A Slight Detour

Banh Bao lady and indoor voices

2010-03-24T22:09:00.000-07:00

One lesson that is repeatedly missed in Vietnam is the use of “indoor voices”. Remember when our kindergarten teachers shhh-ed us and told us to use our indoor voices? Well, no one here does. No one knows how to whisper!

I thought my family was loud in the States, but the decibel level here is on another planet. Every morning at around 5:30am, I am awakened by the “banh bao” lady. I'm really gonna miss her when I go back home to the States. She rides around the streets near my house on her bike with an obnoxious recording announcing a hot batch of banh bao ready to be eaten. Either that or Co Mai, the lady that I’m living with, is talking (screaming) to Chu Viet about making coffee or sweeping the floor or getting up, or something.

Being loud sure adds a different element to gossip, though. No news is new news. Especially in the hospital. Everybody knows everything because nobody can keep quiet. It’s quite amusing! Meal times are especially entertaining. Even with everyone sitting across the table from each other, people still scream what they want to say. I’ve gotten used to it, it’s not that bad. And it adds a special touch to life. But I still end up with a headache sometimes at the end of the day J

Candidness is as loud as people’s voices, too. You will know what is on the other person’s mind, because, again, he or she is not afraid to tell you. That person’s not that good-looking. That was a stupid thing to do. She’s not so smart, is she? How much money do you make in 1 year? Why are you not married? It really is endearing, once you get used to it.

Bac Ho’s mausoleum must be the quietest place in all of Vietnam. And that’s only because armed guards prohibit everything down to smiling.

Being "happy to meet you" is exhausting.

2010-03-24T21:55:00.000-07:00

So I hate being the center of attention. And being the center of attention is one thing that I’ve had to unwillingly get used to while over here. Maybe it’s not so much being the center of attention as it is just being noticed. I blame it on being an only child… after years of having no one else to divert my parents’ attention to, I’d rather not have all eyes on my every move. It’s nice to hear, in a selfish way of course, that some of my friends currently abroad are also facing this charming dilemma. Aaron (teaching English at a commune in Indonesia), thanks for sharing in the venting J

I think I’ve gone on and on about the many paradoxes here. Now, here’s a new one: Vietnamese tend to be extremely friendly to strangers, yet extra critical about friends and family members. And, moreover, they prefer their privacy, yet when it comes to others… they want to know EVERYTHING. And they are not afraid to ask any question. I’ve probably explained my whole life story more times than I’ve ever thought about it in 23 years.

No privacy. And no private place in your head where you can just zone off and not have to worry about paying attention to what people around you are saying. I look anywhere from Korean to Japanese to Chinese. You’d think I could blend in more with my surroundings than, say, a “white” American with blonde hair. Yet everyone HAS to ask where I’m from and why I look the way I do. How the heck am I supposed to know? Now it usually depends on department or hospital. In the ER I’m Japanese, in the ICU I’m Korean and elsewhere I’m American. I now say that I’m Japanese, from Korea and living in the States.. and just happen to know Vietnamese. That usually shuts them up for confusion sake.

One of the few downfalls of staying over here for as long as I have, I really can’t complain too much. I love being in Vietnam and I absolutely love meeting so many new and interesting people. But, I’m tired. Introducing yourself over and over and over again and just merely talking to so many people in 1 day takes a lot out of you, especially switching between 2 languages. Again, maybe it’s the only-child syndrome.

Being “happy to meet you” all the time is exhausting.

I’ll be happy to be hidden among the crowd again soon. April 8^th, can’t believe it.

Envelope culture

2010-03-13T22:38:00.000-08:00

Much to the bemusement of my friends here, I have dubbed the name “envelope culture” for a bad habit of the Vietnamese that I have encountered quite frequently. Envelopes are frequently seen being slipped into the pockets of higher-ups-and by this I of course mean money. This can be seen, if you look closely, everywhere.

On the streets. Traffic cops will conveniently appear out of nowhere when you accidentally go down the wrong street (just following the line of traffic as everyone else is doing the same thing) or drive in the middle lane rather than the far left lane designated for cars. Again, there are about 20 other people doing the same thing. The cops slowly look at your cards and stickers and they could take your license, car and sanity away. Or you could slip them a few hundred dong and call it a day.

Unfortunately, this “culture” does not escape the hospital. Doctors are known for taking their fair share of a “tip” from patients for many reasons. A wealthier family wants their patient in his own bed, instead of sharing a bed with 2 people like everyone else. Bribe the doctor. If the price is good enough, maybe the patient will even get a VIP room, which should be reserved as an isolation room.

A surgeon is about to perform an operation on a patient and the family wants to make sure the doc does his best to keep the patient alive. Give the doc a little paper incentive.

A patient has been waiting to see a doctor for hours and has not seen sight of a white coat. Give the nurse a little money to give to the doctor sitting in the back room playing computer games. Maybe he’ll come out and do a 5-minute check-up.

These aren’t exaggerations and I can't say that the examples apply to every hospital. But, walk into a provincial hospital, and I’ll bet money you’ll encounter something along these lines. It’s bad to the point that certain doctors tend to lose the respect of patients. And it’s no wonder that some opt to go to the countless street “pharmacies” to get whatever medication they may need.

I’ve noticed that this doesn’t exist as much here in BMH, thankfully. I’ve been just as observant as in other hospitals throughout the country, so I know that it’s not that I’m missing something. Maybe it could just be the 3 or 4 departments that I’ve been in, but I wanna say that this envelope culture is not as prevalent here. One reason is that there are just not enough beds to sell to patients. While in the cardiology department, 1 patient’s family offered to pay more money so that he could have his own bed. Tough luck. It’s a good day when there are only 2 patients per bed, let alone 1. I have to give the doctors here credit though, I just don’t think it’s in their chemical makeup (well, some or most of them, at least) to take money from a patient. After all, isn’t it the responsibility of the surgeon or doctor to give the best care to every patient? And you don’t have to bribe these docs away from the computer games to see a new patient. There’s a different philosophy at work here, one that is more driven towards academic achievement and medical training. It starts with the residents, many of them staying at BM after finishing their training, is updated frequently by the openness to foreign visitors and maintained by the staff. Course… there’s always a few exceptions, I’m sure.

Funeral music

2010-03-13T22:32:00.000-08:00

I’ve gotten pretty used to funeral music during my time here in Bach Mai. I hear it every morning as soon as I arrive for a days’ work. And when I don’t hear it, I feel like something’s missing.. The screeching horns and bagpipes have even started to sound like happy music! This was the first thing that caught me off guard when I first came to BM. The sheer number of funerals.. 3-4 every day. White cloaks and headbands, flower garlands and parades of family members line the walkways to say their final farewell.

The music reminds you of the number of deaths that occur each day in the hospital. I guess I never noticed it before in the States (or maybe the numbers are different, which could very well be the case), but a lot of people die every day! I won’t even begin to try to decipher my many theories on this less than scientific observation. For everyone’s sanity. I myself have seen more cardiac arrests in the ICU, Cardiology and ER departments during night shifts than I have so far in my short life. That still leaves a lot of other departments too. Patients are just coming to the hospital too late in the game. But I'll leave that for a separate anecdote..

And most of the funerals are happening elsewhere, not in the hospital. These are just the people that couldn’t make it home in time to die. Family members will ask to take the patient home when they feel it is time to let go, when the doctor says the prognosis is poor or before the doctor pulls the plug or stops compressions for good. In the culture, there is the superstition that it is unlucky to die outside of the home. As a result, patients are often transferred home in the middle of the night by rented van and nurse to keep the ambu bag pumping. If you die at home, your ghost will be able to find it’s way home. If you die hundreds of miles away in the hospital, how will your afterlife counterpart know where to go? Not a bad logical process.

Family autonomy

2010-03-13T22:28:00.000-08:00

[I've decided that there's too much to try to explain and share about my time at Bach Mai Hospital Ha Noi and, in an effort not to bore everyone while still trying to tell a story, the best way to tackle these reflections is by random anecdotes. Hopefully you can catch a glimpse of what I've been up to. If not, ask me in a few weeks when I'm home :)]

Family members may be one of the first things that you notice when coming to Bach Mai Hospital. They are everywhere. Literally. Family members line the perimeter outside on cots and straw mats, and the same goes for the halls inside the hospital. One member is expected to stay here at all times in case the patient needs something, or the doctor needs to ask a question, or a test needs to be done for the patient, or something needs to be bought. Washing, dressing and feeding patients are done by the family. Transporting the patient from department to department, as well as from bed to bed is also the job of the husband, wife, brother, sister or parent. Nurses are in low supply here, and there is no paramedic system, so someone has to do it.

Each test or x-ray and many supplies must be paid in cash by the family members. Another reason to camp out. So they clearly have a lot of responsibility- and in my opinion, the system runs on family autonomy rather than the patient autonomy that we learn to live by in medical ethics class.

Before any serious procedure or decision, doctors will usually inform someone. Instead of speaking with the patient, however, a family member—usually the eldest male is preferred—is called in to consult with the doctor. What the family says goes, although they usually end up agreeing with the doctor and signing whatever form anyway. Doctor knows best, right? 9 years of medical training says so.

And they do know the best here at BMH. One of the only national hospitals in the North, it may be the most respected in the country. Residents are trained here, and so the best doctors hone their skills and expertise within these walls. As expected, then, patients flock from all over in order to get the best medical care. They travel hours from the countryside, knowing that the provincial hospitals are in crap condition and, more times than not, full of ambivalence. The irony is that family members tend to beg for their patient to stay in the BM wards when doctors insist that they can be transferred home. A bed in a crowded ICU, where risk of infection is high, is much more attractive than the quiet of a close-to-home hospital.

Actually ASKING to go home is a different story. And this important request, not really question come to think of it, is also made by the family. When a patient asks to go home, the family is really saying that they want him or her to die at home. Unfortunately, the lack of education of the patient/family is starkly apparent when they ask too soon. I’ve seen a couple times when the family asks to go home before the doctor has even finished treating the patient.

Bat Trang

2010-03-13T21:49:00.000-08:00

Anh Ha, one of the ICU residents, took me to a village called Bat Trang one weekend before Tet. An easy motorbike ride away from Ha Noi, the village is known for its ceramic pieces, which the residents make by hand as well as produce in bulk. The streets are lined with shops selling their crafts and some of the pieces are quite stunning.

Trying to avoid the mass produced side is sometimes difficult, but when you find the good stuff, it’s definitely worth the effort. Vases, tea sets, cups, dishes, you name it. I made sure to stock up, but I’m hoping to get back there to pick up a tea set before leaving for home. Let’s just cross our fingers that everything makes it back to the States in one piece… I took pictures just in case. Worse comes to worse, some of you will be getting a picture of a pretty cool piece of ceramic.

If you venture through the alleyways, you can discover the kilns and little houses where you can try your hand at making something. It’ll undoubtedly turn out a little lopsided and discolored, but it’s the thought that counts, right?

We tried our hand at painting a couple already-fired pieces and then sat down at our own spinning table and constructed a couple very unique pots… or dishes… or cups.

Happy Tet

2010-03-13T21:46:00.000-08:00

Tet- Vietnamese New Years- is like Christmas on crack. One week of non-stop eating, hanging out with family, visiting friends, singing, dancing, great decorations, dragons, and lucky money. Tet was also the main reason why I wanted to stay in Vietnam past February. Luckily, the holiday did not disappoint.

Preparation for the one-week celebration is possibly more exciting than Tet itself. Decorations include, among other red things, fresh flowers and plants. One week before the start of the holiday, I went with Anh Linh to the famous flower market in Ha Noi. We left at the crack of dawn in order to get our hands on the best selections… I’ve never seen anything like it. People come from all over to sell the blossoms- rows and rows of flowers cover the walkways. And, it’s all very cheap! Daisies, lilies, tulips and many more that I couldn’t name. We probably bought way too much, but it was worth being able to give the flowers as gifts to our friends that same morning.

Lotus, or Hoa Lan- a popular Tet flower

An even more important Tet tradition is picking out a Hoa Dao (peach blossom) tree if you live in the North and Hoa Mai if you live in S. Vietnam. Both are basically VN’s version of Christmas trees, and families put a great deal of thought into the type, size and shape of their blossoming tree. After visiting the flower market, I went with Anh Linh’s family to pick out a Hoa Dao—they only grow in the North due to the colder climate—and a Quit tree (a tree with clementines). These are sold along the streets all over Ha Noi.

Some selections, like the 2 that we picked out, are far too large to fit in a car so xe om drivers are hired to transport them to your doorstep. You can tell Tet is right around the corner when everywhere you look there is a gigantic Hoa Dao tree teetering on the back of a motorbike. That was definitely one of my favorite days in Vietnam so far.

The following week I went with Anh Son and Anh Quan (2 ER docs) and 2 Australian medical students also shadowing at Bach Mai to the Hoa Dao garden (vuon dao), a prime place to pick out the perfect Hoa Dao tree. It was an orchard of pink blossoms and orange fruit.

During actual Tet, when I headed south to visit family, I could fully switch gears and appreciate the yellow blossoms of Hoa Mai trees, known to grow in the hotter climate.

The biggest tradition of Tet, obviously, is to spend time with family. And so I did. The first day of Tet was February 14, so I made sure to make it to Vung Tau a couple days before to see all the prep work. Fortunately, I was able to find a plane ticket. I happened to be traveling the opposite direction of most people; most people tend to head northward for Tet, as the cooler weather and surrounding countryside make for a much more comfortable and unique holiday. I couldn’t be away from family during my first Tet in VN, though, so southbound it was.

It’s not too hard to fit into my family here, as long as you can deal with the crowds and appreciate the noise and liveliness J My actual family in VT is actually pretty small, so we usually join Ong Ken’s wife’s side of the clan. She has 11 brothers and sisters… so counting husbands/wives and the dozens of cute kids, you’re looking at around 40-50 people in one house, surrounding a couple dinner tables. Definitely a tad overwhelming at first, but you learn to appreciate the beauty of disfunctionality. I’m kidding, kind of, but you really do love them.

Ba Huong & the littlest member of the clan.

My chameleon-like abilities allowed me to quickly adapt to the “Tet” lifestyle set forth by my ancestors, which includes 1 full week of: eating, drinking, laughing, talking, napping, playing blackjack and bingo… and repeating the cycle. In between, there’s lucky money in red envelopes (even I got some at the ripe age of 23), mass with my side of the family, visiting lots of relatives-I still have no idea who they are, fireworks and dragon dances in the streets. It’s not a bad life, and the Vietnamese live for these glorious 7 days all year long.

Tet is a time for relaxing, for the whole family, so when it comes to food, the less prep the better. Of course the prep work leading up to Tet ensures a great meal. Breakfast, lunch and dinner usually consist of the same 6 or 7 dishes with rice. Again, no cooking during this week. And, basically every restaurant and store is closed, so you’re stuck with what you have. Luckily, my side of the family owns a restaurant and the other side owns a shop selling sandwiches and other deliciousness, so we weren’t exactly starving.

I did manage to win money playing blackjack but unfortunately had to give it all away as lucky money to the younger cousins. Seniority actually means you have to give money away.. see picture below.

The lady in the middle is Ba Huong (Ong Ken’s wife)’s mom… aka the grandma of the clan. Hence getting the seat of honor. I gotta give her props for raising 12 kids. Course, being the oldest, she has to give lucky money to EVERYONE in the family. That sucks.

Each aunt and uncle or elder had their own unique way of handing out the money. After all, how much fun is it receiving a red envelope of money for the 20^th time? I wasn’t complaining, but nonetheless… there were many a tactic and everyone was quite enthusiastic. Prolly the most hectic game was when one person stood on the second floor and threw the envelopes down to the first. Imagine piñata, but add in feisty adults.

They learn young that the money inside the envelope is more valuable.. and so the floor is usually littered with red by the end of the day.

Amongst the fun and excitement, there are beautiful traditions woven into the days, in a style that sets the Vietnamese culture apart from others. The first couple days of Tet are to be reserved for family, but the other days are spent visiting distant relatives and friends. No one is forgotten. And the first person to visit your house on Tet is said to bear the luck of the household for the coming year. Wishes of health, good fortune, love and peace are sincerely offered as you step onto each doorstep, and you can tell that these people are not mere acquaintances. After midnight on Tet, as you look down the street, tables suddenly appear at the doorsteps and sidewalks of each house. Small altars are set up with offerings of fruit and other goods to invite the ancestors for the celebration.

To really experience Vietnam, you need to visit the top sights list in the Lonely Planet. But to really experience the culture, apart from the industrialization and globalization, you need to stay during the week of Tet. This is when the society is stripped of Americanization and politics, and family is the center. It is one of the only times when businesses are literally shut down and the only money people are concerned with is the lucky kind. While there is no Santa Claus or Hallmark or snow, this a holiday you have to be apart of at least once.

Hello, Ha Noi

2010-01-25T01:54:00.000-08:00

So I've been in Ha Noi now for over a month now, figured it was time to write down what I've been up to. Let's start with the sight-seeing!

The residents at Bach Mai have been treating me well, making sure I get to see the city of Ha Noi. While smaller than Saigon, it has a lot of character and stunning places to escape the traffic/dusty roads. Though spending loads of time in Bach Mai Hospital has been great, it's definitely nice to get out into the sun every once in a while :)

Temple of Literature (Van Mieu)

Being the good students of medicine that they are, the residents took me to the Temple of Literature. When they "graduate" from medical residency, they come here to receive their honors before being let loose into the hospital as really good doctors. (Only the smartest medical students can pass the exam to enter residency- so not everyone gets to do residency, unlike the US system). Of course, this place is not foreign to students, as many flock here before exams to pay their respects to the gods of smartness... hoping for some miracle of a passing grade :)

The temple is one of only a few places that has well preserved traditional Vietnamese architecture. There are 5 extensive courtyards, all dedicated to Confucius and honoring the country's finest scholars. VN's first university was established here and was only reserved for those of noble birth (that later changed).

The relationship between teacher and student is one of the most beloved in the country and so the temple keeps true to this tradition. Stelae (82 still remain) standing on stone tortoises record the names, places of birth and achievements of the most prominent scholars, such as Ngo Sy Lien.

Well of Heavenly Clarity. I'm sure many a student has stood here, pondering over the next test.

One Pillar Pagoda (Chua Mot Cot)

A landmark of Ha Noi, the one pillar pagoda has become a symbol of the city as it appears on logos and banners. Constructed by Emperor Ly Thai Tong (1049) as an expression of thanks for a male heir, it was rebuilt after the French destroyed the structure.

The pagoda is made entirely from wood on a single stone pillar, resembling a lotus blossom.

Ha Noi Opera House (Nha Hat Lon)

Literally translated "House Sing Big", this 900-seat opera house was built in 1911 by the French. On Aug 16, 1945 the Citizens' Committee announced it's takeover of the city from the balcony. I've driven by this place so many times, I have to go inside one day. Usually at night, it's good place to people-watch.

Haiphong

One weekend I made the 3-hour trip with Anh Cuong to Haiphong to visit with his friends. It was a reunion of sorts as they all went to high school together. Haiphong, a smaller town outside of Ha Noi, is known to be a great place to go and hangout with friends due to the many karaoke bars, cafes and Do Son beach. We did a little of everything and ate our meals at one of his friend's restaurants. Among the many delicious dishes on the menu... coagulated pig's blood. Not so delicious. Tried it once and that might be the only time ever again.

"Bac Ho" Mausoleum

No trip to Ha Noi is complete without a visit to see Ho Chi Minh's body, right? Bac Ho is contained in a glass sarcophagus housed in this huge marble edifice. A long line of visitors can be seen daily eagerly awaiting their turn to pay their respects to the late ruler. Guards in white uniforms surround the complex 24/7, almost like the Buckingham Palace guards!

Sadly, I was there on a Sunday and missed my chance to stand in a long line to visit Bac Ho. There are tons of rules before you can actually enter: no shorts, no hats, no pictures, no belongings, no talking or laughing, and no hands in pockets. Pretty strict. For some visitors, it is a momentous occasion to see the Liberator of Vietnam; while others don't exactly place him in high regard due to his communistic ideology.

One of my favorite places in the city, though, is Hoan Kiem Lake (pictures in a previous post during the flower festival). The legend is that heaven sent a magical sword to Emperor Le Thai To to drive the Chinese out of Vietnam. After the war, a golden tortoise emerged from the water and reclaimed the sword. Hence the name, "lake of the restored sword".

The lake is located in the Old Quarter, the historic heart of Ha Noi. Most tourists will find their way into one of many small hotels in the narrow and congested streets. Thanks to the many small alleyways and nooks and crannies, it's really easy to get away from the tourist areas to really get a feel for the excitement and elegant old architecture. There's plenty of commerce among the more than 50 streets, plus women walking by with old baskets filled with cheap meals, bia hoi stalls and pho stalls. In the old days, each street was named for the product that was traditionally sold there.

More pictures to come as I take them (been spending much more time in the hospital than sightseeing lately).

A Ha Noi Wedding

2010-01-10T03:41:00.000-08:00

One of my main reasons for heading to Ha Noi was to attend Anh Hai's wedding (an ER doc at Bach Mai Hospital who I met while in Rach Gia). I ended up liking the city and people so much that I've decided to stay here for the remainder of my time in Vietnam! I've been here for a little more than 3 weeks shadowing in Bach Mai, as well as "teaching" the docs English. It's been an awesome experience so far, but more on "work" later. Have to share the weddings pics!

Weddings are a bit more complicated here, so it was really interesting to see some of the traditions that have been lost among VN family weddings in the US. Right off the bat, invitations to weddings are hand delivered to each and every guest by the bride and groom-to-be a couple weeks before the big day. Adds a more personal touch to things, doesn't it? Before the actual wedding day, there is also a ceremony called "An Hoi", which is basically the official engagement. On this day, the groom and his family/friends arrive at the bride's family's home to ask for her hand in marriage. Single young men associated with the groom's side come bearing gifts for the bride's family (cakes, fruit, jewelry), which are accepted by single young women associated with the bride. The older folk (parents of the bride/groom, grandparents, greats, etc) do most of the ceremonial talking until the groom can finally pick up his bride.

An Hoi (12/21/09): Meet the bride and groom-to-be!

The bride/groom then offer the traditional sacrifices to deceased family members and ancestors, offer ceremonial tea to all guests, and family/friends share a meal with their respective sides. (I started off the morning at the groom's side, but then joined the bride's side for lunch).

Prayers & gifts. Wedding days are known as "ngay dep", or beautiful/lucky days.

After all that business is taken care of, a few days later is the wedding! In the morning, the groom's side of the family arrives at the bride's house to pick up the bride. This involves a long parade of cars battling traffic across the city. After some more speeches from the elders, the bride is brought back to the groom's (their new house) for some more celebratory elder speeches. [Traditions here involve a lot of talking from the elders and tea-drinking.] Finally, the reception/party comes in the afternoon. Wedding receptions in Vietnam are usually very big, guests in the hundreds are the norm. Rings are exchanged, both families are introduced and there is a lot of eating and singing and cheers-ing!

Anh Hai & Chi Thao's wedding had an international touch with me coming from the States and their good friends Eloise & Benjamin flying in all the way from France.

My "dates" to the wedding, 2nd/3rd year residents from Bach Mai Hospital.

(12/26/09) Friends with the beautiful bride and groom!

Lastly, after the wedding, the bride and groom must go to the groom's "que" or homeland. Most people in Ha Noi come from rural areas further away, and so there are a lot of family members and friends that cannot attend weddings in the city. A second wedding of sorts is thus celebrated so everyone can be involved. Myself, Eloise and Benjamin joined Chi Thao's and Anh Hai's families for a trip to Thanh Hoa, a town/village (famous for pineapples and sugarcane) about a 3 hour drive from Ha Noi.

Thanh Hoa, right by Anh Hai's home.

There is a huge contrast between visiting "que" and the big city of Ha Noi. Thanh Hoa is a lot more peaceful and life is much simpler. Most families are farmers and live off the land. It is a lot quieter, of course, and at night, it is pitch black! I absolutely loved meeting his family/friends here, everyone is extremely genuine and welcoming.

Four-leaf clovers were everywhere! I felt lucky.

Anh Hai's younger brother chopping up the coconuts that he just picked. He insisted on teaching me the names of the many different trees/fruits. They were delicious!

We spent the night in Thanh Hoa to take in the sights and sounds. One of our adventures included a trip to a temple and nearby beach.

Bonjour, Benjamin!

We sat down and had tea with the caretaker who lives at the temple. He told us the story behind the gods worshipped here; of course I forget it all now, but the scenery was unforgettable.

Unfortunately it was a little too cold to swim.

Happy New Year from Vietnam!

2010-01-07T23:56:00.000-08:00

Chuc mung giang sinh (a late merry christmas) and chuc mung nam moi (and happy new year) from Ha Noi :) I can't believe it's already 2010, and I can't believe I wasn't in the States to celebrate with family and friends. This was the first time that I wasn't at home to celebrate the holidays! Fortunately, I've been able to make some excellent new friends who have become like family, so it wasn't too bad being away (although it wasn't quite the same). I hear you guys are having quite the snowy winter and I am extremely jealous. Thank god I'm in Ha Noi right now, the weather is much cooler than the south so I don't feel as cheated.

Christmas & New Years are not huge celebrations in VN since only a small portion of the population is Christian. Most people are buddhist or have no religious affiliation. Of course, though, parts of Western culture have seeped all the way into Vietnam, and Christmas was no exception.

I still managed to see Santa, even if there was more than one of him, he wasn't accompanied by elves, and he was drinking beer in one of Ha Noi's famous sidewalk stalls (quan via he). I caught a glimpse of this phenomenon while walking through the Old Quarter.

Christmas evening, I went to mass at St. Joseph Cathedral for the Vietnamese service. That night I rode around the city with friends and enjoyed the festive surroundings over some hot coffee. Most people do not get off from work or school, so overall it was just like any other day.

Having an excuse to celebrate, the street traffic was even more crowded than normal.

The city of Ha Noi does a good job in getting decked out in lights for the holidays.

Missed having a Christmas tree this year!

My New Years celebration was also spent with new friends, Australian medical students that I met in Bach Mai Hospital. If you asked me 1 year ago, I would have never guessed that I would be in Vietnam, hanging out with Australians for the countdown to 2010! 20ish 2nd year med students from Sydney participated in an exchange program with Bach Mai Hospital. They come here to study/shadow for 1 month and in return, the hospital sends Vietnamese doctors to Australia to study new techniques. The Aussies were awesome enough to invite me to their New Years party- we rented out the top floor of Avalon Cafe & Lounge, overlooking Hoan Kiem Lake. Not a shabby way to ring in the New Year? Sadly, fireworks are banned in Vietnam and their was no "crystal ball drop" (I had to explain the significance of the Times Square ball to everyone), but we did have 2 countdowns, 1 for Australia and 1 for Vietnam.

Some of the girls of the group.

Known as "really tall guy", these 2 stuck out like sore thumbs in the hospital!

Over New Year's weekend, there was a flower festival (Le Hoi Hoa) around Hoan Kiem Lake, one of the many gorgeous lakes scattered throughout the city. I went to explore the many different flower arrangements with Chu Viet and Co Mai, the people that I am living with. Every evening they usually go for a walk around the lake anyways, so we just extended the routine a bit.

Co Mai & Chu Viet, my "host" parents :)

Hoan Kiem Lake, pretty ain't it?

Decked-out cyclos

My favorite.. lilies!

Mock "Temple of Literature" display

Ao dai (the new "little black dress") made entirely of flowers

There's never a dull day here.

Cheers to the new year, and can't wait to see what 2010 brings!

2 weddings and a funeral

2010-01-07T03:53:00.000-08:00

After 3 months of working/traveling, it was time to head back to Vung Tau to relax and hang out with family for a little. I moved into Ong Ken's house for a couple weeks to spend time with everyone. It was nice having nothing to do and no where in particular to be for a change. My days were spent hanging out at the family restaurant, cafes and beaches. Most nights were spent at the restaurant helping out and cheering on Vietnam soccer in the SEA games! In the end they lost to Malaysia, but it was a good effort. Before coming here, I didn't even know VN had a team. They're not too shabby, but obviously can't compare to Manchester United. I also finally got my visa extended while in VT, so I was not deported from the country :)

I flew down to Rach Gia (again) for the first weekend in December for Anh Dieu's (neonatalogist in Kien Giang General) wedding. On Saturday, I took a 3-hour bus ride over to Can Tho to meet up with Anh Phuc and his friends for the night. Can Tho is the political, economic and cultural center of the Mekong Delta and so, unlike most of southern VN, stays open past midnight with tons of cafes, karaoke bars etc. Definitely the place to see the nightlife. Aside from the very lively waterfront, the city is well-known for its floating markets. Early the next morning, Anh Phuc and I made the 3-hour trip back to Rach Gia by vespa, just in time for the wedding. If you really wanna see the sites in this country, I highly recommend traveling by motorbike. And if you really wanna see some good fun, I highly recommend crashing a wedding. Guests by the hundreds are the norm and the beer never stops flowing. Karaoke and coffee usually follow later on to top off the night.

The following week I went to my first VN funeral. A relative of mine (not sure how we're related, but she was a cousin of someone), passed away and so Ong/Ba Ken and I traveled up for the funeral. People dress in white here, and family members wear white cloth bands around their heads. Children of the deceased wear white cloaks. In my family, or at least in this part of the country, it is customary for people to stay awake the entire night before the burial, which happens in the very early morning, to keep watch over the deceased.

After 2 weeks of Vung Tau, I inevitably got a little stir-crazy being in 1 spot with nothing to do. Ha Noi was next up in my adventure book.

A Little Getaway to Phu Quoc Island

2010-01-07T03:44:00.000-08:00

While in Rach Gia, Jeff, My-Linh and I just HAD to take a break from our hard work in the hospital to speed boat the 3 hours to Vietnam's largest island, Phu Quoc, in the Gulf of Thailand (15km south of Cambodia). Known for its black pepper, pearl farms and "nuoc mam", a potent fish sauce, the island isn't as inhabited and developed as most others- according to Lonely Planet, we explored the tropical paradise right in time, before it gets too touristy and crowded. Anh Phuc booked us a tour guide/car for our trip, so we really got to see the island inside out. A full day excursion turned into a weekend vacation, and we moved from a $10/day hotel to a 3-star resort. Why not splurge?

Phu Quoc Pearl Farm

On Saturday, our driver took us around the island to the more famous tourist spots along Long Beach. People come from all over to buy pearls at the Phu Quoc Pearl Farm. Sadly, our student/nursing/resident bank accounts didn't allow us to indulge here, but it was nice just window shopping. Plus, pearls remind me of Richmond.

The famous Phu Quoc dog, apparently a good hunter, distinguished by the ridgeback and blue tongue.

Cau Castle (Dinh Cau)

A temple on the rocks, complete with lighthouse, in walking distance of our $10/day hotel (I wouldn't recommend staying there, though). The temple was built in honor of Thien Hau, Goddess of the Sea, who protects sailors/fisherman.

My-Linh and Jeff on the pier, best spot to see the sunset.

We explored many remote beaches, including Bai Sao and Bai Dam, all with pristine white sand and crystal clear water.

Coconut Tree Prison

It wasn't until 1949 when the French handed the island over to the Vietnamese. Because of its location, Phu Quoc was a convenient spot for a remote prison during the French colonial period. When the Americans took over Coconut Tree Prison, they housed over 40,000 VC prisoners. Inside the museum today, there are very vivid depictions of some of the more popular torture techniques used back in the day. Seeing the displays is a little eerie since there is still an actual prison next door.

On our first night on the island, we went on a squid fishing tour. Quite the experience. Around sunset, we set sail on a fishing boat with a group of other tourists. Midway through our trip out into the middle of the ocean, we stopped at a floating hut to buy some bait (which for some reason, we didn't use) and food. Squid is best caught at night and so it was pitch black while we were at sea. We used hand-made contraptions, but forgot the necessary light to put in the water to attract the squid. So, no one caught anything. Aside from Jeff's catch of a pile of trash, that is. The boat ride in and out was probably the coolest part. Plus, we had some raw sea urchin for dinner!

Our trusty tour guide (I forget his name!), and our squid fishing boat.

On Sunday, we planned a full day snorkeling tour with the french company Searama. We had two stops for exploring the coral reefs and lunch on the boat. The weather was absolutely perfect for the occasion!

The top deck of our boat had these recliners, so on the 2 hour trip out and back to the island, we all enjoyed glorious naps.

I really like boats.

One of our snorkeling stops.

Snorkeling was good fun! I think we had enough of being out at sea by the end, though. We were getting a little dizzy with all the rocking.

The view from our resort hotel. Much bigger jump from the previous night's.

Great trip, great friends.

Thanksgiving in Rach Gia

2009-12-18T23:42:00.000-08:00

After the PV team headed back to the States, I returned to Rach Gia, Kien Giang province for another 2 weeks (Nov 16-28) to continue working on the infection control project with My-Linh, the peds resident. Jeff, a recent nursing school grad, joined us for our last week. It was lovely being back in a familiar place with friends!

Hoa Bien area of Rach Gia

The street where our villa is located.

Hydrofoil boat that took us to Phu Quoc island for a weekend.

We stayed in the hospital's villa again and spent most of our time in the NICU and microbiology departments of Kien Giang Hospital. Thanks in part to the inevitable PV disorganization & miscommunication, we were working slightly blindly and had a lot of free time. But still, I think we got a good deal accomplished.

We worked with the PICU and ICU departments to make up contact precaution signs for each patient bed. As I mentioned in an earlier post, due to limited space and resources, patients are not necessarily separated by illness. This is of course necessary in cases of various infections and pneumonia. We translated some awesome signs that we made to Vietnamese and hopefully these can help slow the spread of infection. Best case scenario would be to have each patient in a separate room. Or at least have all skin infections in 1 room, all pneumonias in another, etc. BUT, we gotta work with what we have...

In microbiology, we helped the dept recreate the ever-important antibiogram. In infection control, this sheet is incredibly vital, as it tells the doctor which bugs are resistant to which antibiotics at what rate in one specific hospital. While the gang in micro is diligent in keeping theirs up to date, Kien Giang Hospital's antibiogram was 30+ pages long. Hence, no one is going to read through the entire document, let alone use it as a reference in prescribing antibiotic treatments. To make matters worse, there wasn't much communication between the department and the doctors aside from releasing blood culture results. Doctors were not consulting the expertise of micro while dealing with antibiotics--a key factor in the enormous rate of nosocomial infection. (Let me tell you, translating microbiology terminology between English and VN is quite interesting).

Thanks to WHO, we were able to bring micro a program that allows them to easily create a user-friendly antibiogram, as well as other graphing measurements to better track infection and antibiotic resistance. We spent most of our time walking them through the program and showing them the advantages of using the antibiogram as a bible. It will be interesting to see if doctors will comply and how much this change will decrease resistance rates.

Thanksgiving (I can't believe it's already that time of year) happened to fall during our time in RG. My-Linh, Jeff and myself decided we had to introduce the glorious excuse to pig-out to our friends. It was hilarious trying to cook a feast with no oven or stove (only a burner and rice cooker). And it was even more humorous trying to explain this American holiday in Vietnamese to our friends... I think the only thing we got across was that people eat a lot to remember the day that old people first came to America.

The result from hours of slaving over a "hot stove"!!!!

OK FINE. So maybe not...

But, not bad, right? Turkey doesn't really exist in VN, so we had to settle for duck. Mashed potatoes, corn, banh bao (bread substitute), macaroni and PUPPY CHOW (!) for dessert. Man and Anh Phuc aren't too crazy about American food, but they ate our dinner and didn't get sick! And they loved the puppy chow.

Other than that, we spent our time hanging out with the doctors in the NICU and exploring Rach Gia. We ate most of our meals at this awesome restaurant (thanks, Lonely Planet) called Ao Dai Moi. The owner's kids live in the States, so he loved talking to us and feeding us! If you're ever in the area, I highly recommend this place. Excellent wanton. Banh Xeo Thanh Nhi is also a must- they have the best banh xeo (omelette-like dish) and banh khot (small rice cakes with shrimp).

Hanging out had to include some karaoking.

My-Linh and Jeff, choosing our next song. I'm sure it was something along the lines of Air Supply or Michael Jackson.

The incredible sunset from the lighthouse in front of our villa.

Myself, Jeff & My-Linh on our last night together in Saigon. Between the 3 of us, there were a lot of laughs, adventures and funny moments (with trying to translate). They made awesome travel buddies. I miss you guys already!

Goodbye, team.

2009-12-18T22:28:00.000-08:00

40 volunteers, 6 hospitals, 2000+ patients, 2 weeks.

After a whirlwind 2 weeks traveling back and forth from Saigon to Binh Dinh and back again, it came time to say goodbye to the PV team. We had a banquet for all volunteers in Saigon at the end of the trip, the night before everyone was to head back to the States the next day. I had a lot of fun celebrating our last night together.

The ladies of Project Vietnam. They clean up nicely, don't they? Many had traditional ao dai's made, a far cry from hospital scrubs!

My-Linh, myself and Christina at our hotel.

Looking past the headaches of last-minute changes in plans, bureaucracy and disorganization, I really enjoyed hanging out and working with everyone. Each person brought something different to the table so that we could really help our patients. It's definitely different traveling alone again, after they all left, but it is a welcome change. While there was never a dull moment with the entire team, traveling with that big of a group gets tiring! It's more relaxing moving around with only a few, though I do miss the personalities! I know you guys all made it home safely, hope you've readjusted to life back in the States, and can't wait to maybe one day see you all again :)

An unintended beach day

2009-12-18T21:54:00.000-08:00

On Thursday, during the week in Quy Nhon, I had plans to skip out on primary care in the communes and instead shadow Tinny, the peds opthamologist. During clinic, patients were being referred to him for surgery in Benh Vien Khoa Tinh Binh Dinh. I had never seen eye surgery before, so I was definitely looking forward to learning about it. Lectures were on the top of the agenda, and in the frenzy of trying to find a translator for him, I ended up being the only person available. I was a translator for the PC docs all week, but that is far from translating actual lectures for physicians. We sat down at the hotel cafe and dumbed down, slide-by-slide, all 3 lectures on red-eye and ROP. I was definitely butchering the lesson.

After a lot of stress, bureaucracy showed its ugly face again, and the lectures were cancelled last minute for the day. WHEW. So, obviously, the only thing left for us to do was explore Quy Nhon a little. After an interesting taxi ride around town we eventually found a fantastic beach, Bai Bau. I refer to it as Monkey Island now- see picture below for source.

We saw this sign as we were driving in... ignoring the nervousness that comes with a sign wishing you luck before you actually arrive at a destination, we trekked on to discover a beautiful beach.

On weekends (according to trusty Lonely Planet), this beach is crowded, but during the week (while I was there), it's empty. I've never had an entire stretch of beach to myself before!

Profile of a monkey, no?

While the rest of the team was working hard all day in sub-par conditions, we somehow managed to give ourselves a relaxing break with white sands, clear blue waters and a cold beer. Life's rough!

Random statue.

Getting the catch of the day is a team effort.

I thoroughly enjoyed climbing the rocks.

Primary Care in Quy Nhon: Medical Mission Week 2

2009-12-18T21:20:00.000-08:00

Bright and early Monday morning (Nov. 9th), we started our week of primary care work in Quy Nhon. For 5 days, we set up makeshift clinics in remote communes to offer medical care, dentistry, relief supplies/food and medications to over 2000 patients. Around 6:30am each day, all 40+ of us set out for the hour drive to a different community center each day. Ideal time for napping and taking in the gorgeous scenery.

After breakfast at the hotel, our daily routine started off with a group effort to load up the bus with supplies and medications.

Our welcome wagon was already waiting for us when we arrived at the different community centers each morning.

The amount of people already waiting in line was a little overwhelming.

And the crowds could definitely get a little rowdy at times...

But, honestly, who could say no to this face??

First order of business (once we got over taking tons of pictures of the cute kids)- unloading the supplies. We were fortunate to be able to purchase a lot of medications for the pharmacy, but naturally, we were still very limited in what we could offer the people.

Setting up our clinics.

These community centers serve as the "seat" of the gov't in these remote areas. VERY basic care (if you can even call it that) is offered here by the 1 doctor that sometimes shows up.

Each center was built around the same time, so the layout and design was pretty similar for each location that week. And, of course, there was inevitably a bust of Ho Chi Minh ("Bac Ho") staring down at us.

Crowd control.

With ~400 patients/day, crowd control was an important responsibility. While our numbering system was a little old school, it somehow worked in the end.

Most of the patients walked hours to get to our our clinic. We tried to pick locations that were central to these remote villages, but there were still many people that we could not reach.

Vital signs.

After receiving a number, the patient's first stop was at the vital signs station. Basic measurements (height, weight, BP, respiratory rate, etc) were taken to give us a better idea of baseline for each person. Of course, normal numbers for us weren't exactly normal here.

Doctors' visit.

The patient is then herded to the appropriate doctor. We had around 10 doctors: pediatricians (bac si nhi), general practitioners (bac si da khoa) and internists (bac si noi khoa); 1 dentist (nha si); 1 nurse practitioner (dieu duong). [Tiffany, My-Linh and I made up part of the peds team.]

I translated for My-Linh, a pediatric resident from Phoenix Children's. It was great working with her!

Fred, a nurse practitioner, with his translator.

The central VN accent is undoubtedly the most difficult to understand! It's basically like listening to a different language all together. People from this region chop up their words and the intonation is much heavier than normal VN language. To make things even more interesting, the ethnic minorities literally bring a different language to the table. As a result, for many of the patients, the doctors needed 2 translators- 1 local volunteer to translate from central dialect to popular VN, and a PV volunteer to translate from VN to English.

All the effort was worth it, of course, once you saw these kids smile. They especially loved the stickers (and candy) that we brought. They had no idea what to do with them when we handed them out, but soon got the idea once we started sticking them all over our scrubs and hands :) Scooby doo and Disney princesses were big hits.

Facing the challenge.

Many of the symptoms that we saw during patient visits were associated with worms, scabies, diarrhea and tuberculosis. Headaches and coughing at night (due to the "cold" season) was also prevalent. What was most heartbreaking was the amount of stomach pain that we encountered. After listening and asking many questions, I realized that the pain was not necessarily caused by sickness or infection, but by malnutrition. The pain goes away after eating... these kids' stomachs were hurting because they were starving! Normally, they eat 1 meal/day, consisting of rice. While it was terribly frustrating having the ability to offer only 1-month supplies of drugs to patients, it was even more frustrating that we could not offer enough simple food to help alleviate hunger.

Changing patient histories became a problem. The longer we talked to patients (in kids' cases, their parents), the more the pt history changed. Bloody diarrhea and daily vomiting for months at a time somehow became the norm. High fevers for years on end was often a patient complaint. The culture assumes medication will solve health problems, and so patients expect a pill when seeing a doctor. Once they realized that we were not going to give them a wonder drug, their complaints and symptoms became much more dramatic.

This little guy is a doctor in the making.

There was a lot of curiosity on the kids' part. They had never seen a westerner before.

Digital cameras were a HUGE hit. The fact that they could see their pictures immediately after we snapped a shot was extraordinary.

Some of the ladies of the group.

Working with the primary care team was an unforgettable experience. We were constantly laughing and learning from each other.

We also had a lot to learn from the kids. Their joy and ambition, despite their circumstance was quite inspiring. They learn to adapt and work with what they have.

By 6pm each evening, we were exhausted. Dealing with the limited resources and frustrations that come with working in a developing country was tiresome, but made much easier with the graciousness of the patients.

We learned a great deal about their culture and livelihood that week.

And we caught a glimpse of how, despite the remoteness, the culture of the States and western world is seeping into central VN. (Though we won't judge them for their choice in style.)

Sights & Sounds of Central Vietnam

2009-12-12T02:27:00.000-08:00

[Here's yet another long overdue attempt to update on my adventures over here, bear with me if you're reading and hope it's not too boring!]

Our first look at Quy Nhon, the tiny airport.

To continue with the PV team medical mission trip, we arrived in Quy Nhon, the largest city of the Binh Dinh Province in Central VN on Saturday, Nov 7 (to be exact). It was, again, an early am flight, so we spent much of the day at Quy Nhon Hotel recovering from a busy week in Saigon, early am wake-up calls and preparing for what would be a very busy week in the central region. We weren't sure if we would ever make it there since a typhoon had just passed through a week beforehand. There were rumors of all roads being shut down, collapsed bridges, flooding etc. At one point we were preparing ourselves to walk across a man-made bridge and then motorbike our way into the communes (just think of what a gang of 40 motorbikes would look like!). Some swimming through mud might have been involved. While conditions were slightly better for us by the time we arrived- minus some sloshing mud/flooding- it was clear that the locals were still dealing with the devastating effects. The team was able to pool a good amount of money and VN volunteers together to bring enormous bags full of food, drink and gifts to help. And then there were the dozens & dozens of boxes of medications. Needless to say it was a long night of sorting and pill counting. Dr. Tuan, a family practice doc from CA, was our team leader and everything- over 40 volunteers of doctors, pharmacists, therapists, nurses and surgeons- was organized to the tee. It was a breath of fresh air!

Sorting and packing.. sorting and packing.

Our work began as soon as we arrived at the hotel. Tinny, our peds opthamologist, screened patients for eye surgery right on the spot.

Sunday was reserved as a full day of touring and sight-seeing. Quy Nhon is a city on the south central coast and so the province relies on an economy of fishing and agriculture. Known for its martial arts, Cham association (more on that later), difficult accent (more on that even later) and strong women, the region is rich in history.

First stop: Nguyen Nga Center for Ppl with Special Needs

Right in the city lies this awesome center that cares for and trains deaf and blind children. An orphanage of sorts, Co Nga started the center to help these kids with housing, living, school and skills necessary to live productive lives. By the time they leave, they are ready to work and start families!

Aside from everyday skills, the kids are encouraged to take up art and music. This guy busted out some Feliz Navidad in not only perfect pitch.. but perfect Spanish!

Just plain cute.

Next up: Some place dedicated to some poet...

I forget the significance of this place... but here's me and Khanh Linh, my roommate/pharmacist

And here's the team taking pictures at this place.

Quang Trung Museum: Tay Son Dynasty

A dedication to the 3 Tay Son brothers, who considered themselves champions of the people and revolted against the Nguyen Lord.

Thap Thap Pagoda: the first Shaolin temple

Built by a Chinese monk when he first came to Binh Dinh, this ancient temple was used to teach monks & their students martial arts in order to ward off beasts/wrongdoers.

The gorgeous architecture was breathtaking.

Binh Dinh girls are traditionally known to be very tough, chicks that shouldn't be messed with. We got a taste of this during the martial arts demonstration, where the girl always won the fight.

Cute kid, but prolly doesn't stand a chance against these gals.

My favorite part of the temple...

Dr. Tuan, our fearless leader, and a 102-year old man.

After over a century of life, he's still got moves and hasn't forgotten a bit of his martial arts.

Final stop: Cham Towers

Overrun by the Vietnamese in the 15th century, the Cham people make up the largest minority group in Central VN.

Relics of the Kingdom of Champa are now great tourist attractions.

From the inside looking out..

By far one of my favorite pictures of the trip. (Thanks Brendan!)

Frustrated. to the point of exhaustion.

2009-12-04T01:09:00.000-08:00

For the first time in 3 months of being in Vietnam, I am frustrated to the point of exhaustion and SICK of the politics. Just a bad day, I know, but I saw a side of this country that I never care to see again. Here's hoping for an "ignorance is bliss" approach for the rest of my time here. I would say I wish I could be ambivalent about the whole thing, but that would defeat the whole purpose of my being here in the first place.

[Just had a great visit with Ong Ken and family in Vung Tau, now back in Saigon, where I was hoping to extend my visa. So basically that means I spent the entire afternoon waiting in lines and taxi-ing to several different government/immigration places. And you know how much I love the gov't here. In the end, it turns out I have to renew it in Vung Tau... where I just came from earlier this morning. C'est la vie.]

But, it was just lovely dealing with those people in the green uniforms. They were as pleasant as ever. If you think bureacracy in the States is bad, you've seen nuthin. Attitude, holier-than-thou mindset, ignorance and impatience comes across exponentially more childish when in Vietnamese. I may have accidentally thrown my passport across the table at one point in the day. I was not aiming...

[Have I mentioned that I'm extending my stay for another 3 months? I'm definitely staying until after Tet (end of Feb) so I can spend it with my family here. But, they are doing a wonderful job of convincing me to stay until April so I can meet the newest members of the clan (Di Uyen and Mo Phuong are both due in a few months).]

The most sickening moment came right after the fiasco that is VN paperwork. I almost walked back to immigration to throw the paperwork in their faces, but knew better. So I was sitting having a late lunch along the busy streets of Saigon when I noticed a crowd forming outside. I tried so hard to avoid the gaper-addiction of joining in, but alas, I succumbed to jumping on the bandwagon. I walked outside to see a woman in her 50's bleeding liters of blood right in the middle of traffic. A man, who must either have been her "xe om" driver or relative was holding her without the slightest clue of what to do. She was crying/screaming in pain at one point and then must have lost consciousness soon after. It took me at least 30 seconds to realize what was happening. It took 10 minutes for any kind of action.

I anxiously asked the nearby people if anyone had called an ambulance. No one. I asked the two policemen standing right next to me if they had called the paramedics. Nope. Actually, it wasn't a negative verbal response at all, just a nonchalant grunt. I literally spun around in a circle. NO ONE HAD CALLED AN AMBULANCE and this poor woman was bleeding into the streets. Traffic would not stop, and drivers even had the audacity to yell into the road for her and the man to get out of the street, out of the way. Really? It was pathetic. People lined both sides of the street and just gawked. No one moved, no one called anyone. This is the ambivalance of Vietnam. All I could do was walk out carefully to help hold her head still and try to convince the man not to move her. After what seemed like forever and many vain attempts, we FINALLY convinced a taxi driver to take her to the nearest hospital. No ambulance. All the other drivers wouldn't dare take someone who could ruin their precious upholstery with blood.

Well one of the many ironies is, I think my Vietnamese is improving. I didn't know I could be angry in Vietnamese, but apparently I can. After she was finally on her way to the hospital, I couldn't help but yell at the two policemen still standing on the side of the road. Childish on my part? Whatever. It was infuriating. They merely answered that it wasn't their responsiblity to take care of the woman. 5 minutes later, a green uniform appeared and began questioning the man for the basics. Woman got hit by a car or motorbike, motorbike ran off, woman left unconscious & bleeding in the streets, she probably never made it to the hospital.

I could say that this is a great example of why I want someone to let me into med school, but that would be too cliche. Maybe it's just another reason to appreciate the States, the Good Samaritan mentality, or just any form of humanity.

Will have updates on Quy Nhon, Phu Quoc, & the last of Rach Gia when 1.) I'm in a much better mood and 2.) have a steady internet connection on my laptop. Heading back to Rach Gia tomorrow for a wedding, so updates to come soon.

I'm a sucker for cute kids: A Day at the Orphanage

2009-11-20T08:23:00.000-08:00

Before we move on to the absurdly cute babies, I first have to say to all the teachers and professors: Mung Ngay Nha Giao! It's National Teacher's Day in Vietnam, a huge holiday where ALL students show appreciation for their teachers (old/new) by bringing flowers, food and planning special events/outings. The role of teacher is highly respected here, so today was a big deal. Thanks for helping me make it through college and learn "stuff" along the way :)

Meet the 3rd child that I will be packing in my suitcase back to the States.

During week 1 of the PV Medical Mission, I visited an orphanage about 45 minutes from the heart of Saigon with the Developmental Team. As many of the children suffer from developmental conditions, such as Cerebral Palsy and mental retardation, the Dev Team was invited to come and see what they could do to help. I think I was supposed to help translate, but I was having too much fun playing with the cute CUTE babies.

PV Development Team with the orphanage admin.

The orphanage is home to around 250 children, around 175 of which have developmental delays or problems. There is only 1 doctor on staff with about 6 nurses, so the facility is grossly understaffed to care for all of the children. Volunteers thus come to help feed the children and spend time playing and giving some much needed love & attention.

He's gonna be a heartbreaker when he grows up.

This little guy is a stud.

We were able to see every single room and child in the orphanage (m&ms in hand), working our way from the healthiest kids to the sickest. Each time we stepped inside, little arms would appear from the cribs expectantly, waiting to be picked up! As you can see from the very first picture at the beginning of this post, I was instantly hooked. It was rough having to leave each room as the kids would start crying the moment we put them down. We had to be dragged out of each room!

It's a rough life, being me.

I do what I want.

Wiped out.

As we starting playing with the kids, we all realized we were in deep trouble and only digging a deeper hole as we toured on. We wanted to take each child home with us! I couldn't understand how these babies were not being adopted. The problem lies with the fact that adoption is just not the status quo in Vietnamese culture. It is very rare for a family here to adopt an overseas child, let alone a Vietnamese baby. The supposed 2-child rule in urban areas may also be a factor. To add insult to injury, there is currently no standing adoption agreement between the US and Vietnam. Our hearts broke even more as we headed to the rooms with the sicker children...

We met these kids in the hydrocephalus room. Babies with this condition have an exorbitant amount of fluid built up in their brains. While shunt operations are common in the States to solve this problem, these babies have failed to see the OR. According to the staff, there is a small window of opportunity in which doctors will operate and these kids are well past the margin. Sadly, there was 1 child who has been lying in his bed with this condition for over 9 years. Others had bed sores due to not being rotated or moved regularly. It is a hopeless situation that is not being helped by government funding.

Looking past the tragedy, we were able to find some light at the end of the tunnel. Children with development delays and CP were getting some help, and even making some improvement. Though many of these kids are expected to stay in the orphanage their "whole lives", the staff do their best to make sure that they help them achieve small goals regularly--hopefully leading these kids to better lives once they are forced to leave as teenagers. Fortunately, NGOs such as Kids Without Borders work to provide them with the necessary resources and support to move on to adulthood. Before reaching this point, however, the therapists/volunteers work with what they have to provide therapy sessions and playtime.

Therapy session for CP kids.

As rewarding an experience as this orphanage visit (and others) was, and as much as I admire the many NGOs working towards change in Vietnam (and other countries), I am growing increasingly frustrated, inching closer towards ambivalence. It's hard to visit an orphanage, hospital or set up a rural clinic (especially with a large team of 40) ONE time. Like a tornado, we come in, visit, take an obnoxious amount of pictures and make promises that, at the time, we think we'll be able to keep. In reality, are we really helping these kids at all? It sometimes turns into a spectacle and we are the one-time ticket holders. It is difficult to remain committed to this one cause with the life distractions and over-extension that often comes. While NGOs are supposed to be the answer to this conundrum--offering a way to remain personally committed in a more efficient way--I think they end up creating more havoc and inefficiency. If NGOs could combine efforts (they do have similar goals, don't they) and actually work together--rather than desperately working separately to collect funding for similar projects--the various mission statements might actually be a reality. Do it for the kids, guys. Gosh darn it, they're cute.

I'm heading to Phu Quoc Island tomorrow morning for the weekend with My-Linh and Jeff, a nurse also a part of the PV team! Can't wait for some snorkeling and crystal blue waters. Stay tuned for posts re: last week's many adventures in Quy Nhon.

Developmental Team in Saigon: Medical Mission Week 1

2009-11-20T07:09:00.000-08:00

Nov 1-7: Busy week 1 of the PV Medical Mission trip. I finally met up with the team Sunday night for a big team meeting and dinner with about 40 people. What a change from traveling by myself for over 1 month! The enormous PV team includes: Internists, Pediatricians, Neonatalogists, Pharmacists, Nurses, Opthamologist, Nurse Practitioner, Physical Therapists, Speech Therapists, students, just to name a few. There's a wide spectrum of personalities that made the weeks both entertaining and fun- though everyone was from California (and you know how those west coasters can be...). Just kidding! Kind of :) They put us up in Tan My Dinh, a 3 star hotel in District 1 and dinner was planned out for us each night at different restaurants. My accommodations were fully paid for (thank god), so no complaints!

Pediatric 2 Hospital

I spent the week translating (didn't know I could translate? neither did I..) for the Developmental Team, which consisted of physical therapists, speech therapists, and pediatricians. I divided up my time between different people and different hospitals each day, so it never got boring. Plus, the fact that I never knew what the plan was until the morning of kept me on my feet. Again, plans are just a formality here, right? Monday morning was spent touring at Pediatric 2 Hospital (Benh Vien Nhi Dong 2). While Pediatric 1 is both older-looking, hectic and more crowded, Pediatric 2 is prettier on the outside, a bit more organized... but still crowded. The hospital used to be run by the French, so it still has a French colonial feel in architecture, leadership and administration. The hospital has 1000 beds, 5000 outpatients and 1500 inpatients. You do the math. As I was with the Developmental Team, we toured the different therapy wards, NICU, PICU and ER.

Well kids waiting to be seen at Nhi Dong 2.

In the afternoons, I taxied over to Tu Du Hospital, where hundreds of baby deliveries occur daily, to help translate medical charts to English. IRT (International Relief Team) was also there training doctors on neonatal resuscitation techniques- Anh Nat, a neonatalogist I worked with in Rach Gia, happened to be there taking the course! The medical charts were of patients with Cerebral Palsy (bai nao) and developmental delays (cham phat trien)- these would be used later on in the week during workshops. Translating medical charts is a great way to learn a different language. Highly recommended. During one of the afternoons, I toured the Tu Du NICU with Priscilla (neonatalogist). At one time, 20 doctors are responsible for hundreds of babies. Naturally, the NICU was run like a factory. One long hallway had many doors leading to various rooms, holding premies with varying levels of complications. When we walked by the cupboard storing the breast milk, we had to wonder how they did not mix up the milk (let alone the babies).

One day was dedicated to touring Benh Vien Nhan Gia Dinh with the Infectious Disease (ID) Team, consisting of an internist, pediatricians, nurse and pharmacist. Since Gia Dinh is a general hospital, the NICU tends to fall on the bottom of the priority list in funding and staffing. However, the head of the department is a shining star in VN's neonatalogy field and it was clear that the medical staff was doing the best they could with what they had. It was also clear, thanks to the ID team's experience and training, that antibiotics were grossly overused/misused. A lot of this is due to lack of education and/or lack of resources. The doctors were very open to our team's comments/suggestions and it seems like we were able to initiate a good partnership that will continue in the years to come.

Most of our time was spent at a clinic sponsored by the Saigon medical school (phong kham da khoa Sai Gon Y Khoa). Here was where most of the translating was needed and where the team worked hands on with patients. They played the important role of ensuring families that their child with CP or developmental delays is still normal and can potentially be an active member of society. Most children with such conditions are often forgotten about or parents are ashamed of their slow development. The therapists were great at encouraging baby steps in progress and teamwork amongst family members in their child's care.

Girls at the Saigon New World Hotel bar- where Pres. Clinton stayed during his visit.

Any lulls in work were filled with getting to know each other, random conversation and even a couple hours of Egyptian Ratscrew (card game). While many of the doctors and therapists are older, there are a few students around my age and a couple docs in their 30s. Many of these personalities I would not have met if it weren't for this trip, so I have loved getting to know everyone. The team dinners in the evenings were probably the most entertaining parts of each day, as throwing 40 people at one table can be quite amusing. A prime environment for some good people watching and you're most definitely guaranteed to be laughing throughout your meal. Nights were free, and so of course we usually headed across the street to the 5 star New World Hotel for some cocktails/live music to work off the rough day in the life of being a doctor. Next post: my favorite part of the week.. visiting the orphanage!

Healthcare Along the Mekong (Part 2)

2009-11-18T07:36:00.000-08:00

Views of Rach Gia

After a crazy 2 weeks working with the PV mission team, things have finally calmed down enough to start reflecting on what's been going on. I arrived back in Rach Gia yesterday morning after 1 week in Saigon and another week in Quy Nhon. I'll be working here again for another 2 weeks with My-Linh, a 3rd year pediatric resident from Phoenix. Before jumping into what we did during the mission, I'm gonna wrap up my first 3 weeks in Rach Gia- Part 2. See pictures at the end of the surgery that I got to observe!

Hands down, the cutest kid in the NICU. (He will also be coming home with me).

So you've gotten the basic layout and underlying problems of the Kien Giang General NICU in Part 1. This might be a good place to broadly explain how the Vietnamese health care system works. I wish I could say that I've been keeping up with the hc debate back in the States, but honestly I've been slacking on my CNN updates these past few weeks. Someone's gonna need to fill me in. I'm hoping Obama's still my guy and fighting for the public option... Regardless, VN does one-up us on coverage for children. All kids under the age of 6 receive free health care; up to 14 years, they receive subsidized care on a sliding scale. SO, while this Socialist country can't get their act together in many other areas, they have trumped us on pediatric access. Don't even get me started on this irony. But it's sad 1.) to even try to compare a country like Vietnam to that of the States and 2.) to find that, when you do, VN beats the US in health care access. The only catch (isn't there always a catch?) is that the child must be registered with a Social Security-like # in order to have this perk. Course, orphans, ethnic minorities and the very poor are often left out. Bureaucracy-wise, the totem pole of medical care from top to bottom falls as follows: national hospitals, provincial hospitals, district hospitals and communes. The gov't support, funding and therefore quality of care greatly decreases as you move down the line. The wealthy can pay their way to the upper-level sources of care, while the less fortunate must depend on the poorly stocked and under-served communes.

Doctors start their 6 years of medical school training following high school; so by the age of 24, they are considered practicing physicians. While only the top of each class can actually test into medical school (y khoa), doctors do not have the experience that US drs gain through many extra years of residency & fellowship. Some will go for extra training in the big cities (Saigon & Ha Noi) or head to France to study for a few months. As hospitals do not pay very well at all (a few hundred dollars a month?), most doctors have their own private practices (phong mach) on the side. After hospital shifts and on weekends, they see patients in their own offices. Due to the low salary, like everything else in Vietnam, corruption emerges in the hospitals. Money is usually slipped into the pockets of doctors by patient families to ensure good, or at least adequate, care. Through conversations with the docs here, ER drs & surgeons are generally expected to have such practices, while NICU drs refuse. I've also noticed that nurses play a different role here. Instead of having the independence, respect and initiative that they display in the States, nurses act more as servants. They follow doctors' chart orders, and only those orders. They seem to rarely act creatively or instinctively and rely on being told what to do most of the time. Though these nurses are intelligent, there is a distinct hierarchy in the hospitals that is followed.

My role specifically was to work on the nosocomial infection control project by monitoring antibiotic resistance in the NICU. I therefore worked with the drs and read (learned how to read Vietnamese by) patient charts to see which antibiotics (tru sinh) were used with which infections (nhiem trung). What did I find? There's a lot of antibiotics being used, and for long periods of time. And often before blood cultures show positive results (only 20% of patients). Ampicillin and Cefotaxime are used as an empiric combination treatment, usually followed by doses of Gentamycin. Standard practice in the States recommends Amp used in combination with the narrower-spectrum Gentamycin. Also, fluoroquinolones such as Ciprofloxacin are used a lot in these premies- in the States we avoid using these antibiotics on kids under the age of 14. Imipenem seems to also be overused. A negative blood culture within 72 hours is supposed to be the signal to stop antibiotic treatment. Cultures should be drawn every 3 days. I can't be sure whether such poor practices occur due to limited resources and/or lack of education; but we'll find out soon once the Infectious Disease team follows up.

A reminder of the frustrations of medicine.

Now on to the surgery! A couple weeks ago, I follwed Anh Phuc up to the really nice surgery wing of the hospital to observe one of the patients that has been in the NICU for entire time that I was there. His surgery is a perfect example of the frustrating bureaucracy that health care here usually entails. This 1 mo. old had everything from pneumonia to sepsis, and now had a distended belly due to necrotizing enterocolitis. The surgeon (God-complex, per usual?) came down to the NICU every other day for three weeks, refusing to operate on this poor kid... because he didn't have time or was too worried that surgery would make his condition worse. He finally agreed to operate during my last couple days in Rach Gia and we discovered as soon as he opened up the baby that it was too late. The bowels were dead and the intestines were shredded. Everything was leaking into his stomach. The surgeon decided very soon into the surgery that he would close up this kid after examining his intestines. If he had only operated a little sooner, he could have given the baby a better chance of survival. With nothing else to do, we regretfully walked out of the room to change and head back downstairs. It was one of those situations where you feel angry and bitter, but can do absolutely nothing about it. Let's not even mention the fact that the anesthesiologist was less than tactful, leaving the oxygen bag unattended as he walked away to take care of other things (luckily Anh Phuc was there to resume bagging). He also blatantly told a fellow anesthesiologist before we even started surgery that he could take the ventilator in 5 minutes, the amount of time he allotted until this baby would die.

Healthcare Along the Mekong (Part I)

2009-11-01T07:39:00.000-08:00

I just met the PV team of 30 doctors, nurses & therapists that I'll be working with for the next 2 weeks. It's a huge (30ish) and diverse group of people, so I'm excited to get started tomorrow morning! There's a team staying in Saigon (whom I'll be working with), a team going to Rach Gia (where I just came from), and a team going to Binh Dinh (where I'll be going to next week)- so Project Vietnam will be making quite a presence these next couple of weeks. I arrived back in Saigon this past Wednesday, driving the 6 hours from Rach Gia by car with the 2 Hanoi docs/professors. I spent Thursday with them before their flight back to Hanoi, and then had some free time before meeting up with the group today. I think my Vietnamese has really improved since hanging out with Anh Hai & Anh Cuong all last week (we taught each other our respective languages), and I'm even reading more too. And I finally got to meet Dr. Quynh (the head of Project Vietnam), who I've been emailing/skyping back & forth with for the past few months. I have a feeling that these next days are going to be jammed pack, so I wanna tell yall as much about my time in the Rach Gia NICU before I forget! Here's how I saw health care along the Mekong... part 1.

The awesome team of nurses and doctors in the NICU, who I had the privilege of working with for the past 3 weeks. Everyone is really caring and helpful, despite the lack of smiles in this picture.

We'll start with the set-up before we get going with the details of Kien Giang General Hospital. There are 6 rooms total in the NICU, 4 inside for the more seriosusly ill babies and 2 outside for the healthier little ones. The NICU is one of the cleanest wards in the hospital, second only to the OR probably.

Room 1 is where the babies needing continuous care/or oxygen support.

Room 2

Room 3

Room 4

This room is reserved for breastfeeding & educational meetings with the moms. As parents are prohibited for the most part from entering the NICU rooms, this one is packed on days of meetings.

The other rooms of the hospital are absolutely abysmal, especially if you even dare compare to US standards. There is dangerous construction going on all over with wires hanging freely, and the hospital is very "open" to the elements (think of how Shortpump- for you Richmond people- is set up, but obviously ignore how CLEAN Shortpump is). Rooms pretty much consist of 4 concrete walls. Windows will often lack glass and instead have bars. The beds are old and rusty. Don't even think about white fluffy pillows or sheets. 20 patients plus their families are often squeezed into 1 room. Family members that can't fit can be seen lying on the ground in the halls/outside, eating or sleeping. And there is no air conditioning. I really wish I could tell you that I was exaggerating.

Now back to my beloved NICU. The babies here are really sick. The doctors joke that in the States we have so many medicines but no sick babies, while here they have all these kids fighting for their lives and barely any medicine. It’s true. The more “popular” illnesses that these neonates face include Jaundice (vang da), respiratory distress (suy ho hap), Hyaline Membrane Disease (benh mang trong), pneumonia (viem phoi), being born premature (non thang) and most of all sepsis (nhiem trung so sinh), just to name a few. For the 3+ weeks that I spent in RG, there was an average of 40 babies at a time. With every new baby coming through the doors, the same symptoms seem to pop up again and again. And it’s usually a combination of 3 or 4 of these, too.

While the doctors and nurses are excellent health care providers willing to give it their all to help these babies, their hands are often tied with the age-old problem... insufficient resources. I could practically hear Paul Farmer screaming "preferable option for the poor" in the background. There aren't enough CPAP machines, ventilators or oxygen monitors… and so there’s a lot of switching around going on. There aren’t enough child-sized breathing machines, ZERO neonatal machines, and barely enough adult machines. So, when a baby in the NICU needs to breath some oxygen via support, the doctors need to ask permission to borrow a machine from the PICU. If there isn’t enough, then an adult machine is brought in. Adult machines aren’t exactly the best way to go, but I guess it’s better than nothing. Plus, all of this rolling around doesn’t help much with the hygiene and sterilization. Though most babies have jaundice at some point during their stay and are in need of phototherapy, there aren't enough blue UV lightbulbs for the demand. Regular white bulbs (which do little but warm them) are used and some others are broken.

Room 5 is reserved for the "less sick" babies with Jaundice.

Remember those flip flops I keep mentioning? Here's proof that they're worn.

I think an even bigger problem that I noticed my first day here is that X-rays are taken in the hallway! There’s no actual x-ray room, so babies (including ones hooked up to CPAP machines) are disconnected from whatever wires/cables, rushed 10-20 ft into the hallway for a quick picture, and rushed back to their bed. It’s quite a sight watching this happen, and you can’t help but think that it might not be in the best interest of the baby to do this. Sepsis and collapsed lungs are often a result. There's only so much handwashing (which the doctors/nurses are good at) that can be done to prevent nosocomial infection. When it comes down to it, handwashing/hygiene should be an accessory (albeit mandatory) infection control process. Here it seems to be the only way of preventing infection, which is impossible. Washing hands should support the infection control going on in other areas of daily care. Antibiotics need to be used correctly, patients need to be correctly handled, the environment needs to remain sterile and any foreign matter should be avoided.

The hallway/chart writing room/x-ray room.

Have I mentioned how cute these babies are? Absolutely adorable. I'm stealing one before I leave.

the historical Hon Dat district

2009-10-24T09:58:00.000-07:00

Finishing up Saturday night here, after my last week of hanging out in the NICU, tasting more great food thanks to the docs/nurses there, karaoke and cafes. I love it here in Rach Gia! Just a couple exceptions to my enthusiasm: I was getting eaten alive by mosquitos; I was woken up last night by a little lizard that decided to perch on the wall near my head (harmless & kind of cute); I literally JUST spotted my first cockroach (biggest fear after spiders & jellyfish) and it happens to be crawling around my room. My mom just told me (via skype) that they can't climb walls.. or beds.. and I'm not sure that I believe that. But, I'm gonna pretend because the doctors are all asleep so I have no one to chase it away (trust me, I've tried everything that I could do from standing on my bed).

Last night was full of karaoke with a few of the docs/nurses, followed by some strong liquor accompanied with snails, crab and goat meat. I managed to sneak in some Brittney Spears, Michael Jackson & Say You Will- America's finest, of course. Thursday was an especially cool day: I got to watch a surgery in the afternoon and do a little sight-seeing afterwards in the evening. I’ll save the surgery story for a post coming up soon as I need to steal the pictures that Anh Phuc & I took.

I met 2 doctors from Hanoi who are also staying at the villa, BS Hai and BS Cuong. Anh Hai is a doc and professor in the ER at Hanoi Medical University. BS Cuong is a resident at the same hospital. They are both here teaching courses at Kien Giang. On Thurs, we all went with Anh Thanh, a doctor in the ER (Khoa Cap Cuu) here in Kien Giang to Hon Dat, a historical district about 30km from Rach Gia. We first visited the monument and tomb dedicated to the soldiers. (I would link this up to wikipedia so you can get the full story on this battle site.. but it's all in Vietnamese).

Anh Hai & I in front of the monument

Afterwards, it was a trek up the mountain to a small “museum” with old war remnants & guns. It was an interesting place to say the least. The museum of sorts is run by an older gentleman who was very enthusiastic about the weapons. I had mixed feelings seeing some of the displays (see the picture below and you’ll see what I’m getting at). And of course there were many honoring Ho Chi Minh (Bac Ho)- who I also have mixed feelings about, but would never say them out loud in places such as these J

Boys will be boys. The two docs with the US Air Force helicopter.

A view of the Mekong River Delta from the top of the mountain.

Being the only American visiting this museum of sorts was intriguing... especially when there's a display like this questioning if "Americans are friends of the Vietnamese?"

On the way home we stopped by a restaurant because the doctors insisted that I HAD to try buffalo (thit chau). At least I’m hoping it was buffalo and not dog. So, we all feasted on buffalo meat (and brain and stomach lining… and I’m sure other body parts) and some Tiger beer. It was a good time all around! It’s been great hanging out with these two doctors because we’ve been practicing my translating skills between English/Vietnamese, as well as some French (Anh Hai is pretty much fluent in French and knows a lot of English). I’m hoping I can go visit both of them in Hanoi around December once I’m finished with my PV work. I've heard so much about the capital city and the HMU hospital.

Temple festival and singing doctors

2009-10-19T10:14:00.000-07:00

Still trying to catch up here: had an eventful week last week! This past weekend was a temple holiday (le hoi) commemorating Nguyen Trung Truc, a Vietnamese fisherman who died in Rach Gia trying to fight off the French colonial forces. The 3-day celebration marks his death with countless people traveling to the Kien Giang province to eat, worship in the temples and celebrate at night. It was CROWDED beyond belief, we could hardly get anywhere. The town was decked out in decorations for the 1x/yr holiday and it was quite a sight watching people cram into the temple.

The man, himself.

In order to feed the droves people, everyone cooks and serves food together by the temple (all vegetarian). On Wednesday afternoon, Anh Phuc and I had "com dinh" (temple food) for lunch. A tasty meal of rice, tofu, egg rolls and vegetables. On Friday, Chi Nhan and I went to "cung dinh" (I think) or make our offerings at the temple after work. There were rumors of people getting mugged and such amongst the crowd, but we made it through just fine. It was a cool experience overall to take part in the temple happenings!

To continue with the festivities, I went to to my first Vietnamese birthday party (sinh nhat) on Saturday with Chi Loan, a physical therapist around my age who works at the hospital. Her coworker's daughter was turning 1 and so a big dinner party was planned at their house. Here, 1 month and 1 year old are big birthday celebrations. After that, I guess you're on your own? No sweet sixteen or raging 21's I guess. The dinner was fun and the food was great! Mostly family and friends, and of course, karaoke.

And speaking of VN's favorite past-time, I was lucky enough to have been in Rach Gia for the hospital's annual karaoke competition :) The doctors asked me earlier in the week if I'd want to come watch with them... um, YES? Each unit (khoa) was allowed to have 2 people compete, so there was a total of 60 doctors and nurses competing. Let's just say it was quite an entertaining night- 4.5 straight hours of singing doctors. There were some singers that were absolutely spectacular, others.. not so much (but their dance moves made up for their vocals). The NICU (khoa nhi so sinh) was represented by Anh Phuc and a nurse- they were really good. Unfortunately no one we knew won. But afterwards, we all headed back to the khoa for some "chao ga", a rice soup dish with chicken and "goi" or salad. Delicious, just like grandmom used to make it. And to finish off the night? A motorbike ride around town and some "che thai", minus the sau rieng (durian) of course.

Our talented singers!

My favorite audience member.

The beauty in poverty?

2009-10-19T07:39:00.000-07:00

One thing that has struck me here is the extreme poverty. Now I know that there is rich and poor virtually everywhere you go, but I have never seen poor as poor is here--even in the few developing countries that I have worked in so far. And to make it worse, the gap between the wealthy and the very bottom is huge, growing even wider as Viet Kieu and foreign investment seep into this country. Imagine the two extremes in the US that we complain of, and multiply that image exponentially. Driving up to the “resort” of Da Lat and staying in the town, we drove by tin roofs and dirt walls that were soaked during rain storms and ornate, luxurious French villas. The tin roofs here are no different from the ones in Cange, Haiti- for those of you who have read “Mountains Beyond Mountains” or follow Paul Farmer.

In Saigon, I walked by homeless men wearing only pants and lying in the streets, and war veterans with missing limbs begging for money. The VA system over here is not so good. One street over, there are high-end stores selling Louis Vuitton and Lancome Paris (who knew they had these in Vietnam?). But so far, Rach Gia has probably shown me the very bottom of the heap. Here, dilapidated boats serve as both house and livelihood: residents fish in the Gulf of Thailand by day and sleep in hammocks over their unsold catch by night. And these boats are nowhere near those we see on TV and in the movies.

Driving through the Mekong Delta region, boats such as these are the norm and there’s almost a “Three Little Pigs” complex happening. Sticks, dirt, and if you’re lucky, some tin roof draped across the meager scaffold. It’s difficult to imagine life in this setting… until you get to go inside and share a meal.

In poverty, there’s the much talked about bad side. Aside from the utter despair and helplessness, there also lies the deceit. I’ve already mentioned how the government can take advantage of their seat of power in a reverse "Robin Hood" sort of way… steal from the poor and give to the rich. However, you don’t have to look too closely to see lay people taking advantage of the situation too. While my mom and I were walking around in Saigon a few weeks ago, we passed by an elderly woman literally rolling around on the street. We began to take out our money to make a small donation. Upon the sight of the bills, the woman immediately jumped up and proceeded to demand a specific amount in order to buy coffee. Now, if you’re truly poor and rolling around on the ground, chances are you’re not going to have reflexes like a cat or ask for coffee first thing. The people (the many many people) selling lottery tickets for a living are not much better. Young children will use their cuteness to their advantage in guilt-tripping a purchase, elderly women may pretend to be crippled or blind- a woman in An Giang, who acted blind, told me she liked my shirt; teenagers have been known to rent toddlers to carry around with them to win over hearts. It’s a sad reality, but after having a glimpse into their lives, I can’t really blame them. Survival of the fittest is entrenched deep into the culture and society, especially when the government does little to help and the rich turn their eyes away from the sight.

I have been able to see the “good side” of poverty, if there is any such thing. My time so far in Rach Gia has given me this perspective. There is a paradoxical beauty in poverty, one that is lost in the western world among the wealth and ambivalence. You can’t deny the utter beauty of Vietnam. The fantastic scenery is hard to escape when you’re driving by the poorest regions of the country, and it is lost as you join in on the hustle and bustle of richer cities such as Saigon. Development tends to ruin the landscape, but haven’t we already seen plenty of that in the States? Well, it’s especially true here. And when you look even closer, you’ll see the beauty of the people in rural areas such as Rach Gia. Like I said before, I could not fathom how people could live in such conditions until I was invited inside.

The most wonderful experience to have while traveling in a foreign country, I think, is to share a meal in someone’s home. To be invited in as a guest is an honor that I will never overlook or forget. For a person to open his or her door to an outsider is one thing, however, it means so much more when he is struggling to feed his own family. I have had the opportunity to hang out with a few of the doctors' and nurses' families since being here, and these have turned into my favorite memories so far. I got to see a different side of the docs with their parents & kids, kind of like actually seeing your professor in normal clothes. I felt bad accepting food at some homes since it was clear that they were working hard to make ends meet. One thing about the Vietnamese culture, though, is that when someone offers you food… you have to take it. It’s a sign of respect and friendship. As much as you excuse yourself, the food keeps showing up in front of your spot so I’ve learned that the best thing to do is to take it graciously.

In poverty, there is this sincere generosity. While its strange to say there is good in poverty, there is a weird paradox. Though we can never condone the situation that brings this humanity out of people, there is something to learn. Why some people forget the kindergarten lesson of sharing as their income increases while those with nothing continue to give is beyond me. I am getting off my soapbox now. Enjoy the pictures at least.

PS. I just realized that I'm gonna miss Halloween, which makes me really sad cause I wanted to dress up as a zombie this year... picture outrageously fashionable zombie from (So You Think You Can Dance) Wade Robson's "Ramalama" routine. Yes I watch(ed) that show, and no I can't watch it here.

PPS: GO PHILS!!

A Cause Worth Talking About: Truong Khuyet Tat Tinh Thuong

2009-10-16T08:35:00.000-07:00

On Sunday, Teresa and I visited a school for deaf children, about a 20-minute motorbike ride away from Rach Gia. The school- Truong Khuyet Tat Tinh Thuong - is run by 6 nuns, who take care of over 100 deaf children. The kids vary in their ability to speak, some able to communicate verbally and others depending solely on sign language. When we arrived we got to talk with some of the kids and it was great to see the progress that they've made over the years. The nuns always try to encourage the children to speak verbally while using sign language. As they explained, the only way to overcome an obstacle is to be stubborn and keep at it. I was really impressed with how clearly some of the children spoke! They were very curious about the States, many of them wanting to visit one day.

These kids were absolutely precious, and I was in complete awe at their determination and drive for better lives. While many are orphans, the kids that do have families live at the school since it offers more opportunities for growth and development.

To give back to the school, the children are expected to help in the cleaning and upkeep of the grounds.

As you can tell, it's not much-but for most of these children, this school is their ticket to success and a better life. Many families in this area are extremely poor, so a bowl of rice at this school is a luxury.

The boys dormitory. About 100 children are fully taken care of here. If you do the math, 6 nuns for this many kids is no where near enough help. The older kids chip in where they can, but more help is needed. They have come up with a good idea to support their efforts (see below).

To pay for the upkeep of the school, including food and clothing for the kids, the girls (along with a couple volunteers) sew garments, table cloths, pictures and napkins to sell. See pictures below of their incredible creations! Right now, Su Hoa (the lead nun) sells these pieces of useful art to customers in France, working through an elderly couple that heard about the school a few years ago. Customers come by word of mouth alone, and the money coming in through sales is barely enough to keep the school running. They sometimes get private donations, but as the surrounding community is poor, this doesn’t amount to much. I asked if they had a website to advertise the school’s work- the answer was no, so I figured I could use this blog to help out if possible. So, if you would like to make a donation, or purchase some of the hand-made items below, please email me J If there is interest, I can let you know on prices and such. Thanks for any help you can offer, I know the kids will really appreciate it!

As we were about to leave the school, Teresa spotted the many puppies rolling around the grounds of the school. Of course, we couldn’t leave without one, so this is “Bi Bi” on what I am sure is his first motorbike ride. He seemed to enjoy the scenery.

Somewhere near Cambodia

2009-10-13T10:13:00.000-07:00

I got to skip work today and take a little holiday with some of the nurses to the Vietnam-Cambodian border :) ..At least I think that's where we went.. We definitely spent some time in An Giang Province (Rach Gia is in the Kien Giang Province) and possibly Tinh Bien? Everytime I asked where we were there was a different name, so it was hard to keep track; but we were definitely near Cambodia. Regardless, one thing I am sure of is the incredible drive through the Mekong Delta region, which was nothing short of idyllic scenery.

Have I mentioned how beautiful of a country Vietnam is? Every new place I get to explore here always exceeds my expectations. The views are even better than what you see in the movies and I wish my pictures and descriptions could come close to doing them justice. The Mekong Delta is known as the "rice bowl" of Vietnam, supplying the entire country with the staple. We drove by the rice paddies, boats made into houses and markets all floating on the rivers, canals and streams. My favorite part of the day was hands down the drive to and from our destination.

Our stops for the day included a Khmer pagoda/temple. This was my first visit inside a temple, so I was fascinated by everything! The decorations were gorgeously ornate, and there were so many gods inside that I can't even begin to explain their names or meanings. It seems like the more south (nam) you travel in Vietnam, the more temples and less churches there are. We made offerings with incense and asked for a piece of fruit in exchange from the altar. A monetary offering is also expected as you leave. I was told what to do the whole time because I had no idea what was going on. It was a great experience though. One of the nurses explained that I can't eat the apple I asked one of the gods (?) for, so I'm not really sure what to do with it (it's now sitting on the spare bed in my villa room).

We walked past and through many outdoor markets, one of which was set up like Saigon's Cho Ben Thanh, but no where near as big. This region is famous for it's "mam", which is some odd concoction of fish or squid or shrimp in a ghastly liquid. I'm making it sound terrible (which is how it really smells), but I'm sure it's a tasty delicacy. I just don't think I have the stomach to, well, stomach it raw (which is how it should be eaten). This is another food item to add to the very short list of foods that I will never try even once- second to dog meat.

Side notes: 1.) I forgot to mention that I got badly burned by a motorbike muffler in Saigon and now the blister broke and it's killing me. Luckily, I know where the hospital and doctors are. 2.) I find out where Binh Dinh (where I'll spend 1 week in Nov with the PV team) is if anyone else is a mapfreak like me- check out Quy Nhon, further north than Da Lat. 3.) I'm on a roll, stay tuned for further anecdotes tomorrow.

Welcome to Rach Gia, finally!

2009-10-13T07:24:00.000-07:00

I was walking home from the hospital (Kien Giang General Hospital) yesterday and remembered I'm long overdue for a post- I can't believe it's already been 1 month since coming to Vietnam! I've been putting off the updating because it seems like there's too much to talk about and I've been trying to organize my thoughts. Course now, my mind's on overload and a little overwhelmed with everything that's going on somewhere in between two worlds. In order to avoid verbal vomit, I'm breaking up my thoughts & anecdotes into a few different posts, so bear with me.

I finally arrived in Rach Gia (RG), a small town in the Kien Giang province of the Mekong Delta region, on Tuesday morning. Dr. ("Bac Si", BS) Phuc (but I'll call him Anh Phuc) picked me up at the small airport bright & early and we set out for the scariest motorbike ride of my life. Now you know how I LOVE the motorbikes here, but this welcome-to-Rach Gia-moment involved me holding onto the back of Anh Phuc's motorbike for dear life with my luggage on my lap. There's not much room for a normal sized suitcase and 2 people on those seats. Needless to say it made for a good story and a hilarious way to get to know my first RG doc (he asked questions, I nodded in angst, afraid that opening my mouth would somehow slide me right off the seat). Despite the panicking and numerous phonecalls the night before in Saigon over paperwork still not being complete, we were able to drop my stuff off at the hospital's villa, grab some breakfast and spend my first day in the Kien Giang General Hospital.

From the first day, I knew that I would love working here much better than Saigon. RG is a growing town on the coast of the Gulf of Thailand- less traffic/people, better scenery. Despite the poverty here, the growing global market & "Viet Kieu" (ppl born in VN but now reside in the States) investment is expanding this fishing town into a booming southern suburb. There aren't many tourists here, which is actually really nice and has given me the chance to truly experience Vietnam-- without the safety blanket of English speakers & American influence. The doctors/nurses in the hospital's NICU (khoa nhi so sinh) are incredibly welcoming, generous and friendly, willing to teach and work with me from the start. The 4 doctors, including Anh Phuc, are much younger, in their 20s/30s, so they are easier to relate to and hang out with. Being genuine ("that tha") does not stop at the hospital, but seems to be second nature for everyone here. Must be that southern hospitality.

This past week I have gotten to know the doctors, nurses and other health care workers in the hospital really well. I had lunch at Dr. Nhan (BS Nhan or Chi Nhan)'s house my first day here, as well as dinner at Di Nga's house (a lady that also works at the hospital). On Wednesday after work, Anh Phuc took me for a ride around RG to see the stellar views of the coast. Myself and a couple of the nurses ("dieu duong") went over to his house later that night for some karaoke, a big VN hobby; afterwards I went with him and another young doc to a beachside cafe for some cafe sua da. Saturday I had lunch at Di Nga's house with her and her daughter Teresa (she's 24 and is becoming a good friend). That night Chi Nhan's daughter, Nhi (15 yr old), and her friends showed me around town on their bicycles (was great to get back on a bike). We went out for some "che" (dessert soup) and "tra sua tran chau", a kind of bubble tea. All in all, I have felt very welcomed in RG with the great company and conversation.

My first few days in the hospital (benh vien) were spent shadowing the doctors in the NICU to get a feel for how health care works here. The NICU (khoa nhi so sinh) is one of the cleanest and better organized departments in the RG hospital. As far as I can tell, everyone is very careful to wash their hands before/after going into the rooms and in between babies. Masks and gloves are worn when necessary and the docs/nurses seem to really care about their patients, which is awesome to see. I still don't understand the flip flops in the hospital (isn't that against OHSA in the States)?Right now there are over 20 babies on average per day, which they tell me is less than usual. TINY babies, but well taken care of. An obvious problem is the lack of equipment (and personnel). The doctors have a hard time getting the supplies that they need due to high costs (and that beloved bureaucracy). They only just received oxygen monitors, and this was thanks to a PV-related donation. Can you imagine trying to take care of premies, many of whom are in respiratory distress, without a way to monitor oxygen intake??

After word that my paperwork was complete on Friday, I started working on the antibiotic resistance/nosocomial infection portion of the PV neonatal infection control project. Since everything is still done by paper here (only 1 computer in the NICU), it gets to be a little tedious finding the information that I need in the charts, especially with the renowned handwriting that even VN doctors seem to possess. But, they have been helping me decipher both the hieroglyphics & the language. I guess I'm learning to read Vietnamese by the patient charts now! I've been teaching one doc English as well. Like many VN doctors, he knows some, but is very eager to learn more (many know French). Just hanging around and chatting with everyone has helped me in improving my Vietnamese--which is a good thing, as I'll be a translator for the team of doctors coming to Vietnam in November... Another perk of working in the NICU here: a plethora of fruits, drinks & snacks are always available it seems! I barely eat full meals here since in the mornings I have sua dau nanh (fresh soy milk) or cafe sua da (iced coffee) waiting for me, and the afternoon is usually broken up by a snack break of fresh fruit (today we had corn on the cob, which was delicious!). Now that I've been able to spend a significant amount of time in the NICU and I'm finally "official", I can take pics which I'll post in a "health care" post soon. I've learned a lot in my first week and can't wait for you all to see what it's like here!

The hospital-owned villa, my home for now. Foreign guests and doctors of the hospital can stay in 1 of the 8 rooms. Very spacious inside, rooms are good (minus that shower without the tub business), and can't beat the scenery.

The first thing I see as I step foot outside each morning for my 10-minute walk to the hospital. Who knew RG would come with an ocean and lighthouse view.

Lighthouse & right side of the street. The villa is in a newly-built area, thanks to the investment that has poured in to RG. The neighborhood that I'm staying in is exponentially nicer than the RG norm (pics to come on the poverty here).

And the left side. Still construction going on. Kids come here to play soccer everyday after school.

A hypothetical plan

2009-10-05T06:37:00.000-07:00

Firstly, I'm glad to hear everyone is safe/sound after Asia was hit hard with the forces of mother nature- typhoons, earthquakes, tsunamis? That's rough. Aaron's fine in Indonesia, Kate/Mario/Fratburd/Lucy are a-ok in Taiwan & China. The typhoon here in VN hit further north in Danang and Hue.

Secondly, I was walking around this morning and Michael Jackson tunes were suddenly blasting from this one little shop- Billie Jean and Black or White, anyone? It took all my might not to pretend that the sidewalk was the light-up one from his music video and start moon walking. (Oh MJ, how I miss you.) Which reminds me, good luck Pi Phi at Lip Sync this week! Just got the facebook invite and wish I could be there. I do expect a win from you seniors, however. Must carry on the tradition that we so proudly set with our own dedication to the late King of Pop. Here's my shameless plug: if you're on campus this week, help Pi Phi in supporting childhood literacy by buying raffle tickets and/or coming to the show on Tuesday night! Promise you'll be entertained. Ok, I'm done. "You don't even go here."

Thirdly, I was told that I look Japanese, Korean, Chinese, Vietnamese, Spanish (?) and American (??) all in one evening. And that I speak English very well (well thank you). Haha I like it here. One frustrating thing is that while I want to practice my Vietnamese, everyone here wants to practice speaking English..

Fourthly, enjoying my time in Saigon. On Thursday I had dinner with my uncle (Cau Bao), aunt and their friends at Cho Ben Thanh. Friday I ran some errands for PV with Duy, one of the volunteer administrators here. Between running to storage, sending books off to Hanoi via train for doctors and delivering oxygen masks to a hospital, I felt like I was on my favorite reality TV show, The Amazing Race. Only, there wasn't really a cool prize at the end, and no one hosting the show. But after finishing, we did motorbike over to Cholon, Saigon's Chinatown to have some Thai che, a VN dessert soup of sorts. That night I had dinner at Quan An Ngon, literally "Restaurant of Good Eating", which is turning out to be my favorite restaurant in the city. Villa style, they have authentic VN dishes and you can walk around to see them cook the food right in front of you. Crazy crowded though, so reservations recommended. Sunday (yesterday), I went to mass at Notre Dame cathedral with my aunt and uncle, then to dinner at a nearby outdoor eatery. I got to eat chicken feet for the first time, quite tasty! They didn't understand why we don't eat the feet in the States though, and I couldn't come up with a good enough answer haha. They also had tongue and intestines, but I think I'll save that for another time. Cau Bao also invited me to eat thit cho... (dog meat)... at a later date. BUT, I think I'll save that for another time too... (aka, never.)

Ok so now that paperwork is on its way to completion.. here's the hypothetical plan, all for formality's sake of course. I leave for Rach Gia (a small town further south of Saigon) early tomorrow morning for 3 weeks. Instead of taking a bus (xe do), I opted for flying for safety and time's sake. If you know me well, you know that I tend to fall asleep within 10 minutes of being in a moving vehicle (which, I should mention, I do not do on a motorbike). My famly has convinced me that this might not turn out in my favor being on a crammed bus with people that wouldn't mind some spare change or a laptop. Plus, a flight would take 45 min, whereas the bus would take 7 hrs.
So I'll be working at a hospital in RG while staying at their villa reserved for doctors and out of country guests. I'll be helping out with the antibiotic resistance portion of the PV neonatal infection control project. I'll spend the next few weeks monitoring antibiotic use in the NICU department, shadowing/observing care, and collecting appropriate data in order for the team to help come up with strategies to reduce the emergence of antibiotic resistance and nosocomial infection in infants. After RG, I head back to Saigon where I have 1 week before the team of doctors arrives in November. I'll work on the medical mission trip with them, spending 1 week training/working in Saigon and the 2nd week working in Binh Dinh (still not sure where this is yet, but I feel like someone told me N. Vietnam..). After that, I head back to work in Saigon for another couple weeks in a different hospital TBD. ...I'll probs update tomorrow when this whole plan changes...

After November...? A trip to Thailand or Hong Kong to meet with up Kate Simma, Sarah frat Burd and Lucy Hester? Aaron, you coming over here at some point? Mel Salyk, a trip to India? (If funds permit). I am considering extending my trip (don't tell mom) though. If I can find a teaching job here, I'd love to stay through to next year. Tet, lunar new years, is huge in VN and falls in February this year, which would be cool to see. Of course, if some med school happens to decide that they'll let me be a doctor, that'd be just grand too :)

My over-priced Lonely Planet

2009-10-04T21:27:00.000-07:00

Hello over there! Just dropped off my laundry at a street corner (sounds sketchy, right?) and am now sitting at a cafe with a great view of the streets of Saigon on this fine Monday morning. Promised more pictures, so here's where my Lonely Planet has led me for the past week or so.

Pham Ngu Lao area (backpackers' district)-

great views from my hotel (N&N Hotel)

I've gotten to know the two families that run this very new hotel (just opened 2 weeks ago) pretty well the past week. They each have a son my age, and they've been taking very good care of me. Every morning at 8am I get breakfast delivered to my room. They don't have room service here, so I've tried to get the lady to stop going out of her way, but she refuses! At night, I'll sometimes head downstairs to have a beer with the people that work the night shift. If you're ever in the area, I recommend this hotel (khach san), around $22 USD a night.

Ben Thanh Market (Cho Ben Thanh)-

A famous market in Saigon, which is housed like this by day, and moves outside by night.

I walk through this famous market quite often, great for delicious, cheap food, clothes, souvenirs, SHOES, pretty much anything you'd ever need. There's TONS of little stalls packed like sardines- this is the main middle walkway. If you ever get to visit, be prepared for a lot of eager shopkeepers, bargaining and excitement!

This is how I avoid scurvy. Durian is still gross. Right around the corner is the fish market, which is always fun to walk through. When my mom & I strolled through, we jumped (and ran away, hence no picture) when 2 frogs were thrown violently down in front of us. Frog legs are pretty tasty here, but now I know how they're prepared before being put on the table :(

Parks of Saigon (Cong Vien Van Hoa)-

a great escape from the dust, crowds & heavy traffic of the streets. The trees help thin out the pollution (just getting over the resulting runny nose/sore throat now) and the gorgeous flowers are just lovely.

Kids skipping school, tisk tisk.

Gyms are expensive for most people to join, so in the early mornings & late evenings, they come here to exercise.

Cong Vien Van Hoa is known for its huge tropical trees and artful statues that line the paths.

A very old tree.

Another great park near my hotel that I walk through daily. In the mornings and evenings there are people exercising, playing a type of hacky-sack game and badmitton.

Notre Dame Cathedral (Nha To Duc Ba)

ND in Vietnam? I was a little thrown off too, but what a beautiful church! The morning 9:30 mass is in English, which attracts lots of tourists. I prefer the later service because 1.) it's in Vietnamese (when in Rome, right?) and 2.) it's SO much cooler to sit in a non-air conditioned building in the evenings. (The constant camera flashes gets slightly annoying, though.)

Art Galleries-

Vietnam is a prime place to buy great art. The artists are extremely talented and you can't beat the prices. I've visited so many different galleries and have had to stop myself from buying something with each visit- I doubt I can fit paintings in my suitcase :/

The epitome of NAP TIME :)

A cyclo driver taking a break from the hassles of the day. Normal routine: wake up, cafe for iced coffee (cafe sua da), work for a couple hours, lunch, nap for an hour or so, work work, an ice cold beer to finish off the day. It's just a little sad that the government's trying to do away with cyclo drivers for good. With the number of motorbikes and taxis now, they're almost non-existent! I'll try to catch a ride while I'm still in the country and before they're wiped out :( I usually take a motorbike taxi to work everyday (xe om), a much better bargain (and more fun) than normal taxis at 20,000 VND a trip.

A different kind of language barrier

2009-09-28T07:20:00.000-07:00

Morning! I'm actually eating dinner right now, but according to my mac, you guys are probably eating bfast or heading to work :) I'm not sure how I'll re-adapt once I get back home, cause I just paid a whopping 15,000 VND for my dinner of noodles with stir fry veggies & beef... which is less than $1. I start to cringe now if my meal costs over 60,000 VND (3 bucks!).

This morning I moved out of my 3 star hotel and into a smaller hotel to save some money due to the last-minute schedule change. Can't beat $22/night! The staff downstairs is really nice and Duy, one of the PV coordinators is friends with the guy that works here. Connections are helpful when it gets you a huge bed and front view. Bathroom's tiny, but at least there's an actual shower (unlike that interesting experience in Da Lat!) and it's super clean. I'm living in the backpackers' district, or Pham Ngu Lao area, which consists of a bunch of smaller side streets.

Also known as the budget part of town, there's so many tourists and, in turn, a lot of great cafes and shops. I walked around today after a dusty lunch (like Vung Tau, some places aren't into doors here) and heard people speak English. It's been a while! I checked off Bobby Brewers Cafe from my Lonely Planet for some late afternoon "cafe sua da" too. The 3-story cafe has lots of comfy couches perfect for reading, free wifi and plays movies on the top floor. Planning on seeing "500 Days of Summer" tomorrow after work.

So now that I'm pushing 3 weeks in Vietnam, I've discovered a new kind of language barrier. To begin to explain this, we'll start with my illiteracy.. which I swear is getting better! While I was in Vung Tau, Di Uyen was teaching me how to read/write Vietnamese since, as I said, I’m illiterate. Vietnamese characters are the same as English letters, however, there are a lot of accent marks (similar to French) which differentiate pronunciation. A fellow tourist demonstrated last week how mispronouncing a certain street name here to a taxi driver will actually call him a certain male body part. I’m starting to catch on, except I think I’ve skipped over a few key words. Take for example, "ladies and gentlemen". I know the words for man & woman/boy & girl, simple enough. But apparently the former come in handy for restrooms. At a café in Da Lat, I stood outside the two bathroom doors for a good 10 minutes trying to decide which room I was meant to go in. Thank god the wind blew one of them open and a urinal hinted that I should step into the other instead. Crisis averted, lesson learned.

My aunt/teacher (Di Uyen) and her husband, Chu Phuc. She's preggers!

As I've absolutely loved being able to practice Vietnamese on a daily basis here, I've also learned how to use language to my benefit. That might sound terrible at first, but just go with me on this.. It's pretty simple actually: to get the best treatment, I speak English; to get the better price or better food, I speak Vietnamese; and to escape the annoying banter on the street, I speak Spanish. English-speaking tourists seem to be treated the nicest here, especially by those men in uniform. If you ask anyone to do you a favor in Vietnamese (esp a guard or gov't official), you'll most definitely be greeted by an eye roll, grunt and maybe a reluctant favor. So I'll usually stick to playing the American tourist when around the men in green, who apparently don't practice that whole chivalry thing. The downside to being a tourist, of course, is being ripped off price-wise in the markets. The vendors have to make a living somehow and unfortunately Americans are the easiest people to snag a few extra bucks. Walking through the streets in Saigon, you're constantly hounded by people selling things, waiters ushering you into their restaurants and drivers trying to give you a ride. Today as I was walking back to my room, a cyclo driver would NOT leave me alone. I finally blurted out about a paragraph in Spanish and he stopped. The drivers learn necessary phrases in a couple different languages, but Spanish isn't one of them I guess. Cheers to that U of R language education! I even got to practice some French on a group of French tourists that I met in my hotel elevator yesterday. That was a little painful though since my last French words were spoken in high school.

Paperwork for Rach Gia is still not done, so I'm heading back to the pediatric hospital tomorrow am (where I'll stick with the Vietnamese, or at least my attempts at it). On a side note, I finally got around to reading the Pi Phi Class of 09 farewells, and I'm definitely missing you all now!! (My sorority pledge class decided to write farewells to the underclassmen to read at their first chapter of the semester). AND, I finally figured out skype/my camera so if you're free in the early am or evenings your time, let's chat :)

Last, but not least, CONGRATS to my little MAGGIE BROWN for getting the Westhampton College Diamond Award at Proclamation Night!! I'm so proud.

Hello Saigon!

2009-09-27T02:36:00.000-07:00

We took the hydrofoil boat up the river from Vung Tau to Saigon (about 1.5 hrs) on Monday, so I've already been here about a week so far. Ong Ken came up with us because he had to have eye surgery so we got to hang out with him for a little bit more. My mom arrived safely back in the States early this morning my time, so I'm all by my lonesome now! Well, my uncle (Cau Bao) and his wife live in the city and I've met 2 Project Vietnam (PV) team members, so I'm not exactly alone. And the hotel staff here has been really nice and know my name/face by now.

This past week has been all about getting to know Saigon- which means a lot of walking around and exploring- as well as waiting (and waiting and waiting) for the offensively slow paperwork process to finish. Thanks to my trusty guide, Lonely Planet Vietnam, my mom and I successfully battled the pollution (a far cry from Vung Tau's beaches and trees) and scary traffic to see many of the sights around here, a few of which are pictured at the end. I'll put up more in a later post once I play tourist and take even more pictures! Fyi, the best way to spot a tourist (besides the shirt soaked in sweat- locals don't sweat (??)) is to look for a pirated copy of Lonely Planet in the hands of a person who seems both lost and sunburned. I begrudgingly realized early on that I paid way too much for my copy at B&N.

Back to that offensively slow paperwork... I FINALLY stepped foot in the hospital- HCM Pediatric Hospital 1 (Benh Vien Nhi Dong 1)- on Thurs/Fri. They hadn't finished processing my passport/CV/letter of introduction (yeah..) until then. You'd think I was applying for a liver or something. I thought I had seen my fair share of city hospitals and rural clinics, but BOY is this one crazy busy!! According to the head of the hospital, they see about 5000-7000 patients, daily. I feel like that's a lot, right? And it's not like this is a huge, state-of-the-art facility with a plethora of docs. I assumed he was exaggerating until I walked past the main waiting area. Think bread lines, or mobs clamoring to get their hands on the first wii, or teenage girls trying to touch Edward Cullen's great hair.

This is not a great example of how busy it gets with children and parents running around and waiting outside for hours to see a doctor. I was too nervous to snap a shot while I walked through the crowds, but I'll try to sneak a camera in to get better pics this week.

I spent my time in the NICU (Neonatal Intensive Care Unit) working with the premies. Tiny, tiny babies, most of whom are sick with an infection. I was surprised to see how "clean" and well-equipped the facility was, but of course nothing compared to NICU's in the States. The lamps used to warm the premies are basically desk lamps and the little beds look a little outdated. Though the docs/nurses do wash their hands and wear gloves/masks when doing procedures, they wear flip flops and have a few other habits that probably wouldn't pass standards in the US. The bottom 2 floors where I wandered are for the postop and premie babies, while the upper floors are for the "healthier", older kids. The latter are even more crowded, with 20ish kids per room. Picture the largest hospital room at MCV, or a double dorm room at UR and try fitting 15-20 kids AND their parents in. Parents that don't fit can be seen sitting on the floor in the hallways, usually eating or taking a nap. There's a reason that so many of these babies are born with infections and the country has a high infant mortality rate. But, at Nhi Dong 1 and 2 (Pediatric 1 and 2), these doctors are some of the best in the country, which explains the crowds. In fact, Dr. Quy, the neonatologist who works with PV, is reported to be the best. (My 2 aunts here are pregnant and Di Uyen, who lives in Vung Tau, is planning to make the 3 hour drive to deliver at one of the Saigon hospitals). I was left alone to watch and observe in the beginning, but once some of the doctors and nurses realized I could speak Vietnamese, they were very nice in showing me around and teaching me what they could.

I was originally supposed to head south to Rach Gia tomorrow to begin my work on the neonatal infection control project, but alas, paperwork isn't processed. So, it looks like I'll be spending another week in Saigon working in Nhi Dong 1! I kind of expected delays like this so I'm not too surprised at the change in schedule, though it'd be nice if people kept me more in the loop about this paperwork business. Like any other country aside from the US, the culture is used to being buried in paperwork and bureaucracy, and thus moves slower. I still don't mind the 2-hour lunch breaks that people here take, though. 30 minutes to eat, an hr and a half to nap. What a life.

Mom and I in front of the Independence Palace (dinh doc lap), what once was the symbol of the S. Vietnamese gov't. Also known as the Presidential Palace, it was overrun by the communist VC in 1975.

A view of the gates which the tanks crashed through on the morning of April 30, 1975.

Replica of one of the VC tanks.

And a tiny glimpse of the traffic here. Not even rush hour, I'll post a pic of that later. This explains the pollution here in Saigon. My mom and I both came back from a day of walking with sore throats, so we got into the habit of wearing masks when walking in the streets.

We also came across this great restaurant called Huong Lai. Aside from serving delicious "gourmet" Vietnamese food for a great price ($11 USD for a 4 course), the staff are or were disadvantaged teenagers. The restaurant trains these kids in hospitality service to give them a chance at a career and pays for them to attend secondary school and beyond (including English classes). Great cause and highly recommended if you ever come to Saigon!

Da Lat, my favorite place in Vietnam

2009-09-24T07:53:00.000-07:00

Hello from Saigon! Lots to catch up on, but we'll save this post for my recent getaway to my new favorite place in Vietnam. This past Thurs-Sat, I took a little holiday with Ong Ken and my mom to VN's mountain resort of Da Lat in the Central Highlands. To call it a getaway is quite an understatement.. Da Lat has refreshing, autumn-like weather and French flair, compared to the humidity, harsh sun and socialist feel of places like Vung Tau and Saigon. An 8-hour drive up the rocky dirt road of the mountains leads you right into a charming town, the French influence obvious in the gorgeous villas, cafes, and Eiffel Tower-shaped radio tower. We were even welcomed by a rainbow. It was almost too perfect and slightly disarming. Course, reality soon hit as I walked into our hotel bathroom to find that there was no tub, but only a shower head right next to the sink and toilet. But that's just minor details!

Before arriving into town, we stopped by Datanla Falls, one of the action-adventure stops centered around the area's great waterfalls. Probably the only place in Vietnam where you can raft, climb a waterfall and rapell. We managed to get my mom on the bobsled coaster that takes you down the side of a waterfall (very cool). *Georgia cousins, Ong Ken caught our adventures on tape, which is being sent to you as we speak!

I know I keep saying how delicious the food is over here, but nothing compares to Da Lat. The town is known for it's incredible flowers, coffee, teas and FRESH vegetables (which was included in every meal, yum!). The cool climate and red clay earth make it the only place fertile enough to grow these staples; so much so that it basically supplies the entire country. Tra atiso- artichoke tea- will now be on my list of favorite new things. Trust me when I say that this is the best tea you'll ever taste. Sweet and mild, great aroma. It's only grown in Da Lat, but don't worry, we bought plenty to bring back to the States.

Our mornings usually started with a trip to the open-air market (another new favorite thing), within easy walking distance from our hotel, before coffee of course. If the overwhelming number of vendors, school children buying breakfast and patrons buying the day's meal isn't enough, the many different aromas should strike your fancy. Fresh vegetables, tons of fruits different from home, breakfast foods, flowers galore, you name it. I wish I could bring it all home with me! One thing I love about Vietnam is that everything is so fresh that people shop daily for the day's meals. Refrigerators aren't commonly used as much as in the States and left-overs are unheard of. It's a way of life that I could get used to.
*Note to self: dragon fruit (thanh long), lychees, mang caus are delicious... durian is slightly disgusting. If you can handle the smell, chances are you'll like the taste- but I tend to run away at the sight or smell.

We spent all day Friday exploring the sights and attractions of Da Lat, most of which hopefully can be summed up by pictures.
To really see the unique foliage, we stopped by the flower gardens (Vuon Hoa Thanh Pho Da Lat), where we took ridiculous pictures at this little set-up that they had.

The first person to discover this great town was a French physician, Dr. Alexandre Yersin (1893). His wife founded this church, which is now home to the Sisters of Charity.

Bao Dai Palace, another place we visited and took pictures in traditional Vietnamese garb. Bao Dai (whose father was king of Annam) was the Emperor of Vietnam in the 1940-50's, first under French influence and then Japanese. House fit for a king.

In the afternoon, we visited a museum featuring incredible Vietnamese art. There are an astounding amount of talented artisans here; you can find anything from embroidery, sculptures, painting, pottery in the streets, art galleries and museums.

Another beautiful garden in Da Lat. Except this time, there was a farm with "strange animals": dogs with 3 legs, chickens with 4 legs and cows with 2 heads. I'll just skip those pictures.

Langbian mountains, where a rugged jeep ride took us up to incredible views and a Romeo/Juliet-like legend. Lang and Bian, who were from enemy tribes, chose death to protect their love when their marriage was forbidden.

That night we had a traditional meal (and some strong drink) at a Montagnard village, one of the hill tribes of Vietnam. The hill tribes speak different dialects and only a few people know Vietnamese, so it was fun to see their singing and dancing afterwards.

I have lots more pictures that I'll put in a facebook album. We arrived in Saigon on Monday and I started my time in the hospital today, so I'll post some more soon. Sounds like everyone's doing well, I'm loving all the updates from around the world. Please keep them coming!

A "Letterman Top 10" of tidbits & sights (Vung Tau)

2009-09-16T09:58:00.000-07:00

Wed night here in Vung Tau, just wrapped up a few more days of family time and good eatin. I'm heading out early tomorrow morning on a little roadtrip to Dalat with Ong Ken for a few days, so figured I'd leave you with some of the tidbits and sights that I've seen so far.

1. What in god's name is with all the honking? Cars honk, vespas honk, bikes honk... and people yell. I feel like they honk just to honk. I'm crossing the street, yielding to oncoming vespa traffic, and the driver still honks. I see you! God. I have gotten pretty darn good at crossing the streets here, though. Along way away from the close-your-eyes-and-run approach.

2. There aren't as many dogs here as I expected (they're tons in the streets of Peru). My mom claims it's because they've all been eaten, and dog is a delicacy here, but I'm choosing to remain in denial.

3. I hit another milestone this week... I am now officially eating ice and fresh vegetables. This may prove to be a bad life decision later on, but again, I'm choosing to remain in denial.

4. There are a lot of vespa accidents- I've seen 4 since being here! Yesterday a guy somehow balancing 5 baskets of vegetables crashed and burned. And today, two vespas rammed right into the back of a parked SUV. I believe they were texting. (Prolly never saw that violent PSA on texting/driving on youtube.)

5. Tailored clothes are really cheap here, so we went to a fabric store to pick out some (you guessed it, fabric) and then got measured for "ao dai", a traditional Vietnamese garb for women.

6. They have KFC.

7. All the kids that go to school- and there are some that don't either because their families are too poor or they just don't feel like going- wear uniforms. Like Catholic school uniforms, only sin hideous plaid. Jumpers and white shirts usually; older girls wear white ao dais.

8. This is a trash truck.

9. So back to the government presence here... I've been talking with my family and it's very interesting to hear how they have to deal with the "vietcong" (sh, don't say that out loud). On the flight over here actually, I sat next to this American dude who is coming here for the third time to interview at the embassy with his Vietnamese fiance. If you've seen the movie "The Proposal", you'll know what I'm talking about. People who are young and middle aged, basically any productive member of society, have a really hard time coming over to the U.S. If they get the chance, they can only stay for a short amount of time. (Hence why some weddings happen to happen). When my great uncle came over to the States for the first time a couple years ago, his wife had to stay behind since they own a business here. The government's afraid that if too many people are allowed to go, they'll leave for good. Though life here seems relaxing and enjoyable, there's so much more opportunity for growth and success in the US (our teachers were right). They know people here realize this and so they place strict restrictions on foreign travel.

10. It's really hot here.

My "little" Uncle Ben (Ong Ken's youngest son) and momma

My other set of aunt/uncle (Ong Ken's oldest son)

Di Uyen (Ong Ken's daughter) and a baby I'm related to, but I forget how... I'm convinced babies here are cuter than anywhere else (even Peru).

Ong Ken's restaurant. They aren't too big into doors and air conditioning over here.

The first days in Vung Tau, VN

2009-09-13T11:20:00.000-07:00

I told you I'd be bad at this posting thing! Haven't been able to get onto blogger until now for some reason, but I'll try to sum up my first few days here as painlessly as possible!

Now ending my fourth full day in Vung Tau and loving it here so far! We finally got here around 1am on Thurs morning. Didn't think I'd survive the 20 hrs of flying, but 4 movies and 3 glasses of red helped. No problems traveling but you can feel the strong government presence as soon as you get to the airport. The guards at immigration tend to leave non Vietnamese-speaking people alone, but if they know that you can speak the language and are either from here or visiting for the first time, they'll give you a hard time until you bribe them with 5 or 10 bucks. I went through fairly easily, and though my mom was asked a lot of questions, many of which could be easily answered with her passport/visa, our pockets were still full by the time we collected our baggage. Both in Korea and here, tons of ppl are wearing their swine flu masks.. must be a scare or something. No one's allowed inside the airport unless you're a passenger, so it's crazy busy right outside the doors with people screaming names and waving frantically for anyone who they think is theirs. We met my great uncle, who I'll be visiting for the first 2 weeks, and a few of my aunts.

The first thing I noticed when we hit the streets of Saigon, other than it being really humid and hot, is the insane amount of Vespas. Only the few wealthy drive cars, so the streets are teeming with these things, which more often than not have families of 4 crammed onto them. Everyone wears those swine flu masks, and long sleeves when they drive because they're afraid of getting darker than they already are.. I seem to the be the whitest person here and that's somehow a novelty. There's not a whole lot of traffic lights either (if they do exist, no one really pays attention), so driving and crossing the street turns into quite a fun reality frogger game. Much to my disappointment, I don't think I'll try my hand at driving here... at least not for another month?

From the first meal- breakfast with my great uncle (Ong Ken), his wife, daughter (Di Uyen) and her husband (Chu Phuc)- it feels like we haven't stopped eating and trying all the different kinds of dishes! Everything's delicious- Ong Ken and my great aunt own a restaurant here so she cooks us so much food. Plus, you can't beat a $10 USD to 160,000 VND exchange rate for trying out the many different eateries. You step out onto the street and any kind of Vietnamese food is at a walking distance. The time and days are a little disorienting, but meals seem to be the scheduling factor here. AND everyone here is big into naps, which I can definitely get used to. Restaurants and stores will usually close from around 1 or 2 pm until 4 or 5 because most people take a nap right after lunch. We usually go back to our hotel around that time to get some relief from the sun and heat. Vung Tau is a lot cooler than Saigon since it's by the coast and has lots of trees, but very few places have air conditioning. I've also somehow managed to avoid jetlag and having to use the cipro so far, so here's hoping the trend continues!

After breakfast and coffee our first morning here- strong iced coffee is so popular here that there are hundreds of cafes that strictly sell it anytime any day- Ong Ken and Di Uyen drove us around on the vespas to see the sites of Vung Tau. We're in the rainy season right now so downpours will pop up in the afternoons unexpectedly to cool things off a bit.

We climbed up the hill to this statue and chapel of Mary.

The great view of the coast from the top of the hill.

Vung Tau used to be and very much still is a fishing town. Countless boats like these can always be seen out in the water.

The traffic here is comparable to any large city, 'cept it's full of vespas and bicycles. This is one of the schools letting out in the afternoon.

My mom hasn't been back to Vietnam in over 30 years since she left during the war, so on Friday another aunt and uncle drove us to the family's old neighborhood, where she grew up. She could hardly recognize the streets or the people, since a lot of these houses were built after the war. We had a couple older people come up to us that recognized her immediately and they brought us to my late grandmom's old house. Even though we were in a much bigger and different house, it was cool to be where my grandmom and grandpop raised their family. Most of my other relatives lived in the same area too.

The church where my parents got married.

Mom's old neighborhood, a lot nicer than before. The purple house is where hers used to be.

The houses used to back up to the water, where the fishing boats would unload their catches. This is where my grandpop's boat used to dock.. obviously more water back then!

Vespa-ing even further, it was time to go meet some more family. Besides Ong Ken, my grandmom has 5 other siblings, which makes for a heck of a lotta aunts, uncles and cousins! We met my great aunt, who's either the 5th or 6th oldest sibling, (and who, by the way, looks EXACTLY like my grandmom) and her 5 kids (second cousins are considered aunts/uncles) for lunch. Afterwards, we went to one of my aunt's cafes for fresh coconut juice and hammock lounging to escape the heat. Even though people may not have a lot of money here, everyone knows how to relax and enjoy themselves, especially around family. With mine being huge, it's been nice just sitting around enjoying meals with everyone and listening to their stories.

Yesterday (Saturday), Ong Ken and Di Uyen took us out to breakfast at this really nice brunch buffet before hiking up a huge hill/mountain. Vietnamese people, including my family here, are very Catholic and this statue of Christ is a popular spot for people to visit (even for non-Catholic tourists). Ong and I climbed all 700+ steps and then some to the shoulder, where you can see awesome views of all of Vung Tau. It was incredibly hot and yet somehow old ladies that make the climb daily were passing us easily. Ong Ken's oldest son and yet another uncle (Cau Bao) came down for the weekend from Saigon, so we got to hang out with him and his wife. After another delicious dinner, all of us cousins walked out to the beach for a while and then spent the rest of the night at the swanky Garden cafe for another popular drink, sinh to (smoothies).

If you look closely, you can see people standing on the shoulders.

View of Vung Tau from the top.

Not bad, eh?

More pictures and notes to come tomorrow, it's almost 1:30am so too tired to write anymore!

Last minute things

2009-09-07T08:36:00.000-07:00

HAPPY BIRTHDAY MEAGHAN GRIFFITH! If you see her around the UR campus, give her a big 21st-birthday hug for me :)

Packing list:
Scrubs (in 3 fashionable colors)
Lonely Planet Vietnam
Cipro..
Tracy Kidder's "Strength in What Remains" & "Mountains Beyond Mountains" (duh.)
hand sanitizer x 5
little packs of tissues
a jar of peanut butter (just in case)

I don't sit still very well... max 3 hours for a final exam, but even then I took breaks to walk around the halls of Gottwald. So I'm sure I'll be driving my fellow passengers crazy on tomorrow's 20-hour flight. Oh, if you want it, skype: melissapham215

How 'bout them Spiders?

2009-09-06T07:08:00.000-07:00

Dunno if you're aware, but I heard those Nat'l Champ Spiders beat them Duke Blue Devils. I've always disliked Duke. And UVA. But they got beat by W&M. It's a good morning.

So this will be my grown-up version of my old pink Hello Kitty diary (that came with lock/key)... while I take a slight detour post graduation from U of R (Go Spiders) and before med school.

Thanks to the liberal arts, I made the decision a little while ago to avoid the cubicled "real world", bad economy and instead search for a little adventure and inspiration overseas. I'm heading to Vietnam on Tuesday (2 days, already?) to begin this journey, where I'll work with Project Vietnam, (also this) an NGO, to help improve neonatal care in the provincial hospitals, do a little sight seeing and most importantly, meet my family. My mom is coming with me for the first 2 weeks and we'll stay in Vung Tau to see relatives before I start off my work in Saigon. As of now, I just have a 1-way ticket booked; and, as I've re-adopted the procrastination that I swore off in college (sorry, professors) and we all know I'll most likely try to further avoid my withdrawal from UR, this "3 month trip" could last a little longer...

I'll try to post pictures and write some updates as much as possible, depending on Internet availability. Can't wait for the adventure ahead to play doctor and practice a little Vietnamese. I can at the very least order a bowl of pho, ask for a bathroom and tell people that I went to a school with a bunch of spiders. So we'll see how far this gets me.