I have had a visitor, Dr. Leila from Mung Sing, a former Health frontiers pediatrics co-ordinator who now lives in far northern Lao and helps children there. It has been interesting to hear all her stories of living in Lao for the past 7 years, but has also been time consuming, so I have not had much time to blog. (Or reflect on the last week and a half.) However, she has had some incredible experiences, particularly in looking for victims of Noma (a malnutrition / immune compromise related disease in which portions of the face of children essentially rot away - google image Noma if you have a strong stomach). They are located in the poorest areas of Lao (and therefore the hardest to get too. When Leila found the first victim, it was thought to be a disease which occurred only in Africa, though historically it had happened worldwide 200-300 years ago. She has now found 22 victims, and arranged for reconstructive surgery, which not only improves their appearance, but often restores their ability to eat solid foods communicate better, etc. Now she is traveling around the country again to follow up on the outcomes of the patients.
While Leila was away, I went to the COPE ( http://www.copelaos.org/ ) concert Saturday night. It was raining, but this didn’t really significantly diminish my enjoyment of the music, as it wasn’t cold. I saw two bands perform - a sort of Lao ska band who were quite good except when they allowed a female friend (girlfriend of a band member?) to sing with them - then we got a truly off rendition of “Knockin’ on Heaven’s Door.” The second band was “U Luv Us” - a band composed of foreigners who sing pop-esq ballads and faster songs in Lao. Their music is pretty good, and they are totally hilarious to watch with their faux hawks and heart shaped sunglasses and smoke machine. There were two Lao girls standing right behind us that kept screaming with glee when they started/ended a song etc, which only added to the experience. Luckily, no one fainted since we were outside in the rain and mud. Unfortunately, I was too short to get a good look at the hip-hop dancing troop that performed between the bands, but I think hip-hop dancing troops are quite similar world wide, so it’s probably ok. This suspicion was confirmed by the fact that one of them was wearing a Michael Jordan jersey. Dinner before hand was at the Taj Mahal - Lassi’s, samosas, nan, rice, daal, and chicken Korma for two, all for less than 9 dollars. Delicious!
COPE is a great organization that provides rehab, prosthetics, mobility devices, etc for victims of cluster bombs (Thanks, America!) and other disfiguring, disabling accidents. They also have a blind school and a deaf school on their campus. (There is no ADA here, so blind, deaf, or otherwise disabled children are often refused entry to schools.) They have a visitor center that has some information on cluster bombing and it’s prolonged consequences, as well as profiles of some of their successes. The conference to ban cluster bombs will be in Vientiane in November, which is appropriate as Laos is one of the most heavily bombed country in the world. Of course America has not yet ratified this ban. . . Anyone planning to visit me here in Vientiane can expect to visit the COPE visitor center as well.
Sunday I went to the Buddha park. The Buddha park is as statue park about 25 KM (or 45 -60 min) outside Vientiane, past the friendship bridge. It is filled with statues of Buddha and Hindu deities which were commissioned by a man who was out walking in the mountains when he fell through a sink hole landing in the lap of a Guru. This experience inspired him to make or commission giant concrete statues of Buddhist and Hindu deities, which were made by people who had no formal training in art or sculpting. In this context, the quality is actually surprisingly high. The statues are all packed pretty close to each other, which makes them hard to appreciate individually sometimes, but easier to see as a body of work and to think about the inter-relatedness of the myths etc. It was drizzling off an on, which hampered my enjoyment (and photographs) somewhat, but it was a nice way to spend an afternoon. On the way home I stopped and bought oranges and bananas at a local market all in Lao! My visitor from America arrived home from Vang Vieng Sunday evening, and I got to hear about his trip at dinner. Then Leila arrived from Khamua and Bolecomsai, where she was following up on Noma patients, and scarfed down some spaghetti (I’m not the only one that misses pasta!) and we walked home from downtown together.On the work front, things are good. The “most talkative” (his own description) chief resident has returned from two months in Khon Kaen, Thailand, and the other 3rd year chief is away at Khon Kaen, so Phanivone has been ruling with an iron fist. Not really, but last weekend he called me at 7:40 AM on Sunday because the printer in the resident room was not working, and they wanted me to bring a new toner cartridge to the hospital. (I did not.) Turns out that the printing emergency was an organizational chart which assigns all the residents duties in teaching (eg: rheumatology, cardio, endocrine) and in more mundane tasks (budget, accounting, cleaning the resident room). The task and resident responsible were printed, and then they were all pasted to a poster-board, and once they add the resident’s pictures they will hang it. They love adding passport photos to things here - that makes it official. I will take a picture once they’ve got it complete. I don’t know if I’ll ever be able to tell whether people are doing their assigned job, or how the assignments were made (I suspect it was not a democratic process). The good news is, they were able to solve the toner emergency without me by shaking the ink cartridge. Phanivone has translated two or three of my lectures now and I can tell he is adding in things (because I’m hearing english medical words I didn’t say) but I suppose as long as they are accurate things, that’s ok. They seem to usually be things I was going to say later in a more detailed section of the talk. The residents are very patient with me - they do not complain when lecture goes over the 1.5 hr time, and even manage to still look interested and clap at the end. However, I must do better at limiting what I try to cover.
We had KKU grand rounds on Friday. The speaker was an Electrophysiological cardiologist trained at Duke. I remembered to check the gas tank this time, so there were no embarrassing trips to the gas station. The topic was update in the management of arrythmias, and I think it was better received in Thai than the recent french lectures on the same topic. In Lao, we do not have a cath lab, so there are no EP ablations (Or stenting for Acute MI, for that matter), but in Thailand they can do all of those things, and a pacemaker is only 1000$! (Though the Thai have socialized medicine, so they pay 1 dollar for each hospitalization) This doesn’t really help the Lao, because for most of them 1000$ might as well be a billion dollars - there’s an equal chance of them seeing that much money - but I think they are more likely to get cath labs, pacemakers, etc, if they keep hearing about it from their neighbors.
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