.
  • Arrive in Manila at least a day before and check in at a nearby hotel. This is highly recommended for those coming from outside Metro Manila, in order to avoid missing the interview due to flight delays and/or traffic jams. We recommend staying at City Garden Suites, a good mid-price hotel within short walking distance from the embassy. Click here for other accommodation options near the embassy.
  • Leave electronic devices behind. Cellphones and the like are not allowed inside the embassy.
  • Bring full payment of CRBA, passport, and delivery fees. The CRBA application fee is USD $100. Click here for the latest schedule of passport fees (updated February 2018). The embassy cashier accepts either cash (US dollars or Philippine pesos) or credit card (Visa, MasterCard, American Express, Discover, or Diners Club International). Delivery is handled by a third-party courier, AIR21, which accepts cash only.

5. Go to the embassy

Be sure to arrive at the embassy with your child 30 minutes before your appointment time. There will be a throng of US visa applicants queueing outside, but CRBA applicants do not need to fall in line; simply go straight to the entrance for US citizens.

Once inside, go to American Citizen Services (ACS) on the second floor. Pay the CRBA and passport fees at the cashier, then wait for your turn. When your child’s name is called, proceed to the correct counter window for pre-screening.

Present all your original forms and documents. If everything is in order, you will proceed to the final interview with the approving consular officer. While waiting for the interview, you can pay the delivery fees at the AIR21 booth on the same floor.

Our final interview was quick and pleasant, as most of the probing questions were already asked during pre-screening. We signed the CRBA and passport application forms in front of the consular officer, who then returned our original documents. Finally, the officer confirmed that our child is a US citizen, and has been one since birth. We said our goodbyes, left the embassy, and that’s it. Our child’s CRBA was delivered to our address two weeks later. The passport arrived shortly after.

Want to also apply for a Philippine passport for your dual citizen child? Click here to read about our experience.

How to apply for a Philippine passport for an infant at the Department of Foreign Affairs

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It is quite easy to procure a Philippine passport for your newborn baby. It was the first thing my husband and I did after the Philippine Statistics Authority (PSA) copy of our child’s birth certificate finally became available, because in addition to being a travel document, a passport serves as a form of identification and proof of citizenship.

Unlike regular applicants, minors seven years old and below do not need to make an online appointment. Personally, all my husband and I did was show up with our child at the nearest Department of Foreign Affairs (DFA) office with the following documents:

  • Completed and signed application form. Click here to download the latest passport application form for minors (embedded below). It is a fillable PDF file, so you can conveniently type in your answers before printing it double-sided on A4 paper. If you don’t have a printer at home, the DFA office has blank forms that you can fill up onsite. Still, I highly suggest printing it beforehand to save time.
DFA_minor_passport_application_form

 

  • Child’s Certificate of Live Birth issued by the PSA. You can easily get a copy online from e-Census (soon to be known as PSASerbilis). There is no need to photocopy the certificate, as the DFA will need and keep the original.
  • Photocopies of information pages of our Philippine passports. My husband and I presented our original passports for verification.
  • Photocopy of our Certificate of Marriage issued by the PSA. We presented the original for verification.

And that’s it. After paying the passport fee at the cashier, we didn’t wait long for our child’s turn at picture taking and data encoding. All in all, we spent less than half an hour at the DFA office. Kudos to the DFA for making passport application for young children a quick and painless one. (Now, if only they could likewise improve the process for regular applicants…)

Private umbilical cord blood banking in the Philippines: Yea or nay?

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TL;DR: After reading many academic articles on the subject, It’s a NAY for us. Click here to jump directly to our detailed rationale. Fellow parents considering cord blood banking in the country will find it helpful. O’Connor et al (2012) sum up our sentiments:

“Currently, there are few clinical indications for autologous transplants using stored cords. Cord blood is stored privately largely on the assumption that it will eventually prove to be an important source…for regenerative medicine. Regenerative medicine remains little more than a promising possibility…and although some clinical trials are currently underway, the value of cord blood in this wider enterprise also remains uncertain. The medical utility of private cord blood banks is thus more potential than actual… [Private banks] market their services by tapping into parents’ sense of obligation towards their own children, and parents’ anxiety that they may in future regret having missed the opportunity to protect their children and feel guilty for doing so.”

My husband and I are expecting our firstborn in a few months, and one of the things we discussed was whether or not to preserve the baby’s umbilical cord blood (UCB) for potential future use. UCB is rich in hematopoietic stem cells, which are used to treat hematological disorders such as anemia and leukemia.

In several other countries like the USA, there are public cord blood banks that accept and store donations for free. Sadly we do not have such an institution in the Philippines, where only private, for-profit cord blood banking is available.

There are only two options for UCB storage here in the Philippines: Cordlife Philippines and StemCord Philippines. Both are local subsidiaries of private companies with headquarters in Singapore. Their main selling point is that saving the newborn’s UCB is invaluable health insurance, and they really hammer home the fact that the window of opportunity to avail of it is very small — it’s once-in-a-lifetime! It’s during childbirth or never!

Cordlife Philippines umbilical cord blood banking plans and rates
Source: BDO Unibank

As anxious first-time parents, our gut reaction was to bank to avoid later regrets. Between Cordlife and StemCord, the former is more transparent with the cost. Cordlife’s rates for their 18-year UCB storage plan range from PHP 184,800 (if paid up-front) to PHP 230,720 (if paid in annual installments for 18 years).

It’s expensive, but not unattainable. So I searched online for information on these two companies, and the only site with real feedback from local Pinoy parents is this GIRLTalk forum thread. The folks there who actually visited Cordlife’s facility at UP-Ayala Land TechnoHub in Quezon City are unimpressed, saying that it looks like a “kitchen” and is “kakatakot para lang silang magluluto ng kakanin.”

Their descriptions hardly inspired confidence in Cordlife, so we inquired first with StemCord through their Facebook page. Lo and behold, they never followed up after their initial reply. StemCord’s terrible customer service was actually a blessing in disguise, as it cooled our parental knee-jerk response and allowed me to research properly on the matter.

Unfortunately, the web is strewn with obviously sponsored “news” articles and blog posts promoting private cord blood banking. There is a lot of misleading information online, which are certainly not helpful in making a truly informed decision. To separate the wheat from the chaff, I narrowed my search to scholarly articles published within the last several years.

Based on these recent scientific data, we decided NOT to pursue private cord blood banking with either Cordlife Philippines or StemCord Philippines. Below are our reasons why:

  • Our family is at low risk for hematological disorders.

There is no history of blood diseases on either side of the family. The chances of our child or other relatives needing UCB for a hematopoietic stem cell transplantation (HSCT) is low. According to the UK National Health Service, “the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists do not support the commercial collection of cord blood for low-risk families due to the current lack of research evidence to support the procedure.”

Non-hematological disorders like Alzheimer’s and type 2 diabetes do run in our family, and there are clinical trials underway on the use of UCB stem cells to treat such diseases. However, I’m not holding out hope that they will arrive at a standard treatment anytime soon — clinical trials last years, even decades. Many of them are still testing on animals such as mice.

  • There are few established therapeutic indications for autologous HSCT.

If, heaven forbid, our child does need to undergo HSCT, the chances of her using her own UCB is low. There are two main types of HSCT: autologous and allogeneic. An autologous transplant uses a person’s own stem cells, while an allogeneic one uses stem cells from a donor.

Allogeneic HSCT is actually the preferred choice and considered the standard treatment for many blood diseases. According to Waller-Wise (2011), “autologous cord blood stem cells cannot be used to treat malignant cancers such as leukemia because the genetic mutations for the cancer already exist in the DNA of the cord blood. Using one’s own stem cells would be, in effect, ‘contaminating’ oneself with the same disease process.”

Based on the guidelines from the American Society for Blood and Marrow Transplantation for pediatric patients, autologous HSCT is indicated as the “Standard of Care” over allogeneic HSCT only for solid tumors such as Ewing’s sarcoma and neuroblastoma. For the rest, autologous HSCT is “Not Generally Recommended”.

  • The amount of cord blood stored is too small.

According to this mom on the GIRLTalk thread who met with agents of both companies, Cordlife and StemCord only store up to 25 ml and 40 ml of UCB, respectively. (I assume these are post-volume reduction figures after plasma and red blood cells are depleted). Another local mom shares her actual Certificate of Cord Blood Storage from Cordlife on her blog, and it states that her UCB unit has a Total Nucleated Cell (TNC) count of only 7.72 x 108.

This is lower than the storage standard of public cord blood banks. According to Ilic et al (2012), “in the majority of public banks, the criterion for an UCB unit to be considered for storage is >109 [TNC] count…Due to an insufficient number of nucleated cells, ca. 60% of collected UCB is discarded.”

Basically, a public cord blood bank would have thrown out the UCB unit collected by Cordlife. A high TNC count is important, because according to Karasu et al (2014), “approximately 30% of cell loss is expectable in cord blood transplantation because of either cryopreservation or thawing. It should be kept in mind while assessing acceptability of cord blood units with limited cell counts.”

  • A single UCB unit is only enough for one transplant to a child or small adult.

Still, even with the requisite >109 TNC count, Ilic et al (2012) state that “the minimum threshold for an optimal UCB transplant is 2.5 – 5.0 x 107 TNCs/kg of recipient’s body weight…one UCB unit can be sufficient for a [recipient] of 20 – 40 kg.”

Basically, the chances of our kid using her own UCB when she weighs beyond 40 kg are slim. As for adult family members, the likelihood of them using her UCB for an allogeneic HSCT is pretty much zero.

Cordlife even admits it in their own newsletter: “the patient would have to be only 40 kg or less to realize the maximum benefit of these stem cells. This limits the average use of an umbilical cord blood sample to a pediatric setting.”

But what about the possibility of stem cell expansion, you ask? Yes, there are clinical trials underway aimed at increasing the cell dose of UCB. Again, the keyword here is “trial” — I’m not holding out hope that a UCB expansion technique will be available outside the research laboratory anytime soon.

Let’s not forget that even without UCB, all hope is not lost — it’s not the only source of hematopoietic stem cells in the body. There’s still the bone marrow and peripheral blood. That being said, I totally support public cord blood banking. It’s a shame we don’t have such a system here in the Philippines, because I would gladly donate. (Miriam Defensor Santiago actually filed a Senate bill proposing it in 2010, but nothing happened.)