7 Juanuary 2009, Busted Up In Isaan

Busted Up In Isaan
7 January 2009

This is my second attempt to write this blog. On Sunday, I spent a couple of hours composing the blog only to lose all my work on MySpace by hitting an incorrect key - Grrrrr!

I will now try resurrecting it from memory and first write it in Word so that all I have to do is paste it into MySpace.

We had to go into Udonthani Sunday morning for a family emergency. Duang had gotten a phone call that one of her relatives had been in an accident and was now hospitalized. I have written before about the number of her relatives. Here in Isaan it seems that just about everyone is an aunt, uncle, cousin or “cousin of my cousin”.

In Isaan, one’s family extends beyond what we typically define as immediate family in the USA. For me family was made up of aunts, uncles, nephews, nieces, and their children. I am not even familiar with the term for the “cousin of my cousin”. But this is Thailand and things are different.

In preparing to rewrite this blog after a day of sulking or perhaps mourning over my lost original work, I sat down with Duang to get a better understanding of just how many relatives that she has. I restricted my questioning to just aunts, uncles and cousins. I was shocked but developed a better appreciation for how so many people seem to be family for her. Duang has 7 uncles, 9 aunts, and 92 cousins. Now I understand – a little bit.

Duang has difficulty with possessive pronouns – your, my, his, her, our, and their. This leads to some interesting but interesting conversations. Sunday was one of them. She informed me, if I remember correctly, that “cousin of you uncle of my sister” have accident last night.

She assured me that I knew the victim and that he had “taken care of me the other day at party”. “Take care” of someone means to say hello to them. Since half of the village was at the party, I am certain that the victim had spoken to me but I had no idea who he was. I decide to just wait and find out once we were at the hospital.

Her relative, “cousin of you uncle of my sister”, was at Udonthani General Hospital. Udonthani General Hospital is similar to a county hospital in the United States. The farmers of Isaan go to that hospital because they do not have good medical insurance. When their condition can not be adequately handled at the more local facilities such as the Kumphawapi Hospital (Maternity Ward Blog) or the outlying clinic that I had previously described where Duang and her aunts had enjoyed a medicinal sauna, the patient is transferred to a facility in Udonthani.

Udonthani has five hospitals – one Army, three private, and one public. Udonthani General hospital is the public hospital.

Udonthani General Hospital is located across from the park in central Udonthani. The hospital is located on one of the main 4 lane divided streets in the city. The far side of the street is bordered by the park, a sidewalk, and a lane of pull up parking. The sidewalk is mostly taken up with sidewalk vendors and sidewalk restaurants as well pedestrians weaving their way through the gauntlet. The one row of pull up parking is no where adequate for area so people park in a single row perpendicular to the parked pull up spaces. This only uses about one-half lane of the street so there are one and one half lanes of vehicle street traffic. The Thais have a system for parking that seems to work rather well. People park behind other parked cars leaving their locked vehicle in neutral. If your vehicle is blocked, you just go up to the offending vehicle and push it out of your way – no problem, no emotion, no anger – it’s just the way it is here. Can you imagine this happening in the USA – blocking half lane of street traffic, blocking another car, and putting your hands on someone else’s vehicle? I think not – not in our lifetimes!

Duang’s son parked the truck in the single remaining pull up parking space a short distance up from the hospital. As we left I started to think about how difficult it would be to remove a blocking vehicle behind the truck if the offending vehicle was one of 4 or more parked bumper to bumper. When we eventually returned to the space, we were blocked. Maybe we were just lucky but there was room beyond the offending vehicle so we only had to push one car out of our way. Perhaps there is an unwritten code to park so that someone only has to push two cars to free up their vehicle. I’ll keep an eye out to understand what the system is – if there is one.

The other side of the divided street is similarly congested. The sidewalk is cluttered with street vendors, sidewalk restaurants, and pedestrians. There is no car parking on this side of the street but one half lane is occupied by parked somlaws (three wheeled passenger carrying motorcycles). The numerous somlaw drivers are scattered about hustling potential customers, eating, drinking, smoking, gossiping, or napping. Neighborhood and street dogs wander in and about the masses of people making their way to and from the hospital. It is quite a congested sight.

Udonthani General Hospital is a large complex of three story concrete structures reminiscent of 1960’s era urban school architecture in the United States. It is apparent that there was little advance planning in developing the hospital site. Buildings were shoe horned into the restricted sight as their need was identified. Each building is connected to others through a maze of open sided covered walkways. The combination of walkways and cantilevered balconies of each building creates many sheltered areas at ground level. Some of the sheltered areas have been turned into gardens with plants and benches along the edges. The other sheltered areas have been paved over with concrete.

The paved sheltered areas were occupied by many people. The people of Isaan who use Udonthani General Hospital are typically poor people from the outlying farming regions. There is no Ronald McDonald House for relatives of patients to stay at while their loved one is being treated. Transportation to and from the hospital is difficult and not convenient - pickup truck – up to 10 people per vehicle. No problem. The people of Isaan spend much of their time outdoors. So it is at the hospital. In the sheltered area families set up their sahts (woven reed mats) and camp out for the duration of their loved one’s stay. Atop the sahts, they place their woven baskets of sticky rice, plastic bags of other Lao food, plastic bottles of water, plastic bags of clothing, and plastic bags stuffed with blankets.

Typically the grandparents sort of hold down the fort at the sahts while watching over the grandchildren who are running all about trying to amuse themselves all the while annoying others and being nuisances. The children are so cute and precocious that they are easily tolerated.

There were not any elevators in the hospital. Access to the upper levels is by stairs or ramps. Since the ramps were congested with patients being transferred in wheelchairs or gurneys, we used the stairs.

Duang’s relative was in a typical 24 bed open ward. We were not the first ones to arrive at his bedside. With our arrival, he had 12 family members hovering around his bed. I had expected to see an older man before me and was surprised to see a 12 year old boy in the bed. He was hit by a pickup truck with no headlights on while driving his motorcycle across the road to visit his uncle. Twelve years old! Driving a motorcycle on a public road! No problem – this is Thailand. There were no arrests, no charges and the pickup driver will make restitution after the boy is discharged from the hospital.

We were not the only people in the hospital ward. The ward was about 1/3 filled with patients. Patients ranged in age from about 6 years old to 70 years old. Some were on machines to assist their breathing. Privacy was at a premium. Although there were curtains that could be drawn to isolate a bed, no one was using them. Each patient had about 8 family members tending to them. Family members perform many tasks that nurses do in the USA. Family members wipe brows, feed patients, and assist them with going to the bathroom.

Visitors brought their own food and drink for their consumption while visiting. Children of all ages visited along with their older relatives. It was all very free and open as well as somewhat chaotic. Once again the sense of family and community was very prevalent.

Thai people have a fascination with pain and suffering that at times I find rather disconcerting. On television news broadcasts it is common to see up close and intimate filming of accident or victims of crime. I have seen broadcasts where the film crew followed the victim into the ambulance focusing on the victim’s anguished face or injuries. At ambulance facilities they have display boards with photographs of the victims that they have assisted or those that they just ended up picking up off of the road. The photographs are very vivid and leave little to the imagination. They are also very popular. I always feel like an intruder when confronted with these types of displays. In fact, upon leaving the hospital, Duang, her son and his girlfriend made a point of looking at each and every photograph on the “Don’t Drink and Drive” display in the hospital lobby.

Duang’s family is no exception to morbid curiosity. When we arrived, a point was made to show us each and every injury that the boy had endured. The blood stain on the hospital bed was pointed out and hospital gown was adjusted as needed for full viewing as well as for the convenience of the onlookers. The boy had an injured knee and would be operated upon in about two hours. His other injuries amounted to scrapes, and some cuts that required stitches.

After our visit we went off for awhile and returned later to give some family members a ride back to Tahsang Village. If you have a vehicle in Isaan, you are often called upon or expected to provide transportation for family members. When we were walking towards the boy’s ward we were called up by Duang’s sister to the second floor of a different building. This building was apparently the surgery building. The second floor had a door that indicated that it was an Operating Room. The exterior of the Operating Room resembled the exterior of a 60’s era high school classroom – metal, and glass curtain wall within concrete structure. Access to it was by way of open air covered ramps. Abandoned gurneys and wheel chairs cluttered the walkways outside of the room. In a corner a large bin was overflowing with used hospital linen. The boy’s family was congregating on the second floor outdoor hallway outside of the operating room. There was no nurse’s station or any other sign of life around the room. The windows to the room were heavily tinted so I had no idea what was on the other side. After surgery the patients are wheeled outside to their ward.

We gathered up the clan and I drove them back to Tahsang Village – about 40 miles. The boy did fine and will be released from the hospital tomorrow.