Albania US Consular Information Sheet November 04, 2008
Albania is a parliamentary democracy that is transforming its economy into a market-oriented system. Albania's per capita income is among the lowest in Eu
A passport is required. All travelers entering or exiting Albania must have six months or more validity on their passport. Customs officers strictly enforce this law. U.S. citizens do not require a visa prior to entering Albania, but those traveling without a visa will be charged a fee for an entry stamp at the point of entry, which is valid for a stay of up to 90 days. This fee is currently 10 Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Travelers without a visa who intend to stay in Albania for more than 90 days should be aware that Albanian law allows a traveler without a visa to remain in Albania for 90 days only within a specific 180-day period. That 180-day period is defined from the first day of entry. For example, a traveler entering without a visa on January 1 may remain in Albania for 90 days total during the period of time between January 1 and June 28. Departing Albania during this time period does not "restart the clock." Travelers attempting to reenter Albania without a visa and within 180 days of a previous entry and after an aggregate stay of 90 days may be denied entry. For stays exceeding 90 days within a 180-day period, those interested must apply for a Residency Permit at the police station with jurisdiction over the city of residence. Information on how to apply for a residency permit is available on the Embassy of Albania web site at http://www.embassyofalbania.org/. There is also a departure fee of ten Euros, or the equivalent in any easily convertible currency, including U.S. dollars. Visit the Embassy of Albania web site at http://www.embassyofalbania.org/consular.html#visa for the most current visa information. Dual Nationality: The Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. If such persons are found guilty of draft evasion in Albania, they are subject to prosecution by the Albanian court. Those who might be affected should inquire at an Albanian Embassy or Consulate outside Albania regarding their status before traveling. In some instances, dual nationality may hamper U.S. Government efforts to provide protection abroad. Information about dual nationality or the prevention of international child abduction can be found on our web site. For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY
Although the overall security situation in Albania has improved in recent years, organized criminal activity continues to operate in all regions, and corruption is pervasive. US Government employees need permission to travel to the northern administrative districts of Shkoder, Malesi E Madhe and Tropoje (with the exception of the route along the national road to Montenegro and the city of Shkoder) and to the southern town of Lazarat, with such travel restricted to secure vehicles with escort. Travel restrictions for U.S. Government employees have been lifted for overnight stays in the city of Shkoder. In most cases, police assistance and protection is limited. A high level of security awareness should be maintained at all times. Photographing anything that authorities regard as being of military or security interest may cause travelers problems. All gatherings of large crowds should be avoided, particularly those involving political causes or striking workers. For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs’ web site at http://travel.state.gov, where the current Travel Warnings and Travel Alerts, as well as the Worldwide Caution, can be found. Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the U.S. and Canada, or for callers outside the U.S. and Canada, a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays). The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas. For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s A Safe Trip Abroad.
In the latest State Department assessment, Albania’s crime rating is “medium.” Crime against foreigners is rare in Albania, as targeting foreigners is often viewed as too risky. Visitors should maintain the same personal security awareness that they would in any metropolitan U.S. city. Caution should be exercised in bars in Tirana where violent incidents, some involving the use of firearms, have occurred in the past, particularly in the early morning hours. Within the last years there have been fewer cases of carjacking compared with previous years. Anyone who is carjacked should surrender the vehicle without resistance. Armed crime continues to be more common in northern and northwestern Albania than in the rest of the country. Street crime is fairly common in Albania, particularly at night. Criminals do not seem to deliberately target U.S. citizens or other foreigners, but do seek targets of opportunity, and select those who appear to have anything of value. Vehicle theft is still one of the biggest problems in Albania. Pick-pocketing is widespread; U.S. citizens have reported the theft of their passports by pick-pockets. INFORMATION FOR VICTIMS OF CRIME: The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate. If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance. The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed. The local equivalent to the “911” emergency line is 129, though coverage is inconsistent at best. See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION
Medical facilities and capabilities in Albania are limited beyond rudimentary first aid treatment. Emergency and major medical care requiring surgery and hospital care is inadequate due to lack of specialists, diagnostic aids, medical supplies, and prescription drugs. Travelers with previously diagnosed medical conditions may wish to consult their physicians before travel. As prescription drugs may be unavailable locally, travelers may also wish to bring extra supplies of required medications. Recent electricity shortages have resulted in sporadic blackouts throughout the country, which can affect food storage capabilities of restaurants and shops. While some restaurants and food stores have generators to properly store food, travelers should take care that food is cooked thoroughly to reduce the risk of food-borne illness. Water in Albania is not potable. Visitors should plan to purchase bottled water or drinks while in country. The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Albania. Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s (CDC) hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx. For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en. Further health information for travelers is available at http://www.who.int/ith/en
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation. Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Albania is provided for general reference only, and may not be totally accurate in a particular location or circumstance. Major roads in Albania are often in very poor condition. Traveling by road throughout Albania is the most dangerous activity for locals and tourists. Vehicle accidents are the major cause of death, according to police statistics. Electricity shortages have resulted in sporadic blackouts throughout the country that can happen any hour of the day or night. Such outages affect traffic signals and street lights, making driving increasingly treacherous at any time of day. Travel at night outside the main urban areas is dangerous and should be avoided due to deplorable road conditions. During the winter months, travelers may encounter dangerous snow and icy conditions on the roads throughout mountainous regions in northern Albania. Buses travel between most major cities almost exclusively during the day, but they are often unreliable and uncomfortable. Many travelers looking for public transport prefer to use privately owned vans, which function as an alternate system of bus routes and operate almost entirely without schedules or set fares. Please note that many of these privately owned vans may not have official permission to operate a bus service and may not adhere to accepted safety and maintenance standards. Persons wishing to use privately owned vans should exercise caution. There are no commercial domestic flights and few rail connections. Please refer to our Road Safety page for more information. Visit the website of the country’s national tourist office at www.albaniantourism.com.
AVIATION SAFETY OVERSIGHT
As there is no direct commercial air service to the United States by carriers registered in Albania, the U.S. Federal Aviation Administration (FAA) has not assessed Albania's Civil Aviation Authority for compliance with International Civil Aviation Organization (ICAO) aviation safety standards. For further information, travelers may visit the FAA's web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa SPECIAL CIRCUMSTANCES: Albania's customs authorities may enforce strict regulations concerning temporary importation into or export from Albania of some items. It is advisable to contact the Embassy of Albania in Washington, D.C. or one of Albania's Consulates in the United States for specific information regarding customs requirements. As noted previously, the Albanian government considers any person in Albania of Albanian parents to be an Albanian citizen. In addition to being subject to all Albanian laws affecting U.S. citizens, dual nationals may be subject to Albanian laws that impose special obligations. Male Albanian citizens are subject to compulsory military service regulations. See our information pertaining to dual nationality. Albania is a cash economy. Credit cards and travelers checks are not generally accepted, except at the major new hotels in Tirana and some international airline offices. Travelers' checks can be changed at banks in larger towns. Automated Teller Machines (ATMs) are available in most cities. Please see our Customs Information CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Albania’s laws, even unknowingly, may be expelled, arrested or imprisoned. Penalties for possession, use, or trafficking in illegal drugs in Albania are severe, and convicted offenders can expect long jail sentences and heavy fines. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States. Please see our information on Criminal Penalties. Under Albanian law, police can detain any individual for up to 10 hours without filing formal charges. U.S. citizens are encouraged to carry a copy of their U.S. passports with them at all times to show proof of identity and U.S. citizenship if questioned by local officials.
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION
Americans living or traveling in Albania are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site and to obtain updated information on travel and security within Albania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at Rruga Elbasanit 103, tel. (355)(4) 2247285; fax (355)(4) 2232222. The U.S. Embassy web site is http://tirana.usembassy.gov/ * * * This replaces the Consular Information Sheet dated June 10, 2008, to update sections on Entry and Exit Requirements, Medical Facilities and Health Information, and Traffic Safety and Road Conditions.
Travel News Headlines WORLD NEWS
Tirana, March 9, 2018 (AFP) - The military has been deployed in northern Albania to help hundreds of people trapped by floods following heavy rainfall, authorities said on Friday. More than 9,230 hectares (22,800 acres) of agricultural land is underwater in the Shkodra region, including villages where the only means of transport is by boat, the defence ministry said.
Army personnel are evacuating residents and securing food supplies in the affected areas, 100 kilometres (60 miles) north of the capital, Tirana. The torrential rain in recent days has caused landslides damaging dozens of homes and flooding roads, said the transport ministry. The rain has also forced the Albanian authorities to release excess water from a hydroelectric plant, which has added to the flooding in northern areas of the country. Weather forecasters say the rain is likely to ease from Saturday.
Tirana, Dec 3, 2017 (AFP) - Thousands of police and soldiers have been deployed in Albania to rescue stranded residents after heavy rainfall triggered major flooding, and caused the death of a utility worker, officials and the power company said Sunday. The victim, Sabri Vlinga, died while he was working on a electricity pole at Roskovec in the flooded south of the country, the power company said in statement. Two other people were injured in similar accidents. it added. Some 6,400 police and soldiers have been sent to help rescue people stranded by the floods, Prime MInister Edi Rama said Saturday, calling the situation "very critical".
Around 1,500 people in the affected areas have been rescued, while several thousand homes were without electricity as many utility poles have been swept away by mudslides, said Shemsi Prenci, head of civil protection. More than 7,874 hectares (19,450 acres) of farm land as well as 3,193 homes are under water and several roads in the south remained impassable.
Army forces have built a temporary bridge at Darezeze, about 70 kilometres (44 miles) from the capital Tirana, to come to the aid of 2,000 residents stranded by the floods, the defence ministry said. In neighbouring Macedonia, the heavy rains have also caused flooding as several rivers include the main Vardar river have burst their banks, the MIA news agency reported.
By Briseida MEMA
Tirana, Feb 6, 2017 (AFP) - Emira Sela covers her face with her hand to hide a disfiguring abscess, the traumatic result of unregulated cosmetic treatments now rampant across Albania. The 31-year-old began to worry when wrinkles appeared on her face. Sela's hairdresser told her that a simple injection, costing around 60 euros ($65), would banish the signs of ageing. "She assured me that I would not risk anything. She even listed well-known names" of women who had undergone such treatment, said Sela. "I did not think twice, I trusted her without asking questions," said the blonde woman with green eyes, her voice trembling.
Albanian hair and beauty salons lacking expertise and medical supervision are offering such cosmetic treatments, unregulated in a legal vacuum, much to the alarm of qualified doctors. A single injection of a product whose content and dosage Sela knew nothing about was enough to ruin her life in late August. Despite antibiotics she has permanent pain, fever and nausea, while the abscess on her right cheek forces her eye to half-close and her face is nearly paralysed. "I am so disfigured that I tried to commit suicide," said Sela, who lost her job in a bank. Her only hope now is corrective surgery at an Italian hospital, scheduled for this month.
- Desiring Kardashian look -
"There are more and more impostors with syringes," said Panajot Papa, a plastic surgeon at a private clinic in Tirana. "The problem is also the products... Forbidden in Europe, they enter illegally from Turkey or China." Eriona Shehu, a dermatologist at Tirana's university hospital, said these unregulated synthetic products, such as injected liquid silicone and acrylamide, were being offered at temptingly low prices.
"Cosmetic interventions have become a lucrative industry. The patient is only a customer, exposed to a number of risks." Shehu said the desire to look like voluptuous US reality television star Kim Kardashian was "destroying the lives of young Albanian girls looking for beauty". Albanian doctors say the typical age of clients for such procedures is between 16 and 28. In the country of about three million people, the demand for cosmetic interventions rose more than 50 percent in 2015, according to a study published by Albania's economic magazine Monitor.
Promotional offers can be seen everywhere, such as a beauty salon advertising 20 percent reductions for three people coming together for treatment during the holiday season. Papa says he has treated a dozen young women aged between 20 and 27 who suffered complications after having their lips and cheekbones swollen with injected liquid silicone for 40 to 50 euros. The product has been banned for cosmetic use in countries such as Italy and France for more than 15 years. Papa said such botched interventions left these women prone to particularly bad swellings during their menstrual period, requiring further treatment -- and he warned they may suffer such symptoms for life.
- Closing legal gap -
Albanian doctors are worried about foreign practitioners who come from Italy, Turkey and Greece to work just for a weekend. "They may not have a diploma, qualification or licence for these kind of interventions or for assuming the responsibility of a patient's medical follow-up," said Besim Boci, head of the otolaryngology department at Tirana's university hospital. Due to legal loopholes, the judiciary cannot step in. A spokesman at Tirana's tribunal, Alba Nikolla, admits that it is currently impossible to "open investigations and prosecute based only on complaints" against practitioners.
But authorities are set to tackle this with a draft law to control cosmetic products and beauty salons, which is due to be introduced in parliament in the next few months. The law complies with the requirements of the European Union, which Albania aspires to join, and will enable authorities to shut down rogue establishments using synthetic products. When health is adversely affected, practitioners could be imprisoned for three to 10 years. Such regulations could go some way to easing the trauma of women like Elisa Lura, a 22-year-old economics student. She underwent a laser treatment to restore her natural look after paying 50 euros to a neighbourhood salon for permanent eyebrow tattoos, which went wrong. But the laser made things much worse. "Everything is spoiled!" she said of her face now covered with painful scars.
By Briseida MEMA
Tirana, Albania, Jan 13, 2016 (AFP) - With her sick daughter in the arms, Mira Lela pushes her way through the hallway of the doctor's clinic, crowded with patients ailing from heavy pollution in Albania's capital. "This is an emergency, she has difficulty breathing," said the tearful woman, forcing open the door to the office of Bardhyl Vaqari, who has worked in the specialist Tirana clinic for more than 20 years. "An acute asthma attack," said the doctor on seeing the child. "The number of people with respiratory allergies and cardiovascular problems has greatly increased," he told AFP, adding that the number of patients on the clinic's books has more than doubled to 8,000 in the last four years.
On the noisy and congested streets outside, clapped-out bangers and Hummer trucks cross paths with Mercedes, BMWs and overloaded buses that leave a trail of black smoke and heavy odour. Having been cut off from the world under a strict communist regime until 1991, the Western Balkan city had just a few hundred cars on its roads in the 1990s.
But today, through a mixture of pride, luxury-seeking and necessity, given the lack of public transport, there are more than 190,000 cars circulating in a city of about one million people. "Albanians take the car even when going to buy bread in a nearby store. That's why the traffic is overloaded all day and this increases pollution levels," said Altin Duka, a despairing 65-year-old shopkeeper.
The average age of vehicles on Tirana's roads is around 16 years, twice the European average, according to Gani Cupi, deputy manager of Albania's Road Transport Services. Many of the vehicles do not meet the standards of the European Union, which Albania hopes to join. "The traffic load, the age of vehicles, their technical condition but also the poor quality of fuel are all factors contributing to the capital's pollution," said Cupi.
- Taxing dilemmas -
In a bid to clean up the air, Albanian authorities considered doubling taxes on ageing vehicles but then dropped such plans. Analysts suggested the cost would weigh too heavily on citizens in one of the poorest countries in Europe. New cars are already exempt from paying annual tax for the first three years, but authorities in 2012 lifted a levy on the import of old vehicles as the EU considered it a "fiscal discrimination".
Tirana's Mayor Erion Veliaj has pledged to battle against the fumes by increasing the number of green spaces, introducing hybrid buses and improving infrastructure in the city, which is crammed with mostly illegal constructions. "The number of vehicles does not stop growing," he told AFP, pointing out that about 500 people die in the city each year "because of respiratory or cardiovascular problems related to pollution".
A report this year from the European Environment Agency noted a 20 to 30 percent decrease in Tirana's concentration levels of PM10 and PM2.5 -- damaging particulate matter -- according to data assessment from 2011 to 2013. But Laureta Dibra, head of the air and climate change department at Albania's Environment Ministry, told AFP that PM10 levels had actually been rising in areas of heavy traffic in recent years. Tirana remains "among the most polluted cities in Europe", added the director of the National Environment Agency, Julian Beqiri. "The level of the population's exposure to pollutants is still a problem," he said.
- On your bikes -
In an effort to improve air quality in the capital and educate residents, Tirana organised two car-free days in 2015, when the air was said to be at least four times less polluted than usual. Worried activists are campaigning to promote the bicycle as a means of transport and a way of life. Ecovolis, a bike sharing system, rents out at least 200 bicycles from different tations around Tirana, at 60 leke (44 euro cents, $0.47) per bike per hour -- but many people still prefer getting behind the wheel.
Although Albania's energy minister claims that 95 percent of fuel meets the required standards, even Prime Minister Edi Rama attacked its quality in May last year. "It is so bad that even a strong car like a Mercedes ends up being bad for Albanians' lungs," he said, calling for urgent measures to improve fuel controls. The government says restrictions have since been tightened, but those at the frontline of the fumes remain unhappy. "I come home in the evening with a completely dry throat and a bitter taste my mouth," said Bequir Veseli, 37, a traffic policeman who spends eight hours a day at the centre of a chaotic roundabout. "I have trouble breathing but what can I do? The next day I have to go back to my post".
June 17, 2008
The Philippines is an emerging economy with a democratic system of government, located in Southeast Asia.
The archipelago consists of more than 7,000 islands
The major island groupings are Luzon in the north, the Visayas in the center and Mindanao in the south.
Tourist facilities are available within population centers and the main tourist areas.
English is widely spoken in the Philippines, and most signs are in English.
Read the Department of State Background Notes on the Philippines for additional information.
U.S. citizens may enter the Philippines without a visa upon presentation of their U.S. passport, valid for at least six months after the date of entry into the Philippines, and a return ticket to the United States or an onward ticket to another country.
Upon arrival immigration authorities will annotate your passport with an entry visa valid for 21 days.
If you plan to stay longer than 21 days you must apply for an extension at the Philippine Bureau of Immigration and Deportation's main office at Magallanes Drive; Intramuros, Manila, Philippines or at any of its provincial offices at http://www.immigration.gov.ph.
Persons who overstay their visas are subject to fines and detention by Philippine immigration authorities.
American citizens are urged to remain aware of their visa status while in the Philippines and to strictly follow immigration laws and regulations.
Travelers departing the country from international airports must pay a Passenger Service Charge in Philippine Pesos.
Visit the Embassy of the Philippines web site at http://www.philippineembassy-usa.org for the most current visa information.
Special requirements exist for the entry of unaccompanied minors.
In an effort to prevent international child abduction, the Philippine government requires that a waiver of exclusion be obtained from a Philippine Embassy or Consulate or from the Bureau of Immigration and Detention in Manila for a child under 15 years of age who plans to enter the Philippines unaccompanied by either a parent or legal guardian prior to the child's entry into the Philippines.
Information about dual nationality or the prevention of international child abduction can be found on our web site.
For further information about customs regulations, please read our Customs Information sheet.
SAFETY AND SECURITY:
U.S. citizens contemplating travel to the Philippines should carefully consider the risks to their safety and security while there, including those due to terrorism.
While travelers may encounter such threats anywhere in the Philippines, the southern island of Mindanao and the Sulu Archipelago are of particular concern.
Travelers should exercise extreme caution in both central and western Mindanao as well as in the Sulu Archipelago.
Kidnap for ransom gangs operate in the Philippines.
In October 2007, one such gang abducted a visiting U.S. citizen whose whereabouts are unknown at this time.
Several other foreigners were also kidnapped for ransom in 2007.
The New People’s Army (NPA), a terrorist organization, operates in many rural areas of the Philippines, including in the northern island of Luzon.
While it has not targeted foreigners in several years, the NPA could threaten U.S. citizens engaged in business or property management activities, and it often demands “revolutionary taxes.”
Terrorist groups, such as the Abu Sayyaf Group, the Jema’ah Islamiyah and groups that have broken away from the more mainstream Moro Islamic Liberation Front or Moro National Liberation Front, have carried out bombings resulting in deaths, injuries and property damage.
In November 2007, a bombing outside the House of Representatives in Metro Manila resulted in a number of deaths and injuries to bystanders.
On January 3, 2008, a bomb exploded at a Cotabato City disco pub, killing one and injuring eight.
The central and western areas of Mindanao have also experienced bombings targeting bus terminals and public buildings.
While those responsible do not appear to have targeted foreigners, travelers should remain vigilant and avoid congregating in public areas; U.S. Government employees must seek special permission for travel to Mindanao or the Sulu Archipelago.
When traveling in Mindanao, U.S. official travelers attempt to lower their profile, limit their length of stay and exercise extreme caution.
Some foreigners who reside in or visit western and central Mindanao hire their own private security personnel.
For the latest security information, Americans traveling abroad should regularly monitor the Department of State, Bureau of Consular Affairs web site at http://travel.state.gov where the current Travel Warnings and Travel Alerts, including the Worldwide Caution, can be found.
Up-to-date information on safety and security can also be obtained by calling 1-888-407-4747 toll free in the United States and Canada, or for callers outside the United States and Canada, a regular toll-line at 1-202-501-4444.
These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).
The Department of State urges American citizens to take responsibility for their own personal security while traveling overseas.
For general information about appropriate measures travelers can take to protect themselves in an overseas environment, see the Department of State’s pamphlet A Safe Trip Abroad.
As in many of the major metropolitan areas in the United States, crime is a significant concern in Metro Manila.
As a rule of thumb, Americans should exercise good judgment and remain aware of their surroundings.
Reports of confidence games, pick pocketing, internet scams and credit card fraud are common.
Be wary of unknown individuals who attempt to befriend you, especially just after you arrive in country.
A number of robberies and assaults involving the “date rape drug” (known locally as Ativan) have occurred; the drug is generally administered to unwitting male or female victims via food or drink.
It is best not to accept food, drink, or rides in private vehicles from strangers, even if they appear legitimate.
While Americans are not typically targeted for kidnapping, kidnappings and violent assaults do occur in the Metro Manila area.
Taxis are the recommended form of public transportation.
However, the following safeguards are important: do not enter a taxi if it has already accepted another passenger; and request that the meter be used.
If the driver is unwilling to comply with your requests, it is best to wait for another cab.
It is also a good idea to make a mental note of the license plate number should there be a problem.
When driving in the city, make certain that the doors are locked and the windows rolled up.
All other forms of public transportation, such as the light rail system, buses and “jeepneys” should be avoided for both safety and security reasons.
Visitors should also be vigilant when using credit cards.
One common form of credit card fraud involves the illicit use of an electronic device to retrieve and record information, including the PIN, from the card's magnetic strip.
The information is then used to make unauthorized purchases.
To limit your vulnerability to this scam, never let your card out of your sight.
A continuing problem is the commercial scam or sting that attempts to sell or to seek negotiation of fraudulent U.S. securities.
Visitors and residents should be wary when presented with supposed Federal Reserve Notes or U.S. securities for sale or negotiation.
For further information, consult the Federal Reserve System's web site at http://www.federalreserve.gov/.
In many countries around the world, counterfeit and pirated goods are widely available.
Transactions involving such products may be illegal under local law.
In addition, bringing them back to the United States may result in forfeitures and/or fines.
More information on this serious problem is available at http://www.cybercrime.gov/18usc2320.htm.
INFORMATION FOR VICTIMS OF CRIME:
The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. Embassy or Consulate.
If you are the victim of a crime while overseas, in addition to reporting to local police, please contact the nearest U.S. Embassy or Consulate for assistance.
The Embassy/Consulate staff can, for example, assist you to find appropriate medical care, contact family members or friends and explain how funds could be transferred.
Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and to find an attorney if needed.
The Philippines has a victim compensation program to provide financial compensation to victims of violent or personal crime and of unjust imprisonment.
Information may be obtained from the Philippine Department of Justice at 011-632-536-0447 or via the Internet at http://www.doj.gov.ph/.
The local equivalent to the “911” emergency line in the Philippines is: 117.
See our information on Victims of Crime.
MEDICAL FACILITIES AND HEALTH INFORMATION:
Adequate medical care is available in major cities in the Philippines, but even the best hospitals may not meet the standards of medical care, sanitation, and facilities provided by hospitals and doctors in the United States.
Medical care is limited in rural and more remote areas.
Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost several or even tens of thousands of dollars.
Most hospitals will require a down payment of estimated fees in cash at the time of admission.
In some cases, public and private hospitals have withheld lifesaving medicines and treatments for non-payment of bills.
Hospitals also frequently refuse to discharge patients or release important medical documents until the bill has been paid in full.
A list of doctors and medical facilities in the Philippines is available on the web page of the U.S. Embassy in Manila at http://manila.usembassy.gov/.
Information on vaccinations and other health precautions, such as safe food and water precautions and insect bite protection, may be obtained from the Centers for Disease Control and Prevention’s hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747) or via the CDC’s web site at http://wwwn.cdc.gov/travel/default.aspx.
For information about outbreaks of infectious diseases abroad consult the World Health Organization’s (WHO) web site at http://www.who.int/en.
Further health information for travelers is available at http://www.who.int/ith/en.
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and whether it will cover emergency expenses such as a medical evacuation.
Please see our information on medical insurance overseas.
TRAFFIC SAFETY AND ROAD CONDITIONS:
While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States.
The information below concerning the Philippines is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Travel within the Philippine archipelago is possible by boat, plane, bus or car.
Few tourists rent cars to drive, as the road system is crowded and drivers are undisciplined.
Driving off the national highways and paved roads is particularly dangerous, especially at night, and should be avoided.
To avoid overcrowded or unsafe transport, exercise caution in planning travel by older, inter-island ferryboats, or other public conveyances.
For specific information concerning Philippine driver's permits, vehicle inspection, road tax and mandatory insurance, please contact the Philippine Embassy in Washington, D.C. at tel. (202) 467-9300 or one of the Philippine consulates in the United State (Chicago, Honolulu, Los Angeles, New York, and San Francisco) or via the Internet at http://www.philippineembassy-usa.org/home.htm.
Please see also related information from the Philippine Department of Tourism at http://www.tourism.gov.ph and http://www.dotpcvc.gov.ph.
Please refer to our Road Safety page for more information.
Visit the web site of the country’s national tourist office and national authority responsible for road safety at http://www.lto.gov.ph/.
AVIATION SAFETY OVERSIGHT:
The U.S. Federal Aviation Administration (FAA) has assessed the Government of the Philippines’ Civil Aviation Authority as not being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for the oversight of the Philippines’ air carrier operations.
For more information, travelers may visit the FAA’s web site at http://www.faa.gov/safety/programs_initiatives/oversight/iasa
SPECIAL CIRCUMSTANCES: Marriage in the Philippines:
The Philippine Government requires foreigners who wish to marry in the Philippines to obtain from the U.S. Embassy a “Certificate of Legal Capacity to Contract Marriage” before filing an application for a marriage license.
Because there is no national register of marriages in the United States, the U.S. Embassy cannot provide such a certification.
As a result, the Philippine Government will accept an “Affidavit in Lieu of a Certificate of Legal Capacity to Contract Marriage” in its place.
Americans may execute this affidavit at the U.S. Embassy in Manila Monday-Friday, between 8:00 a.m. and 10:00 a.m., except for Philippine or American holidays.
The American must present his/her U.S. passport.
There is a fee of $30.00 or its peso equivalent for the affidavit.
Philippine authorities will not accept any substitute document issued in the United States.
Before traveling to the Philippines to be married, U.S. military personnel should contact their personnel office regarding Department of Defense joint service regulations.
Execution of the affidavit by a U.S. consular officer is a notarial act, and the consular officer is authorized by U.S. law to refuse to perform the service if the document will be used for a purpose patently unlawful, improper, or inimical to the best interests of the United States (see 22 C.F.R. section 92.9b).
Entering into a marriage contract for the principal purpose of facilitating immigration to the United States for an alien is an unlawful act, and the U.S. Code provides penalties for individuals who commit perjury in an affidavit taken by a consular officer.
Relationship fraud is a persistent problem in the Philippines, and it is not uncommon for Filipinos to enter into marriages with Americans solely for immigration purposes.
Relationships developed via correspondence, particularly those begun on the Internet, are particularly susceptible to manipulation.
The Marriage Application Process:
Once an American citizen has obtained from the U.S. Embassy an “Affidavit in Lieu of a Certificate of Legal Capacity to Contract Marriage,” he/she may file an application for a marriage license at the office of the Philippine Civil Registrar in the town or city where one of the parties is a resident.
The U.S. citizen applicant must present: (a) the affidavit; (b) divorce decree(s) or death certificate(s), if applicable (required to verify civil status and legal capacity to contract marriage); (c) his/her U.S. passport; and (d) documentation regarding parental consent or advice, if applicable.
(Persons aged 18 to 21 must have written parental consent to marry in the Philippines; those aged 22 to 24 must have received parental advice.
Philippine law prohibits marriage for persons under the age of 18.)
A judge, a minister, or other person authorized by the Philippine Government can perform the marriage.
Marriage to a U.S. citizen confers neither citizenship nor an automatic eligibility for entry to the United States.
A foreign spouse requires an immigrant visa to live in the United States.
Questions about filing a petition to bring a foreign spouse to the United States may be directed to the nearest U.S. Citizenship and Immigration Service office, to the U.S. Department of State’s Visa Office (telephone: (202) 663-1225) or, while in the Philippines, to the U.S. Embassy’s Immigrant Visa Unit at http://manila.usembassy.gov/.
The Philippines is a volcano-, typhoon- and earthquake-prone country.
>From May to December, typhoons and flash floods often occur.
Flooding can cause road delays and cut off bridges.
Typhoons in the vicinity of the Philippines can interrupt air and sea links within the country.
Updated information on typhoons is available at http://www.pagasa.dost.gov.ph. Volcanic activity is frequent, and periodically the Philippine Government announces alerts for specific volcanoes.
Updated information on volcanoes in the Philippines is available at http://volcanoes.usgs.gov.
Earthquakes can also occur throughout the country.
General information about natural disaster preparedness is available via the Internet from the Philippines National Disaster Coordinating Council (NDCC) at http://ndcc.gov.ph/home/ and from the U.S. Federal Emergency Management Agency (FEMA) at http://www.fema.gov.
Customs: Philippine customs authorities enforce strict regulations concerning temporary importation into or export from the Philippines of items such as firearms and currency.
It is advisable to contact the Embassy of the Philippines in Washington, DC or one of the Philippine consulates in the United States (Chicago, Honolulu, Los Angeles, New York and San Francisco) for specific information regarding customs requirements.
Counterfeit and pirated goods are widely available in the Philippines; transactions involving such products are illegal and bringing them back to the United States may result in forfeitures and/or fines.
Please see our Customs Information.
While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law.
Penalties for breaking the law can be more severe than in the United States for similar offenses.
Persons violating the Philippines’ laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in the Philippines are severe, and convicted offenders can expect long jail sentences and heavy fines.
Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime, prosecutable in the United States.
Please see our information on Criminal Penalties.
For information see our Office of Children’s Issues web pages on intercountry adoption and international parental child abduction.
REGISTRATION / EMBASSY LOCATION:
Americans living or traveling in the Philippines are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department’s travel registration web site so that they can obtain updated information on travel and security within the Philippines.
Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate.
By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency.
The U.S. Embassy is located at: 1201 Roxas Boulevard, Manila, Philippines, tel. (63) (2) 301-2000.
The American Citizen Services (ACS) section's fax number is (63) (2) 301-2017 and the ACS web page is at http://manila.usembassy.gov/.
This replaces the Country Specific Information for the Philippines dated January 17, 2008 to update sections on “Country Description,” “Safety and Security,” “Crime” and “Medical Facilities and Health Information.
Travel News Headlines WORLD NEWS
Oslo, May 10, 2019 (AFP) - A 24 year-old Norwegian woman died this week of rabies, after she was bitten by a puppy she rescued while on vacation in the Philippines, her family announced. In February, while on holiday with friends, Birgitte Kallestad found a "helpless" puppy on the side of the road during a scooter ride. "Birgitte put the puppy in a basket and brought him home. She cleaned it and cared for it and to her joy it started healing. They played with the puppy in the garden" of the resort where they were staying, the family said in a statement published Thursday evening. "After a while the puppy started trying to bite them like puppies do. It nipped their fingers when they were playing," the statement continued. The young woman, a hospital employee, started feeling ill after her return to Norway and was put into intensive care at Forde hospital, where she worked and where she passed away on Monday evening.
According to the Norwegian Institute of Public Health, the last recorded case of rabies contracted by a human in mainland Norway dates back to 1815, and to 1826 for an animal. According to the family no one in the group of friends had been vaccinated against rabies. "Our dear Birgitte loved animals. Our fear is that this will happen to others who have a warm heart like hers," her family said. At least 59,000 people worldwide die each year worldwide from the animal-borne disease, according to the World Health Organization (WHO). More than 99 percent of victims are concentrated in Asia, Africa and South America.
The number of dengue cases continues to rise and is now close to 60,000, according to the Department of Health (DoH). Data from the epidemiology bureau showed that there were 59,139 dengue cases from 1 Jan to 6 Apr this year .
By Ron LOPEZ
Porac, Philippines, April 23, 2019 (AFP) - Philippine rescuers raced Tuesday to reach some two dozen people still feared buried under a building near Manila that collapsed a day earlier in a deadly earthquake, as a powerful second tremor hit the nation. The US Geological Survey put the second quake -- on the central island of Samar -- at 6.4 magnitude, stronger than the one that wrought significant damage Monday near the capital in the north.
The latest quake sent terrified locals fleeing into the streets, with images on social media showing cracked roads, crumbling church walls and shattered glass. "No one started crying, but of course some panicked because it was really strong," said Rey Estrobo, a supervisor at a hotel in Borongan town, near the epicentre. At the same time, the toll in Monday's quake rose to 16, with most of the fatalities in the worst-hit northern province of Pampanga, national disaster officials said. More than 100 others were injured by falling rubble on Monday, including in Manila, according to police.
However, initial reports indicated relatively minor destruction in Samar given the strength of Tuesday's quake, which could be down to differences in ground composition. "The damage is more pronounced if the houses and buildings are built on a foundation of soft soil," seismologist Myla Advincula told AFP, referring to Pampanga's soft sediment. "It enhances the shaking effect."
Scores of rescuers in the northern town of Porac spent Tuesday using cranes and jackhammers to peel back the pancaked concrete structure of a four-storey market building where the Red Cross said 24 people were unaccounted for. "Every minute, every second is critical in this rescue," Cris Palcis, a volunteer rescue dog handler, told AFP. "Time is short for the people under the rubble so we have to be quick."
Pampanga Governor Lilia Pineda told journalists that rescuers could still hear at least one person trapped beneath the rubble, but the digging was proceeding delicately to avoid accidentally crushing the survivor. Rogelio Pacelo was shopping with his wife and child when the market building collapsed around them, but they incredibly made it out almost without a scratch. "I thought this only happens in movies. I thought that was the end of the world, it's our end," he told journalists. "I looked for a way out." The quake also damaged several centuries-old churches which were crowded with worshippers in recent days as the majority-Catholic Philippines marked the Easter holiday.
- 'Ring of Fire' -
Father Roland Moraleja, who is based in Porac, said the 18th-century belfry of the Saint Catherine of Alexandria church collapsed in the quake. "It was the only part left from the old church," he told AFP. "The historical value is now gone, but we are hopeful that it will rise again." High-rise buildings in the capital swayed after the tremor struck Monday evening, leaving some with large cracks in their walls.
Thousands of travellers were stranded after aviation authorities shut down the secondary Clark Airport, which is located on the site of the former US military installation that lies about an hour's drive north of the capital. It was still closed on Tuesday as officials assessed the heavy damage to the terminal building and some cracking on the air traffic control tower.
The quake was centred on the town of Castillejos, about 100 kilometres (62 miles) northwest of Manila, local geologists said. Seismologists put Monday's tremor at 6.3 initially, but subsequently downgraded it to a 6.1 magnitude. The Philippines is in the Pacific "Ring of Fire", an arc of intense seismic activity that stretches from quake-prone Japan through Southeast Asia and across the Pacific basin.
Dengue cases in the Philippines have reached 52,595 from 1 Jan to 23 Mar , with 210 deaths, the Philippine Department of Health (DOH) said on Thursday [4 Apr 2019]. This is a 76% jump from the 29,861 cases reported during the same period last year , the DOH added. Most of those affected are 5-9 years old.
- National. 12 Apr 2019. From 1 Jan to 30 Mar , 55,976 cumulative cases with 227 deaths have been reported. This is 245% higher compared to same Q1 in 2018.
- Zamboanga City. 14 Apr 2019. The Department of Health Region 9 (DOH-9) has recorded high cases of dengue with 20 deaths in the Zamboanga peninsula and in Basilan since January .
- Western Visayas. 2 Apr 2019. Dengue fever already claimed 26 lives in Western Visayas based on the 11th morbidity week of monitoring by the Department of Health - Center for Health Development (DOH-CHD). The 26 deaths came from Negros Occidental with 14; Aklan and Iloilo provinces and Iloilo City with 3 each; Capiz, 2; and Bacolod City with one. Regional epidemiologist Dr. Jessie Glen L. Alonsabe said that as of January to 16 Mar , dengue cases in the region reached 4347, or an increase of 142% when compared with the 1794 cases and 11 deaths in the same period last year . The highest increase was in Guimaras with 738%, or from 8 cases for the same period last year  to 67 cases, with no death. Meantime, Negros Occidental posted a 98% increase with 1450 cases, up from 733 last year , with the highest number of deaths at 14.
- Cebu province. 5 Apr 2019. Two dengue fatalities have been reported from the town of San Remigio in the midst of the dry season in the province of Cebu. According to the latest situation report from the Provincial Disaster Risk Reduction and Management Office (PDRRMO), 52 dengue cases have been reported in the town of San Remigio, 109 km [68 mi] north of Cebu City.
- Soccsksargen region. 30 Mar 2019. Mindanao: 13 die of dengue, and 3783 individuals had been hospitalized in the last 3 months in the provinces of South Cotabato, Sarangani, Sultan Kudarat, and North Cotabato, and in the cities of Cotabato, Kidapawan, Tacurong, Koronadal, and Gen. Santos, according to the DOH-12 Regional Epidemiology and Surveillance Unit (RESU).
- Negri Sembilan. 27 Mar 2019. 682 cases - 2.5 times compared to same period in 2018.
- Calabarzon region. 27 Mar 2019. 5910 cases with 21 deaths so far this year .
- Iloilo City. 27 Mar 2019. With 250 cases and 3 deaths, dengue cases soared 495% in the 1st 2 months of the year  compared to the same period last year . There were 165 cases with one death in January  and 85 cases with 2 deaths in February . "Normally, dengue has a cycle, wherein every 3 years dengue cases increase. The last time we have had many dengue cases was in 2016. In 2017, it decreased because a patient has 6 months immunity. In 2018, it went up until it reached its 3rd cycle, which is now in 2019, city health officer Dr. Bernard Caspe said.
- Cavite. 26 Mar 2019. Deaths rise to 9 in 8 provinces with 1917 cases.
World Travel News Headlines
By Nazeer al-Khatib with Hashem Osseiran in Beirut
Maaret al-Numan, Syria, May 22, 2019 (AFP) - Syrian government air strikes killed 18 civilians, including a dozen people at a busy market, as fierce fighting raged for the jihadist-held northwest, a war monitor said on Wednesday. Regime forces battled to repel a jihadist counteroffensive around the town of Kafr Nabuda that has left 70 combatants dead in 24 hours, the Syrian Observatory for Human Rights said. The Hayat Tahrir al-Sham alliance, led by Syria's former Al-Qaeda affiliate, controls a large part of Idlib province as well as adjacent slivers of Aleppo, Hama and Latakia provinces. The jihadist-dominated region is nominally protected by a buffer zone deal, but the government and its ally Russia have escalated their bombardment in recent weeks, seizing several towns on its southern flank. At least 12 people were killed and another 18 wounded when regime warplanes hit the jihadist-held Idlib province town of Maarat al-Numan around midnight (2100 GMT) on Tuesday, the Observatory said.
The market was crowded with people out and about after breaking the daytime fast observed by Muslims during the holy month of Ramadan. The bombardment blew in the facades of surrounding buildings, and ripped through the flimsy frames and canvas of stalls in the market square, an AFP photographer reported. The bodies of market-goers were torn apart. "Residents are still scared," stallholder Khaled Ahmad told AFP. Three more civilians were killed on Wednesday by air strikes in the nearby town of Saraqib, the Observatory said. Two others were killed in strikes on the town of Maaret Hermeh, it added. Another civilian was killed in air raids on the town of Jisr al-Shughur, the monitor said. The Britain-based Observatory relies on a network of sources inside Syria and says it determines whose planes carried out strikes according to type, location, flight patterns and munitions.
- 'Worst fears'-
The strikes came as heavy clashes raged in neighbouring Hama province after the jihadists launched a counterattack on Tuesday. Fresh fighting on Wednesday took the death toll to 70 -- 36 regime forces and militia and 34 jihadists, the Observatory said. It said the jihadists had recaptured most of Kafr Nabuda from government forces, who had taken control of the town on May 8. State news agency SANA on Wednesday however said the army repelled a jihadist attack in the area, killing dozens of insurgents.
Russia and rebel ally Turkey inked the buffer zone deal in September to avert a government offensive on the region and protect its three million residents. But President Bashar al-Assad's government upped its bombardment of the region after HTS took control in January. Russia too has stepped up its air strikes in recent weeks. The Observatory says nearly 200 civilians have been killed in the flare-up since April 30. The United Nations said Wednesday that Idlib's civilian population once again faced the threat of an all-out offensive. "A full military incursion threatens to trigger a humanitarian catastrophe for over 3 million civilians caught in the crossfire, as well as overwhelm our ability to respond," said David Swanson, a spokesman for the UN humanitarian office. Swanson said more than 200,000 people have been displaced by the upsurge of violence since April 28. A total of 20 health facilities have been hit by the escalation -- 19 of which remain out of service, Swanson said. Collectively they served at least 200,000 people, he added.
- 'Break the status quo' -
The September deal was never fully implemented as jihadists refused to withdraw from a planned buffer zone around the Idlib region. But it ushered in a relative drop in violence until earlier this year, with Turkish troops deploying to observation points around the region. The Syrian government has accused Turkey of failing to secure implementation of the truce deal by the jihadists. But Turkish Defence Minister Hulusi Akar accused the Syrian regime late Tuesday of threatening the ceasefire deal. "The regime is doing all that it can to break the status quo including using barrel bombs, land and air offensives," Akar told reporters. "Turkish armed forces will not take a step back from wherever they may be", he however added. Earlier, the US State Department said it was assessing indications that the government had used chemical weapons on Sunday during its offensive in Idlib. HTS accused government forces of launching a chlorine gas attack on its fighters in the northern mountains of Latakia. But the Observatory said Wednesday it had "no proof at all of the attack".
By Amelie BARON
Port-au-Prince, May 22, 2019 (AFP) - With no oxygen in intensive care or gloves in the emergency room, residents at Haiti's largest hospital have gone on strike to protest the filthy environment and demand six months of back pay. "We have almost nothing when we talk about emergency services," said Emmanuel Desrosiers, 24, one of the doctors-in-training at the State University of Haiti Hospital (HUEH) that began the work stoppage Monday. "When a patient arrives, when we should immediately take charge, we start by listing the things they or their family need to go buy." The HUEH, known as the "general hospital," is where the most disadvantaged families in this impoverished Caribbean country crowd. Buying the medical supplies themselves is a financial headache, but private clinics are far too expensive. In crumbling buildings in the center of Port-au-Prince, male and female patients are crowded together in tiny rooms, while trash cans overflow. "We feel ridiculous when we give hygienic advice to patients," one resident said of the situation.
The residents' selflessness as they work in an unsanitary environment is compounded by the fact that they have not been paid since the start of their residency, nearly six months ago. After five years of medical studies, the state is required to pay them 9,000 Haitian gourdes (HTG) per month -- only about $100, due to the devaluation of the national currency. Nothing is being done about the hospital's disrepair, with those in charge waiting for a new building to be completed, according to resident Yveline Michel. The new HUEH will have two floors and more than 530 beds once it's finished -- but it's unclear when that will be. The project began after the January 2010 earthquake, which destroyed more than half the hospital. The United States, France and Haiti invested $83 million in a new hospital, which should have been completed by 2016. Instead, there is little visible activity on the construction site, which can be seen through the windows of the current building.
Due to the heat, the windows are always open, letting in noise and dust from the street. There are only a few fans in the hospital rooms, which do little to combat the humidity or the flies. "At any moment we could lose patients, but the state isn't doing anything to save their lives," said Michel, 25. "We're striking for the population, since it should make these demands." But some locals question the residents' position because the strike prevents the already struggling hospital from functioning. Since the strike began, the poorest families in the area no longer know where to go for medical emergencies, as the residents are in charge of admitting patients. "Due to the lack of resources and the unsanitary environment, there are always people dying in the hospital, so it's not the strike causing that," said Michel in response.
For a description of Hwange national park, go to
Hwange is in the western part of the country bordering Botswana and Zambia
(<https://en.wikipedia.org/wiki/Hwange>). - ProMED Mod.MHJ]
One has to ask: Why are we seeing it in the USA?" is more and more relevant. We are seeing these outbreaks because of the inability to deal with marginalized populations among their midst. The dramatic cutbacks in public health infrastructure in some of these states clearly feed the fire of these outbreaks. They must be addressed by bolstering public health resources and education and directly addressing the needs of these marginalized populations. - ProMED Mod.LL]