Wednesday, January 30, 2008

Not a very exciting day. Just reports and work. Stayed at home in the afternoon to work on reports - it's hotter in the house than in the office, so it was just work and hot too.

Just saying...

Tuesday, January 29, 2008


We finished our tour of two district hospitals and returned to Pakse. As a treat, I stopped by an Indian restaurant and got take-away. Now I'm feeling very energized by finishing a dinner of chicken tikka masala and paneer korma. And still more savory dishes for tomorrow.

In Salavan, there aren't many restaurants and not much variety. Most people don't eat out for dinner - they might grab a bowl of noodle soup for lunch, or pick up a few servings of something exotic for dinner. Many restaurants have grilled food, to eat as snacks while drinking beer. And there are a few riverside restaurants where you have a nice view while eating grilled fish. Well, it's not so bad - especially when compared to going out to the more remote districts where it's forest animal soup, sticky rice, and the chances of getting fresh vegetables are nil.

So I enjoy having Indian food when I can - too bad it's a two hour drive for take out, and there's no delivery service!

The picture above has nothing to do with Indian food or anything. They are not even Indian elephants. On Monday, we stopped at Pa Suan resort, which is a wonderful restful place outside of Bachineng town. About ten years ago, a Thai man leased the land and developed in a very sustainable way - no trees were cut down to build the small cabins that blend into the foliage. A few years ago, he developed cerebral malaria and went blind - but continued with his dream. Although there are busloads of Thai tourists who visit the site, the staff, who are all ethnic minorities, are tour guides and know a lot about preserving culture and the environment.

The elephants aren't exactly green - they're the dorkiest thing in the area.

And this is a view of the river. The banks are made of hexagonal basalt crystals.

Monday, January 28, 2008

thoughts on training

Yesterday was a very long day - we left Pakse in the morning and spent the day following up activities at a district hospital. We had supported training in emergency medicine and laboratory services and the two trainers who organized the trainings came with us to see the results of their training. After summarizing the results with the director of the Dept of Health, we continued on to another district hospital where we'll be doing the same thing tomorrow.

When thinking about development, a lot of people emphasize training. But even more important is this kind of follow-up activity. First, it allows contact between the students and trainers, so if they are having difficulties, the trainers can help them work on solutions on site. Second, It also helps the trainers to see the situation at the district hospital and understand the difficulties so that they can design better training in the future.

The advantage of having district staff train at the province is that they get wider experience because there are more patients and they can exchange ideas with more staff. The down side is that when they return to their hospitals, it's sometimes difficult for them to make changes on their own. We also support trainings at the district level so that the rest of the staff can understand what new skills are available. Any training strategy has to include a combination of on and off-site training, establishing key people at each site, regular monitoring and follow-up, and a strong sense of participation of all the stakeholders.

Sunday, January 27, 2008

Book #6

I just started A Door into Ocean by Joan Slonczewski. So far, it's incredible - she builds an amazing, realistic water world complete with tensions between the two worlds in the story. It's been kicking around my house for so long - I don't know why I haven't read it before. Anyway, better late than never.

Ponderings on the world

I'm quite amazed to learn of Barak Obama's victory in South Carolina. CNN International did an analysis of the exit polls and found that he did the best with younger and better educated voters, whites as well as blacks. He seems to be growing a wide base of support - but is a base that will turn out to vote in November (just in case he does get the nomination)? Can he pull together people? Is Clinton too divisive? With the worries about the American economy, will Americans pull inwards and try to ignore the rest of the world?

It's a very strange perspective, to be on this side of the world.

Saturday, January 26, 2008

Pictures for Thursday Thirteen

Couldn't get the pictures to load as I wanted them to do in the text of the TT13 - so you'll have to figure out which is which!

Book #5: Was by Geoff Ryman

As I looked over a few reviews about the book, it seems that readers approached it with the expectation that it would be 'Fantasy.' One person concluded that it was 'anti-fantasy' because it exploded the fantasy around the Wizard of Ox, creating the reality that the fantasy had come from, which was not the prettiest place.

Like The Kings Last Song, the book goes back and forth between times, following the lives of Dorothy Gael, an orphan sent to live with her Aunty Em, Jonathan, a gay man with AIDS trying to find Oz, a Frank Baum who was a substitute teacher who stimulated his students to think of another life outside the confines of Kansas, Bill who meets an old crazy woman in a mental hospital and changes his life.

At the end of the book, Ryman writes about his sources and how they fit into the story.

I fell in love with realism because it deflates the myths, the unexamined ideas of fantasy. It confronts them with forgotten facts. It uses past truth - history.

I love fantasy because it reminds us how far short our lives fall from their full potential. Fantasy reminds us how wonderful the world is. In fantasy, we can imagine a better life, a better future. In fantasy, we can free ourselves from history and outworn realism.

Oz is, after all, only a place with flowers and birds and rivers and hills. Everything is alive there, as it is here if we care to see it. Tomorrow, we could all decide to live in a place not much different from Oz. We don't. We continue to make the world an ugly, evenmurderous place, for reasons we do not understand.

Those reasons like in both fantasy and history. Where we are gripped by history - our own personal history, our country's history. Where we are deluded by fantasy - our own fantasy, our country's fantasy. It is necessary to distinguish between history and fantasy wherever possible.

And then use them against each other.

Book #4: Pattern Recognition by William Gibson

I've had this book on my iPod for the longest time. After trying to read Neuromancer, one of the first books to define the term "cyberpunk" as a science fiction sub-genre, I wasn't sure if I could get through this. But good reviews made me reconsider and I had a long bus ride and I wasn't up for going through my current affairs podcasts. I'm glad that I did listen to it - while the writing is choppy and the characters are nerds, it's a book of ideas, dealing with the issue of the internet, how the cyber-culture changes or creates relationships, and security.

Anyway, the book is about Cayce, a woman who is a high-end marketing consult, who because of a phobia, knows what logos will take off. She also is one of a growing movement of people obsessed by "The Footage," a series of internet movies that appear randomly on the web. She is hired to find out who "The Maker" is - but she's conflicted by the idea. Although she wants to know, she doesn't know or trust the motives of those she's working with.

Meeting the Maker is the strongest part of the book. Those scenes are full of a 'sense of wonder,' what science fiction tries to create in its pages. There's a funny bit about creating internet personas, but also a chilling big when one of Cayce's offhand forum posts sets the stage for trouble.

Tying things up in the last quarter of the book are very weak, and a last 'talking heads' segment is a big infodump.

Friday, January 25, 2008


A long day of meetings and finally, we drove back to Salavan after dark. It's a whole different world on this highway after dark, in a land where there's a strong belief in ghosts and spirits. And no lights along the highway, and the truck suddenly comes up on something, barely perceptable in the dark. A tok tok, stranded in the middle of the road, without lights, a sudden herd of cows just standing there, and people sitting at the edge of the road, just talking.

In 2000, my strangest drive along this road was as someone was driving us back to Pakse. As it started to get dark, the truck broke down. At that time, no one lived along this stretch of road. As the sky darkened and the driver crouched down on top of the engine, pulling out the carburator and blowing through the intake value to dislodge dirt, I wondered if we would have to sleep there during the night. Fortunately, whatever was wrong with the carburator got fixed and we continued to Pakse. In the glow of the city lights, I laughed about the experience - but at the time, I felt very spooked.

A belated Thursday Thirteen

Thirteen things I can see from where I'm sitting

There are pictures that go along with this, but I got halfway through and my finger slipped. Huh. Stay tuned. I'll upload when I can get to a fast internet place.

1. My 2008 Yosemite Park calendar, for January, a view from Horse Ridge- snow covered pine trees in the foreground, a lake and distant mountains covered with white. I do like the snow but since I've lived here in Asia, I haven't had a chance to play in it. I used to enjoy going to Yosemite National Park on the weekends during the winter and go cross country skiing

2. My small shrine with a marble image of Quan Am, the Vietnamese name for the Boddhisattva of compassion, sitting on a blooming lotus flower. I bought this image, along with the marble incense burner next to her (a frog on top of a stylized lilly pad), the last time I was in Hanoi. Every day, before going to work, I meditate on compassion, dedicating my energy to the people I work with, and those we try to help.

3. On the wall, a cross bow and quiver of arrows. The owner of the house had pointed them on when I arrived, telling me how the ethnic minority people hunt for small animals in the forest. While I don't like the idea of weapons, they are beautifully crafted, so I've left them hanging.

4. A handwoven piece of cloth, which the Dept of Health gave me for Lao New Year. It's made of cotton and woven on a backstrap loom, with small beads of shells woven into the pattern.

5. A lot of books. I'm enjoy reading and I brought a lot of books with me when I set up this house in southern Laos. There are a lot of other things I do, though, such as work in the evenings and weekends and go to ceremonies and weddings.

6. Phou Ta-Khae, the mountain that fills the window at the back of my house.

7. The tops of the heads of people riding their motorcycles on the other side of the fence.

8. The trees in my yard. My landlord takes great pride in the garden. The area around my house is green and restful.

9. The basket containing chia ana-mai, clean paper, which is what people use on the tables instead of paper napkins. This bamboo basket is made with the cover on the bottom, so when you're hands are greasy with grilled chicken or tacky because of sticy rice, you can rest the heel of your hand on the basket and pull the paper up with one hand. In the developed world, we call this kind of tissue, "toilet paper." When I returned to the US in 1990, I brought back several paper holders and used TP instead of napkings in my house - some of my American friends got grossed out. I still wonder why - it is clean paper!

10. Basket holding my pens. I bought this basket at a stall in Bachieng District. The basketry in southern Laos is so incredible - people can do amazing things with bamboo or rattan which grows abundantly in the forest.

11. My cell phone - the simpliest type. Which right now, shows no signal. That's common here - on Saturdays, there's no electricity water for most of the day when they work on the electrical grid. While it can be inconvenient, especially if I sleep in, I also think it's all right - it reminds us that we didn't use to have all these conveniences. When I lived in a northern province, we only had electricity for four hours/ night and we had to carry our water into the office from the well because there was no municipal water system.

12. The walls of my house, which are made of woven bamboo.

13. My laptop! It goes everywhere with me!

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Thursday, January 24, 2008

Child mortality in Burma

I just found the Tricycle Editor's Blog, with this post about Burma and Bhutan. After the government crackdown on peaceful protests led by Buddhist monks in September, things have getting worse. Donors are cutting aid, which worsens the situation for the common person in Burma. Healthcare has been bad for years, and this has worsened - according to the Unicef State of the Children Report, up 400 children are dying every day from preventable diseases in Burma, which has a population of about 60 million people, about 1/5 the population of the US. If children were dying at the same rate in the US as in Burma, that would mean 2,000 children/ day.

Make my day award

This is pretty cool! Heaven in Belgium just bestowed up me the "You make my day award!" along with nine other people who have pretty interesting blogs that I'll have to spend some time reading.

I send it on to the following bloggers and their journals:

A roll in the Universe. I've met Keera at Blog 365 and she's been blogging since 2002. She has a bunch of cute memes on her blog, including this post.

Sarcastic Mom has a cute blog, which is a finalist for 'best new blog' over at the 2008 Bloggies! Go and vote!
Pure Thought is an Indonesian-based blog and covers everything from daily life to love. Her post of Bali photos made my day! Although I live in a sunny country, it's also a land-locked one so I do miss the ocean.

Deep End of the Gene Pool writes about international and social posts. She has a post on the Peace Art Project in Cambodia, where guns are turned into art. I first went to Cambodia in 1994, and was profoundly moved by being in the country where many of the refugees and my friends came from. But it was very dangerous - people died and were injured in land mine injuries plus everyone had a gun. It was common to see people carrying AK-47's in the street and the worse part of that was if the person was drug. I've been going to Cambodia for meetings and visits about every year since then and have been impressed at how the country is changing. I'm glad to see a post on one of those positive changes.

I'll add to this post as I read through more blogs. But I'm not sure how far I'll get tonight. I using wireless at the only restaurant that has wireless in the whole city of Pakse. Unfortunately, I've got some inebriated friends at the next table who keep calling over to me to join them. I'm a little worried about the beer + laptop scenario!

Tuesday, January 22, 2008

Progress on Wat Meaung Wat update

temple progress, originally uploaded by c_p_lew.

Before going to work this morning, I realized that I haven't taken a picture of the progress at the temple for a while. I think the work has been going on for about a year now - they raise money from donations and the occasional festival and then there's a growth spurt. But the roof is on and they've taken the boards protecting the main Buddha image away so that people can make offerings. Still a lot of work left to go, including the sculpting of the columns and the stairway and painting various scenes from Buddhist stories on the walls.

The old traditional roofs were made of ceramic or wooden tiles; this roof is made from red plastic roofing sheets. The roofing supports are made of iron, and the sheets are hung rather than nailed to the supports. Lao temples are very ornate with several roofs like Wat Meaung Wa. This building is called the Bodt, which is the home of the Buddha images. The building to the left is the community hall where people offer food to the monks and eat breakfast and lunch together with them. The building in the back used to made of old teak wood but was replaced around 2000 (termites) - the older monks live there and it houses the libraries and classrooms for the young monks. There are also two dormitories for the young monks on the temple grounds.

Book #3: Mortals by Norman Rush

This book is both a psychological study of the break-up of a marriage and an action-thriller. Jay Finch is a spy and a teacher in Botswana but what he really wants to do is write poetry. Rush captures the feelings and conversations between husband and wife, a thousand changes of mood and feelings within each conversation.

The 'action' in the middle of the book moves it along well enough, and while there are some crazy scenes, it weakens the plot. Jay becomes more of himself - neurotic and paranoid - which threatens both his safety and sanity. He says that he knows he shouldn't do something - and goes ahead and does it. Maybe that's how "Mortals" is different from other spy books, where the agent stuffs his true feelings and gets on with his work. Jay is a bumbling agent, who discovers that he's disgusted with the work he's asked to do.

The book is also about redemption, though the last section doesn't quite fit with the picture of Jay that evolves during the book.

Rush's writing is inspired in many places. He captures the contradictions of being an expat in a foreign place, of being in a country but separate from the culture. Some of it is just too long, and I gloss over many of the sections of tormented internal ramblings.

Monday, January 21, 2008

Book #2: A Girl's Guide to Hunting and Fishing by Melissa Bank

This was an enjoyable book to pass a few hours. Some people have called it 'chick lit' but I wouldn't classify it as that. Then again, maybe I don't know from chick lit since I don't read many books in this genre. Or maybe, it expands the definition of the genre.

The book is divided into a set of longer and shorter short stories, revolving around key themes in the life of Jane - first seeing her brother's romances and later, going through a series of her own. Throughout the book, she tries to define herself as a person, a definition which gets strengthened through her relationships or totally confused. 

It's not the greatest piece of literature, but enjoyable, so I give it a 3/ 5 or maybe a 3.5.

My book list

I read about this book challenge on Names Have Been Changed
Anyway, since I'm always trying to read at least one hundred books per year, I'm giving it a shot as part of the The TBR Challenge

So far, this month, I've read two books on my list. In addition, I listened to the audio-book of The Life of Pi by Yann Martel.

My list of twelve books is:
1. The White Castle by Orhan Pamuk
2. The Pakistani Bride by Bapsi Sidhwa
3. Bird by Bird by Anne Lamott
4. Mortals by Norman Rush
5. Carnival by Elizabeth Bear
6. The Vision of Emma Blau by Ursula Hegi
7. Was by Geoff Ryman
8. The Biographer's Moustache by Kingsley Amis
9. Brasyl by Ian MacDonald
10. The War of the Nerves by Ben Sheppard
11. Baghdad Burning II by Riverbend
12. A Door into Ocean by Joan Slonczewski

Alternative Books:
1. In the Spirit of Crazy Horse by Peter Matthiessen
2. The Girls Guide to Hunting and Fishing by Melissa Bank
3. Shriek: an Afterword by Jeff Vandermeer
4. Ammonite by Nicola Griffith
5. The King of Torts by John Grisham
6. Dark Sun by Richard Rhodes
7. Gate of the Sun by Elias Khoury
8. Black Lamb and Grey Falcon by Rebecca West
9. The Terrorist by John Updike
10. Farthing by Jo Walton
11. Wandering through Vietnamese Culture by Huu Ngoc
12. Espresso Tales by Alexander McCall Smith

I'm going to see if I can keep pulling this entry through the months as I read the books.

Book #1: The Life of Pi

I wasn't very interested in reading The Life of Pi when I first heard about it. On the one hand, it sounded gruesome, on the other, uh well, boring. How interesting could a story about being shipwrecked on a life boat with a Bengal tiger be?

Once I started listening to the audio-book, I realized how interesting the book could be. In the first third, Pi narrates the story of a young and magical life, living in the zoo run by his family in Pondicherry. He is drawn to everything mystical - something which gets him in trouble when he studies and finds the value in Hinduism, Islam and Catholicism. At the same time, he excels in school, especially in science. His enthusiasm for all beliefs and systems is both naive and wise.

As an aside, I liked these sections of the book. It reminded me of my student days when I was on teams with foreign medical graduates from Pakistan and India. On one rotation, I was on a team at a VA hospital with a Hindu man from Orissa, and a Pakistani man from Karachi who believed in Islam. On the nights we took call together, we would talk about life and religion in between restarting IVs, checking labs and writing orders. The voice of Pi, as a youth from India, was very believable to me.

On the boat, Pi and the tiger come to an uneasy understanding. In order for Pi to survive, he has to be scientific in figuring things out, and also to take care of his physical side. He becomes the Alpha male in the boat. And he acknowledges that he learned that from the tiger - they both needed each other in order to survive. At one point, he could have left the tiger behind - but his compassion would not let him do that. 

The action of the book is also influenced by "The Emergency," a horrible period in Indian history (1975 through 1977) where Indira Ghandhi's government declared martial law. I had read A Delicate Balance by Rohinton Mistry, at the end of 2007, where the action is centered in Bombay during that same period of time. 

There are some very graphic scenes in the book - and I don't think I can deal with sushi for a bit, but there's a kind of light in the book, some wonderful passages that when I looked up, it took me a while to see what was around me.

Sunday, January 20, 2008

I can't think of anything to say about my daily life today.

Uh, well a Lao Airways helicopter landed behind my house today, generating a cloud of dust which looked like some kind of computer generated imagery of the base of a nuclear bomb induced mushroom cloud. After running around to close my windows, I wondered who would come in on a helicopter, then turned my attention to coffee, breakfast and preparing to come to the office. Helicopters don't create much mystery - except for the kids who, once the blades stopped turning, stood around in the hot sun noting the details of the craft in hushed whispered while trying to move closer.

Strain my brain some more. Oh, the primaries in the US just have me shaking my head (I originally had written, "just have me shaking their heads." Yeah, I'd like to shake their heads) Just after the NH primary, all the reporters were going on about how there's no one candidate standing out, etc. etc. so it's an atypical primary season. Sigh. Maybe we just are exposed to too much media - everything has to be decided quickly, or maybe the news outlets are generating this frenzy to increase the number of viewers - but it's still early in the season and ten months from the elections. It makes my head ache.

And I'm half-way through Mortals by Norman Rush. I'm enjoying the combination of action and the obsessive thoughts of his main character.

So that's my day. I'm taking the overnight bus to Vientiane this afternoon and back in Pakse by Weds for a meeting. That's my life.

Saturday, January 19, 2008

The Story of Toby the Tokay

Toby behind the Cabinet On my other journal, I wrote about Toby, the Tokay lizard who lived behind my cabinet in the kitchen. Although these lizards are large, they are quite peaceful - though they can bite and not let go if they are angry. Tonight I heard the characteristic cry of the Tokay, a shuddering breath followed by a cry sounding like "Toke-KAY" which can go on for ten or more cycles. It made me feel happy to know that Toby is still around the house - somewhere over the ceiling. The sound of his cry reverberates throughout the house!

Toby appeared towards the end of 2006. One night, I thought I heard some scampering noises from the area of the kitchen. The light just burned out and I haven't replaced it yet. I jumped some when I saw my new friend on the wall. I think he must have been hiding behind the cabinet and since it's been dark, he's gotten a little braver so came out for bigger and better bugs.

Toby's kinda shy so he - or she (I'm not about to try to lift its tail to find out) - has gone to ground, from his or her perspective. It's amazing how such a big creature can stick to the wall like that for hours or weeks.

My new pet

For a while, Toby appeared and disappeared. Whenever I returned to my house, I would look for him (or her). Sometimes he wouldn't be in his usual place and I'd think it was for the best. One night, after searching for him, I heard the hiccupping sound of the call of the tokay - really loud. The kitchen cabinets vibrated with his, or her, call for attention from the universe. So I looked behind the cabinet and there he was.

But! The following day, he vanished. I looked around for any holes that he could have wiggled out of, couldn't find any. Later that night, he was back again.

Now does that sound like he's found a door into an alternate universe or what?

I discovered that there could be another answer when a mouse ran out from behind the rack where I keep the coffee cups. Toby changes into a mouse to go traveling, or when he gets bored.

About a year ago, Toby took off. After hiding behind the cabinet in my kitchen for the past three months, Toby got restless and galloped across the wall, flopped onto my stove and disappeared into another wall. There was another tokay who ran down the hole as well, so I guess spring was in the air. I'm not sure that Toby will be satisfied by his previous position behind the cabinet.
Toby makes a break for freedom

Friday, January 18, 2008

flags and mountain, originally uploaded by c_p_lew.

It's nice to feel well again. My staff have all recovered from their illnesses yesterday - sufficiently so they could attend a wedding party at lunch time. I decided to pass on it, just handing over an envelop with lucky money inside. The above picture (which won't upload right now) is of the front of the hospital from the front of our office, which is up on the second floor of the hospital.

My boss sent me a link to pictures of the "Death Highway" in Boliva, which got me thinking of my trip to Ecuador in 1974. I'm lazy to copy and paste so here's the link to my post in my LJ.

Whoops! It's Friday and I forgot Thirteen Thursday. Will correct that in the next post.

Thursday, January 17, 2008

Thursday medical report

I had a Skype appointment with a home office person so I got to the office early. It was very quiet and rather pleasant in the early morning. Then my staff said that one of the project assistants had a fever and stomach upset. A little while later, the other staff person started looking very pale. After she had run to the bathroom three times, I told her to go home.

I still think that the fermented fish we ate on Monday was the cause of all ills. The alternative is that they caught a virus from me - after all we were in the car together for nine hours. But I prefer to think it was the pa daek.

Wednesday, January 16, 2008

Road to Recovery - my amazing thing of the day

Although I'm still a little spacy, I realized that there's an inverse relationship between health and boredom. When I could sit up or look at the computer because of my illness, I didn't feel bored. I just kept my eyes closed and nodded off while listening to an audio-book. There's only so much sleep that one can sleep This morning, I started feeling better and started to miss our field office - so I'm here now, catching up on all I missed while I was sleeping through my illness.

I guess the amazing thing of the day was just how much I like my job and would rather work than take a sick day!
Feeling more alive today. After having slept all day yesterday, I slept 12 hours last night. I had a funny dream just before waking up - I visited the health center where I used to work and they started to give me treatment for a sickness. When I woke up, I felt much better - fever gone. I think I got medical treatment for this sickness in my dream.

Tuesday, January 15, 2008

For some reason, I got hit by a high fever during the night. This was after thinking, "Strange that I haven't gotten sick for a long time." Spent the day in the guest house while my staff did all the work. Then we drove back to Salavan. That's my journal entry today.

Monday, January 14, 2008

I'm sitting in a restaurant in Pakse, after a nine hour trip from Vientiane. I'm feeling very tired, so no real post today or pictures. Stay tuned for more tomorrow.

Sunday, January 13, 2008

For those who like to wander through someone else's picks of the week, here's two can't misses:

Dynamics of Cats has the Space Pick of the Best for the week - Carnival of Space #36

There's been all sorts of strange astronomy news this week, some of which was announced at the American Astronomical Society meeting this past week. In about 20 - 40 million years a giant gas cloud will crash into our galaxy. And the risk of an asteroid vs. Mars collision is dropped to nearly zero. Black holes are in the news: Middleweight Black Holes roam the Galaxy Undetected. No, while this article may sound like a tabloid headline, it comes from New Scientist reporting of the AAS meeting. And they may be an amazing number of planet in the universe if the news in the article Wherever a Planet can form, it will  That's good news for science fiction writers! And the article, Biggest Black Hole in the Universe Discovered just about makes my head explode - is 3.5 million LY away, is part of a binary with a smaller black hole and has a mass equivalent to 18 billion times of our sun (the smaller black hole has a mass of only 100 million suns).  And the strange heat in a distant planet may be due to a collision between it and another planet.

Back to Earth, and things I can wrap my mind around. Other Things Amanzi hosted last week's Online Ground Rounds. He's a doc in South Africa and has beautiful pictures of wildlife to go along with the introductions to the various blogs highlighted this week. The picture of the lionesses drinking at a pond is really beautiful.

This week's Grand Rounds is hosted by Path Talk. Yes, us medical types like to talk about pathology - but also in this week's line up are the usual blogs about medical articles of interest, medicine from medical staff point of view as well as the perceptions of the people receiving care.

Saturday, January 12, 2008

Amazing thing for Saturday

Of course I had great plans for getting out of the house early, going for a bike ride, cleaning, shopping, reading, doing some school assignments (I'm in a distance learning public health program). Stayed up too late last night, woke up at 9:30 am and dawdled. Read some more of Mortals but haven't gotten out of the house yet. Though I did get grossed out by the carelessness of kittens so spent a few hours cleaning.

My landlady's daughter in law came over. I don't know her real name but everyone knows her as Mae Waew or "Waew's Mother." My landlady's other daughter, Keo, who went to the US as a refugee now works in a casino in Atlanta City (I don't know her job position and have never asked) either comes over here or sends money with other relatives every year. Mae Waew just told me that she had come in person during the time that I was in Xieng Khouang. But she thought of me and had brought a Christmas gift - a one cup coffee maker in a bright red. 

I'm still smiling.

Friday, January 11, 2008

Amazing things for the day - Thursday and Friday

Someone asked me why I've stayed in Laos for eleven years. I answered that my work is meaningful and fascinating and something amazing happens every day. So I decided I should keep track of the amazing things that happen.

Thursday's thing

I spend all my time in the provinces and when I come to Vientiane, it's for meetings. I don't often get a chance to look up from what I'm doing to meet up with friends. So on Thursday, I walked to a restaurant for lunch. I ran into my boss who told me that a friend of ours was at that restaurant. Along the way, I met up with another friend who had, I thought, left Laos for good - and now he's back. In front of the restaurant, I bumped into another friend and we were joined by a third. By the time I got into the restaurant, the person I wanted to meet was gone but I was happy to have met the other folks.

So today's amazing thing was:
I had to get some information about inclusive education and called someone I had never met. We talked about her program and how my project could help kids with disabilities get into the schools supported by her project. Then we talked about general things. At the end of an hour, we finally hung up and I felt happy to have made a new contact - and a new friend.

Thursday, January 10, 2008

Thursday Thirteen

Thirteen Cats

1. Cicero was the first cat I ever had when I was a kid, a black tom cat. He was an outdoor cat, who couldn't stand to be inside. We tried taking him to the vet for shots and he ran away. We lived about 20 miles from the vet's office so thought we'd never see him again. Six months later, he returned. That was about 1965.

2. Cluster and her sister, 3. Nebula were two tortoise shell cats. We learned our lesson with Cicero. These were indoor cats.

4. Irving was a gray cat. We thought she was a neutered male and thought that she was a banker's gray so that's how she got the name Irving for Irving Trust. Well, we couldn't trust Irving. One night he was acting funny and the next morning she had kittens. Around 1968, she took off to bestow kittens on another family I guess. Maybe she thought we'd neuter her.

5. Woody was the first cat I had as an adult (1972). I carried her in a suitcase on my bicycle while she yowled all the way. She was a nice gray tiger cat.

6. Peggy was a Siamese cat, whom I adopted in 1973 as a humanitarian, or rather felinitarian gesture. She had been in an accident in which she lost a hind leg. Her owners wouldn't take her back.

7. Saita was my first Seattle cat, after fast forwarding a few years. In between cats, I got divorced, moved to New York City, hitchhiked around the country and finally, in 1978, decided to live in Seattle. One day I was walking around Green Lake and a nice looking young man with soulful eyes convinced me to take this kitten. When I left Seattle for another long trip, not sure if I would return, a friend took care of her - and wouldn't give her back.

8. Hatty - in 1983, some friends who had moved into a loft together had cat wars. She had two big cats and he had Hatty. Hatty became absolutely catatonic and refused to eat or come out from a hole in the wall. By that time, I had moved into a house which I shared with a friend so I took her on. She remained neurotic - she didn't like to be outside so she would climb up on the roof and yowl for hours until I got back home. Equally embarrassing was that she would get on the fire escape of the apartment building next to our house and yowl into people's windows. Fortunately, I worked night shift so I didn't have to meet people's eyes. When I went to work in Thailand, I had a traumatic experience trying to find a home for her; it eventually worked out all right though.

9. Unnamed Cat in my Office who had three kittens under my desk and then they all disappeared one night. When I worked in a refugee camp in Thailand, I was amazed to open my office one morning and find a cat family there. While the refugees were not allowed to have pets, many managed to find cats or bring them from other camps. The mother cat was quite aggressive and when she felt my office wasn't secure enough, she dragged the kittens across the outpatient department and into our field coordinator's office. The following morning, she would not let her get into her office. Pretty wild!

10. Som - again more fast forwarding. I left Thailand in 1990 and returned to school. After graduation, I worked in rural community health centers in Arizona and California. Finally, when I returned to Asia in 1996 and got my own house in 1997, I could have a cat again. I inherited Som (which means Orange in Thai language) from a friend. Unfortunately, in the upcountry site where I was working, there were too many rats and people bought rat poison to take care of the problem. Som caught a rat which had been poisoned and then he died. I almost didn't want to have cats again.

12. Neung, Song, Sam- Then someone gave me these three black and white kittens. The names mean One, Two and Three since I couldn't think of what to name them. Sam eventually ran off, and other people in the neighborhood absorbed the others. I was doing a lot of traveling at the time so the cats found families to adopt.

13. Shadow was a tortoiseshell cat. My landlady in Vientiane decided that I needed to have a cat so she brought Shadow to me from a Buddhist temple. Often people will leave kittens and puppies at the temples because there is always surplus food and a lot of mice and rats. She was my constant companion for five years and a very Buddhist cat. When people in the neighborhood had ceremonies where the monks came to the house to chant, she would sit in the back of the room, listening. She had many litters of kittens who found homes around the country until two years ago, when she was run over. I still have three cats from her last two litters.

So that's my contribution on a Friday. But since I still have work to do tomorrow, I'll consider this a Thursday and date it so.

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Resorting to cat pictures

This is my entry for today

My kittens are really scaredy cats. They tend to run into the pots and pan cabinet whenever I even look in their direction. I guess since I'm so tall, it's scary for them. On the other hand, they seem to be able to dissemble this mountain into parts - the parts that feed them are fine. Maybe my fingers look like cat legs.

The black one has decided that the safest place in the house is the basket of my bicycle. I should take him for a ride.

Wednesday, January 09, 2008

Stone Jars

This is a post I never got around to posting because it took me awhile to get it together to upload and edit the pictures. I took the pictures when I visited the Plain of Jars on Saturday.

POJ 5 jan 08, originally uploaded by c_p_lew.

I think I've been here thousands of times, but somehow I never get tired of visiting the Plain of Jars.
The first day I arrived in Phonsavanh in 1996, I suggested to the staff who had been working in the project, that we go out there. The expatriate who was working there at the time rolled his eyes. "You'll get tired of it soon enough," he said. "I'll take you but you have to promise that you'll bring guests out there when they want to go." I agreed.

That day was freezing cold with a wind that spun around the jars isolated on the wide hills. Since it was in November (and the dry season), the grass was already dead and dry, and looked as gray as the sky. We ran around the hills and the jars. I felt exhilarated to be out there, in the wind and weather. I think the staff were grumbling but if they were, their words dissipated in the wind.

Since then, I've brought guests out there, including people who live in the province and had never been there. And I often go by myself, on days like this, when the light of the setting sun sets the landscape on fire.

So who made these jars, and how did they get there? There isn't a lot of information - there are about fifteen jar sites around the province. At some of the sites, there are remains suggesting that the jars were funerary urns. This site, also called Ban Ang (Basin village) is the largest site that has been excavated since it was close to Phonsavanh - which also meant that it was easy to be vandalized. And it was also a main battlefield during the 'Vietnam War.' There are big bomb craters scattered among the jars, the aftermath of 2000 lb. bombs.

Some links:
Wikipedia Article

Article from the American Air Force Association

Historical article which also talks about the effects of the bombing both on the jars sites and around Xieng Khouang

Article from the Telegraph

Unesco article. A few years ago, they contracted the Mines Advisory Group to clear the main foot paths of UXO.

biggest jar, originally uploaded by c_p_lew.

view of the Plain of Jars, originally uploaded by c_p_lew.

Tuesday, January 08, 2008


I've been working on my reading list for 2008, which I posted a few entries back. Since not very much happened today - other than meetings - I thought I'd thrill everyone with my choice of reading.

The Girls Guide to Hunting and Fishing by Melissa Banks. Some reviews I read had classified this book as chick-lit. If that's what it is, it's a cut above the rest. It's a series of short stories dealing with Jane (and she seems to be a plain Jane at that), who watches her brother with his new girlfriend - then she enters her own series of love dramas. There are touching moments with her family and the regrouping that takes place at the Jersey Shore.

I also just finished listening to Contact by Carl Sagan. The first 3/4 of the book was incredible. Since he was a scientist, he wrote about the minute details in the life of a radio astronomer. This would seem to be a boring job, except one day an unexpected signal is picked up the radio telescope - and changes the course of the world. Towards the end of the book, there's some fuzzy religion wrapped up with the aliens. It's a fun book to read - I enjoyed Sagan's superlatives about the universe.

I'm now reading Mortals by Norman Rush. It has an interesting plot - tangled American lives in Botswana though it is full of densely carved characterizations and relationships. It reminds a lot of Dom Delillo but more plot driven.

Monday, January 07, 2008

One person's journey

I was looking at the Legacies of War website when I came across this video. One of the main people interviewed on this film is Bounmee, whom we had helped with vocational training and providing funds so he could study the three-year English language program at the local teacher training college. 

Bounmee was injured in 1995, when he was about 13 years old. He's fortunate that he had a supportive family, and they encouraged him to continue with school. When he finished high school, he stopped by our office and asked if we could help. He didn't have funds for additional school. "I really find it difficult to be a family with only one arm," he explained. "I'd really rather study a subject where I can use my mind."

For the next few years, we provided the funds so he could study basic English and computer use and then helped him get into the Si Keurt Vocational Training School for the Disabled, where he graduated with a certificate in IT. Since then he's been helping us on and off, interviewing other UXO survivors and talking with guests who visit our project. For the past two years, he's been a volunteer with the Lao Disabled People's Association, helping with disabled people's groups and attending their training programs. Now he has been working at the Khun District Community Radio, the first community radio in the country.

Every time I go to Xieng Khouang, I spend some time with him and his family - he brought his father to my baci ceremony, where as an elder, he joined his voice with the mor phone who led the ceremony. When I happened on this video, I felt very proud of him. He's a very confident and articulate person now.

Sunday, January 06, 2008

baci ceremony

Our trip from Xieng Khouang to Vientiane went more quickly than usual - I nodded off most of the time though I intermittently jumped away to take in the clear skies and far vistas along the road.
On Saturday, I had a baci at my house. This ceremony is also known as a Suu Kh-uan, or ceremony to call the souls. Most Indochinese cultures believe that each person has several main souls - the soul of the physical body, an eternal soul which continues on to rebirth, and an intermediate soul which can linger after the body dies (This is the soul which can linger and haunt people). Some people also believe that each of the openings in the body and organs have a spirit, or vital force as well (32 in all). Imbalances in the body can lead to sickness when one or more of the souls can wander so a baci ceremony invites the souls to return.
While Thai and Khmer culture are more strict about when they do string tying ceremonies - it should only be done for major changes in life when the souls are apt to wander, such as birth of a child, inviting the souls of the baby to stay with the family (the naming ceremony at one month), weddings, moving into a new house and major sickness, the Lao tend to have ceremonies for other occasions. They are an excuse to have a party - but they also function in welcoming or sending a guest, celebrating holidays or other occasions. My baci was just to bring people together to welcome the new year - and also to send back the old year, the end of which was very sad because a close friend of ours was killed in a road accident.
The Mor Phone are usually elders in the community, and usually older men who had been monks at some earlier time in their lives. Usually one man will 'officiate' the ceremony but for my ceremony this time, two elders came, plus the father of another friend. The role of the Mor Phone is to chant Buddhist chants, starting with the chant, "I seek refuge in the Buddha, the Dhamma and the Sangha" - the person of Lord Buddha, his teachings and the community." Often call out the bad - taking a stick with the baci strings on it and passing it over the back of the person's hands, then burning one of the strings to destroy the bad luck. Then he will continue to chant, or tell a fable, and calling the spirits back to the body by the soft words and good thoughts. At the end, he will brush the strings - and good luck - back towards the person's body with the person's hands palms up to receive the blessing.
After that, it's fun and games. After the Mor Phone ties a string on to the main person's wrists with more chanting and wishes, everyone else does the same. Usually, you hold out a plate with everyone's offerings in one hand, with the other hand raised in thanks for the blessings as the people tie the strings to the wrists. Meanwhile, people add food and fill up a glass of alcohol to the plate - which you're expected to eat and drink everything on the plate.
Following the ceremony, the flower arrangement is carried to the person's bed room and you're supposed to sleep in the room with it for the next three days. Marigolds do have an interesting scent, which seems to affect dreams. Unfortunately, we had to return to Vientiane so the flower arrangement stayed in my room.

Saturday, January 05, 2008

I'm having a baci at my house today, to bring in the new year. My neighbors started coming by at 6:30 am. Now we're in the throws of setting everything up. Stay tuned!

Friday, January 04, 2008

It's been a quiet day. Again the temperate was mind-boggling this morning 5 deg C. I kinda suspected something when I see my breath when I exhaled - while I still in bed. In order to get the ice cubes out of my blood, I took a walk in the am then a hot shower, which steamed up the whole house.

Once the sun came out, my shivers stopped. But you had to be directly in the path of the sun beams - sitting inside and working on a report on the computer did not work. In the afternoon, the building had warmed up enough to be tolerable.

Finally in the early evening, a person who had attended our animal raising/ veterinary workshop called me to say that he had gotten his neighbors and their chickens and ducks together so he invited me to watch him vaccinate the lot (it's recommended that chickens get vaccinated for Newcastle Disease and chicken cholera every six months). So I hung out behind his house, next to the fire, while the kids ran around and gathered up chickens, hugging them to their chests. Once he had finished with vaccinating one bird, a child would gather it up and talk to it, making the hurty go away. I really had to laugh at the kids crowding around to see the birds gets their shots; Leu's brother told me that they had just gotten their shots. The Ministry of Health organized a countrywide campaign to vaccinate all the children. I imagine that they were now really interested to make sure the chickens all got their shots - it's always more interesting when you're not the one getting poked.

Thursday, January 03, 2008

This morning, I woke up at 3 am, feeling really hot in my double layers of sweat pants and sweat suits. Went outside and the sky was blazing with stars - I think Xieng Khouang has the best night skies during the cold season than any place else in SE Asia. After checking the thermometer - it was 6 deg C - and looking at the sky, which looked like the sun was coming up - I decided that it was getting close to sunrise so I heated up some rice and water for coffee. 

It was still dark when I finished breakfast, so then I decided to look at the clock. Groan: 3:30 am and I felt wide awake. I started reading Mortals by Norman Rush (which is on my book list) until I fell asleep again and woke up late. Of course.

I've been living in Laos for eleven years now. When I first arrived, I lived in an old battered wooden building. We had electricity for four hours/ night. While we had a small electric generator for the times we really needed to prepare for a workshop or write reports, we wrote most things out by hand, which were typed out later. So, even if I woke up very early, I was thankful for 24 hour electricity allowing me to read. 

Wednesday, January 02, 2008

2 January, in retrospect

The temperature has dropped down in the single digits (Celsius, that is but still plenty cold). It's strange to think it can get so cold in a tropical country but Xieng Khouang province is up in the mountains (1,300 M. in altitude) and during the winter, the wind can blow. Our office is in an old wooden building and my house is concrete, renovated about 4 years ago; however, none of the houses here have any indoor heating. Whatever temperature it is outside, is just about the same temperature inside. And during the day, while it warms up outside, it doesn't warm up inside my house.

The main heater available is staying active - doing sit-ups and push-ups during the evening. Otherwise, I'd just settle in my quilt and read all night.

Also as part of the winter special package, the cold affects the phones, internet, fax and all that. So I'm just posting quickly for today, that we're still alive up here. Just cold that's all.

Tuesday, January 01, 2008

Happy New Years

Quite a great day yesterday. It started out at 2 pm for the annual report of the province hospital - number of patients seen in each service, goals for the coming year, and awards to the hospital staff. At about 4:30 pm, we went outside and snacked on the barbeque that people had whipped up for the party, while the sun dropped towards the horizon and a cold wind started to pick up. 

I returned to my house to get a warmer coat and noticed that the outside temperature was already 50 degrees F, before returning to the dept of health. From that point on, I went back and forth between the parties at the hospital and at the dept of health. Just about midnight, the hospital staff were doing a medical quiz game - "Is leptosporosis caused by a virus, bacteria, toxin or food?" - when I noticed that it was already 12:01. When the person questioned corrected answered that it was caused by bacteria, the band started up and everyone popped corks on the Chinese champagne (like Listerine but with bubbles). I finally returned home at 2 am.

Today we were supposed to go to a friend's village but everyone woke up with sore throats. We all croaked to each other that maybe we should rest today. So that's what I'm doing. Already starting with my reads for 2008, which are lying on the floor next to my feet.