World's Busiest Maternity Ward This World


World's Busiest Maternity Ward

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The world's population is growing at a rate of 80 million people a year.

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Manila, the capital of the Philippines,

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is home to one of the world's busiest maternity wards.

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How many babies have you delivered? Maybe 200,000.

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'In Manila's teeming slums,

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it feels like the world can't possibly support even more people.'

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Oh, gosh. I'm just trying to take this place in.

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It goes on and on.

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'But for the first time in living memory,

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'here and around the world,

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'there's the possibility of a very different future.'

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It's contagious when you talk to Filipinos,

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being so proud of our own country.

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I've followed the lives of three families across Manila

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during a time of dramatic change.

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How are you? Congratulations, Daddy. I'm very happy.

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I will get out of this kind of place. I got a job.

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Who knows? Maybe all your dreams will be fulfilled some day.

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He's opening his eyes.

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It's a future that will see the world's population explosion

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finally come to an end.

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Hello, ladies. Hello. All these pregnant ladies, hello.

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Dr Jose Fabella Public Hospital is in the heart of downtown Manila,

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one of the most densely populated cities on earth.

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How many women have registered today?

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Today? 200.

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And what time is it?

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It's 10.30 in the morning? It's 11... 11.00.

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One in five of central Manila's mums come here to deliver their babies.

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The midwives work day and night,

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bringing young Filipinos into the world.

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Ana Apruebo is the most senior nurse on the ward.

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How many babies have you delivered?

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I'm sorry, but I can't remember, it's so many.

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Give me a ballpark figure. Maybe...

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200,000.

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Yes, because I am already here since 1986,

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been here for almost 28 years.

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OK, I think we may have found

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the most experienced baby deliverer in the world.

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This is maternity on an industrial scale.

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With 24,000 babies born a year, Ana has to run a tight ship.

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When contractions have begun in earnest,

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the women are packed into the tiny labour room.

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How many to a bed? Five. Five in a bed? Five in a bed.

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Sometimes we have more.

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At the very last minute, the mums are wheeled into the delivery room.

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Good luck. Good luck, lady.

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How many women are giving birth in here?

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Six. Six.

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With minimum fuss, the midwives get to work.

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There's a little arm!

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BABY CRIES

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They have what you might call a hands-on approach here.

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And despite the relentless pressure, there's no sense of panic or chaos.

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A woman has just given birth to a baby.

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There's a woman who's about to give birth any second, and...

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I can't hear anybody screaming, I can't hear any babies crying,

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everyone is so controlled, composed...

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I mean, she's obviously in a lot of pain.

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I don't know what that says about the Filipino women..

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maybe it's something about their psyche,

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maybe they are...

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ANITA GASPS

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Yes, oh!

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Just like that, a baby's born. Another one.

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BABY CRIES

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Is it a boy?

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Yep, that's a boy.

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Welcome to Manila.

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BABY WHIMPERS

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This is a 24-hour operation.

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As babies are wheeled out at one end of the hospital...

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expectant mums are checking in at the other.

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How are you? Anita.

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Rosaly.

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Rosaly. Rosaly.

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So, how pregnant are you, Rosaly, when are you due?

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July 17th.

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This month.

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Well, that's in a few days. Amazing.

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What number is this? How many children do you have?

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Seven. You have seven children already? Yes.

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Is this number seven or number eight? Number seven.

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Number seven, lucky number seven.

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And how old are your children?

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16... Uh-huh. ..14,

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nine, eight, four and two years old.

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And...? And then...

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You've been having babies for a long time.

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By baby number seven, the final check-up should be routine.

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When the patient comes in, you must know, how many kids do you have?

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We must know the case, even if you are dealing with this patient.

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You've got to know their case histories...

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Yes, everybody that comes into the delivery room.

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Amazing.

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Even if 10 or 15.

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And you must recognise women as well.

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Oh, I've seen you before. Baby number ten. Yes.

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So, I am just checking the head.

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Would you like to? Yeah, I would. Could I? What do I do? Just...?

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It's the head. That's the head!

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Awww, amazing!

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So I'm checking the uterine size.

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'Everything seems normal, but there are always risks around childbirth.

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'One of the most serious is haemorrhaging,

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'especially for women who've had so many babies.'

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'Because of the shortage of blood for transfusions, every mother has

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'to bring friends or relatives

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'who can give blood in case of an emergency.'

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OK, Rosaly, let's get you up.

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Well done, well done. Thank you.

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The women who give birth in Fabella Hospital

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come from the poorest parts of the city.

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Manila is one of the fastest growing cities on Earth...

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..and there are children everywhere.

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In the next 40 years, the population of the Philippines

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is expected to grow by 50%.

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Rosaly lives in Tondo, Manila's biggest and poorest slum.

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Here we go.

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Tondo grew up around the city's huge rubbish dump.

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It's now thought to be home to up to half a million people.

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The first thing that's really obvious

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is that there's children everywhere.

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Absolutely everywhere.

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Hello. Hello. Hello. Hello.

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There's a shack behind you that's made out of bedsprings.

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God, this is really intense.

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Oh, gosh. I'm just trying to take this place in.

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It goes on and on.

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This is one of the most densely populated places,

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certainly in the Philippines, if not in the world.

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There's thousands of families that live here,

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in this tiny little space.

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Every year, hundreds of thousands of people

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migrate from the countryside, looking for work in the city.

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Are you recycling?

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Yeah, I think they're recycling. Emptying all the rubbish.

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How much money for one bag?

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Six pesos. Six pesos.

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Less than a penny.

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Hello. Hello, hello. Whoo!

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Steady!

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Steady, steady.

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God, this is where they live, this is where they play.

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They live on a rubbish dump.

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In the back streets of Tondo, I finally found Rosaly's house.

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Hey, Rosaly.

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How are you? Lovely to see you again. Thank you.

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Is this your husband? Yes, Eduardo.

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Eduardo, pleased to meet you. How are you, Sir?

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Nice to meet you.

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So where's your home?

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Where do you live, which is your house?

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This one here?

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It's pitch black.

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Be careful.

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Are you being careful? I'm not the one who's nine months pregnant.

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How do you get up here in your condition?

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A-ha, it opens out.

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This is your home. Yeah.

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The whole family lives in this one small room.

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380? Yes.

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Just over ?6 a day, OK.

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And you do a bit of embroidery? Yeah, yeah.

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And how much do you earn from your embroidery?

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So ?4, but it could take you about three to four days to earn ?4.

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So, between you, your income is quite low.

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Rosaly's story is replicated around the world.

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More than a billion people live in extreme poverty,

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battling malnutrition and disease.

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And the poorest families have the most children.

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In Tondo, families of ten or more are common.

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A future with billions more mouths to feed feels very scary.

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But things are changing,

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in ways we couldn't imagine just a few years ago.

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Not far from Manila's biggest slum

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is evidence of an economic revolution.

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This is Makati...

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..Manila's business and financial district.

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Just 20 years ago, most of this wasn't here.

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These skyscrapers now house more than 60,000 different businesses

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including multi-national companies, global banks

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and huge shopping malls.

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In the last few years, the economy here has grown at breakneck speed.

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Along with the posh shops, there's also an exclusive private hospital.

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Makati Med is known for its state-of-the-art maternity unit.

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Its medical director is Dr Annebelle Aherrera.

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OK, "Dr Rani".

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I'm ready to deliver a baby.

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Wow.

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This is where they undergo the caesarean section.

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State of the art.

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It's a huge room, isn't it?

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How much is it to have a caesarean?

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Roughly, in a small private room,

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anywhere from about 140,000 to 150,000.

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That's a lot of money.

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That's about ?2,000.

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Who is it? Is it middle class women? Is it wealthy women?

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Middle class. Upper middle class.

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And is that section of society growing?

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Are you finding your hospital is becoming busier? Yes.

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There is now a growing population of the young professionals,

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the yuppies.

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They can earn more and spend more and actually be able to afford

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this kind of service.

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Now we will enter the operating room theatres. Right.

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This is a caesarean section.

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Oh, someone is actually having a caesarean. Yes.

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This is the anaesthesiologist, the obstetrician,

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the assist, two assists,

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the husband, then the nurse and two paediatric residents.

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Gosh. Lots of people. Yes.

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Is that normal? That's normal.

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So we have three birthing rooms and this is the biggest of the three. OK.

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Oh, this is a birthing room.

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This is the birthing room.

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You have your own bathroom.

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You've got a massive window. A massive window.

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You've got a sofa. Yes.

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This is amazing.

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I want to live here, never mind having my baby here.

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Check out this view!

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This is awesome.

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Welcome to the world, baby!

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And as your yuppies grow, as you call them,

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then more of them will want to come and have their babies here.

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Yes, they are increasing. Although, we do notice

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that they would actually limit to about two or three children.

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The heart...

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the stomach...

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and the thigh bone.

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Rose and Gino Artillaga are having their second baby at Makati Med.

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You see the mouth maturing there? It's a good sign.

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I'm so happy. Of course.

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As part of Manila's growing middle class,

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they can afford the hi-tech facilities here.

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BABY'S HEARTBEAT PLAYS THROUGH MONITOR

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That's the heartbeat.

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OK, we're done.

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Hello, Gino. Hello, Rose. Anita. Pleased to meet you.

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How are you?

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Hello. Who's this?

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Hello?

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I think he's so engrossed into his iPad.

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How are you feeling, Rose?

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I feel...heavy.

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Heavy? How long have you got? You're nearly there, aren't you?

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Just a few days?

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Yeah, actually, I have my scheduled CS on Friday.

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Scheduled Caesarean. Yes.

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Do you know what you're having? Are you having a girl or a boy?

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It's a baby girl.

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Wonderful, perfect.

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One boy, one girl. Done.

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It's done.

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'Like Gino and Rose, most wealthier Filipinos have just two children.

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'Gino wasn't born middle class,

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'he's worked his way up to a job in an international bank.'

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Is there something within the Filipino psyche,

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do you think, that is driving you?

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Yeah, I think so. I think Filipinos, by nature, are hard-working people.

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We strive very hard to improve our lives

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and I think we also try very hard to achieve that.

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From very humble beginnings, I think I've started my way up

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and then I would like to believe

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that I'm still on that path going up.

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The opportunities are there,

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you just have to grab it and take advantage of it.

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More middle class families, like Gino and Rose, means fewer children

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and potentially an end to the population explosion here.

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It's all about creating new jobs.

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For years,

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poverty has driven millions of Filipinos to work abroad.

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Now, like Gino, more and more are finding work here.

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'Siva Subramaniam is the national manager of one of the largest

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'outsourcing companies in the Philippines.'

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We are a Swedish company

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and we service multinational companies from the US, Canada,

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the UK, as well as Australia.

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So when I'm picking up my phone

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to call some customer service company for X, Y or Z,

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I could possibly be speaking to somebody in this building? Yeah.

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High possibility that you could be talking

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to somebody in the Philippines.

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WORKERS CHAT

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The Philippines recently overtook India

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as the call centre capital of the world,

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employing nearly half a million people across the country.

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Companies like this are on a massive recruitment drive.

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How many people come in on average a day?

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On a given day, a good day, 350 to 450.

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That many people?

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And how many jobs are you offering at the end of every day?

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Typically, our hit ratio is anything between 10 to 14%

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of those who will get a job offer at the end of the day.

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So you could walk in here, apply for the job

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and by the end of the day, you could have a job? Job offer.

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Patient, polite and well-educated,

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Filipinos are great at handling customers on the phone,

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even the most difficult clients.

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On this floor, they're dealing with Brits.

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If someone is really aggro with you on the phone, right,

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and a British person, like, "I want some service and I want it now"

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and getting angry, how do you deal with them?

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I say sorry.

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I say, "How is your day doing so far?"

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And then eventually, you get along with the short conversation

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and then you get along with them

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and they say, "Hi, lovey. I believe you can do this, you can do that"

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so basically, you're really working in the end, so it's like...

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And they're calling you "love" by the end of it.

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Yeah, that's the best thing about it.

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You know you've won them over when they're calling you "love". Yeah.

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"Thanks, love." Then I say, "Thank you for calling, bye."

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But getting one of these highly-prized jobs isn't easy.

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There's a rigorous selection process, including interviews

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and language tests.

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Once you're through that, things begin to get serious.

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Right, guys, so welcome to day one.

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We're going to deal with UK culture right now, OK?

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So here's your question.

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So which festival involves putting one's head in a horse collar

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and making the ugliest face that he can?

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What? Maybe...

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You have ten seconds left.

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No idea. Nine, eight, seven...

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Amazingly, one of them actually knew the answer.

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I think it's gurning.

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Pardon? Gurning?

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All right, let's see.

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And there we go. Gurning?!

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How did he know that? I didn't know that.

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OK, so let's go with a few more.

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So if I tell you "donkey's years..."

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Ah, there you go.

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How could we use it and where would it come out during an interaction?

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If the customer complains that he already applied for an iPhone,

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and it hasn't arrived yet,

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he'll probably complain to say, "I've been waiting donkey's years."

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CHEERING AND APPLAUSE

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OK, that's great, that's great.

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All right, bloody hell.

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All right, no, wait, wait, wait. I'll have her say it.

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Could you help us out, please? Say "bloody hell".

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Yes. Bloody hell.

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Bloody hell.

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Flippin' heck, bloody hell.

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You could say that to somebody as a greeting...no, I'm kidding.

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THEY LAUGH

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They're like "OK, OK." No, don't!

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So you're only allowed to hear it, not say it. Yeah. Cool?

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Once they've successfully grasped the subtleties of our language,

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these workers are willing to work long hours for a rate of pay

0:24:090:24:12

far lower than in the West.

0:24:120:24:14

A job here can be the gateway to a whole new life.

0:24:140:24:18

Because of this job,

0:24:180:24:19

I was able to actually send three of my siblings to school

0:24:190:24:24

and, of course, provide for their needs and put food on our table.

0:24:240:24:27

That's seriously impressive.

0:24:270:24:29

How old are you? I am 21. You're 21.

0:24:290:24:33

And you've paid for three of your siblings to go to school

0:24:330:24:36

and you support your whole family. Yeah. That's amazing.

0:24:360:24:39

Unbelievable. I am so impressed.

0:24:450:24:48

I've spoken to a handful of people.

0:24:480:24:50

All of them have got great degrees,

0:24:500:24:53

fantastic grasp of the English language.

0:24:530:24:56

But also, we're talking about ?300 to ?400 a month.

0:24:560:25:01

That's what they are prepared to work for

0:25:010:25:03

and that would radically improve the quality of their lives.

0:25:030:25:06

Very impressive. You can see why

0:25:060:25:08

companies would want to be here in the Philippines.

0:25:080:25:12

It feels like business is booming here.

0:25:180:25:22

But this is a huge country and in rural areas,

0:25:220:25:25

more than a third of people live below the poverty line.

0:25:250:25:29

Can you really lift a country of a hundred million people

0:25:290:25:33

out of poverty with call centres?

0:25:330:25:35

This is the central part of Makati,

0:25:390:25:42

which is really the Wall Street of the Philippines.

0:25:420:25:45

I went to meet one of the country's most respected businessmen,

0:25:450:25:48

Ramon del Rosario.

0:25:480:25:50

Is it happening? It feels like it's happening.

0:25:510:25:53

It feels like the world's eyes are definitely on the Philippines.

0:25:530:25:56

I think it's beginning to happen

0:25:560:25:58

and this is not just call centres,

0:25:580:26:01

these are things like doing medical,

0:26:010:26:04

medical transcription work or work for lawyers

0:26:040:26:08

or even doing more sophisticated things like financial analysis.

0:26:080:26:12

The whole range of business process outsourcing

0:26:120:26:14

has grown in this country tremendously.

0:26:140:26:17

And that's really what's happening in our country now.

0:26:170:26:20

I think maybe part of it is contagious

0:26:200:26:22

when you talk to Filipinos, being so proud of our own country,

0:26:220:26:25

but I think a lot of foreigners have also noticed what's happening

0:26:250:26:28

and that's why there is so much attention.

0:26:280:26:31

I've been here for a little while

0:26:310:26:33

and we know that this country is performing well.

0:26:330:26:35

You outperformed China in terms of your economy

0:26:350:26:38

at the beginning of this year, that's the big headline,

0:26:380:26:40

and I've met people working in call centres.

0:26:400:26:43

You can see that there's a foreign interest here.

0:26:430:26:45

I've also met the poorest of the poor here in Manila.

0:26:450:26:49

What are the opportunities

0:26:490:26:50

for the people at that end of your social structure?

0:26:500:26:53

Well, that's really the big challenge.

0:26:530:26:56

While our economy has grown,

0:26:560:26:58

I guess there's a lot more work that needs to be done

0:26:580:27:01

so that the benefits of this economic growth

0:27:010:27:04

will reach the poorest of the poor.

0:27:040:27:07

And I think number one there is education.

0:27:070:27:10

And the whole idea is to equip our people,

0:27:100:27:12

even the poorer kids in our country, with good education

0:27:120:27:16

that will allow them to lift not only their own lives

0:27:160:27:19

but the lives of their families

0:27:190:27:21

and enjoy part of this prosperity

0:27:210:27:23

that we're looking forward to in this country.

0:27:230:27:26

It's a huge challenge but around the world,

0:27:270:27:29

an extraordinary and hardly-noticed change is going on.

0:27:290:27:33

Despite the growing population,

0:27:330:27:35

a smaller proportion of people now live in extreme poverty

0:27:350:27:39

than ever before in the history of the world.

0:27:390:27:42

And population growth has also begun to slow.

0:27:420:27:45

As improved healthcare leads to greater child survival,

0:27:450:27:48

women around the world are now having far fewer babies.

0:27:480:27:51

Even in places like Tondo, there is now real hope of an end

0:27:510:27:56

to the cycle of large families and extreme poverty.

0:27:560:28:00

GIRL SINGS KARAOKE

0:28:000:28:03

'I was heading to meet someone fighting to improve her life.'

0:28:090:28:13

Hello. Hello, what's he selling?

0:28:130:28:16

Fish?

0:28:180:28:19

Fish and sausages and eggs.

0:28:190:28:21

What's your name? Erlinda Flores.

0:28:230:28:27

Erlinda Flores! How long have you lived here, Erlinda?

0:28:270:28:31

SHE SPEAKS FILIPINO

0:28:310:28:32

Your whole life? Hello. Hello. What's your name?

0:28:320:28:36

I am Junalyn. Junalyn, Anita, pleased to meet you.

0:28:380:28:42

You've got very good English. Not so good. No, it's excellent!

0:28:420:28:46

So you help your mum with the store? Yeah.

0:28:460:28:49

I am the one who helps my mum store managing here.

0:28:490:28:52

And how old are you, Junalyn? 24. 24 years old.

0:28:520:28:56

And what do you want to do?

0:28:560:28:57

Now? What's going on in your life these days?

0:28:570:29:00

Actually, I am working at CBPS. You're working where?

0:29:000:29:03

CBPS. CBPS? CitiGroup Business Practice Solutions. At Citibank.

0:29:030:29:09

You're working at Citibank?

0:29:090:29:11

Yes. Amazing.

0:29:110:29:12

And you live here? Yeah, unfortunately.

0:29:120:29:16

I am working for six months over there.

0:29:160:29:18

Every day, Junalyn travels from her home in Tondo

0:29:200:29:23

to do work experience in the offices of a global bank.

0:29:230:29:27

How long have you lived here?

0:29:270:29:29

20 years, almost 20 years.

0:29:290:29:31

Wow.

0:29:310:29:32

This is my sister. Hello, pleased to meet you!

0:29:330:29:36

Pleased to meet you. Yes.

0:29:360:29:38

And what's your name? Rolinda.

0:29:380:29:39

Rolinda, pleased to meet you, Rolinda.

0:29:390:29:41

So you're Junalyn's older sister? Older sister, yes.

0:29:410:29:44

And what do you do? Well, I am a housewife.

0:29:440:29:47

You're a housewife, OK, where do you live?

0:29:470:29:49

Here. Here, at home. The same home. The same home.

0:29:490:29:52

You must be incredibly proud of your sister?

0:29:520:29:55

Yes, I am.

0:29:550:29:56

She motivates herself to reach her goals,

0:29:560:29:59

which I am not able to do on my own,

0:29:590:30:01

because, as you can see, I am a mother of three.

0:30:010:30:04

What did you want to be?

0:30:040:30:06

Before, I want to be a nurse, but I didn't finish my course.

0:30:060:30:09

Because I get...married

0:30:090:30:12

and you know, so on...

0:30:120:30:14

If you want an example, just look at me,

0:30:150:30:18

you see I never get that far.

0:30:180:30:20

But you can do it, keep it up.

0:30:200:30:24

Junalyn's mother had 11 children.

0:30:260:30:28

Her sister already has three.

0:30:280:30:30

But she's determined to break the cycle of poverty

0:30:300:30:33

and endless childbirth.

0:30:330:30:34

This is our house.

0:30:380:30:40

Yeah, I'll take my boots off.

0:30:400:30:42

No, it's OK. No, no, no. No, it's OK!

0:30:420:30:45

No, I can't, you've just taken yours off, I'm taking mine off.

0:30:450:30:48

Seriously.

0:30:480:30:50

I am sorry it's a bit of a mess.

0:30:500:30:52

It's not a mess, it's incredibly tidy, you don't have to apologise.

0:30:520:30:55

Can I have a look? Yeah, it's OK.

0:30:550:30:57

How many people live here?

0:30:570:30:59

Seven - my mum, my sisters, my nieces and then my brother.

0:30:590:31:02

Who sleeps up here? I sleep here and my mum.

0:31:030:31:07

Then my sister and her three kids.

0:31:070:31:09

Your sister and your three kids there.

0:31:090:31:10

And you sleep here? And my mum. And where do the boys sleep?

0:31:100:31:13

Downstairs, in the living room.

0:31:130:31:16

Quite right, in the living room, and you get the nice bedroom.

0:31:160:31:19

One of Junalyn's 11 siblings works in Egypt as a maid -

0:31:190:31:23

she sends home what little she can.

0:31:230:31:25

But that money is barely enough to keep the household afloat

0:31:250:31:29

and it isn't nearly enough to allow Junalyn to go to college.

0:31:290:31:32

When you were young, what did you want to be?

0:31:320:31:35

When I was young, actually I want to be...

0:31:350:31:38

..a doctor.

0:31:390:31:41

But it would be a hard time for me.

0:31:410:31:44

And, of course, a financial problem. Mm.

0:31:440:31:46

Finding a job is the only way Junalyn will be able

0:31:470:31:50

to cover the costs of going to college.

0:31:500:31:52

What about kids, what about marriage?

0:31:540:31:57

It's not my plan, it's not my plan.

0:31:570:31:59

It's not on my mind right now.

0:31:590:32:01

I need to pursue my dream first before get marriage...

0:32:010:32:05

I know...

0:32:050:32:07

Lots of population here in the Philippines

0:32:070:32:09

so I don't want to...

0:32:090:32:11

To be them, you see, you see it, I know you walk around this.

0:32:110:32:15

There's a lot of family problems here -

0:32:150:32:17

they cannot feed their children.

0:32:170:32:19

So I don't want to be one of them...

0:32:190:32:21

In my mind, if I get marriage,

0:32:230:32:26

I have my own job, a good job.

0:32:260:32:28

I've walked through this area.

0:32:290:32:31

I've seen... You live on a rubbish dump?

0:32:310:32:33

This is a rubbish dump, right? Yeah.

0:32:330:32:35

So how have you managed to...

0:32:350:32:38

get yourself to study and get an internship at Citibank?

0:32:380:32:42

I grow here and then...

0:32:420:32:45

I thought to myself, that some day...

0:32:450:32:49

I will get out of this kind of place because...

0:32:490:32:52

even though I am not...

0:32:520:32:55

Even though I am not that...

0:32:550:32:56

College degree...

0:32:560:32:58

I know if I get a job...

0:32:580:33:00

I can finish my study and pursue my goal

0:33:000:33:02

and get out of this, this kind of place

0:33:020:33:05

because I didn't have father, my father is died

0:33:050:33:09

so before he left...

0:33:090:33:11

..he told me that,

0:33:120:33:14

"Even though you have not finished your degree,

0:33:140:33:17

"finished your study,

0:33:170:33:20

"don't forget to look after your family first.

0:33:200:33:25

"I believe in you."

0:33:250:33:26

So that's why...

0:33:260:33:28

I always put in my mind.

0:33:280:33:29

Who knows, maybe all your dreams will be fulfilled,

0:33:290:33:33

some day I get out of this kind of place.

0:33:330:33:35

I am sorry.

0:33:380:33:40

Sorry. I'm sorry. No, I think you're incredible.

0:33:400:33:43

I'm just, I'm trying to understand

0:33:430:33:45

where this comes from within you.

0:33:450:33:47

Tell me what kind of life you want to live.

0:33:470:33:49

I want a simple life.

0:33:500:33:52

I have own house, I'm working at the office.

0:33:520:33:55

Finished my... That's my goal.

0:33:550:33:58

If I can do...

0:33:580:34:00

If I can do that, I am happy

0:34:000:34:02

and I know my dad would be happy too...

0:34:020:34:04

for me.

0:34:040:34:05

Junalyn now has the chance to fulfil her dreams.

0:34:130:34:17

In a few days, she has an interview for a permanent job at the bank.

0:34:170:34:21

Even a salary of just ?200 a month

0:34:210:34:24

would be enough to change everything.

0:34:240:34:26

And who knew that I'd come

0:34:310:34:33

to one of the worst places I've ever visited

0:34:330:34:36

and meet someone so utterly inspiring.

0:34:360:34:40

With every ounce of her being,

0:34:400:34:42

Junalyn wants to get her and her family

0:34:420:34:46

the heck out of this place...

0:34:460:34:47

..and I really, really hope she does it.

0:34:500:34:53

On the other side of Tondo, Rosaly and Eduardo's baby is due any time.

0:35:060:35:10

With a seventh child on the way, Rosaly can't afford to stop work.

0:35:180:35:22

Eduardo is also working every hour he can before the baby arrives.

0:36:080:36:12

The Philippines is a strictly Catholic country.

0:36:330:36:37

For women like Rosaly,

0:36:370:36:38

contraception isn't readily available

0:36:380:36:40

and when it is, it's expensive.

0:36:400:36:43

Rosaly and Eduardo have come to the Fabella hospital.

0:37:000:37:03

Rosaly's contractions still haven't begun

0:37:050:37:08

and the midwife is worried that she's bleeding.

0:37:080:37:11

Are you OK? Is everything OK? Yes.

0:37:140:37:16

You look a lot more worried today

0:37:170:37:19

than the last time I saw you, Eduardo.

0:37:190:37:21

This is a public hospital, but you still have to pay for operations.

0:37:450:37:49

The cost of a Caesarean would bankrupt the family.

0:37:490:37:53

How do you feel?

0:37:530:37:54

Eduardo is worried, worried about your health,

0:37:540:37:57

worried about the delivery.

0:37:570:37:58

I am just giving Eduardo and Rosaly

0:38:120:38:14

a bit of time to think...

0:38:140:38:16

They're obviously both incredibly worried.

0:38:160:38:19

It's just a waiting game, just have to sit and wait.

0:38:190:38:22

They just...don't want to have a Caesarean section

0:38:250:38:27

at any cost, really.

0:38:270:38:28

For tonight, Rosalie and Eduardo are given the all-clear.

0:38:500:38:54

Now all they can do is go back home to Tondo and hope for the best.

0:38:540:38:57

On the other side of town, Rose has been rushed into hospital.

0:39:080:39:12

It's a day ahead of their scheduled Caesarean.

0:39:120:39:15

I thought the baby was coming tomorrow! Yeah.

0:39:190:39:22

She had other plans.

0:39:220:39:24

She wanted to come out earlier. Yes!

0:39:240:39:27

I was in the office

0:39:270:39:30

when Rose texted me...

0:39:300:39:31

..and they said that...

0:39:330:39:35

the operation can't wait until tomorrow,

0:39:350:39:37

it has to be done tonight.

0:39:370:39:39

So what did you do, just pack up, leave, come straight here?

0:39:390:39:43

Yeah.

0:39:430:39:45

I finished something up in the office before coming here.

0:39:450:39:48

How long did you spend in the office?

0:39:480:39:50

You got the text, how long did you spend in the office

0:39:500:39:53

before you left?

0:39:530:39:54

Three more hours.

0:39:540:39:56

We're cleaning up the baby. How are you?

0:40:250:40:27

Congratulations, Daddy. Very happy.

0:40:270:40:30

How is she? Uh...

0:40:300:40:32

How's little Madeleine?

0:40:320:40:34

She's OK.

0:40:340:40:36

She seems to be very healthy.

0:40:360:40:38

She cries very loud.

0:40:380:40:40

She cries very loud.

0:40:400:40:42

You must be absolutely delighted. Yeah.

0:40:420:40:44

How was the operation? How was it in there?

0:40:440:40:46

It went well. Were you quite tense?

0:40:460:40:48

Oh, yeah, but I tried not to show it.

0:40:480:40:51

Yeah, of course, trying to stay strong.

0:40:510:40:52

And now, how do you feel? Relieved.

0:40:520:40:55

Relieved.

0:40:550:40:56

Done, family done? Yes. That's it. That's it.

0:40:560:40:59

Gino and Rose have decided that two children is enough.

0:41:070:41:11

My name is Junalyn B Flores.

0:41:210:41:22

I am taking a bachelor of science degree.

0:41:220:41:25

Bachelor of science and business administration.

0:41:250:41:27

It would be a four years' course

0:41:270:41:29

but unfortunately, I didn't finish it.

0:41:290:41:31

It's the morning of Junalyn's interview for the job at Citibank.

0:41:320:41:36

Her sister is rehearsing some questions.

0:41:360:41:39

So, Junalyn...

0:41:390:41:40

..tell me...about your skills.

0:41:410:41:45

Do you have any skills?

0:41:450:41:46

I have skills.

0:41:460:41:48

Of course, all of us have our skills, ma'am.

0:41:480:41:51

My skills are more computers

0:41:510:41:53

and I am hardworking.

0:41:530:41:55

How can you prove yourself that you are hardworking?

0:41:550:41:58

I don't have any job experience yet, but I know in myself

0:41:590:42:03

that I'd be hardworking

0:42:030:42:05

because this would be my first job that I'd get hired,

0:42:050:42:08

so I need to prove to myself and my employer-to-be

0:42:080:42:11

that I am hardworking.

0:42:110:42:12

Neither of them has ever had a job interview before,

0:42:120:42:15

so they've researched interview techniques on the internet.

0:42:150:42:18

When you speak in English and you try to answer,

0:42:180:42:21

just be yourself, look at the eyes

0:42:210:42:24

and then have a confidence, that's all I can say.

0:42:240:42:28

Eye contact, try my confidence, be myself during my interview.

0:42:280:42:33

Yeah, she trembles, she doesn't have enough confidence,

0:42:370:42:40

I am very worried for her English.

0:42:400:42:42

I do try to brief her, but...

0:42:440:42:46

..I don't know how can I help her.

0:42:480:42:51

There is lots of competitors,

0:42:510:42:54

fresh graduates from well-known universities.

0:42:540:42:57

I am really worried, I really don't know what to do.

0:43:000:43:03

'There's a lot of mud in Tondo.

0:43:100:43:12

'I don't want to get my good shoes dirty.

0:43:120:43:15

'I need to wear flip flops

0:43:230:43:25

'because my long way...

0:43:250:43:27

'..will be muddy.

0:43:290:43:31

'I need to walk slowly and watch my step.

0:43:330:43:37

'I really need this job.

0:43:430:43:45

'My entire family needs it.

0:43:450:43:47

'My mum worked hard and she always worried about us,

0:43:490:43:55

'so I really...

0:43:550:43:58

'want to give her the best while she is still alive.'

0:43:580:44:02

Junalyn's journey from the slums of Tondo

0:44:090:44:11

to the Makati business district symbolises the challenge

0:44:110:44:14

facing countries like the Philippines -

0:44:140:44:17

how to use this economic boom to lift ordinary people

0:44:180:44:22

out of extreme poverty.

0:44:220:44:23

For Junalyn, today could be the start of that journey.

0:44:280:44:31

'I am so very nervous

0:44:420:44:44

'because if I don't get this job, I'm not sure what I am going to do.'

0:44:440:44:48

There have always been rich and poor in countries like the Philippines.

0:44:540:44:59

What's new is the rise of the middle classes,

0:44:590:45:02

and it's their spending power which is transforming the country.

0:45:020:45:07

But the brashness of this new wealth can still be shocking.

0:45:070:45:10

Not far from where Junalyn hopes to work,

0:45:100:45:13

I'd arranged to meet Manila's own celebrity plastic surgeon

0:45:130:45:16

and host of a popular TV makeover show - Vicky Belo.

0:45:160:45:21

Anita, hello. Pleased to meet you.

0:45:210:45:23

I have heard so much about you!

0:45:230:45:25

Thank you for visiting Belo Medical Group.

0:45:250:45:27

Thank you, Vicky. Can I just say?

0:45:270:45:29

Are these gold computers?

0:45:290:45:31

Yeah, we're the Gold Clinic.

0:45:310:45:33

I'll show you something. I'm so proud of this.

0:45:330:45:35

This is what we call - to bring us luck and feng shui -

0:45:350:45:38

this is a "mother of pearl wall". Oh, wow.

0:45:380:45:40

You know how you buy bags, and they're so expensive?

0:45:400:45:43

I know all about mother of pearl.

0:45:430:45:46

That is quite something.

0:45:460:45:48

Is it real? It is, of course! That must have cost a bit!

0:45:480:45:51

Yeah, but it's worth it, it makes me feel rich.

0:45:510:45:54

I have to say, I've stepped into a completely different world.

0:45:550:45:58

Thank you so much, we appreciate it.

0:45:580:46:01

We really wanted to show off and make our clinic "First World."

0:46:010:46:05

Vicky has nine clinics across the country

0:46:080:46:11

and an increasingly younger clientele.

0:46:110:46:13

We have a lot more patients.

0:46:150:46:17

It used to be that there was very rich and very poor.

0:46:170:46:20

Now, because a lot of people come here to invest,

0:46:200:46:22

our middle class is strong,

0:46:220:46:23

which is really the backbone of any successful country.

0:46:230:46:26

I don't think we could have been successful

0:46:260:46:28

if there were just so many people

0:46:280:46:29

below the poverty line.

0:46:290:46:31

In Britain, if you've made a bit of money,

0:46:310:46:33

the British way is to be very modest and not to tell anybody. Oh.

0:46:330:46:37

What's the Filipino way?

0:46:370:46:39

No, the Filipino way is to show off.

0:46:390:46:42

The Filipino way is to have only signature stuff - the watches.

0:46:420:46:48

It used to be just bags and shoes and now Louboutin,

0:46:480:46:51

everybody's wearing Louboutin, those $1,200 shoes,

0:46:510:46:56

they all have it.

0:46:560:46:57

You know how Imelda Marcos had 3,000 pairs of shoes?

0:46:570:46:59

Yeah. I think a lot of my friends have 3,000 pairs of shoes!

0:46:590:47:03

Shall we go in? Come on, Anita, let's go and meet a patient.

0:47:030:47:07

Hello. Hello, this is Denise.

0:47:070:47:08

Hello, Denise, pleased to meet you.

0:47:080:47:10

How old are you Denise? I am 18.

0:47:100:47:12

Denise, you are so beautiful,

0:47:120:47:14

what on earth could you possibly be having done?

0:47:140:47:17

Oh, I am going to have my underarm lasered and whitened also.

0:47:170:47:21

Underarm whitened? Yes. At 18...

0:47:210:47:24

Can I see your underarm? Here.

0:47:240:47:27

Why does it need whitening?

0:47:270:47:29

I don't know, you know how you get conscious.

0:47:290:47:32

They want it all even.

0:47:320:47:34

So this colour has to be that colour.

0:47:340:47:37

So this one is a bit dark for them.

0:47:370:47:39

I talk to the men,

0:47:390:47:40

and it's really true, they check it out all the time. Really?

0:47:400:47:43

They have an armpit fetish. They have an armpit fetish.

0:47:430:47:45

A lot of people have feet fetish and breast things,

0:47:450:47:49

in the Philippines, it's armpits. Armpits.

0:47:490:47:51

OK, that's it.

0:48:080:48:09

It's hard to understand how this western-style consumerism

0:48:160:48:20

can help the millions of poverty-stricken Filipinos.

0:48:200:48:23

But many economists believe that this country,

0:48:250:48:28

like many others in the developing world,

0:48:280:48:30

have a unique opportunity to move forward.

0:48:300:48:32

I went to meet Batara Sianturi,

0:48:340:48:36

the country CEO of the bank where Junalyn is hoping to get a job.

0:48:360:48:40

Very exciting time.

0:48:400:48:42

The huge workforce of the Philippines economy

0:48:420:48:47

will drive this economy between now and 2050,

0:48:470:48:51

for example, to become one of the, maybe,

0:48:510:48:55

top 15 largest economies in the world.

0:48:550:48:58

But it's also got very high unemployment rates here,

0:48:580:49:01

high levels of poverty,

0:49:010:49:02

surely that's going to be a stumbling block?

0:49:020:49:05

As the economy grows,

0:49:050:49:07

whether it's manufacturing or service,

0:49:070:49:09

the middle class will grow,

0:49:090:49:11

because between the supply and demand,

0:49:110:49:14

it's probably going to be creating a huge domestic consumption economy

0:49:140:49:18

as well, just like other economies have experienced.

0:49:180:49:23

The lower class, which is still not enjoying middle class status,

0:49:230:49:27

will be lifted up and that grows the middle class,

0:49:270:49:32

which will be, you know,

0:49:320:49:33

the basis of the economic growth of the Philippines.

0:49:330:49:36

For Rose and Gino and their new baby daughter Madeleine,

0:49:390:49:42

the future could not look brighter.

0:49:420:49:45

This looks quite nice, doesn't it?

0:49:450:49:47

Gated community.

0:49:470:49:49

They've seized the opportunities on offer in the new Manila.

0:49:490:49:53

Tight security.

0:49:530:49:55

INDISTINCT CONVERSATION

0:49:550:49:56

There he is, he's come out to meet us.

0:49:590:50:01

Hi, Gino. Hi, Anita.

0:50:060:50:08

Good to see you. Yeah, good to see you again.

0:50:080:50:10

Yeah, so this is your place?

0:50:100:50:12

Yeah. Lovely. Our humble home.

0:50:120:50:14

It's very nice.

0:50:140:50:16

How long have you lived here?

0:50:160:50:17

We've lived here two years.

0:50:170:50:19

You can come inside. Thank you.

0:50:190:50:21

(Sound asleep.) Yeah, sleep.

0:50:230:50:25

She's beautiful, look at her!

0:50:280:50:31

You've done very well.

0:50:310:50:32

We are so amazed she has two dimples here.

0:50:330:50:36

I...am not expecting it

0:50:360:50:40

as we don't have any member in the family who has dimples.

0:50:400:50:44

So I don't know why she has them.

0:50:440:50:47

First of all, I want her to grow healthy...

0:50:480:50:51

finish school and then later on,

0:50:510:50:53

she can choose whatever she wants -

0:50:530:50:57

she can choose the college course she wants,

0:50:570:51:01

whatever profession she wants to be.

0:51:010:51:03

We will be here to support her

0:51:030:51:05

and we both hope that she becomes very successful.

0:51:050:51:10

As her parents, I think we did well, so we were hoping

0:51:100:51:13

that she would do better than us...

0:51:130:51:15

..and we did it here in the Philippines.

0:51:170:51:19

We did not have to go out of the country to have it done.

0:51:190:51:22

It's almost impossible to imagine from the crowded maternity ward

0:51:260:51:29

of the Jose Fabella hospital,

0:51:290:51:31

but population growth is now slowing dramatically.

0:51:310:51:35

The average number of babies per woman here

0:51:390:51:41

has dropped from over five to nearer three in just 30 years.

0:51:410:51:46

Globally, the figure is much lower.

0:51:480:51:50

The era of fast population growth will soon be over.

0:51:530:51:57

In another part of Fabella Hospital,

0:52:040:52:06

Rosaly had finally gone into labour.

0:52:060:52:08

It looked like the natural delivery she wanted,

0:52:170:52:20

not the expensive Caesarean they feared.

0:52:200:52:22

Hi, Rosaly.

0:52:250:52:26

Does she...? Should she push?

0:52:320:52:34

Or not yet?

0:52:340:52:35

Oh, my gosh.

0:52:390:52:41

Wow.

0:52:410:52:43

Oh, my God, here it comes.

0:52:430:52:45

Here it comes.

0:52:450:52:48

I can see the head, it's got a lot of hair.

0:52:480:52:50

Come on, Rosaly.

0:52:500:52:51

Go on, girl, go on, go on.

0:52:530:52:55

You can do this.

0:52:560:52:58

OK, Rosaly. Should she be pushing?

0:53:200:53:23

Oh, my gosh.

0:53:270:53:29

Here he is.

0:53:370:53:39

Here he is. Oh.

0:53:390:53:41

And he's perfect.

0:53:440:53:45

He's opening his eyes.

0:53:470:53:49

Hello, sweetheart.

0:53:520:53:53

Rosalie's new baby, Matthew, faces an uncertain future -

0:54:010:54:05

born into poverty in a tough city with no safety net.

0:54:050:54:09

And for the first time in decades, there is real hope

0:54:260:54:29

that kids like these

0:54:290:54:30

will have a better chance in life than their parents.

0:54:300:54:33

There's another one over there, look.

0:54:330:54:35

Do you want to get stuck in?

0:54:350:54:37

No, I'm tired.

0:54:370:54:38

Before leaving Manila, there was one last person

0:54:420:54:45

I wanted to catch up with.

0:54:450:54:46

I am on my way to Citibank to meet Junalyn.

0:54:500:54:53

She's had a six month internship with the bank,

0:54:530:54:56

but today she had an interview for a job.

0:54:560:54:59

It's huge.

0:55:010:55:03

So I'm going to go and meet her to find out how it went.

0:55:030:55:05

If she gets this job...

0:55:070:55:09

it will change that girl's life, not just hers, her entire family's.

0:55:090:55:13

Hi, Junalyn, look at you! Hi.

0:55:150:55:18

How are you? I'm very well.

0:55:180:55:20

How are you? I am good. Tell me, how was your interview?

0:55:200:55:23

My interview is doing...

0:55:230:55:25

GREAT! Perfect!

0:55:250:55:29

Did you get hired? Yeah!

0:55:290:55:31

Yes, I have a job! I have a job!

0:55:310:55:35

I am so proud of myself.

0:55:350:55:38

I am so proud of myself now.

0:55:390:55:41

Now I have more confidence, and dreams to achieve.

0:55:410:55:44

I know I can do it.

0:55:440:55:46

I know I can do it and I am so very excited...

0:55:460:55:48

to work here as an employee.

0:55:480:55:51

Look at the office, look at the surround.

0:55:510:55:53

You see the people who are working here,

0:55:530:55:56

they are corporate. So I am so lucky that I get this job.

0:55:560:56:00

Ah! Thank you.

0:56:000:56:01

Thank you!

0:56:030:56:05

Excited to go home! Yes, go float, run home. Bye-bye. See you.

0:56:050:56:10

She's got a job at Citibank.

0:56:100:56:11

She lives in Tondo, she wants to change her family's life

0:56:110:56:15

and she's done it.

0:56:150:56:16

My hairs are standing on end.

0:56:170:56:19

I'm so thrilled for her. I'm so thrilled.

0:56:190:56:21

After decades of stagnation and seemingly hopeless poverty,

0:56:220:56:26

it feels like the Philippines is finally on the move.

0:56:260:56:29

If current economic trends continue, children born today could,

0:56:330:56:37

by the time they reach middle age,

0:56:370:56:39

be as wealthy on average as westerners are today.

0:56:390:56:42

And as the birth rate falls,

0:56:450:56:47

the era of rampant population growth is also set to come to an end.

0:56:470:56:51

It's a pattern repeated in many parts of the developing world.

0:56:530:56:57

Who knows, there is a chance

0:57:020:57:04

that places like Tondo will one day disappear for ever.

0:57:040:57:08

Next time, Professor Hans Rosling presents

0:57:160:57:18

the amazing population statistics

0:57:180:57:20

that overturn many of our assumptions about the world today.

0:57:200:57:24

I start the world, here we go.

0:57:240:57:26

And you can see that China is getting the big bubble,

0:57:260:57:29

is getting to better health, and then they start family planning.

0:57:290:57:32

They move along to a smaller family. Then India's following.

0:57:320:57:34

'His message is...don't panic.'

0:57:340:57:36

What a change we have.

0:57:360:57:38

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0:57:580:58:01

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