Warning! Not our usual chatty, flippant travel tales. A bit more serious but stick with it and learn about the lovely people of Laos and their lives.
After leaving China through the ornate border gate and the commerce of the Chinese trading town of Erenhot the difference of Laos is striking. This often is the case when crossing between rich and poor countries as it was leaving Mongolia into China. It’s quite relaxed and the officials don’t seems much bothered with us. There are no customs, or if there is then we didn’t see it so we gingerly edge our way into Laos looking where to go next. There is the ATM. Ah. That’s nice. We are millionaires again! About 12,000Kip to the pound.
The roads are not so good in Laos. Mostly just very bumpy so we have to keep the speed down and progress is a little slow but this is not a bad thing really. It gives the driver chance to look around and get to see the countryside instead of just looking at a blur through the windows. Laos is extremely rural with little villages of timber and tin lining the road in little communities. People, animals and children wander apparently carefree along the roadside outside their houses and we wonder at the mortality rate. Why is it that the poorer communities we see, seem to be the smiliest?
Hello Laos - we like you already
Rice drying outside the houses
Typical Laos houses lining the road
Into Luang Prabang. Don’t like it! There are so many Western tourists here and mostly backpackers. It somehow dilutes the magical feeling of being one of a rare breed ( glorified tourists ourselves of course ) but nonetheless it’s a little bit of a shock. It is a beautiful town though and especially at night when the central tourist area comes to life and the grime is shrouded from sight by the shadows. We stay in a centrally located hotel just off the night market road and are allowed to park Tigger in the monastery next door. The side streets here are only just wide enough for us, but the height of overhead cables and stall umbrellas is our limiting factor. We get a little stuck a couple of times until we learn our lesson and just stick to the main roads from now on. On the hotel street there is the morning market which starts at about 5.00am every day so we get up to sample this and are rewarded with a real market offering, food (live and otherwise fish, poultry and amphibian) and as a bonus we see the monks doing the rounds picking up their daily food offerings from the faithful. There is lots going on here in LP. Restaurants are many and there are quite a lot of top notch French and fusion eateries to choose from. It’s a little bit more expensive here but that’s to be expected as it is the main tourist destination in Laos. We are warming to the place.
They also have bread, real bread! Due to the French influence in Laos, they have the most wonderful crusty French Baguettes, this is the first decent bread we have had since Europe - Luang Prabang seems much better all of a sudden!
The morning market is for the locals, vibrant and colourful - no tourist tat here
Not always easy to identify all the veggies- answers on a postcard as to what the logs are bottom right!
The reward for getting up early - to see the monks collecting alms
We have a meeting with the NGO, a German organisation called Bamboo School and get our instructions and introduction. When I say we, I mean Suzanne as it is a hospital appointment but I am promised some construction work in another village near to our posting so I’m looking forward to that. We get a food allowance for one person, and a room in a guest house. I’m not officially appointed so nothing for me. Boo hoo! The next few days we hang around town, visit a couple of waterfalls about 20 km outside the town and enjoy the good food (and wine they have wonderful wine here as well!)
Some cooling off required at the waterfalls
Next, off to the village of Nong Khiaw for Suzanne’s post. We have a new room that has been added between the stilts of the guest house building and it has a largish balcony which we convert into our outside kitchen, lounge and sitting area. The view is limited but beautiful. Forested mountains the other side of the river, bungalows lining the riverside just beside us, banana and mango trees loaded with ripening fruit in the garden which, if you get up out of your chair, we are allowed to pick and eat. But to be honest, that’s such an effort we just sit back until the landlord picks them and gives some to us! Seriously, it is so relaxing here that there is a very real risk that you may fall over backwards as it is so laid back!
Buntings up - that must mean we are setting up home!
Nong Khiaw is really two villages either side of the river Nam Ou. This river is rising rapidly thanks to the development of 7 Chinese dams which are going to generate electricity soon but at the expense of many river villages that will be flooded as the river level rises. This is predominantly a river and mountain environment and almost no road system to join the numerous settlements that exist scattered along the river and up in the mountains. I didn’t know that rice also grows on the side of mountains in fields not dissimilar to wheat in the west. However, the farming method is not the best for the land as the farmers mostly strip the rice from the plant by hand and then burn the fields. This is also how they open up new fields by destroying the jungle with fire. Can’t blame them though. They are lucky if they are food sufficient. They have no surplus cash to buy equipment or invest in the land. They are continually in fear of digging up unexploded ordinance especially in new land. What else can they do? When you have seen a typical Laos / Mong village you will understand. No electricity. One water standpipe in the middle of the village shared by all, for all purposes.
The river Nam Ou as seen from the bridge in Nong Khiaw
So this is home for 6 weeks. Tigger is parked next to the main guest house family building and I can carry out various minor repairs and mods but I can’t find a new intercooler anywhere so that will have to wait until Bangkok. Hope I can keep it going until then. The local food is a bit samey here and not as varied or good quality as China but it is certainly fresh. Be prepared to wait at least an hour even for a papaya salad. After you order the lady usually jumps on her moped to go and buy the ingredients! Seems like most restaurants work like this. One cook/waiter and one meal at a time. Top tip…both order the same meal then you might get served at the same time. Only might though, no guarantee. You may even get a different meal altogether and to be honest, it's just too much hassle to send it back and wait another hour - hey ho this is laid back Laos!
Our original plan had been only to stay in Laos a couple of weeks before moving on to Thailand. Mirjam, a German Doctor and one of our fellow travellers through China, told us about the volunteering job and I applied through a website called Workaway https://www.workaway.info. After a few emails and exchanging of CVs, I found myself employed for six weeks! It felt a bit strange, the thought of working somewhere again after 8mths of doing nothing, having to get up and be somewhere 5 days a week like a "normal" person. Actually, I was quite looking forward to it and realised I had missed some sort of routine in our lives. We hadn't really planned for this in the grand scheme of things and hadn't done any research on Laos, we, therefore, had no idea how very poor and undeveloped the country is.
The Hospital in Nong Khaiw
Neither staff or patients wear shoes in the hospital!
Out of the estimated population of 6.6 million, only 32% live in urban areas. The rest of the population is scattered in mountainous, hard to reach parts of the country. For some of the patients that visited our hospital, it involved more than a 2-hour boat trip to reach us. The mountain people are barely food sufficient, consequently, malnutrition in the young and old is a common occurrence. Access to water, sanitation and healthcare are also inadequate in rural areas, the villages we visited didn't have toilets you just took yourself off into the bush, diarrhoea and dehydration were a common complaint. The main cause of mortality and morbidity are still communicable diseases, such as Malaria and the main cause of death for children under 5-year-old is lower respiratory infections. It is reported that in rural areas infant mortality is around 350 per 1000 which means 35 percent of children die before the age of one year .
Our hospital was very, very basic and had virtually no facilities. The laboratory had one blood analyser which could give a full blood count, kits for diagnosing Malaria and Dengue fever, a blood glucose monitor and some urine dipsticks, there was an Ultra Sound - but nobody was qualified or knew hot to use it!. The emergency room didn't have an ECG or Defib but did have a small supply of emergency drugs even with a lack of resources, the nurses did a great job. They were fantastic at patching up the frequent motorbike accidents and their suturing skills should have won prizes, some days everything that walked through the front door they had to deal with, without any medical back from Doctors - anything from a headache due to too much Lao-Lao (the local hooch) to dying babies.
The emergency room
Emergency room equipment
IV fluids were often administered but obviously no blood products. Regularly you would see people on the back of a motorcycle with their IV fluids hanging from a stick as they zoom along, heading off to do something more important while they had their infusion. There was a maternity unit which was supported by Save The Children, it wasn't exactly state of the art but with the help of the charity, it was fairly well equipped. The hospital itself was, more like a Doctors surgery than a hospital, although it did have an inpatient ward with four beds. Infection control is shall we say "minimal" sheets don't always get changed from one patient to the next, OPD beds don't have disposable paper and are not wiped down between patients. Paper towels for drying your hands after washing are too expensive so you just let your hands air dry. During the 6 weeks we were working, a red hand towel hung next to the sink in our OPD room, it was never washed to our knowledge.
On the ward, there weren't any curtains to separate the beds, usually, the whole family come to the ward to be with their sick relative, food isn't supplied by the hospital so the family would join the patient for dinner, it could feel like a bit of a party! Usually, people were only admitted for observation or IV administration (if you could keep them there) as anything more serious would need to be dealt with at the larger hospital in Luang Prabang, which was a 3.5hr bumpy truck ride away. We did have an ambulance although in reality all this was, was a glorified Tuk Tuk including an Oxygen bottle, nothing else.
The hospital was mainly run by nurses, there were doctors but they weren't there every day, as they were often teaching. The hospital had a very good teaching programme which taught health promotion to villagers from the more remote areas, plus each village had a birthing assistant to help mothers who could not get to the hospital in time to give birth.
One doctor had recently had a baby so used to bring him in to work with her, bouncing him on her knee as she spoke to patients. Confidentiality doesn't seem to be in the Laos dictionary, but nobody seems to mind, one patient would be being seen/examined while another patient would just wander into the room to ask a question - often there would be 4 or 5 staff/patients in the room, with at least two consultations going on at the same time . It seemed totally chaotic to us but it's just the way things are!
Cuddle Duty :) :)
So that's six people in the picture and there were two more - a usual consultation!
The use of traditional medicines and spirit healers are a big part of the Laos culture, There are lots of teas and tinctures which will cure anything and everything and of course don't cost as much as conventional drugs so are very popular.
The remote villagers will usually visit the spirit healer before coming to the hospital. On one occasion we witnessed an extremely sick 5wk old baby brought to the hospital only after the spirit doctor had spent a number of hours trying to heal her. The family arrived with the mother clutching the baby wrapped in a bundle of rags to her breast attempting to get the pale and flaccid infant to feed. The baby was daubed with black ash marks all over her head and tiny body where the spirit healer had been presumably anointing her. The baby was way past feeding and didn't even complain at our numerous attempts to insert a cannula. Our hospital was not equipped to deal with the severity of this case so she was sent in the "Ambulance" to Luang Prabang accompanied by one of our nurses, we know she survived the journey but beyond that, we don't know.
Mirijam and I were both surprised with the liberal use of medicines especially antibiotics - it seemed that everyone who came in to be seen left with a prescription with at least 5 items and one would always be an antibiotic irrelevant of what was wrong with them! A slight exaggeration maybe but they really do dish out the AB like sweets. In the West, we would have done many more diagnostic tests before making a definitive diagnosis but in our tiny hospital this wasn't an option and the patient often couldn't even afford a blood test let alone anything else. The expectation of the patient was to receive drugs when they came to the hospital and the more drugs they got the more likely they were to get better.
During our first few days there we checked the admissions book (no computers here!) to see what the most common cases were and what we would likely be dealing with, it broadly fell into three categories and I quote - "Fever", "Gastric problems" and "Muscular aches and pains" with a sprinkling of Diabetes and Hypertension thrown in for good measure. So where were all the other more serious problems? surely not everyone came in with a temperature, a tummy ache or a pulled shoulder? Of course, there were more serious problems, but they sort of fit them in under these headings. Unfortunately, nothing more is usually done about the suspected cancer or the thyroid problem or whatever else it might be because the majority of the time the patient can't afford to pay for the bus fare to the city let alone the investigations or treatment.. Some government assistance is given but not enough for these very very poor people
The staff were lovely though and did their best with what was available to them. We went in with lots of ideas of how we could change things for what we thought would be for the better but quickly realised that as a Westerner who was there for 6 weeks we were going to change very little. I totally enjoyed my experience and believe we helped support the staff but you can't change a culture in 6 weeks.
The lovely team we worked with
Being part of the community was a great part of the volunteering , our guesthouse was around 2 km from the hospital so we hired bikes to travel to and from work. We would pass the same people every day and the locals would wave and shout good morning to the crazy Westerners on their bicycles. We became great friends with our guesthouse hosts who invited us to family meals, shared BBQ's with us and invited me to a healing ceremony. We also wore the traditional Laos skirt called a Sinh to work as a sign of respect, which they loved - one of my skirts was a particular favourite with the nurses, when I wore it there was always a chorus of "beautful, beautiful" as they stroked the skirt and smiled. - so I wore that one most even if it was a bit hot!
Our traditional Sinh skirts for our uniform - although this isn't my beautiful one!
Not a bad bike ride to work every day
Overall it was a wonderful and humbling experience and made us realise how lucky we are to have been born in the West. We have so much and yet take it for granted, simple things like running water, sanitation and healthcare, we don't even think twice about them, yet here in Laos, they are a luxury . You could say they don't know any different, but surely in today's world of affluence, people should not have to live without basic needs such as food, water and healthcare - but that argument is for another day. The Laos people are happy, smiling and welcoming, and never seem to complain about what they don't have or can't afford. So I feel very privileged to have had the opportunity to give something back to this tiny little Laos village even if only for a short while.
So whilst Suzanne is helping at the village hospital I have offered to help with a water supply project that the NGO is going to undertake in another small isolated village up the river. They get all of their water from a stream 1 km away on the other side of the river Ou (the river water is not good enough to use) and is piped 300m across the river to the village suspended from a steel cable. In the wet season, the river rises 8m and then the water pipe is in the river and gets damaged by passing debris so needs to be replaced and raised higher. Luckily we have a good friend in the UK who is a structural engineer and he advises us. We construct new concrete ground anchors and fabricate a steel post to support the new cable and pipe
The concrete has to be transported up the river in a small boat
The village Pump
The pump is used by the whole village for drinking, washing and laundry water
Work is completed by midday and we leave for the next village. I have been foolish and refuse to eat the local meal of fishy water and sticky rice thinking I will catch up with food later at the next place or from our own snacks. The result is I struggle later in the day suffering from heat exhaustion and dehydration, needing Dioralyte! Moral of the story – don’t be a wuss and eat the local food as it keeps you going and take plenty of water, I will next time! What a berk!
John advising on some building aspects at the school
Despite this stupidity on my part, we have a fantastic trek for 4 hours solid and make the village at dusk. I thought the last place was rustic. Here we were shown to our accommodation. Several bamboo huts built 10 years ago and probably not used much since then. Each has a plastic mat to put down on the slatted floor, a very poor quality and ragged mosquito net, a moth-eaten mattress and a couple of pillows. Imagine you put this lot in your garden shed and shut the door on it for a few years. Now you sleep on it. No problem. I don’t get phased by dirt and dust or even a few creepy crawly. But man! Cockroaches the size of fag packets, spiders bigger than your hand and mouse droppings and nests in the mattress. Hell. I am too tired and weak to care. I put my head torch on the lowest setting and keep the beam pointed down on the bed area whilst I get it all set up. No way am I looking around to see what else is in there with me. Into bed. Wrap the covers and mozzie net around me so nothing can get in and I’m off to sleep. Morning sees us up early and surveying the school floor. I make my notes and recommendations to the village elder and then we are off to catch a river taxi which will be about 5 hours trekking away.
Everyone has to help with the rice harvest including the children - this little poppet is carrying a heavy bag of rice on her back/head
One of the mountain village schools - click on the link here to see the Village kids showing us their morning routine
The climbing frame at the school
Can you see the huge nails sticking out?
There is very little animal life in the Laos jungle here as it seems that the people have eaten most things over the years of hardship and nature has yet to re-balance. It is beautiful none the less. Spectacular views from the hill tops, clouds, rice fields on the impossible slopes, remnants of trees burned to make way for the rice and eventually…the river!! Mid-afternoon this far up river doesn’t seem to be a favourable time to get a boat to stop for us. We wait for hours, nearly dusk before we are rescued from the remote clearing by the river. At least we can relax now. Well, not really. It's flipping uncomfortable but its transport home and that’s all that matters. I’m glad to have been a part of this and hopefully some help. If you get the chance then grab it with both hands and do something to help others. It's immensely rewarding for both parties.
Fishing on the river
We have to go back to Luang Prabang to renew our visas and enjoy it much more on the second visit - the bright lights after the sleepy backwater of Nong Khiaw. We also treat ourselves to some luxury in a nice hotel with a pool! LP isn't cheap, probably the most expensive place to stay in the whole of Laos, but we deserve a bit of luxury for a couple of days - well that is what we convince ourselves anyway!
If you happen to be visiting LP then a few tips on where to eat are (although none of these are particularly budget!)Utopia for western boozer, but atmospheric and fun, Elephant for French fine dining, Blue Lagoon good top end fusion, Tamarind is also very good Laos food even if we did have a slightly dodgy tummy the day after going! Most of the higher end restaurants require you to book a table as they do get very busy. Bamboo Tree is also very good and apparently run an excellent cookery school as well. LP also has a curfew time of 11.30pm everything shuts (including your guesthouse!) so don't expect any late night raving here! Apparently if you want late night boozing you can go to the bowling alley - suffice to say we didn't!
After 6 weeks we are done. We decide to visit Vietnam but will do this without Tigger as its too expensive and complicated to drive in. We have agreed to leave Tigger at the guest house.
We spend a few days in Vientiane before flying to Vietnam, primarily to meet up with some members of AMEND (Association for Multiple Endocrine Neoplasia Disorders) the charity we support on our travels. We spend a lovely afternoon with Kerensa, David and the adorable Eden . AMEND is a UK-registered charity, it is a patient group providing information and support services to families affected by multiple endocrine neoplasia disorders and associated endocrine tumours and syndromes. www.amend.org.uk.
We discover that David is working for the charity MAG (Mines Advisory Group), Which helps to clear landmines and unexploded ordnance around the world. From 1964 to 1973, as part of the Secret War operation conducted during the Vietnam War, the US military dropped 260 million cluster bombs – about 2.5 million tonnes of munitions – on Laos over the course of 580,000 bombing missions. This is equivalent to a planeload of bombs being unloaded every eight minutes, 24 hours a day, for nine years – nearly seven bombs for every man, woman and child living in Laos. This is more than all the bombs dropped in Europe throughout World War II, leaving Laos, a country approximately the size of the UK, with the unfortunate distinction of being the most heavily bombed country in history. These bombs are still being found today, and often by children, with horrifying consequences. It also prevents land being used for growing food and the building of schools as people are too scared to use the land - this helps to perpetuate the poverty in Laos. MAG do an amazing job by training the local people (and therefore giving them jobs) to identify and either detonate or make safe the ordnance, allowing fields to be used for growing food, building schools, roads and helping to make these very poor people more food sufficient. Read more about their work here http://www.maginternational.org/the-problems/the-uxo-problem-in-laos-statistics/
We were so touched by the work they have done John has decided to support them through his business at home www.johncurran.co.uk
We also go to the visitor centre for the charity ‘COPE’ (Cooperative Orthotic and Prosthetic Enterprise) COPE helps with providing artificial limbs and rehabilitation for those affected by UXO, the visitor centre re-tells some very sad stories of how in rural communities simple tasks like just lighting a fire to cook a meal can cause a bomb to explode and change people's life forever. It’s very sad, moving and uplifting all at the same time. It’s impossible to visit these places without feeling upset , take lots hankies when visiting. http://www.copelaos.org/
On a happier note Vientiane – not a bad place. We found a cheap hotel place to stay for a few days, Vientiane Garden Hotel. Got a pool too! Within walking distance of most places, it fits the bill for us. Lots of temples including the oldest in Laos. Some shabby and dirty, some beautiful and wonderfully charismatic and even a very blingy one! The night market by the river is big and full of same same tat but not different! Amusing for 10 minutes or so. A fantastic curry restaurant near the Thai Embassy which we dined at 3 times called The Dheli Derbar. Yum. A taste of home! :-)
The Lonely Planet suggests going to the largest temple in Laos at sunset - they fail to mention that it will be shut! Still worth the visit!
John receiving his string bracelet for health and happiness from a monk
And this was the blingy one!
And so to Vietnam….”you don’t know man! (unless you were there!)
We are back into Laos just in time for us to see in the new year.
The guest house family invite us to their party It’s a big low table with low chairs and laden with local delicacies like goat meat, buffalo innards and all of its other bits, (which aren't always easy to identify, I have become vegetarian in Laos so have a valid excuse to refuse some of the very dubious looking dishes!), fish from the river which is not so tasty, river weed which is quite good, morning glory and so on. It looks like it’s going to be a bit boozy too what with the beer Laos and Lao Lao whisky, (this all kicks off at 3 in the afternoon so I am going to have to pace myself if I want to make midnight, especially as drinking Lao Lao every few minutes seems obligatory!) Later on there is a village party in the centre where there will be fireworks and dancing so we go there about 11pm and by now most of the village is in attendance and the party is in full swing. It’s fun and sort of low-key at the same time. Dancing involves a slow synchronised shuffle around the dance floor in an anticlockwise direction and you have to negotiate this swirling mass to get to the bar. It's quicker to go against the flow than with it but safer to conform for the return journey with hands full of beer!
Preparing the feast for New Years Eve
And the party begins!
We pack the van and it’s time to leave sleepy Nong Khiaw for the last time. Our home for 2 months, new friends, favourite restaurants and cute puppies and kittens are going to be left behind now but we have become restless to move on to pastures new.
Goodbye guest house family - we will miss you
Saying goodbye to our lovely friends made for a fun evening!
A minor disaster becomes apparent that night as we set up camp for the night. Where is Ted? Our dearest teddy toy given to us by our good friends at the Norfolk Overlanders group as a going away present is MISSING! (Even though he is a ‘Land Rover’ accessory he is welcomed into the VW community. After all, he wants to get to the end of his journey rather than spend most of it under his ride!!! Ooops Landy people.( Only kidding.) We contact Sergio who is still working at the village and he discovers ‘Landy Andy’ is now in the possession of the landladies grandchildren. Little scamps. They abducted him whilst we were packing. One of the other volunteer nurses will take him with her to Bangkok later and our contact there will look after him until we arrive. It’s strange being on the road again after 3 months. A little nervous like when we started back in April 2015 but soon enough we are in full stride and rolling along nicely until…..
Pop goes the intercooler again. Thought I had fixed it really well last time but no, it’s blown apart again under the strain of hill climbing. I’m so pissed at the guy in Telford with whom I placed my trust to do a solid job with quality products. Cheap intercoolers made of plastic and alloy are not fit for purpose but now the allow lugs that hold the plastic inlets pipe in place have started to break off and even though it’s held together with cable ties it still blows apart between the secure points and we are losing power and oil again. I foresaw this in Laos and bought some rubber pipes and now I throw away the intercooler plastic bits and replace the whole thing with the new hoses. These proved to be inferior too and only lasted a few kilometres before splitting. More makeshift repairs and we change our route to head directly to Bangkok where we have contacts in the Thai VW community. They will get this sorted. Our new route takes us to Vang Vieng. Once a mecca for tubing nutters but now a bit of a grimy backpacker town. Still able to hire canoes and tubes etc. but the drug and booze bars that used to line the river are gone and so are the deaths by misadventure. We camp the opposite side of the river not far from the town centre and have an ok undisturbed night after the loud music ceases midnightish. Now to Vientiane again to make the border crossing.
Goodbye Laos. You have been a wonderful experience and so chilled and relaxing. We will miss you. and over the Friendship bridge to Thailand.
Laos has been a very different and enlightening part of our travels for us and it will always be defined by our volunteer experience. It brought home that travelling isn't always about seeing the best view, or the world renowned monuments but seeing how other people live in very difficult circumstances and the daily challenges they face. In rural Laos this is often as simple as getting water and food, (and always with a grateful smile it would seem). Volunteering has made us realise how much we take for granted in the West yes, but also to appreciate the small things in life, and the difference between what you "want" and what you "need". In our life we have never experienced real hunger or watched our children dying of malnutrition or not had access to healthcare to where preventable diseases can be treated. A humbling experience and hopefully we will be able to volunteer somewhere else around the globe. Goodbye Laos you will always have a special place in our hearts.
Getting the Thai visa.
Go early. Be prepared to queue a couple of hours to submit your application. Return the next day to collect. Mornings to submit and afternoons to collect. You don’t need the help of the many local fixers prowling around outside. We applied for a 3-month visa but only available as a single entry. The visa needs to be stamped for the final 30 days at immigration where ever you are in Thailand to complete the 90-day status. A "visa" for the car will be issued at the Thai border it is only ever for one month. It’s frustrating but you can get the car visa renewed every month and this is done at Customs and is free. Failure to do this is a $25 fine per day!!! Also, don’t be shocked at the value they estimate your vehicle to be. It's academic unless you try to leave without your vehicle.