Residents just wanna have fun

Dr. Xaykesone (2nd year, Chief resident) and Interns Drs. Chilapah, Kongpath, Panivone (back) , Sisomphone and Phonepaedith take a break from dancing.



One thing that I am adjusting to about the Lao culture is there is always an opportunity for a celebration. A bacci for a new house, welcome home, farewell, etc. Even weddings which are common times of celebrations around the world, get celebrated with more enthusiasm here. Nothing like throwing a party for you and your 1000 closest friends. Not only are your friends and family invited but the friends, coworkers and other random people your parents and grandparents know. So it was for the wedding party I went to last week with the residents. The groom was the son of one of the leaders and "founding fathers" of the internal medicine residency program. None of us knew the bride or the groom, but the majority of the IM residents and teachers came for the night of dinner and dancing. Although a very different style of dancing than anything I have previously experienced, it is kind of fun in its own slow, hands off way. I have also recently discovered the passion the Lao have for line dancing. Who would have guessed? The residents said they will teach me the various dances before Lao New Year so that I can fit it. I also need to get some fancier clothing and less sensible shoes to really fit in. I will choose to not fit in when it comes to drinking too much and then driving home. It is hard work to keep the glass from getting filled with alcohol but I am learning little tricks along the way. Unfortunately I will be on vacation for the next wedding which is for someone I actually know, but I am sure there will be many more occasions to celebrate.

One of these things is not like the other

Health Frontiers IM graduates and now teachers at Mittaphab at the gala dinner to celebrate the 20th Anniversary of Mittaphab hospital. (left to right) Drs. Veluvanh, Christine, Manichanh, Chanmaly.


Ever felt like you were different than everyone else? Well, here, I am. Not only is my skin whiter, my dress size bigger and my clothes not so beautiful, but I have the biggest problem with red eyes. It is a recurring problem that when photographed with people with dark eyes, my blue eyes produce a red eye effect so much more pronounced than the others in the photo. It makes me look possessed or something. I dislike that red-eye feature on the cameras, but maybe I should turn it on.

The Meaning of LIfe

I went to a funeral yesterday. It was unlike any funeral I have ever been to before. Not only was it held in one of the three Evangelical church buildings in Laos, but very few people in the room had ever met the departed. This was a service for a 71 year old American man who had been a pilot in Laos in the 60s and 70s and then returned to the country in the mid 90s. He was orphaned after his mother died and his stepmother killed his father. He left the care of his older brother when he was about 10 years old before joining the Marines at age 17. He married once, had no children and was separated from his wife before she died of cancer 15 years ago. He failed at several business attempts and had no meaningful relationships. He was a self-described recluse. His only friend was the owner of the Scandinavian Bakery where he helped set up the outside tables and chairs every morning in exchange for an omelet. It was this Swede who looked after him (and paid the hospital bill, I think) while he was dying a painful death of renal cell cancer metastatic to the bones. I met this man only once on the day he was admitted to the hospital. The residents tried to tell me his story, but even after talking to him in our native language, I was confused. Before I really delved into it too much, he was transferred to a private room in the ICU where he stayed for the next several weeks. I never made it back to see him before he died last Friday. The owner of the bakery asked the International Church community to visit the patient while he was out of town for a few days. Two men from the church went to see the man regularly for the next two weeks and they were the ones who arranged the funeral service for him. They had known him for only two weeks, during much of which he was on powerful narcotics.
What is there to say at a funeral for a man with no family, no friends no one to grieve and no clear religious preferences? As I sat and listened to the recounting of this sad story, I wondered if he had any regrets. Would he do things the same way again? I started to write that his life seemed to have little impact, but then I guess it has had an impact on me. It showed me that it is relationships that make life remarkable. I do not know the meaning of life, but it seems that if pleas have to be made to gather a handful of people to attend ones funeral, that is not it.

Western influences

During my recent trip to Bangkok, I was amazed by the Western influence in this city. I spent quite a bit of time studying in a shopping mall where Ronald McDonald greeted visitors with a wai (Asian respectful greeting) and this Christmas display from Starbucks lured visitors inside. Then I went to one of the many large shopping malls where Christmas lights were glowing and Christmas music was playing and throngs of people ate at McDonalds, Sizzler and Burger King. It was before Thanksgiving in America, but since Thanksgiving is not celebrated in Thailand, the"not before Thanksgiving" rule doesn't apply. I was thinking of the irony of listening to songs about snow and the birth of Christ in a tropical, Buddhist country. Then I thought just how sad it was that Christmas is so secularized. It is even celebrated with gift giving in the Communist country with significant Buddhist influence where I currently live. When I commented to my housemates about how strange it seemed, I was told "Christine, Christmas is a secular holiday." Huh? Maybe that is what the world has made it, but it is not a secular holiday. So, I am getting ready to start my Christmas music and I will strive to remember the reason for the season.

Traditional Lao-style house???

Minister of Health for the Lao PDR, H.E. Dr Ponmek Dalaloy addresses
those in attendance of the opening of the new WHO office

As the Health Frontiers Field Representative, I was recently invited to the Open House for the new WHO office in Vientiane. Leila and I rode our bicycles to the event and were hastily directed to the back of the building so that there was room for the shiny SUVs of the other NGOS and the black, sedans of the diplomatic corps. During the ceremony, the director of the WHO in Laos welcomed us to their new "traditional Lao house." Huh? Has he looked at the building? Traditional Lao-style houses do not have Roman columns and grand curved wooden staircases. They don't even have running water or electricity. The new WHO office looks more like a southern mansion, or the White House. There is a lot of money to be made in development. This event just served to help me appreciate the volunteer, low-budget mission of Health Frontiers. I rode my bicycle away with pride.

An historic day

Regardless of one's political leanings, it is difficult to deny that Tuesday, November 4 was a historic day in American history. For me, it was actually Wednesday, November 5 around noon as I sat with a room full of Americans in a far away land and watched the acceptance speech of America's first black president-elect. To be living in a country that is the most bombed in history and that is still suffering terrible effects from the unexploded ordinances left behind by my own nation, causes one to question the unabashed patriotism that used to be prevalent in America. America went from a partner to an enemy in this country where I reside based on fears of socialist ideaology and hatred. As was explained to our group by the US Embassador in a meeting yesterday, the US continues to slowly work to regain trust and partnership in this region. The terrible deeds and enduring consequences of the situation in SE Asia, remind me of slavery and the long-lasting consequenses it has had in America, among its own people. With this election, the US is making further strides to regain partnership and trust with its own people. While you may not agree with President-elect Obama's opinion on certain high profile and highly polarizing issues (I don't agree with all of them either), the importance of this event in history is not lost on this Caucasian, Christian woman. Although, I no longer have naiive unquestioned faith in my country, I am proud to be an American and I hope the rest of the world will work toward restoring its partnerships with us.

Another fun bathroom

When we went to the National Rehabilitation Institute last week for the Colin Cotterill evening, Leila made sure to show me this sink. Apparently it used to wear a pasin (Lao-style skirt) but now it stands naked in all its glory.

A Literary Event

Colin Cotterill at the book event at COPE. Yes, those are prosthetic limbs hanging behind him. Some of them are even made of bomb casings. Oh, the sad, sad irony.



I had never heard of Coliln Cotterill until I arrived in Laos. I was then introduced to his novel, The Coroner's Lunch, and am now a big fan. Colin is a native of Britain, with an Australian passport who spent 4 years in Laos in the late 1970s who now lives in Thailand. He is writing a series of novels set in Lao PDR in 1975 just after the Pathet Lao came to power. They feature an elderly surgeon who is forced from retirement to serve as the national coroner of Laos. He comes to discover that he is the host for Yeh Ming, an ancient Hmong shaman, and consequently has unusual interactions with the recently deceased people he examines. These interactions lead him to be a sort of amateur detective into these mysterious deaths. They are set in Vientiane with street names and sites I pass every day. They involve a fair amount of satire and do not always cast the Party in glowing terms but have not been banned. They also have a fair amount of animism which confused me at first. I read all 5 in the series to date in the first 2 months I was here and am already looking forward to number 6 which will be published next August.

It was exciting, therefore, to meet the author this past week. He returns several times a year to do research for the novels and has become an advocate for several charities around the country. His novels have recently been published in Lao and he is donating all the proceeds to three of these charities, including COPE. COPE is located at the National Rehabilitation Hospital and helps provide prosthetics and other adaptive equipment to disabled Laos. Many of their patients are victims of previously unexploded ordinances which remain a huge problem in this country which is the most bombed in history. He gave a presentation and signed books at COPE as well as gave a short reading from his 6th book. I had never been to such an event, and it was fun to meet the author of the books I enjoy so much, right in the city where they are set.

Thalea's Baci

I just returned from my first baci this morning. A baci is a traditional Lao ceremony to celebrate a special event such as a birth, marriage, homecoming, welcoming, or festival or to bring a cure to the sick. Before the ceremony, the women prepare a pha kwan which is a bowl from which an arrangement of flowers, bananas leaves and pieces of white thread is created. This is placed in the center of a white cloth which will be the site for the ceremony. An elder, often a monk, then calls all the wandering spirits back to their inhabitant. The kwan are components of the soul described by some as “vital forces, giving harmony and balance to the body, or part of it" or "vital breath". According to the Lao, the kwan look over the 32 organs which unite to form a human being. Sickness or suffering is often blamed on the wandering or loss of one of these kwan. The kwan are called back and then white strings are tied around the wrists of the people of honor with blessings of long life, health, prosperity, etc. Sometimes small monetary bills are tied on with the strings. The strings should be left on for at least three days when they can be untied, but not cut off. It is preferred to leave them on until they fall off. Afterward, everyone shares a meal (and alcohol) together.

So, when the neighbors came over this week to invite us to the baci for their newborn daughter, I had a vague idea of what was involved, but hadn't yet seen one. Thalea was born 1.5 weeks ago to her Thai mother and Belgian father. Overall, it was a baby shower with animist/Buddhist spiritual rituals. I do not share their spiritual beliefs, but they are our neighbors and it was nice to celebrate with them on the birth of their baby and interact with some other folks. Bryan and I bought baby gifts at the Shell station (yes, it was a little like doing Christmas shopping at the mini-mart on Christmas morning, but it is a nice gas station!) When we arrived, it seemed that the only people who brought gifts were falang and most of them had also come from the gas station. We tied the strings, ate the food and chatted with folks. Ning, our housekeeper, and Sou, our administrator, also came and it was nice to chat with them. This ceremony has special meaning to the Lao people, but for me it was just a nice break from my Saturday morning studies.

Ning and Sou with Thalea and her father.

Boat Racing Festival

So I experienced my first holiday in Laos last week. Or course, it was difficult to determine if it was an official holiday or not. Our office staff took two days off, but the hospitals only had one day of holiday (and maybe one day of pseduoholidaty) and some places were business as usual. Hmm, interesting. . . .

Anyway the occasion was the end of Buddhist "lent" or the Rains retreat. During the rainy season, the monks and novices remain stationed at a single temple and do not travel around. Many men are ordained as monks during this time (even if just for 2 weeks) and it is known as a time of spiritual renewal. On the day of the full moon of 11th lunar month, corresponding with the end of the rainy season, the lay people make merit giving the monks needed gifts and then they are once again allowed to travel about. This is also the night that people release heau fai into the Mekong River.. These are boats of bamboo or banana leave with flowers and lighted candles that they believe will carry away all the past and current bad luck and good luck will enter their lives the next day. This is also the night of naga fireballs--the one night a year that the Mekong Dragon releases balls of fire. All sorts of controversy exists as to the actual etiology of this phenomenon, with accusations of human involvement straining Thai and Lao relations. Overall, there was a jubilant atmosphere in Vientiane on this night with sparklers and fireworks all over the city. Of course, lots of Beer Lao and Lao-lao (rice whiskey) add to this merriment. I was very thankful to arrive home safely from Bible study and leave the drunk people to their celebrations.

The next day (?the official holiday?) was the boat races. This involved teams of people in long narrow boats, rowing down the Mekong in one-on-one heats with a bracket system. Paul, a British infectious disease physician with Wellcome-Trust, lives right on the river near the start line and invited us over to watch the races. We mostly ate good food and conversed with the other invited falang (foreigners). We did get brief glimpses of the boats as they sped by and then as they were being towed back up river to the starting line. Apparently the Beer Lao team wins every year and like with other amateur sporting events there are accusations of unfair recruiting, including professional crew members from Thailand. Plenty of Beer Lao and lao-lao was also consumed on this day and I was again relieved to park my bicycle in our driveway.

Something New

So, I have been sending out periodic email updates of my life for several years. I get feedback from people that they enjoy these newsy messages. I know some people are offended by the impersonal nature of them and I assume some people just delete them, but it seems to have worked OK to this point. Now, however, several people have asked if I have considered blogging. The answer to that question is "yes". In fact, I set up this blog in January shortly after I arrived in Thailand. I never managed to get anything posted, however, because the perfectionist in me (who I actively try to beat down) was never satisfied with the product. Trying to create something that was current and something I wasn't embarrassed about was just too much pressure. I returned to my previous periodic email updates. Now with some more encouragement, I have decided to give it another try. I am not too optimistic, but maybe I'll get the hang of it.

After being a medical trainee for so long, I had forgotten what weekends were all about. To have two whole days every week where I don't have any real responsibilities is still amazing to me, even though I have been enjoying full weekends for 3 months. Last week was even a semi-holiday in Laos and I also stayed home one day sick. So, my work week was pretty short last week. With all this time, however, you'd think I'd get more accomplished. It once again demonstrates that my productivity is inversely related to the amount of time I have. Now entire weekends can go by and I can't exactly say what I have accomplished. This one has been a bit like that. Although, I have not been feeling well so I will use that as an excuse.

Today I did accomplish something as I made my monthly journey across the border to Thailand. My visa must be renewed every 28 days so I use the opportunity to go to Tesco Lotus in Nong Khai, Thailand which is like the Thai version of SuperTarget. This trip involves driving the 17 km to the Friendship Bridge, waiting in line at the Lao passport control, waiting in line to pay the exit fee, getting the ticket for the bus to cross the bridge, waiting for the bus, crowding onto said bus for the drive across the bridge. Once in Thailand, there is the waiting in line at the Thai passport control and then finally negotiating a ride to the desired location in Nong Khai. The return trip is even more tedious--negotiate ride to bridge, wait in line at Thai passport control, buy ticket for bus, wait for bus, load and unload bus, wait for forms for Lao visa, fill out forms for Lao visa, wait for visa, wait for Lao passport control, wait to pay entry fee, wait to prove that you have paid entry fee, traverse the hoarde of tuk-tuk drivers and drive back from the bridge. Today's return trip was even more unpleasant due to the creepy French guy who went on a tirade about the evils of Christianity and how ridiculous Americans are for paying attention to Christianity. His monologue continued all the way from Tesco to the bridge and was only briefly interrupted by our arrival at the bridge. He then set out on a rant about American politics and how the world hates Americans. You can imagine how fond I was of this man by now. Didn't his mother teach him not to talk about religion and politics as small talk? I thought I had escaped him, only to find that the immigration people had stapled his paperwork into my passport. His paperwork was returned to him, but the paperwork in his passport belonged to some third person and mine was never located. I was quite relieved to finally get back to the truck and enjoyed the silence of the trip home. On the bright side, I can now stay in Laos for another 28 days and I bought a desk lamp to make it possible to see the book I should be studying for my nephrology boards.

Ok, so that wasn't a very good first post but it's a start.