Short and sweet

The night market

We had 2 days off and for the first time since we got here, we actually took it easy.  Todays exciting adventure involved sitting by the pool reading books with some of the other people working at the hospital.  The pool was full of children (who apparently were not in school) but we had a blast just relaxing and getting some sun.  Tonight we did a group dinner at Secret Pizza.  This is a pizza shop that is only open 2 days a week and finding it is a big secret.  The first time we tried to find it, we almost turned around 2 times but were able to find it.  It was much easier today.

Yesterday we did our own thing in the morning.  I went to the Traditional Ethnic and Cultural Center to check out some of the awesome fair trade gifts they have and learn more about the villages the gifts come from.  It was a nice geography/history lesson.  In the evening we went out to dinner at the new Mexican restaurant before heading to buy some gifts at the night market.  The night market goes on every night here and is a few blocks of vendors selling everything from textiles and slippers to Laolao (strong whiskey) to paintings and wood carvings.  We were able to pick up some fun gifts for love ones back home.  And since it was on our walk home, we did stop by a restaurant in town that we had been told was the best chocolate lava cake and it did not disappoint.  We have 3 more days of work here before the long journey home begins.

Thats all for now.  We are both healthy, full of pizza and tired!

Time Flies

Emergency Department

3 weeks down at the hospital 1 week to go.  Before we head back to the US though, we are headed to Phuket for some fun in the sun and relaxation.  No really exciting adventures here in the last few days as Anna is working nights and I have been working days.  We are just ships passing along the road while we bike.

Kaung Si Waterfall

The hospital has been busy with lots of unique pathology we do not see in the US.  The first case of malaria since our arrival
was this week (we are taking our anti-malaria meds and using bug spray).  I have learned a lot about beriberi, something I remember from medical school and the boards but has never seen in the US.  I am also brushing up on my inpatient management skills since most of the time I am working on the inpatient wards.  The ED is usually not very busy.

The soon to be opened nursery

 Kaung SiWaterfall

Part of the goal of coming to Laos was to exchange information with the local physicians.  I have learned a lot about tropical medicine while I have been here and really enjoyed working with the Lao doctors.  As part of the exchange, visiting physicians are asked to give lectures every week.  This week was sedation week here which Anna and I identified as an area for improvement on our arrival. There are many kids with burns and broken bones who need sedation for their procedures.  Most of the medications we use in the US are here but the comfort with using the drugs is not the same.  We have implemented the idea of a "Time-out" here which is part of every procedure back home.  It seems to be well received.  Anna and I have both given lectures on the different sedation drugs as well.  I am hoping that some of the patient safety we have taught will stay and improve the care of the local children.

Children along the Mekong

This has been a challenging trip at time but full of awesome adventures and meeting a lot of new people.  The group who work at the hospital could not be more fun or caring.  All of us from the US are Midwesterners so we have bonded over cornfields and big 10 sports.  I have made new friends from across the world who I hope to see again after we leave and would absolutely be up for coming to work at the hospital again.

That is about all for now. I have added some of the awesome picture we a have taken during our trip so far.

Laura and Anna

Kaung Si Waterfall

Fisherman along the Mekong

Sunset on Mekong

Riding elephants

Giving of Alms to the Monks, a daily tradition

one of the numerous Temples

Picking Indigo for dying

Nam Khan River

Riding to the Elephant

Sunset Over Luang Prabang

Tad Si Waterfall basin

Sunset ontop Mt Phousy

Boat Ride to the Tad Si Waterfall

From the middle of the Kaung Si waterfall

Working hard at the hospital

Nahm Ou River

Anna Diving and me attempting Yoga

A sobering history lesson on UXOs

Large bombs outside the Museum

I will be the first to admit that history is not my strongest subject nor something I spent much time thinking about in high school (total science nerd).  That being said, I totally missed the boat on the history of Laos and their involvement in the the second Indochina War (Vietmnam war).  I knew Vietnam and Laos shared a border but I didn't realize most of the Ho Chi Minh Train actually goes through Laos.  Today Anna and I went to the unexploded ordnance museum here and were both quite sobered by today.

UXOs that have been disarmed

More UXOs

Just incase you are like me and did not know your Lao history, it is the most bombed country per capita in the world!  There are more then 80 million unexploded ordnances in Laos alone and cause almost one death a day in the country.  The ordnances include bomies (cluster bombs), grenades, munitions and land mines.  Most of the ordnances are in areas that could be rich in agriculture to improve the local economy but there is great danger in trying to farm.  Many of the ordnance are found by children and lead to significant injury and cost to the family/community.  We were surprised when we found the map of unexploded ordnances how many in this area have been found.  According to the museum, with the current staff of just over 1K, it will take 100 years to clear all the UXOs from Laos.

Just incase you forget how to place 

We had thought about hiking up into the mountains but todays history lesson has nixed that idea and encouraged me to do a little more reading into Laos history.

Lao Food and Rock Climbing

Over the weekend we were off again so decided to take advantage of the slightly cooler weather here and take a Lao cooking class as well as go rock climbing for a day.

Amazing colors 

The Lao cooking class is run through one of the best restaurants in Luang Prabang called Tamarind. After a short 20 minute tuktuk ride to the cooking school we were ready to learn to make a few Lao dishes.  The setting of the cooking class was beautiful!  The fresh herbs came from the garden growing right on property and the backdrop was the mountains.  There were 9 other people in our class.  The first thing we made was Jeow which is a dipping sauce for your food.  Anna made one with tomato and I made one with eggplant.  The ingredients are cooked over an open wood flame and it was hot trying to roast the vegetables!  Most food here is spicy and the spice level comes in terms of the numbers of red vs green chilies.  Both of them were quite tasty to try.  We then learned to make Mok which meat or vegetables steamed in banana leaves.  I did Mekong fish and Anna did cloud ear mushrooms.  While those were steaming in a bamboo steamer we then made chicken stuffed in lemongrass.  The lemongrass is a long herb that we cut to make a little basket.  We then stuffed the baskets and cooked them in hot oil.  Last but no least was dessert of purple rice in coconut milk topped with tamarind sauce and fruit.  We actually made the coconut milk ourselves which was much easier then I expected.  After making all this food, we sat down to dinner to enjoy our hard work. Both of us left with a belly full of tasty food!  We liked it so much, we bought some of the ingredients to bring home.  They also sent us home with a recipe book so we can attempt to recreate at home.  If you want to try the food, let me know.  I am always happy to have a dinner party.

Laura climbing

On Sunday we met up with a group from the hospital for a day long rock climbing adventure at Gecko Wall.  It was about a 20 minute boat ride south of the city then a crazy trek up to the wall.  Neither Anna nor I have done a lot of outdoor climbing so looking at the wall was a little daunting.  In our group, about 4 of them were quite experienced climbers and set the routes for us to top rope climb.  It was some pretty tough climbing but the views at the top were amazing!  During the day we sustained a few bumps and bruises but had a lot of fun.  We then enjoyed a nice cruise up the river while the sun was setting over the mountains.  It was quite the day but am I sore today!

We only have 2 weeks left in our trip and it has been quite the adventure here.  We can't wait to share our stories and the 2000+ pictures and videos. We hope everyone is safe and healthy!

Anna working at a very difficult route

Sunset on the way home

With some of the other drs working at the hospital

We even manage a little fun

Rock Climbing group

Food glorious food

Coming to Laos I had a few concerns; were the toilets just holes in the ground or westerns style, how much could I sweat before I melted and what would I eat.  I had heard somewhere that fish soup was about all there was and that made me very nervous.  I am happy to report that I have not even seen fish soup and the toilets are western style.  I am still not sure how much I can sweat but its a lot.

Most important is the food.  It has far exceeded my expectations.  I am tired or rice but luckily there are other options.  We are staying near the river street which is filled with fancy restaurants by Lao standards.  If we got 2 blocks, we have a bakery, pizza place, French restaurant and traditional Lao food.

For lunch at the hospital, most of the staff goes to the "cafeteria" which is really a mom and pop style restaurant.  While they speak very little english, pointing has lead to a variety of tasty treats for a little more then the cost of ramen.  In the shop there is also a variety of treats and drinks to round out your meal.  I have become quite fond of the vegetables and pork/chicken in broth.  The pho is also a winner.

Lao is know for its fish, Mekong seeweed, papaya salad and Mok.  I have attempted the papaya salad and Mok which were both a surprise.  I expected a papaya salad to be sweet with big chunks of papaya.  To my surprise it was unripe green papayas and was spicy!  Mok is a traditional dish with meat, lemongrass and egg steamed in a large banana leaf.  This was surprisingly good.  

Chicken Mok

On the main drag through town you can find just about anything you want.  There are many ex-pat restaurants around town as well including a speak-easy bar with great gin, a new tex-mex restaurant that had Chipolte style burritos and an India place we have yet to try.  Two days a week there is a place called Secret Pizza that is down a random dark road but was a nice taste of home. The best ice cream in town is called U Like (gotta love the name) and 2 scoops are 8000Kip or $1.

For now we are off to learn how to make our own Lao food at the Tamarind Cooking Class.

Lao Food pyramid

Elephants, Waterfalls and Buddha oh my

Some of the mud we got stuck in

Driving along the Mekong

Riding the Elephants

We have finally had a break in the heat here and the rain has started.  The daytime highs are finally below 100 and we can walk outside without melting.  We had the weekend off so we took full advantage of our time off.  On Sunday we went to go see the elephant sanctuary and it provided quite an adventure.  Overnight we had received some impressive rain and the dirt roads made for some difficulty getting to the sanctuary.  The van we were in got stuck more then once in the mud to the point we had to have another truck pull out out of the mud.  On one side of the road was a steep drop off straight into the Mekong River so we opted to get out of the van and walk.  However, this was not without adventure either.  We stepped out into the mud and I lost a shoe into the mud and Anna was covered in mud from walking in flip-flops.  We made it out and have a funny GoPro video to go with the event.

Boat ride to Pak Ou Cave

We finally made it to the sanctuary where we had our own private tour.  We each had an elephant to ride with a Mahout to lead it.  We rode along the riverbank for about an hour with some spectacular scenery in the background.  It was an amazing experience!  After riding the elephants we took them down to the river to have some fun.  The elephants would drop into the water and roll over to try and buck us off.  It was a lot of fun and we ended taking quite a few swims.  The elephants were amazing animals and so gentle.

Having fun

After lunch on the riverbanks we took a boat across the Mekong river and went to Pak Ou cave.  Its a cave on the river with hundreds of Buddha statues inside.  There were two different caves at the top of the stairs.  It was beautiful looking out at the cave at the Mekong river.  After walking up several flights of stairs, we got back on the boat to head to Tad Sae Waterfall.

Feeding the elephant

Because its the end of dry season the waterfall was not no impressive but the hiking around the waterfall was amazing.  Our tour guide took us to the top of the waterfall and to the caves near the waterfall.  It was an adventure to say the least.  Both Anna and I took a little tumble hiking but no one was injured.  After a long day day of adventure we made it back with only a few bruises and a lot of great memories.  We have a ton of pictures and are slowly making out way through them.  Here are a few from the days adventure.

Pak Ou Cave

Mekong River

Looking out from Pak Ou Cave

Overlook at Pak Ou