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 piñata was just cracked open. A very interesting ceremony and nothing like I've been to before, but I think Gom would have appreciated it.

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.