New book!

This was on my mind for years. Can you imagine? The national medical school doesn’t have texts. It’s all ad hoc. Teachers throw material together for each class. I saw the medical library in Vientiane and the books are a mixture of French, Thai and English and a few rare Lao texts. After all the translations, you might as well be playing pin the tail on the donkey. Would you want medical care here?

I’m taking pictures at the nursing school. There’s a plastic model with removable organs. The stomach lid falls off and a woman is trying to put the liver back in, but she’s approaching it like a puzzle she doesn’t know. “Maybe if I push harder, it’ll fit in here." The liver goes every which angle to find some space.

Who can solve the puzzle? In the case of English, some of the top students in the class speak in a babble I don’t understand. They can get away with it because nobody else understands either.

In the case of math, I’ve heard teachers will give points for “4+6=11” because it’s close. Some students at the teachers’ training college are terrified to become teachers because they know how little they know. Would you want to be under the knife of a terrified surgeon looking for your liver?

A basic medical text in Lao/English doesn’t solve the problem, but English is so unavoidably necessary, we have to start here. Even when education was a bit better in the past, doctors couldn’t agree on standards because they had been educated in Rumania, Cuba, Russia or France. Nursing students feel English is essential if they want to get further education outside of Laos. It’s not imperialistic to say more current knowledge is based in the English language than in Lao. For the sake of everyone’s health, let’s hope they learn quickly.

Among the many NGOs scrambling for a corner of Laos, cleft palate and cataract surgeries are probably the most easily funded. I did my best to appeal to one organization in the past to focus on producing medical texts rather than swooping in and out for intensive care. Texts are not glamorous and I got no response.

Now, I am blessed to be working with Health Leadership International (HLI) based in Seattle. They’re all about education, capacity building and leadership and are not shy to invest in producing texts, no matter how daunting that task is.

I’ve also found a doctor sent from the heavens in Savannakhet who has diligently proofed and translated the text. Thanks too for all the people who let me take photos even though they probably felt really rotten.

So here is the book. A primer, but hopefully a promise for more to come.

Please Ma'am, may I have a drop?

I’ve been hanging out in hospitals these days. Fortunately, not for Dengue or dysentery; diseases that everyone seems to have now.

The pool I go to in Vientiane uses so much chlorine that my teeth get fuzzy after two laps and there shouldn’t be much living there. That’s why I’m surprised, soon after a swim, to feel like something with five fingernails has attached itself to my eyeball. By the next morning, I have to pull my eyelids apart as they’ve crusted together. In Lao, it’s descriptively called red-eye. In English, it’s called conjunctivitis.

Someone tells me it’s caused from watching dogs mate. That’s why I take their advice for cures with a grain of salt. People vow that boiled Betel leaf or the drip of fresh milk does the trick. I’m told, “The next time you see a woman nursing, just go up and ask for a few drops.”

Don’t really know if that’s a joke or not, but when I go to the hospital, not for Dengue or Dysentery or Red-eye, but to take photos for a new text, I’m told that short of a pap smear, I’m perfectly free to take any pictures I want. Privacy of the patient? At first, I try to explain why I’m there, but nobody seems to care a bit. No signs of alarm that someone is walking into their examination room and snapping pictures. Can you imagine that in an American hospital? I’d be arrested.

I took the first batch of 400 pictures on the wrong setting. The next time, I was less shy about asking people to stick out their tongues. The woman in this photo came in for her ears, not her throat.

Let’s call this one “Communion: the consecrated tongue depressor.” Intimate, yes? We always see a sense of intimacy expressed with a mother a child. Sometimes intimacy is suggested in a Vemeer with the pouring of a milk jug. As we can see, intimacy is also created when peering into other people’s orifices. On the other hand, people tend to shut off the lights when having sex so as not to see what’s inside.

Return

I am on the night train from Bangkok to the Thai/Lao border. I’ve taken it many times, but wonder for the first time if riding retro is not a good enough reason for just going cheap. We’re riding through another rainstorm and the water starts to splatter all over the sheets. In the middle of the night I find that the sliding doors on both ends are jammed and I know what claustrophobia is, the panic of knowing there is no exit.

It’s 3 AM and I can’t sleep anyway. I’m heading back to Laos and the thoughts creep in again. The school that won’t pay for a thousand books, the debt, the bleak outlook of making books sustainable.

There is no exit. In the early days, somebody prophesized, “If you leave Laos, you’ll just try the same thing somewhere else and you’d have to be crazy to think it’d be any easier in Cambodia.” In the early days, somebody else assessed that I was in a kind of Lala land.

I pried one door open in the train. Maybe it was a staff car or something, but a group sitting and eating on the floor seemed very displeased that I had intruded. “Go to the other side,” they said. I explained that that door was stuck too and it was pretty scary to know we were locked in a train carriage. The guy who had to answer my plea couldn’t squeeze his body through the opening, but didn’t seem concerned. So we crash, there’s a fuel leak and the train threatens to explode into an inferno while everyone is going to try to squeeze through this space one-by-one?

Chicken little is vindicated because true to my words, the other door is stuck fast too. The guy struggles with it, gets it loose and walks off without saying anything.

I’ll soon be back in Laos. How am I going to make these doors open?