Lao-Vientiane Hospital

The two weeks we spent teaching in Vientiane Province at the Lao-Vientiane Provincial Hospital, I am sad to tell you, were remarkably within my comfort zone. The work, which was constant and all-consuming, was not unlike the work at home in the way that I engaged with it. This has led me to believe that the experience of work is a deeply personal one, but one that is within a small range. We specialize. We bring to it what we carry. Our baskets full of what we have been taught, what we believe to be right, and a way of seeing the world. Perhaps, if I worked in a rice field, as Andy did, or as a river boat driver or carried rice over my shoulder, like poor Justice, in a pair of evenly-weighted woven baskets or climbed the green and brown mountains with a basket strapped to my back, like the many little boys and girls I saw from the VIP bus, and spent the day collecting firewood for my mother, I would feel different. Or, perhaps, like Ajahn David, whom I met last week in Vientiane, I could leave the world as I know it, become a monk, move to the forests to meditate among the last-remaining tigers and elephants, who are themselves in crisis, and engage with my world in a different way. I have come away feeling that I will need to be more uncomfortable to do something really important.

We spent the two weeks training three groups: the hospital staff, the district health workers, and other hospital administrators. The training was divided into clinical, English, and leadership classes. I spent the time leading up to the training preparing book materials for the training. I had prepared three books for the team: 1) a clinical training book of PowerPoint slides with English versions on left hand pages and Lao versions, translated by doctors from the hospital, on the right and 2) a small behavioral health book comprised of Lao-translated chapters from Where Women Have No Doctor and 3) a small reproductive health book comprised of Lao-translated chapters from Where Women Have No Doctor. I was most proud of the first book which was helpful to the clinical trainees and solidified in black and white the importance of getting the Lao right. The second two books were iterations, as I see it, on something I may or may not do in the future but that has broad importance to the Lao people, creating literate and accurate handbooks for health for the Lao people.

Much of my time was spent keeping organizing and collecting new PowerPoint translations and/or English presentations in a format that was appropriate and thinking about the best ways to distribute this information going forward. In order to make sure there was an authoritative collection, I would store them on my computer and parcel them out to others using usb drives. Not an ideal solution for collaboration in the field, and if we do this, again, I would want to bring along a small computer network from which trainers and trainees could access and add content. I spent a remarkable amount of time walking from the little house that was our headquarters located on the outer edge of the hospital grounds through the back entrance of the open air hospital restaurant—where people were always washing pots and dishes outside, tending the open fire, chopping vegetables, rolling rolls on the outside tables—through the 6 table restaurant into the open air walkways surrounded by well-tended gardens to the main office, where I would ask for help copying. The ladies of the office were very nice to me, always correcting my Lao, eventually succumbing to English when things got complicated: like the time, towards the end, when I needed certificates of completion printed in color, and the office staff and I spent half an hour working it out in Lao, until one of my most accomplished English students, Xaiphone, came by and was able to interpret.

I also helped Chip, as the A-V team, making sure that everyone had what they needed in the classrooms. I, also, when nothing else was needed, doubled as the photographer, taking pictures of classrooms, people, events. Disty and I gathered over 1,000 images of the two weeks and put together a slide show that I showed to the musical accompaniment of "We are Family" at the final ceremony, on Thanksgiving day. I will try posting it, somehow.

I also spent every day, from 12-1:30, helping to teach and, occasionally, teaching on my own an English class comprised mostly of nurses. I enjoyed this immensely. It was fun and energetic. But I wondered, constantly, about the value of teaching English, and they knew far more than we taught them, and I worried we were teaching down. I came to love this group of people and wish that I could have engaged with them even more.

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By the way, I am sitting outside in Luang Prabang, with time now, writing this. A pair of brown large dogs just jogged by, one wearing a faded red t-shirt.

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The hospital is located in the Phonhong District of Vientiane Province. Laos is divided into eighteen Provinces and each of these into multiple Districts. Vientiane Province, with its seven districts is distinct from Vientiane Municipality, which comprises the urban area surrounding the capital city. Vientiane Province is located just north of the capital city of Vientiane. It is relatively wealthy. It has easy access to the city, high literacy rate and level of education, employment, services, transportation, and health care. The hospital was built over the last decade with support primarily from the Duchy of Luxembourg. It is a beautiful one-story building that provides the necessary infrastructure to deliver healthcare to the Province.

Health Leadership International has gone there to train the people in the hospital and those who deliver care throughout the District. They use a "train the trainer" model to drive knowledge and expertise top down into the districts and villages that need it most.
Their approach is different from that of other NGOs operating in health care, here in Laos. I have started to believe that their approach leaves the most opportunity to let the Lao people find the tools to deliver their own solutions, thereby leaving the smallest cultural footprint. The people of Laos need so much, and they need to find creative ways to deliver "modern" life-sustaining care, without sucking the life-blood from their culture.

From the statistics we see, it is clear that pre- and postnatal care are areas of great need, with Laos statistically twice the World average in infant mortality. Every 8 in 100 children born in Laos will die before they reach the age of 5. I hope there is a way to stop the hurt of losing children. I want to find something meaningful to do.