Day 12: DESTINATION-XAYSETTHA DISTRICT HOSPITAL

February 26, 2008


HAPPY 17th BIRTHDAY LINDSEY LOWE! Your daddy loves you very much and will surprise you with a brand new car of your choice when he gets back home.



LOST AND FOUND


Okay, need to do some aerobic exercise. I tell my patients that the trick of weight management is calories in and calories out. Simple. The more you take in above what you put out the more weight gain. The more calories you expend, the more that you loose. We definitely be puttin on them calories. In defense, we never know when the next meal will be or if it would be “good quality.” So me and Andy decide to get some calories out. We take our morning stroll. People are already walking early in the am, going to work, or preparing to work in front of their homes setting up shop. Others are sleeping in their shops. Last time we went right, then right, then right, then right and it worked. Andy’s technique worked. Okay let’s try left toward the Mekong River. This is great. My Z coils are becoming part of me. I have to slow down for Andy since I spring forward with each stride. We wave to our monk friends who are walking as well. I should have brought my camera but I feel it might be a rude awakening to have this flash go off in the dark (it could remind them of bombings) or I don’t know if they would be offended and mug us. But then I wouldn’t have missed the Kodak moment with the monkey sitting on the scooter seat and holding on to the driver from behind. So cute! The street cleaners are up using there wisk broom into the bamboo containers. Some are bringing bags of fruits held between two people and a lady is pushing this 10 foot cart balanced by one set of wheels stacked with goods. They are taking it to their kiosks to sell.


We notice a congregation of motor cycles, tuk-tuks look alikes, bicycles, and people carting away food in long wooden carts (also saw a high tech one made of metal). There was a lot of foot traffic, bumping, and shoving. Then it opened up. We found the Lao Farmer’s Market. It was still dawn and there were about a thousand people in the open market. Food vendors with fruit, vegetables, live catfish gasping for air, etc. in there own tiny space that they are squatting sell there goods. A lady is gutting chicken with her bare hands. A shopper is grabbing live frog with her bare hands putting them in her shopping bag destined for a meal. A wooden cart with the remains of a slaughtered cow go to the meat market pass us by uncovered and unprotected. It probably isn’t grade A choice meat. Sanitation is not a priority. Curiously, there are apples covered with the protected netting to pad them. Imported? Hmmm… I am upset I didn’t bring my camera. On the other hand this mob might rip it from me for taking their pictures. There are no formal stores. The vendors bring their goods and ware and sell them. I am told that some vendors get here at 3 am to set up. Early risers and hard workers are competing for your business. They want your kip (8000 kip=$1 US). Where do all the farmers come from? They must have to bring them in from outside the city hauling them day by day. Their trek must take all day by foot. Later I am told that many people have this small business and IMPORT! As it turns out they’re not farmers, they’re business men and women. Many of these foods are imported from China and Thailand and then sold here. Some grow their frogs in there homes for extra money. It’s similar to San Francisco Chinatown but flat. I haven’t seen any rat-on-a-stick here like they have in China. Good for you, you entrepreneurs! We see a man pushing one of the long carts with a lady sitting in it. He must be the chauffeur, or the husband.


AIMLESS AND ANDY


Andy and I find our way out of the market through a side street onto a long street. We past two drunks and its only 6:30 am. There are already about 8 empty bottles next to them. One shouts at us and the slurred words confirm his intoxication. No thanks, we don’t want to party with you. We check our bearings. Andy’s sense of direction is un-uncanny. “I think the Mekong River is that direction” he says with authority. Neither of us, I think, is an eagle scout and the stars are fading away. Some family is outside so we go over to them to ask directions. They don’t understand our Lao. A light bulb pops over my head. A hah! I reach into my wallet and pull out the hotel business card-DON’T LEAVE HOME WITHOUT IT! It has the address on it in in Lao and English. Finally we will find our way home. “You a Speaka Engrish?” I ask. They don’t know. Hmmm, aren’t we just around the corner? It’s getting late because we have to meet for breakfast.


Taxi?!? Tuk-tuk? We see this pair of drivers and their vehicles just waiting for customers. Are they in cahoots or are they going to fight over us. I strategically hand them the hotel business card. Clever, aren’t I. They say 150 baht ($5). That seems a lot. “50 baht I argue.” They volley back with “50 each.” I thought these guys are hard up for money. We are hard up for a ride back. I hesitate and move away like “Hey Andy, we can walk.” Then they didn’t come after us so we reluctantly said “Okay.” As it turns out we were about 2-3 miles away and headed in the wrong direction. And would have continued in that direction. So we headed back for a long ride back with our tails between our legs. At least we got to see a monkey on the back of the seat holding on to the driver of a scooter. What a site. They were just monkeying around. Then we see the team headed for breakfast since we are kinda late. mmmmm errrr errrr … the tuk-tuk gives us away. We at first try to hide our faces but explain to them that we were on a guided tour from this tuk-tuk we chartered. Our feelings were hurt because no one was looking for us. Well, we’re on our own.


DAY AT THE OFFICE


We set up house at the district hospital. There are 4 major hospitals and 8 district hospitals. These “hospitals” would only be classified as a rural clinic by US standards and it would be substandard and shut down by OSHA . Even my own office/OR is more well equipped that this and more sophisticated and sterile. We set up outside on a platform. The dentists are on a field and they move a tent to shade them. It is fairly hot and humid today. It’s always crowded but we have to work with each clinic side by side and bump elbows. We see a lot of gastrointestinal pain, heart “jumping”, back pain, and tendonitis.


One of the interpreters was telling Andy she became a Christian 4 years ago. She was Buddhist. She lost a 24 year-old daughter who had advanced nasal cancer which had metastasized. Apparently she was being treated in Oakland and still she died. She was invited to church so that she might be consoled her since she couldn’t sleep and eat for three days. She started crying as she explained this to Andy. She said she was comforted by the church and was invited to accept Christ. It gave her a sense of peace and hope. Another lady shared with Andy that she was sick with a neck mass. She went to the Buddhist monks “charged her” for them to pray for her and it didn’t work. She got fed up and she was invited to a Christian church and they prayed for her and the mass went away. She in turn accepted Christ. She shared this experience with others in her village and eventually 35 accepted the Lord because of her experience.


Get this. I think Bill tried to console me by giving me an interpreter named, you guessed it Jen. Ohhhh! (sigh) It’s not the same. I saw a 14 year old who looked odd always smiling and not making eye contact. He felt anxious. No suicidal or homicidal thoughts but he felt like hurting someone. Unfortunately, the shootings at the colleges and schools in States come to mind. Further questioning revealed some mental illness. I think he is schizophrenic and had delusions and hallucinations. He needed a lot of help but we only had a few drugs to palliate his abnormal thoughts. He seemed to understand he had a problem and wanted to do something about it but we can only give him limited treatment until his “system” can help him. I got to see some blood and removed a cystic mass behind a reluctant lady’s ear. Her last doctor said that if it was operated on it could spread to the rest of her body. I don’t know if that was poor judgment and he thought it was cancer or he just didn’t want to or couldn’t do it. I thought it was a sebaceous cyst and was able to remove it in a small room under semi-sterile conditions with an assistant holding a small flashlight. She lived.


The dentists are literally out standing in their field (I know, old joke). I guess you can consider them migrant field workers (better?). Anyway, as you gaze over there with three or four patients with their mouth wide open, like an angelic sounding choir, you not only get a sense of the impact that they are making on all of these patients who would have otherwise have rotten teeth, you appreciate the time and expense and the sacrifice of working in suboptimal conditions that they make in a tremendous effort to work with what they have here and bring with them. As the sun moves throughout the day, so does the large tent to alter the shadow to cover the dentists. Ming makes his rounds assisting the dentists in big top. Indeed, it often looks and feels like a circus but all are serious in what they do, except for one guy who clowns around a bit. The docs are getting squeezed tighter on the platform since the sun’s rays are beating on our backs and we head toward the shade for cover. All in all we saw hundreds of patients and we are on a roll. More of the same and in larger numbers. Today went smoother so it was less hectic and more controlled without the strays making their way into the clinic. Some of the strays were Hmongs traveling from the hills that tend to get pushed aside by the natives. Tomorrow will be another district hospital. Since there was some patients that could be seen by Cindy who is a nurse practitioner, she was able to take care of some patients herself and advising appropriate drugs so that they didn’t have to go to the docs. This will help us tremendously and get patients in and out faster. Way to go Cindy; you go girl! The local news media (newspaper and t.v. wear here covering the story. “Makeup!” They mingled and had photo ops. Maybe we will be on t.v. With a lot of us wearing masks it looks like a bird flu quarantine.


CHOW TIME (NOT DAVID)


Our fearless leader decides to take the team and helpers out to a nice buffet. We seem to be going in the direction of the airport. Pastor yells out to Bill, “We’re picking up Jennifer!” Now I didn’t set you up Bill. It must have been wishful thinking. We attend this wonderful buffet at the airport. We like buffets. All you can eat, the American way. What a spread of Laotian food, desserts, sushi, smoothies, soup, steak, and all the alcohol you can drink (no we didn’t). Okay, stop feeling sorry for ourselves. The members of the church team said they never experienced this type or as much food at one time before. A lady said, “Thank you, this is a big treat. We don’t get to eat like this.” It would be just too expensive. Our US cost was $6.00. We are trying to stay under budget. We mixed up the tables to break up some of the cliques and to be more sociable and learn about them. The Americans, as usual, make ourselves at home and pig out. Forget about the calories in/calories out thing. I sat with the daughter of the Pastor or chief of the Lao Evangelical Church. Her English is pretty good and she said she learned it in adult school in 4 months when she and her dad visited Fresno a few years back. I thought that was pretty cool. We get transported in this big fancy bus reminiscent of the Partridge Family. There are about 45 of us and sometimes the headcount is off. Oh well, at least they can call for a tuk-tuk.


Lena told me she doesn’t know when these ejournals end because they seem abrupt with no good-bye. Okay, for me good night and for you, good morning.


I love you Lena and Allison…I miss you…Now I’m going nigh nigh.