Health Headlines

My friend and colleague Not said it best (and with such cute English) with, "Ellen sad because small cat pass away."

That was the closest thing I've had to caring for an animal farther up the evolutionary tree than a fish, so the whole experience was rather traumatic for me. If a vet had been at the office, they never would've let me take it home b/c its chance for survival was so slim from the start.

And well, I've always said that I'd make an interesting case study for the mental-physical health link, and so here we go again. My stomach has not sat easy, and I'll leave it at that. Out of curiosity, I went online to see what's new in health and found these interesting headlines (disclaimer: I haven't actually reviewed any of these studies, so can't vouch for their findings):

• Lack of Exercise Explains Depression-Heart Link
• Women’s Heart Symptoms Often Blamed on Stress
• Americans Are Sicker Than They Think, C.D.C. Finds
• The Benefits of Therapy by Phone
• Better Mental Health, Down on the Farm
• Using Music to Lift Depression’s Veil

2 December is National Day here in Laos, and everyone in the city is getting ready with new coats of paint, strings of lights, and flags (the red, white, and blue Lao national flag + red and yellow hammer and sickle flag). The lights and gentle coolness of the evenings remind me of Christmas back in Louisiana. Curious to see what this 2 December holiday brings.

IMA-MAMA!

On Thanksgiving Day, Monica found a litter of 5 less-than-one-week old kittens in the cupboard of the CARE office. We think someone left the door open, and the mum came in to give birth. But when she left for food, she couldn't get back in. Monica put them in a box and got puppy's milk from the veterinarian for them. I was so joyous to have these furry visitors that I plopped the box on my desk and gazed/cooed at them in lieu of lunch (exactly between 12pm and 1pm). The fuzziness was quite very soul-nourishing after this stressful week at work.

We set the box outside in the late afternoon, and the mum cat actually came back for them -- even after we had touched them. I'd heard that mother animals wouldn't touch their young if they smelled human scent on them, so I'm glad that wasn't the case here. However, now we'll have a bunch more feral cats running around.

But this morning, we found that she had left behind the runt (the black one underneath the calicos). So in my excited state, I volunteered to be Mama Cat for the weekend!! This, of course, means no sleep -- which I fully acknowledge at 2am. Maybe I'll give you another update at 4am. My first experience taking care of "a baby." And I pray it goes well until we see his first poop (and know all his insides are functioning properly). THEN maybe we'll name him!

(Anne, I'm doing this for you. ;-P. Just kidding!)

Happy Turkey Day!

Maybe not so surprisingly, I had a more "American" Thanksgiving here in Laos than I often have back at home in the U.S. Ambassador and Mrs. Huso had a quaint dinner party for about 40-50 on their spacious front patio. Guests were mainly folks who work at the embassy and also a group of old friends and visitors from the Husos' native Hawaii.

The ambassador's residence, like most official residences here, is set in the French colonial style. Since it was my first time really spending time within an American presence abroad, I had never heard of the ART in Embassies Program. The new ambassador starting his/her tenure may choose from a collection of American art to exhibit in the residence to share a bit of American culture with guests. The Husos' collection features all Hawaiian artists.

Here is the painting Luana (Giclee print) by Pegge Hopper flanked by Pair of Whiskey Jugs (glass) by Mark Mitsuda who was the Husos' daughter's art teacher.

We had turkey and all the trimmings, plus sweet hibiscus tea. Dave was my +1, and I guess like attracts like because our dinner table became the "health" table with, among the Hawaiian visitors, a Japanese-American pediatrician, a Vietnamese-American biochemist/public health person who leads medical missions to Southeast Asia, and a fellow who had worked with the Hawaii health department.

The Hawaiian visitors were all en-route from the East-West Center alumni function in Bali, but got stranded here because the Thailand airport closed down yesterday. That has really caused a raucous here. Tons of stranded people, and the alternative flights out of Laos to Hanoi and Kuala Lampur are packed.

Overdue, but alas, keep waiting

Hey hey! Sooo much has been happening the last 1.5 weeks that it'll take quite a while to recount it all here. I'll do my best in fitting photographic glory! Meanwhile, here's a quick summary in reverse chronological order:

1. This week - Big deadline to complete protocol/questionnaires for technical review
2. Last weekend - Detour through Luang Prabang
3. Last week - Work visit to mountainous project site in northwest Laos to observe mobile health clinic in ethnic minority villages and collect info for protocol
4. Last Monday - Le sigh, motorbike accident...but I'm fine!!!

Here are a few photos from my site visit to keep your eyes happy. :-)

Mountain road and foot access to the villages

Modest homes in Prai ethnic villages

Villagers waiting outside the mobile health clinic set up at the school

Sneaking a peek at the AI awareness video with the children

That Luang Festival

Last Wednesday (the November full moon) was the culmination of the That Luang Festival here in Vientiane. Pha That Luang is the most important national monument in Laos. The golden stupa is a symbol of both the Buddhist religion and Lao sovereignty (according to Lonely Planet).

All I really know about the festival is that thousands of monks come from all over Laos to be here (it is jolly to see all the bright orange robes about town), but the trade fair definitely outshines the religious element of the event. Early Wednesday morning, monks lined up to collect alms from locals, and there was an afternoon hockey/polo game staged in the street between "the man" and "the people." However, I didn't see any of this because I couldn't handle the throbbing crowds of people.

I did go in the evening to peruse the trade fair (still throbbing with crowds of people), check out the CARE co-sponsored avian influenza booth, and visit more nuns. I had never known of Lao Buddhist nuns until this event. Women who have no family, are disabled, or unable to care for themselves may become nuns and live inside the monastery. Asian grandmamas are so cute! I collected several more good luck bracelets from these nuns.

Healthy Poultry, Healthy People! The AI booth was co-sponsored by CARE International, AusAID, AED, and sorry my eyesight is bad so I can't read the other logos. But the central Lao body that this all supports is NAHICO, the National Avian Human Influenza Coordinating Office.

As you can see, the booth was replete with all sorts of AI awareness materials, including posters, Tshirts, demonstration booths for handwashing and proper chicken cooking habits (CARE Lao staff did the cooking!), coloring for the kids (a relatively new concept here), and dramatic renderings of handwashing (in song) and what to do when your bird dies.

And now introducing Super Kai!!

(exhibiting the superb chicken butt above)

Look at those strong arms! Now I am no longer afraid of avian influenza.

Here I am with CARE Lao staff, Not, Monica, and Noi.

More photos of the festival. No, the stupa is not on fire. Those are just the fireworks!

Who me? An epidemiologist??

Sooo, have I failed to mention why I'm actually here in Laos? If so, it's probably because it's taken me this long to get a handle on what I'm supposed to be doing. Basically, CDC is a donor agency for CARE Lao, and I'm here to support a project to build local research capacity and increase the knowledge base surrounding influenza and health behavior of the Lao people. I function as a consultant to CARE Lao and the local school of public health.

Work has picked up dramatically since I started writing up the research protocol two weeks ago, and now that I've just gotten off a technical consult call with CDC, I've realized that the next two weeks will be even crazier as I hurtle towards the December deadline of having the protocol complete and translated so we can submit for IRB approval on both the U.S. and Lao sides. Wahoo!

So, target populations, sampling strategy, census data, sample size calculations, cluster analysis...here I come!! UMSPH should be proud. ;-p

P.S. Next week, I'm going into the field to one of our study sites in Sayabouli Province up north. I will observe nutritional assessment and mobile health clinic activities in the mountainous region (read: cold) bordering Thailand. The villages are all of the Prai ethnic minority group. Should have an interesting report for you when I return!

Nong Kiaw Village

My activities have snowballed since my first weeks in Laos, but I finally have a bit of time to recount for you my two days traveling in Nong Kiaw Village back in early October. What a serene sojourn into backcountry bliss.

From Luang Prabang, Dave and I took a 3-4 hour, 40,000kip sawngthaew trip north to Nong Kiaw, a sleepy village cut into the green, limestone cliffs along the Nam Ou, a tributary to the Mekong farther south. The road was dusty and bumpy all the way, so the face mask I'd gotten earlier (for the awful hack I'd developed idling in Vientiane traffic) was vital to my well-being. Here are photos from the first day...the ride out to Nong Kiaw Village and walks around the village.

Here's day two, my favorite part! Dave and I rented bikes to visit a nearby cave that was used as a hiding place during the war. Then we hurried back to town to take a boat up the Nam Ou with Home and his father. Home's family owned the rustic herbal sauna and massage shop in town. A very bright kid who wanted to go to college, but the family didn't have the money to send him. So he's working at home...learning English and Japanese at a break-neck pace as Nong Kiaw further opens up to falang travelers.

Check out the video on the right of the local boys playing an acrobatic 3-on-3 game of kataw.

Gimme a "change!" ...CHANGE!

The world was watching on Tuesday, still is watching today, and will be watching for weeks to come. So many people congratulated me today on the results of the U.S. presidential elections. I've never considered the word "congratulations" for myself for an election, but I guess congratulations are in order for the U.S. and for the world.

There weren't many election viewing parties here in Vientiane, but I did manage to get onto the guest list to morning coffee election viewing at the U.S. Ambassador's residence. Arrived a bit too late and missed all the buildup, but no worries, there would be more celebrations to come.



After work, I had a little trouble finding other Americans to celebrate with, but when we did find each other, we were like giddy schoolchildren. After drinks at Sticky's, where Anais, new friend Jessa, and I explained the electoral college to the Germans, Aussies, Brits, and Kiwis sitting around the table, Dave caught up with us, and the four of us headed off in the dark to find the Democrats Abroad house party in the rice paddies. Peddling about on our bicycles, we chanted,

Change! Change! Yes, we can! Yes, we can!

Unfortunately, by the time we found the house around 10pm, the party was over! And it was starting to rain...and downpour. And me in my nice new sinh too...boo. Rainy season was supposed to have ended a month ago, and it's unseasonably warm right now. Go, go, global warming! We quickly found cover under a shop awning, but booked it once the rain settled up a bit. Anais was so prepared with her umbrella.

We would not be deterred from celebrating, and so gathered at Jessa's place for drinks... various bubbly waters and juice, accompanied by talk late into the night.

P.S. I was having lunch with two new friends from Argentina and Laos, and they mused that the rest of the world is so affected by American policies that they should be able to vote for the U.S. president too! They'd happily make up the other ~40% of the U.S. population that isn't voting! Along the same vein, here's an interesting Electoral Map of the World, if the world could vote.

Heeeere, chicken chicken...!

Voting has begun!!! There aren't many Americans among the expats over here in Laos, so 2:1 expats (mainly Aussies & Kiwis) I've spoken with just don't get how I can be so excited -- personally effusive -- about these elections (ok, ok, n=3). BUT I'm proud to see through Facebook how vested my friends at home are in this election. And the world is galvanized from parties in Africa to dedicated cakes in the town of Obama, Japan.

THE WORLD IS WATCHING!!

While we wait for the results (and I OD on CNN International and Katjes gummy fruits), let's talk about chickens. Real chickens. And ducks and turkeys. Today I tagged along on a visit to an in-city backyard poultry slaughterhouse. Sounds icky, but it was really interesting!

Caution: the following images may not be for the faint of heart (not much blood though).

Lao Wedding Bells

Vieng sweetly invited me to her high school friend's wedding and lent me the Lao outfits for the occasion.

Here are photos from throughout the day, starting with the ceremonies in the morning at the bride's home, and ending with evening festivities at a hotel. No cheesy wedding tricks. Just speeches (short!), food, drinks, and dancing!

It's an Animal's World

Here is a casual collection of animals I've caught on film in Laos.

This cutie pie is a binturong, or Asian bearcat (although it's neither bear nor cat), related to the mongoose and civet, and is one of two carnivores with a prehensile tail, useful for swinging about in its home among the rainforest canopies of Southeast Asia.



Here's something interesting...binturong are one of 100 mammal species that can undergo delayed implantation. That means female binturong can get pregnant, but then hold the embryo dormant and time the birth with favorable environmental conditions. Kick ass!! Can you imagine if humans could do that?? No more surprises, but more like...oh, well let's just tuck that away for a bit and go traveling! Or I can be CEO for a while longer...

BIRDS BIRDS BIRDS!! Chickens, ducks, turkeys...there's no getting away from them here. Countryside, cityside...they're everywhere!

And what do birds (and apparently, humans too) eat? Bugs. From left: raw larvae at the Morning Market; larvae and grasshoppers cooked with chilis; and a boy's pet beetle on a string (he was moody, so I couldn't get very close).