Tuesday, March 17, 2015

Life and Death (and the health care in between) in Laos

I have now seen the beginning of new life, and unfortunately the end of life as well, while being in Laos. In both these situations I have witnessed the health care system in its misery and some of the reasons it will take a long time to get more people to trust and use the hospitals here.

Most births in Laos are home births and are extremely dangerous. Roughly 470 out of 100,000 women die in childbirth in Laos (as opposed to 21 in the US) and 55 babies out of 1,000 die during childbirth (as opposed to 13 in the US). But most women still have home births either by choice or their situation. Unless you are in a major city of Laos, of which there are few, the closest hospital could be several hours away making hospital births unattainable. Porxiong, the construction manager at PoP, and his wife recently had a baby boy. Before the birth, we asked him where his wife would be having the baby, and he responded she would be having the baby at the Luang Prabang hospital (they live about 20 minutes away).  All the falang (aka expats) were very glad to here that, but this was the first child in their family to be born in a hospital. Porxiong lives with his brothers, sisters-in-law, parents, nieces, nephews, and other family members in a few house complex right outside of Luang Prabang. Many of his sisters-in-law had already given birth to healthy babies, some up to 6 babies already, and they were all home-births.

Around the time of her due date, we heard that Porxiong's wife was in the hospital and was having major surgery. That could only mean C-section, which in Laos is not a very common operation and was extremely risky. We heard later that after the C-section, the nurses/doctor did not tie the umbilical cord correctly and so when the family was finally able to see the baby it was turning blue. Porxiong, being a well-educated man in Laos, was livid for obvious reasons and told us that if he had enough money he would send all these people to school!

I realize that people under stress say things like this all the time, even in the US, but at least we know the rigor of schooling that our doctors and nurses go through in the states. The education system in Laos is so horrible that we have no idea what kind of education they received (but that's a whole different topic and of course the reason that I'm even in Laos) and corruption is so high here they most likely bought their way in. Also, many people have told me that the most stable jobs in Laos are with the Communist government and doctors/nurses do not that make money, making these professions even less appealing. I know personally a pair of sisters: 1 is the head of the anesthesiologist department at the Luang Prabang Hospital, and 1 works in tourism giving tours to the backpackers who come through. The sister in tourism makes more than the anesthesiologist.  Just saying...

I am happy to say that Mom and baby boy are both healthy now and doing well, and I got to go to the basi celebrating his birth! However, after this story comes back to the women who have already given 6+ homebirths, I highly doubt anyone else from their village will be going to a hospital to give birth anytime soon.

In this situation, a healthy baby was produced despite the bad health care. Unfortunately this next story is not so happy. When I first moved to Luang Prabang I stayed in a guest house called Sakura Guest House. Gom, a super friendly 20-year-old worked the front desk, and with his great English skills and friendly manner, immediately befriended all backpackers and PoP staff that stayed there. Even though I moved out after 1 month, Matt and Pavath (intern and fellow at PoP) stayed and still live there. Since I would hang out with Matt and Pavath, I would see Gom at Sakura and around town and he would always say hi to me and strike up a conversation. Matt, Pavath, and I would always discuss how smart Gom was and how he was so great with computers and technology, hacking into nearby guest house networks and wanting you to ask him super hard computer questions so he could research it on his own and tell you what he found. We wanted him to graduate college so we could hire him at PoP!

About three weeks ago, Gom was sitting on a stopped motor bike with his girlfriend on the side of a road in Luang Prabang, and a car hit them. Gom's girlfriend broke a few teeth, but Gom broke his femur bone and neck. He was sent to a hospital in Vientiane and after about 1 week was responsive and even talked to Matt on the phone with his sense of humor asking Matt who would help him take his laundry to get washed and such. It seemed like he was on his way to recovery - maybe would probably never recover completely, perhaps partial paralysis or a limp, but he was there mentally. Shortly after that, the hospital said they couldn't do anything further to help him recover and sent him to the hospital in Oudomxay province closer to his family, which is extremely north in Laos and very far away by car (18 hours?). I know nothing about medicine, but after someone breaks their neck and femur, which is supposedly the most painful bone to break, I'm pretty sure they should stay put in a hospital for more than a week. 

After a few days in the Oudomxay hospital his family took him out of the hospital and brought him home. I have no idea what kind of house they live in, but if it is like any normal Lao house outside the city, it is small, dirty, and no air conditioning. Gom died from lack of oxygen in his families house when his mom went to the market one day. I'm not exactly sure what "lack of oxygen" means, but since it is super hot here, no air conditioning, and being only 2 weeks after the accident, he was probably still in so much pain and discomfort he had trouble breathing. Either way, it is something that could have easily been prevented if he hadn't been released from the hospital when he was.

When I heard I was completely surprised and heart broken. Someone I thought was recovering, died because he was allowed to leave a hospital before he was ready.  I don't know all the facts, but from what I've heard and how angry and shocked every one is, I'm not the only one to blame the hospitals and lack of education all around.

Today I went to a ceremony that was held at Sakura Guest House for Gom. Although I am still angry at what happened - a young Lao boy, extremely intelligent, educated, motivated, and had the chance to really make something of his life, was stripped of that life because not enough care was given to him when he really needed it - it was nice to honor him with this ceremony. The ceremony more a celebration of his life than a funeral. He used to be a novice monk, so there were many monks present chanting and leading the rituals. At one point, someone through candy and rolled up dollar bills to everyone and kids and adults alike were scrambling like a piƱata was just cracked open. A very interesting ceremony and nothing like I've been to before, but I think Gom would have appreciated it.

Wednesday, January 21, 2015

Religion in Laos

On Christmas Eve I went to a Christian service with my worker Bounlam. The service was to start at 8:00 PM and we got there around 5:30.  When we got there, everyone was milling around eating food, talking, and singing. Bounlam and I ate our dinner in the Pastor's house where the Christian School students also slept.  As we were eating I asked him a lot about religion in Laos. These are some things I learned:

1) Buddhism is the main religion, and all other religions are persecuted even though you are technically allowed to practice them (Animism, Christianity, etc). I have not heard of anyone getting physically beaten, but they will take your livestock or find other ways to degrade you (see below).
2) If you work for an NGO or in your own private business, it is fine if you openly practice Animism/Christianity/etc. However, all government held positions, including teachers, must be Buddhists.
3) You need to put your religion on your CV/Resume! And if you are hired/fired based on your religion - that is completely acceptable!
4) Therefore, if you are a practicing Christian and you want to be a teacher, you need to change your CV to say you are Buddhist, and you can no longer go to Christian services regularly.  If the government finds out you are go to Christian services you could get fired and be red-listed. So crazy!

After we finished eating we went into the little building that served as their gather space. They had it decorated with Christmas decorations (paper chains, Christmas trees) and they had a projector that showed random Christmas images, probably pulled down from Google Images.  Later, the projector would serve to show song lyrics (in Lao).  Bounlam told me that the Christianity he practiced was Gospel and so the set up of the service was very different than what I was used to. There was about 30 mins of songs and "drama" (short skits), then the pastor preached for 30-40 minutes, and then we had more songs and drama, all of it in Lao. However, one of the songs was Silent Night! Granted it was in Lao and there are more syllables in Lao than English so they were trying to squeeze it in to the same melody. I couldn't even sing the English version because it threw me off so much - I had to stick with humming. We stayed for about 2 hours of the service and got home around 10pm.

Usually when travelling, I love going to church in different languages because I can still follow it and it gives me a sense of peace and community in an area I'm not familiar with.  However, since the services aren't Catholic I don't know what is going on and I didn't get as much out of it as I had hoped.  Overall, I'm still very glad I went so that I had my Christian fix for the year.

Wednesday, December 24, 2014

Luang Prabang Brings Home the Gold!

Every three-four years, Laos has a two week long event similar to the Olympics called the Lao National Games. This year marked the 10th National Games. They have grown significantly over the years, and now every province (18 provinces in Laos) takes part with their own teams, and there are 7 Government Department teams (for example, the Department of Foreign Affairs has a team). With 25 groups being represented in most, if not every, sport, you can imagine how big this event can get!

The games that are featured include track and field, football, basketball, boxing, boat racing, volleyball and beach volleyball, tennis, swimming, petanque (bocce ball), shooting, sepak takraw, top spinning, crossbow, muay lao (Lao boxing), wushu, karatedo, pencak silat, taekwondo, judo, cycling, table tennis, golf, bowling and wrestling. If you haven't heard of any of these games, neither have I haha. The only one that I know of is petanque because there is a petanque court right outside our office.

Lanoy, our Country Director, was on the Laos National Basketball Team when she was about 20 years old (she is now 35), so every Lao National Games she is invited to be on the Luang Prabang Province basketball team. It is very political, because the Department that organizes the National Games is called the Department of Education and Sport.  As you can probably guess, since we build public schools in Laos, this is also the department that we deal with on a day-to-day basis to get approvals, so Lanoy didn't really have a choice whether or not to play. Granted, she absolutely loves basketball so it worked out, but training also took up a lot of her time prior to the games when we were also getting into our busy season at the office.

Since Lanoy was playing, our office scheduled a trip last weekend to go watch her play. This year, the games were in Oudomxai Province, which is a 7 hour drive from Luang Prabang. If we took paved highways like we have in the States, it would have taken about 2 hours, but since the roads here are sooooooo bad (unpaved, curvy, etc), it takes more than 3 times as long. We headed out Sunday morning (December 14) for her game started at 7 pm that night. Everyone was really excited about it and 25 out of our 35 staff signed up to go! We took 1 large van that could fit 15 people, and one truck that could fit 10 people (5 inside, 5 in the truck bed). I was lucky enough to get a spot inside the truck because the roads were so dusty that everyone in the back of the trust was orange with dust by the time we got to Oudomxai.

We arrived in Oudomxai at 3:30 and we checked into the guest house. Very Lao style, we were put 3 people to a room that had 2 twin beds.  The two girls I was sharing a room with, Da and Maisaa, were very polite and offered me my own bed, which I took with little hesitation. I love the people I work with, but sharing a twin bed with someone is a little too close for comfort! Da and Maisaa are also very petit ladies - I am definitely at least twice their size, so I justified it pretty quickly to myself.

As it was also Lanoy's birthday that day, we decided to wait for her and have a big celebration dinner after the game.  As it got closer to 7, we walked over to the stadium and watched the end of a soccer game and men's volleyball match.


When 7 o-clock rolled around we were at the Basketball Court, but two men's teams came on the court, not Lanoy's team! It turns out that Lanoy's team was playing at 8:30. This is all well and good, except for the fact that no one had eaten anything and now we wouldn't be eating until about 11. I was already starving at 7, so I went and got some cold fried rice at one of the vendors to hold me over.  We watched the whole men's basketball game, and it was pretty pathetic to US standards. Matt and I decided that it was the equivalent of a high school JV game. We were pretty excited when it was over.


Then it was time for Lanoy's team! It was Luang Prabang vs Vientiane, which is the capital of Laos, and Lanoy had informed me that these were the two best teams playing this year so it was the biggest game of the tournament. Before leaving Luang Prabang, we had shirts made that said "Suu Suu Luang Prabang", which is a rough translation of "Lets Go Luang Prabang". When the game began everyone took off their jackets and started screaming "Suu Suu Luang Prabang!, Suu Suu Luang Prabang!" and everyone was drinking a ton of beer Lao and cheering crazily - we didn't sit down once during the whole game! Especially when Lanoy got the ball - our section was deafening.

Our cheering paid off because Luang Prabang beat Vientiane by only 3 points! This level of play was better than the men's game before theirs - more like a High School Varsity game. Lanoy also held her own by scoring many three-pointers!

Overall, it was an extremely fun trip! One funny story though - when we were on our way back there were 4 of us were squished in the back seat of the truck (fine for about an hour - but for 7!?) and we stopped at a road vendor for some snacks. Ai Keuang, who was in the back seat with us, bought a HUGE dead rat. This thing was the size of a cat. I'm getting used to many Lao things, but if this monster of an animal was sitting next to me in the truck I think I would lose it. Luckily I didn't have to say anything because it went in the truck bed with the boys, so unfortunately Matt had to deal with it.

Looking ahead to the end of the tournament, Lanoy's team won the gold!
To see more pictures from the games in 2012 that took place in Luang Prabang, look at a different blog I found online. The last picture is of Lanoy when they won the gold medal! They are on a winning streak!

http://www.journeyswithintravelblog.com/2012/01/11/lao-p-d-r-national-games-in-luang-prabang/

No more Lao classes

After a lot of thought, I have stopped meeting with my Lao tutor and learning Lao formally.  A few reasons:

1) I have decided to take the GMAT when I get home so I need the time I would usually be in Lao class and doing my homework to study for the GMAT
2) I would like to be fluent in 2 languages, but I have to realize that Lao will probably not be one of them. I already have 7 years of French behind me, so I will be focusing on French instead. I am studying on my own right now and I'm looking into the French Institute in Luang Prabang to see if they have any opportunities to speak to French speakers.
3) Looking forward, I don't see myself speaking Lao ever again unless I work for an organization that is in Laos. French is a much more lucrative language as it is spoken in Africa, Haiti, part of South East Asia, Canada, and Europe. Lao is only known in Laos, and if you know it really well you can kind of understand Thai.
4) Lastly, since I didn't see myself using Laos in the long term, it was really hard to motivate myself to study. I know that I should take advantage of being here but there are just so many other things I would rather be doing with my time.

It is definitely sad to stop because I love my teacher and one nice thing about taking Lao is it shows the staff that you want to be able to speak with them and that you are not haughty and want to only stick to your own language. I will keep trying to learn Lao through my coworkers though!

Wednesday, December 10, 2014

My Decision to Extend

As many of you saw on Facebook a few weeks ago, I have decided to extend my time in Laos by an additional 5 months.  I wanted to write this post to explain to everyone my thought process for making this decision, as it was not an easy one.

Even before I accepted this position at PoP, my goal was to do so well the first few months that they would ask me to stay for an additional length of time. I knew that past interns had extended their time for up to a year, so I knew it was possible. My goal  to get an extension for a year was for two main reasons:

1) I have personally always wanted to live abroad for a full year. When I did my term abroad in college it was for 4 months, and we moved around every month to a different country so I never felt settled or learned about one culture in depth.
2) Many jobs in the international development field recommend (if not require) some field work in developing countries (the longer the better). Six months is too much like a term abroad that most people partake in now, and even one year is not that long since most people will do the Peace Corps (2 years) or something similar.

During my first 2.5 months in Laos, I kept thinking I was going to live in Laos for a full year. When people asked me how long I was here for, I would say "6 months, but I might stay longer". I was planning in my head where I would take people if they came to visit me. I was taking Lao 3 times a week so that I could communicate with staff at work and around town. In my head, I was already staying.

So you would think that when I had a call with my supervisor in NY and she told me they would love to have me stay, I would be jumping up and down! I was not. The week before I had this call with my supervisor, I started having mixed feelings about staying longer. It came down to a huge battle - professional vs personal.

Professional:
  • I was told that it was not a huge deal if I stayed here for 6 months or 12 months. Its not like I was going to be international for 3+ years, which is where it would really make a difference.
  • I wasn't sure how it would look if I was an intern for a full year. I was using this opportunity to switch my career path to go into international development. An additional 6 months would not be needed to prove that I was passionate about this line of work.
  • I wasn't sure if I would be challenged at work my whole time here, especially if I extended.  Now that I was used to my surroundings, the culture, the language, the office, and the people, simple things were not difficult anymore and so I was starting to get bored. I wanted more responsibility, and I was told that I wouldn't necessarily get it because my role was supposed to be a supportive role to the Country Directors.
  • My goal was to get to DC to work in international development - so why hold myself back. I should just get started already!
Personal:
  • That reason I mentioned before - about me wanting to live in a developing country for a year was still there and looming above my head. There are some parts of a culture you do not experience until you live there for an extended amount of time (more than 6 months).
  • I also wanted to prove to myself that I could do this. I needed to get it out of my system, and I didn't know if 6 months would cut it.
  • I have my whole career ahead of me, and probably 40 years to work. Why do I need to rush back to get back into the grind if I'm enjoying myself here?
So the battle began. I had 2 weeks to make my decision and tell NY.  I had multiple teary calls with my family and best friends, I emailed and set up Skype calls with people in my network about what they believed the pros and cons would be, I researched online, I did some job searches (even applying to one job), I talked with all the mangers at work to see if they had additional responsibilities/challenges I could take on.

Karin, the M&E Manager in Laos, suggested that I write out a list of everything that I want to get out of being here and what I need to learn in order to get to my dream job. One morning before I had to give my decision, I went through the list I created with her, and it turns out that I could get a lot of those things here! Including a research project, which was a top contender. I also made a long pro and con list, and it turned out that the pro list for staying vastly outnumbered the con list.

As I mentioned before, I have decided to stay and I will be using the time to 1) learn as much at the office as I can 2) study for the GMAT so I can apply for business school 3) talk to ask many iNGO representatives here in Laos to get a better understanding of the field. I am very excited I made this decision and I think that it was the right choice for me and my future. I will not have another opportunity like this again and I want to take advantage!

So if anyone will be in South East Asia before June 20, give me a ring! 

Sunday, November 30, 2014

Happy Thanksgiving!

The Saturday before Thanksgiving Andrea and I hosted a huge Thanksgiving feast for all of our falang friends and Lao coworkers. Since the Lao staff never let us help pay or cook when they have events, Andrea wanted to treat all the Lao staff to a big dinner to give back, and I was going to help by being her sous-chef. Since we were preparing to cook for around 30 people, it turned into a full week affair.
  • Monday: We had to start off by buying all the dry ingredients (flour, oats, etc) and wet ingredients (vanilla, oil, etc) on Monday night. At two stores in Luang Prabang they have a few western foods, including canned cranberry sauce, canned green beans, Dijon mustard, and gravy packets.
  • Tuesday: Andrea prepped any dishes that had multiple steps, for example roasting the pumpkin, frying the bacon, and making the dessert.
  • Wednesday: Big trip to the market.  As I usually go to the market on Fridays with my Lao teacher, I asked if we could go on Wednesday instead because I had to cancel on Friday. We bought 6 kilos of potatoes, 4.5 kilos of carrots, 30 eggs, 2 kilos onions, 2 kilos of mushrooms, and a few more items. Good thing I went with Geo (my teacher) so we could ride her motor bike.  I would not want to lug all of that home on my bike.
  • Thursday: cleaning and making sure we had enough sleep in preparation of Friday and Saturday!
  • Friday: Turkeys arrived! Unfortunately, the 4 turkeys we had originally bought and were supposed to come on Thursday never showed up. As a back up plan, one Lao staff member asked his mom to send 2 turkeys from his town (2 hours away) and they came on the bus. Live turkeys being put on a regular bus with people... enough said. Our driver Ai Mai went 4 hours in a different direction to pick up 2 to more turkeys.  They all arrived Friday night at which time we had to kill and dress them.  Luckily, I did not actually have to do any of this and I just watched two boys from the office perform the dirty deeds.  After the turkeys were dressed, Andrea and I went home and cooked for the next 6 hours until midnight.
  • 1) drain their blood when they were still alive so that their heart could pump all the blood out 2) put them in boiling water to kill them and loosen the feathers 3) pluck them 4) cut their heads off and take out all the innards. 
  • Saturday: Cleaning, cooking turkeys and heating up all the sides, getting ready, people arrive at 6:00 
Carrots with honey-mustard glaze, turkey, green bean casserole,
mashed potatoes, stuffing, cranberry sauce, gravy, pumpkin casserole,
pumpkin pie, and apple spice cake with cream cheese frosting

Overall, it was a super tiring affair to cook for 30 people (32 ended up showing up!), especially because I have never cooked for more than my immediate family before, and never for Thanksgiving or in a foreign country. But it was completely worth it to see how much the Lao staff enjoyed it! Their favorite dish seemed to be the turkey, but the pumpkin casserole (aka sweet potato casserole but made with a pumpkin looking vegetable instead) was the second favorite which was a surprise to us since pumpkin is not used in sweets here (unlike the US with pumpkin cheesecake, pumpkin muffins, pumpkin bread, etc).


Aaron's delicious plate!
Our living room filled with friends!


Pick and Khamhoung killing the turkeys, Na really enjoying
 the turkey legs!, very full table but half the food gone, everyone enjoying the meal

Wednesday, November 26, 2014

Lao Wedding

Last weekend (Nov 16) I went to my first Lao wedding! I say first, not because I have so many friends getting married in Laos this year, but because I've heard you get invited to a ton of weddings even if you don't know the bride and groom. And this was one of those cases - it was the nephew of one of the guys on the construction team at PoP that does not know any English, so our interactions have been slim to none.

Since I had no idea what to wear or do for a wedding, I called my friend Amphai who works in the finance group at PoP.  I asked if she would come to my house in the morning, pick out my clothes and jewelry for me, and then take me to get my hair done with her.  When she looked in my closet, I could tell she didn't know what to tell me to wear since I have NO appropriate Lao wedding attire here. Appropriate wedding attire for women is formal, traditional Lao clothes, so a silk structured blouse (or collared shirt) and Lao skirt called a sinh.  I never wear collared shirts, so I only have 4 here - 3 are PoP shirts with the logo on it, and 1 is a sleeveless flowy shirt from express. We settled on the sleeveless one because it was the best option, but I was surprised since sleeveless shirts are supposed to be frowned upon.

Next, we went to Amphai's hair dresser. I was expecting to go to one of the places I've seen around town that look pretty dirty, no walls/doors so I can see people getting their hair washed, and people most likely just do the hair of their family members and close friends. I was pleasantly surprised when we pulled up to this place where the 2 male hair stylists looked very stylish and they had a hair dryer and flat iron. They straightened and then curled my hair with the flat iron, put WAY too much hairspray in so my hair was rigid like a board, but looked good until I started sweating (5 minutes later).  We stopped at Amphai's house so she could finish getting ready and she let me borrow a belt that is supposed to go with the Lao skirt so I looked more appropriate.
Me and Amphai all dressed up!
We were early for the reception, so we went to the Basi ceremony at Ai Keuang's house (PoP construction worker). It was an extremely small ceremony so I felt a little out of place to waltz in during the ceremony, but they were extremely welcoming and I soon found myself up at the front and tying the white strings around the bride and grooms wrists while I wished them luck in the future.  Also to note here - this was an interesting wedding to attend because the man was in his 20s and the woman was in her 50s.  As you can imagine, this is NOT common here so I liked to see what the interactions were like between the bride, groom, and guests.


As soon as the ceremony was over, everyone went over to a school in downtown Luang Prabang where they had set up tents for the reception. About 10 minutes after we got there, all of my PoP coworkers found 2 tables that we pushed together, and everyone started eating! I looked around and most people had not arrived yet, and no one was sitting at tables. And there is my table pigging out and will finish all our food before others even arrive! Apparently, this is normal. People eat throughout the whole reception, so you can start whenever you want, as food will just keep coming out. The food was normal Lao food, and consisted of steamed rice, mushroom/carrot stew, papaya salad, Luang Prabang salad, fatty meat, and clementine's for dessert. And of course... Beer Lao.



Once most of the guests had arrived, the bride and grooms families went to the front to have a large picture together. Matt, the other intern, and I could not stop laughing - everyone was so serious! No one was smiling and just staring at the camera. We know they were happy because we had seen them smiling and joking right before hand, so it seemed like that was the style of picture they wanted. To each their own.

no smiles...
 A few cute things they did at this wedding:
1) The bride and groom came around with 2 Luang Prabang shot glasses to everyone and offered a shot of whiskey.
2) Their first dance as man and wife was a Lao dance (faan dancing) in which you do not touch each other but go around in a large circle facing each other. Many other people came in to join in.
3) They also had a "Western" dance in which the man had his hand on her lower back/waist, hers on his shoulder, and them holding one hand out to the side. It was very sweet to watch, and only 2 people joined in.


After the first dances, the real dancing got started. All Lao dancing, but now I'm a pro and we had a lot of fun dancing with the whole PoP group. I didn't stay too long, but left around 3 pm.  Even though the wedding and reception seemed super long to me, I realized that I had only stayed a fraction of the time as a wedding I would go to in the U.S. One major difference though is that I would know people at a US wedding or at least can speak their language so I can easily converse with people throughout the whole day/evening. It is super tiring to stay engaged when you can't talk to anyone!

A few things I learned:
1) You give a gift between 50,000 -100,000 Kip, which is $5-13 USD
2) The ceremony is a Basi (same as every other celebration here) at a relatives house for only close friends and family, and then a reception follows at a different location where everyone is invited
3) You wear a Lao sinh and a collared shirt for women
4) When you show up at the reception, as long as its after the bride and groom, you just sit down wherever you want and start eating the food on the table without waiting for the other guests to arrive
5) All the food is homemade by the relatives
6) Tourists LOVE taking pictures! It was so funny how many pictures I must have gotten in from tourists just walking into the wedding or peering over the wall
Me being weird and Matt tolerating it