Baan Hat Hien - Blacksmith Village



Baan Hat Hien Blacksmiths Forging A Cane Knife

 Since we had rented a Tuk-Tuk along with a driver during our trip to Lunag Prabang, Laos we had the freedom as well as flexibility to do some sightseeing outside of Luang Prabang proper.  As part of my research for our second trip to the area I determined that visits to three villages would be interesting.


Baan Hat Hien, "Blacksmith Village" Lao People's Democratic Republic

One of the villages that I wanted to visit was "Baan Hat Hien" which is also referred to as "Blacksmith Village".  According to my research on the Internet Baan Hat Hien is well known for making knives out of reclaimed American artillery shells and other war materials.  America's not so secret, "Secret War", in Laos ended 35 years ago and even though Laos is the most heavily bombed country in the world, the amount of available war material has apparently diminished greatly.  During our visit to the village which included three homes where blacksmitting was being performed, we did not observe any brass or bomb materials.  The Baan Hat Hien blacksmiths were creating knives and machetes out of recycled steel - high grade steel from leaf springs of Tuk-Tuks and Somlaws.  Although the amount of material from the war now available for forging into knives has diminished, the threat to the Lao people from the wars remains a real concern and danger.  During our visit we saw Lao government vehicles associated with their campaign to rid the country of unexploded ordinance.

Today the blacksmiths purchase leaf springs from the suspensions of Tuk-Tuks and Somlaws from scrap metal dealers from Vientiane for 6,000 KIP ($0.75 USD) a kilogram ($0.16 USD per pound).  The blackmiths disassemble the leaf springs and cut them into the proper length.  They use their forge to heat the steel in order to cut the steel with a hammer and chisel.  I did not see any oxy-acetylene cutting torches in the village.  Oxy-acetylene cutting torches use compressed bottles of oxygen and compressed bottles of acetylene to fuel a hot flame to cut steel.  I suspect that both the cost and the lack of availability of the gases preclude their use in Baan Hat Hien.  The blacksmiths of Baan Hat Hien heat their steel in small charcoal fires.  Charcoal is a local product and cheap.



A Typical Forge in Baan Hat Hien

I didn't count the number of houses in the village, but I would guess that there were 10 to 15 houses.  From the blacksmiths I learned that there were 5 forges in the village.  Five forges?  Actually there were five homes where the family forged knives over a very small charcoal fire in the front yard of the home.  Typically the 6 inch diameter fire was contained in a rough furnace built with a few bricks and supplemented with a forced draft fan.  Everything was fit for purpose and from readily available cheap materials.  The forced draft fans are small blowers that appear to be recycled truck defroster, heater, or A/C fans.  Air from the fan was sent by a metal tube to discharge beneath the coals of the fire.



 As is typical in these cottage industry facilities and many homes the electrical system was very primitive and suspect.  Electrical cable ran unprotected along the ground from a very small junction box on a post or pole to the blower.  I did not see any protective measures such as metal conduit or a GFI (Ground Fault Interrupter).  If there is one thing that concerns me more than being involved in a traffic accident over here, it is having some sort of electrical accident.  My concerns are in general not shared by the local people.




A Husband and Wife Work Together In Front of Their Home

The people working with the hot steel wore no personal protection equipment.  Due to the heat of the day and from the forge, they wore cotton tee shirts and cotton shorts.  None of the workers wore gloves even though they were handling hot metal.  None of the workers had safety boots.  The workers were barefoot or wore their everyday rubber flip flops.  I never saw a pair of safety glasses despite the various activities that could injure the worker's eyes.  If any type of head wear was worn it was a simple baseball style cotton cap.  Despite the soot from the charcoal fire none of the workers wore a dust mask or anything else over their nose and mouth.  Although the workers were handling yellow hot steel and striking the hot steel with heavy hammers causing sparks to fly and undoubtedly small pieces of hot metal, the workers did not wear any "leathers".  I grinned to myself thinking of the heart attack any of the safety men that I had worked with in the past would have had upon inspecting these work sites.  We were witnessing a cottage industry no doubt very much like those operating in Europe or America in the mid 19th century.  The blacksmiths do not go to school to learn metallurgy or manufacturing techniques.  The ones that we spoke to were taught their craft by their fathers.  The workers were masters as well as slaves to their trade.  They pretty much controlled the entire process and means of production.  However, if they didn't produce they did not earn any money.




Two Workers Beat On A Hot Steel Blank to be Forged Into A Cane Knife


The man and wife that we spent the most amount of time with start work at 8:00 A.M. and work 7 days a week until 5 or 6 P.M..  I suspect that their quitting time is more determined by available day light than any defined schedule.  Their product is purchased by a "big company" for 16,000 KIP a cane knife ($2.00 USD) which the company then distributes and sells for $4 USD.  The blacksmith team can make 10 knives a day.  In comparison Lao field workers make $2.67 USD a day versus $20 USD for the blacksmith and his wife.

A Worker Inserts A Hot Blank Into A Bamboo Handle That is Being Prepared


At two of the forges, wives worked with their husbands to produce cane cutting knives.  The women tended to heating the steel in the fire.  They also took the hot semi finished knives from their husbands and shoved the blanks into prepared pieces of bamboo.  Bamboo is a type of grass.  It is hollow but at intervals there is a diaphragm that closes off the interior of the bamboo.  These periodic internal bracing gives the bamboo plant strength and rigidity. The prepared pieces of dried bamboo were cut so that one of the internal diaphragms was close to one end and far from the other end. As the narrow tapered end of the hot knife entered into the hollow bamboo at the long end it eventually burned through the internal diaphragm at the far short end thus creating a good mechanical connection once the blade is completed.  When the blade has been completed the blade is reinserted into the bamboo handle and the void filled with an epoxy.  The day that we visited the women were only burning the internal slot into the handle and removed the still hot blade to complete cooling on the ground.  The handles were set off to the side for use at a later time.

Baan Hat Hien Knives For Sale - We bought one of the antler handle knives

In addition to cane cutting knives, the blacksmiths of Baan Hat Hien produce smaller hand knives.  These knives are presented with a great deal of pride and available for purchase directly from the blacksmiths.  We ended up buying a knife with a simple etched bamboo handle for 50,000 KIP ($6.25 USD).  A short while later we wee presented with some other knives for consideration.  Two of the knives had antler handles.  We ended up purchasing one of them for the same $6.25 price.  We like to purchase local handicrafts on our various travels.  It is a way to support and encourage local crafts and make wonderful souvenirs as well.




Handcrafted Knives with Bamboo Handles

 We spent about an hour at the village and learned a great deal about knife making but more importantly about the people's life.

Once again I was impressed and in awe of people making do with what was available to them.  The people were able to survive with little outside involvement or perhaps more importantly without outside interference.

It is these triumphs of the individual and cultural adaptations that I enjoy witnessing and documenting.

It is crafts, skills, and traditions like these that make up the heritage of mankind.  They are priceless gifts for the future and inspirations for today.

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Luang Prabang Tak Bat



Lao Monks Receive Offerings from Tourists

 Life has a way of presenting pleasant surprises if you are willing to take advantage of the opportunities as they present themselves.  A willingness to take advantage of opportunities often requires an unabashed curiosity and the realization that even though you may believe that you have seen it all before, you most likely have not.

During our recently concluded journey to Luang Prabang in the Lao People's Democratic Republic, I was presented with an opportunity which ended up in a couple of surprises.  Our hotel was located next door to a Vat (Wat in Thai) in the Temple Historical District close to the Nam Khan River.  At 4:00 A.M. I was awoken by the banging of a bell at the Vat.  I had heard a similar sound before from Wats in Thailand as well as Vats in Laos.  I refer to the sound as the Monk's alarm clock.  The heavy walled metal tube is struck several times to notify the Monks that it is time for them (perhaps everyone else next to the temple) to awake and start the day.  For the Monks the day commences with meditation, followed by personal hygiene, and then around 6:00 A.M. their morning alms walk.

Although I have witnessed and documented the morning alms walk, Tak Bat, many times in Thailand as well as Laos, I decided to get up and watch the morning's Tak Bat.  It was a wise decision in that I was able to photograph events that I had not seen before; events that I can now share.

When I went downstairs of the hotel, my hiking boots were still lying next to my wife's shoes beneath the Christmas tree.  Both the boots and the shoes were empty.  Prior to going up to our room the night before, I had joked with the staff and Duang about perhaps Santa Claus would come early and leave something in my boots.  I guess it was too early for Santa or I have been not necessarily a bad boy but more likely a naughty boy this year for the boots never were filled.

I walked out into the very early morning darkness to observe what was going on.  Some of the local people were up and about starting small wood or charcoal fires in refractory lined cans for cooking on the sidewalks.  They were also busy setting up their sidewalk restaurants.  Several Lao women were silently walking along the street in their flip flops carrying large baskets suspended from a bamboo poles balanced over their shoulder.  Their baskets were filled with food, mainly packets of sticky rice, to be offered to the Monks as part of a merit morning ritual.

Tourists Lined Up Along Th Sakkarin In the Early Morning Awaitng the Monks

On the sidewalk that passed in front of our hotel and eventually intersected with the road that runs parallel to the Mekong River, there was a series of long sahts, woven reed mats neatly placed.  Each saht had several woven bamboo covered small containers, gon kao, that store cooked sticky rice.  This arrangement had been set up for the tourists who would arrive shortly by a wide variety of transportation.  Tourists arrived by three wheeled motorcycles called "somlaws".  Some tourists arrived by small trucks called "Tuk-Tuks".  Many of the tourists arrived in specialized Toyota passenger vans.  Some of the wealthier tourists arrived from their resort accommodations in long electric golf cart type vehicles.  It was quite a sight and also a little noisy.  The people were excited about the upcoming ritual and busy posing their family as well as friends for photographs.


Tourists Come in All Sorts of Shapes, Sizes, Nationalities, as Well As Vocations

There was on group that I was fascinated by.  I had not seen a group of Monks before making offerings to other Monks.  Several Monks had arrived and set themselves along with their plastic bags of offerings and gon kao of rice on sahts placed on the sidewalk just like the other tourists.  One of the younger Monks took great delight and interest in filming his companions.  Next to me there was a Lao tourist guide, I found out from him that the Monks that were preparing to make offerings were visitors from Thailand.  I had never seen Monks making offerings to Monks before so this opportunity in itself was worth the early morning wake up.

After a short while the local Monks appeared silently and purposefully walking along the long sidewalk of Th Sikkarin. 


Thai Monks Making Offerings to Lao Monks

I have walked with the Monks in Luang Prabang as well as in Luang Namtha on previous trips, but this morning's Tak Bat was unique.  First of all the Monks did not chant after receiving offerings from the people.  In Thailand I have witnessed and participated several times in the ritual where Monks appear to give a personal blessing to the individuals who had made offerings of food.  In Luang Namtha, the Monks did not appear to give personal blessings to the donors but instead walked a very short ways from the donors and instead appeared to give a blessing to the donor's property. Since most of the land behind the donors was actually Vat property, that might explain the absence of "blessings".

Tourists Make Offerings to the Monks



Young Boys Follow Monks In Expectation of Food Offerings From the Monks

 Another difference in this morning's Tak Bat, was the young children who accompanied the Monks or who waited along the sidewalk for the Monks.  In Tahsang Village and some of the other villages where my wife and I have participated in the Tak Bat ritual, the Monks sat on a slightly raised platform in the Wat complex.  People came to the Wat and brought their food offerings with them.  The family's offerings were then placed upon a metal serving tray and offered to the Monks; typically by a male member of the family.  The Monks would pass the tray along amongst themselves after taking what they wanted off of the tray.   If any food remained on the tray after the Monks had completed their meal it was available for the worshippers to eat.  In Tahsang Village, which is my wife's home village, the worshippers are all friends, family and neighbors so eating the remaining food becomes a festive community social event - sort of a picnic.

A Young Lao Boy Awaits A Food Offering from a Novice Monk

Monks are supposed to eat only one meal a day and it must be consumed by Noon.  They are forbidden to store food and do not have refrigerators.  The assembly line of food offerings along Th Sikkarin in Luang Prabang presents some logistical challenges.  Everyone wants to earn merit by offering food to the Monks.  The more Monks that you offer food to, the more merit that you gain.  This boils down to every worshipper wanting to offer some food to each and every Monk.  It is not proper for a Monk to decline an offering, so in a very short period of time as well as in a short space, a Monk's alms bowl is filled with way more sticky rice as well as other foods than he could possibly eat in one seating.



A Monk Tosses Some Sticky Rice Into Young Boy's Basket

 For every problem there is a solution and often there are more than one solution.  In Luang Prabang, young children follow along with the Monks.  The young children, typically boys, carry plastic bags or baskets into which the Monks place the food that they will not be able to consume during their one meal of the day.  The children are collecting food for their families.  Some of the children set up on the sidewalk and patiently wait for the Monks to pass and hopefully add some food to their basket.  There was one boy who caught my attention.  He seemed to eloquently express his condition without words but with an admirable dignity.  I spent a great deal of time observing him and photographing him - more reason to be pleased that I had gotten up at such an early hour to witness an event that I had seen so many times before.

I have titled my blog "Allen's World" but unlike Disney World or Disneyland this world is not a fantasy world.  It is often fascinating but the occupants of this world, which is as much yours as it is mine, are real people.  They are real people, many of them with many hardships and struggles to survive.  They are not actors employed for amusement or entertainment.  There is a dilemma in photographing and writing about the people and their hardships.  It could be misconstrued that my work glorifies their struggles and hardships which to me would be offensive.  There is nothing glorious or noble about hardships or struggles.  Unfortunately for many people, hardships and struggles define their conditions.  However I believe that there is a need to communicate to other people the condition of others in our world. So my intention in writing and photographing the people in our world is to express my respect as well as admiration for the various peoples and  how they deal with their individual circumstances.  I guess my desire is to speak for those who can not speak for themselves, and to share with an audience that they are unable to address.  My goal is to increase the awareness of  others to the other people who inhabit their world.

Headed Home

A young boy and his sister also captured my interest during the Tak Bat.  They were working together to gather food for their family.  After the Monks and tourists left, they were left behind to consolidate their bounty for the walk back to their home. 

Brother and Sister Consolidating Their Morning's Bounty

Preparing for the Walk Home

The little boy and girl had amassed about 12 to 15 kilograms of sticky rice along with other food items.  The boy, who was older than his sister, supervised the consolidation of the sticky rice into a single thin plastic bag.  This did not look to be a good idea to me.  I was certain that the thin bag would eventually split open spilling its contents on the road.  I got down on the sidewalk next to the children and tried to communicate my grand scheme of placing all the rice into a single bag and then to place the filled bag inside of the just emptied second plastic bag.  The children's suspicions that I was scheming to steal some of their food apparently prevented them from understanding what I was trying to communicate.  A woman who was walking by understood what I was trying to do and explained it to the children.  Even though she spoke Lao, the children remained reluctant - perhaps they thought that we were working together.  The woman got down to the sidewalk level and between the two of us with the children eventually joining in got the sticky rice double bagged.

Off to the House!

With their food successfully bagged I told them to head off to home.  They each grabbed a side of the heavy bag and walked down the street dragging the bag as they went along.  This appeared to me to be another disaster in the making.  I caught up with them and was able to communicate that I would carry the bag of rice for them.  I had developed some level of trust with them by now so they let me carry the bag.  We walked down a side street towards the Nam Khan River and then along the road running parallel to the river towards the Mekong River.  After a while we came upon another narrow street leading up from the river.  We climbed part way up and I saw where their home was.  It appeared that their grandmother was waiting so I returned the bag to the children and continued my pre-breakfast foray about the town.

Almost Home

That night Duang and I had a nice pizza and a couple of Beer Laos for dinner at a restaurant that we had eaten at two years ago.  Some hip-hop music was playing.  The irony of listening to the trials and tribulations of a young American making millions of dollars "singing" his tale of woe and defiance was not lost on me after what I had experienced and observed earlier in the morning - in the real world.

Been There and Done That; Only This Time It Was Different



A Young Hmong Girl Eats Her Snack At the Festival In Laos

We arrived back home in Isaan, Northeast Thailand, last night from our four day trip to Laos.

Here in Isaan there is a phrase that is utilized often, perhaps too often for some foreigners who are of a more structured and precise ilk.  The phrase is "Same, Same, but Different".

At the risk of offending those foreigners I will describe our just concluded journey/adventure as "Same, Same but Different".  We specifically went up to Luang Prabang to witness "Pee Mai Hmong" (Hmong New Years).  It had ended up being a pretty much spur of the moment decision.  I had wanted to attend the festivities last year, but I had a great deal of difficulty determining exactly when the celebration would start.  Actually to paraphrase a recent former US President; "It all depends on what the meaning of the word, start, is"

Hmong Girls In Traditional Festival Clothing

The Hmong New Years celebration occurs in December but it is a 10 day festival with the first two days being allocated for rituals conducted in the homes.  The public celebration, which we had previously witnessed and wanted to see again, starts on the third day and runs for 8 days.  So for Duang and me, the "start" day was for the start of the public celebration.  I called the driver that we had used on our previous trip, Johnee's father, to no avail.  His cellphone was no longer in service.  I suspect that since he was married to a Danish woman, he and Johnee had immigrated to Denmark.  I had the phone number of the headman from the Khmu village outside of Luang Prabang but he was not all that helpful last year - the exact "start" date is determined by the moon and decision of the local people as to exact "start" date.  I researched the Internet and came up with a date of 16 December.  Having made what I considered to be a good go at it by myself, I reached out to a friend of mine with extensive knowledge as well as contacts in Laos.

My friend reaffirmed the difficulty in determining the "start" date.  He had a contact in Luang Prabang did not know the exact date.  I resigned myself to missing out on the celebration for yet another year.  Fortunately, my friend's friend  came through about a week ago with the "start" date of December 6 and a completion date of 9 December or 10 December.  I still did not know the meaning of the indicated start date of 6 December so I figured instead on working backwards from the end date of 10 December and worked to our arrival date of 7 December and departure of 10 December.

Previously we had stayed overnight in Vientiane and caught the 7:30 AM VIP bus to Luang Prabang up Highway 13 to Luang Prabang some 12 or perhaps 13 hours away.  This was a been there and done that experience - an experience that I nor Duang wanted to do again.  I researched flying to Luang Prabang on Lao Airlines.  There is or was or perhaps there is a direct flight from Udonthani to Luang Prabang.  However I was unable to book a flight on the Internet.  I kept getting a message to effect that a flight was not available for one of the dates that I had selected.  Great help; I have encountered the same problem at other airline websites - you are left to try to figure whether or not the problem lies with your departure day or return date or is only a particular flight time that is the issue?

After further research at other sights, I came to the conclusion that the direct flight from Udonthani to Luang Prabang had been suspended.  Later I was lead to believe that the flight has been reinstated now that it is the "high season".  No matter the case I dropped back to Plan "B" which was to go to Vientiane and fly out of there to Luang Prabang.  There are a couple of daily flights from VTE to LPQ.

We were not able to book on the morning flight on Tuesday 7 December so we settled for a 1:20 P.M. departure from VTE with a 2:00 P.M. arrival in LPQ.  This still saved us the overnight expense and time in Vientiane and got us into Luang Prabang 6 to 7 hours earlier than the bus.  With a 2:00 P.M. arrival there was still some time on Tuesday for some touring.  For the return flight, I selected a 5:50 P.M. departure which gave us most of the daylight of Friday for sightseeing.  With no difficulty our flights were reserved and paid for - $320.80 USD.



Hmong Girls Strolling - Seeing and Being Seen

 We had flown earlier this year from Vientiane and Luang Namtha on Lao Airlines.  This month's as well as our flights at the start of the year were great.  The flights were what you used to enjoy and hope for today - no nonsense.  Our ticket included baggage.  There was no additional fee for checked baggage.  We split up the camera gear into two carry on backpacks; I carried one and Duang carried the other.  There was no problem with our carry on size or weight.  Our clothing and other gear was in a single checked baggage weighing 12 KG.  The checked bag was an approved size for carry on by international carriers.  I indicated that there was one bag for two people and it was accepted without question and more importantly no additional fee.  On our return to Vientiane, the bag weighed 14.4 KG and again there was no problem.

Lao Airlines flies ATR72 and MA60 turboprop planes.  We once again flew on the Chinese made MA60.  A Chinese designed and manufactured 60 passenger plane powered by Pratt and Whitney of Canada engines - a common situation in the global economy of today;  an American company supplying aircraft engines through it's Canadian subsidiary for a Chinese company.  This is like a Toyota, a Japanese company, assembling cars in the United states out of parts made in Mexico, Canada, and Japan.  Is it a Japanese car or an American car?  Perhaps the answer is not on the manufacturing details but rather on the financial side.  The answer may be defined as to where the profits are sent.

I had used the Internet, http://www.agoda.com/, to research and book a room in Luang Prabang.  For our travels here in Southeast Asia, I always rely on Agoda and have never had a problem with them.  I am pleased with the discounts that Agoda can offer for all types of accommodations.  We did not like the hotel that we stayed at two years ago so I selected a different hotel, the Chang Hotel, to stay at this year.  The price was roughly double the rate where we stayed before but was well worth the money - but that will be the subject of another blog.

We had our airline and hotel reservations, our plan was once again to trust our intuition and select a driver for local transportation upon arrival at our destination.  Yes, there are people who will rip you off.  Yes, we have been ripped off a few, very few, times.  However most of the people that you encounter in these rural out of the way destinations are typically just an ordinary guy trying to make a living.  Duang and I do not go on organized tours.  Our traveling style is not compatible with an organized group in that we do not like being told how long we have to visit what particular location that they have selected.  We prefer to select our own locations and sights to visit supplemented with knowledge from local people who drive us about.  We are able to get a more personal experience from our travels by closely interacting with local people.  Very quickly the local drivers realize what we are interested in and take us to more unique places that meet and often exceed our expectations.  We run the risk perhaps of being ripped off but if we don't like a particular driver we do not hire for the next day.  I believe that the costs that we have paid for being ripped off are far less than the profit and overhead charged by an organized tour.  The benefit to us is to travel on our own schedule and a flexibility to enjoy serendipitous events or locations.




A Little Hmong Girl At the New Years Festival





This Little Guy Actually Managed to get Some Food Into His Mouth

 So yes this was basically a trip to a place we had been before for things that we had done before.  Same Same but different.

We stayed at a better hotel in a better location.

We ate at the restaurants that we ate at before but I could not drink the free draft Beer Lao that came with our second pizza at the Hive Restaurant; a large bottle and the first free draft Beer Lao was more than enough for me this year.

We went to the same locations for the public Hmong celebrations but this year I had a new and better camera.

We went to the Presidential Palace just as we did on the previous visit but whereas on our first visit the Sala Pha Bang was filled with scaffolding and workers, it is no longer under renovation.  It was a thrill to see the completed renovation but that will also be the subject of a different blog.

On this visit we visited two different outlying villages and saw Lao Kao (whiskey) production, embroidery, silk weaving, knife making, and brick production.  This was different.

Since our visit this year coincided with the Lunag Prabang International Film Festival, one night we attended the screening of a foreign film from Malaysia.  This was different.

We went the Night Market every night.  That was the same.  We spent far less at the market than during our previous visit and that was a big "different".

We ate French pastry at some new cafes.  That was different.

I went to an elementary school for the start of the morning.  I wandered about the school grounds photographing the young students and then photographing the classrooms.  I was ignored by the adults and never saw a security guard or policeman.  I was however like the Pied Piper with the children.  I enjoyed speaking or trying to speak with the children.  They were pleased to see digital photographs of themselves and their friends.  I did introduce myself to a couple of teachers and got to speak with them - a little bit.  This was different - wonderfully different.  But once again that will be subject of a future blog entry.

So this year's trip just as in life was a continuation as well as refinement of the past.  We built upon what was good from the last trip and took steps to eliminate or improve what was not 100% from our last trip.  To keep it all interesting and improve the overall experience we tried some different activities and locations on this trip.

Same, Same but different.

Perhaps even better!

Love During My Time of Cholera

The news out of Haiti in regards to the current cholera outbreak continues to be a concern.  People continue to contract the disease, suffer, and for some; die.  The outbreak appears to be spreading and given the living as well as sanitary conditions in Haiti its spread is no surprise.

As a child I remember reading stories of people suffering and dying from cholera in WWII prison camps or in Southeast Asia jungles.  From school history books, I learned of historical cholera outbreaks in America as well as in Europe due to the lack of proper sanitation facilities and procedures.

Cholera to me was an old historical disease of far away places that as a person living in Connecticut I had no reason to fear.  Cholera was a disease of the old and primitive world.  Cholera, in the modern world, was a disease found only in exotic lands such as Bangladesh - so I thought.

In September 2007, I started working on a project in northern Vietnam.  I was assigned to a project in the Halong Bay area not far from the port city of Haiphong and about 3 hours north of Hanoi.  Once again the exotic and distant lands that I learned of during my youth from books, newspapers, television, and movies had become part of my life experience.  Just as I had visited the "lost" Inca city of Machu Picchu, rode upon the waters of Lake Titicaca, climbed the ruins of Angkor Wat, and enjoyed the natural wonders of America as well as Canada, I was enjoying the opportunities of a far away land.

I arrived in Vietnam in early September, and after settling into a rented villa I returned to Thailand in Mid-October for a weekend in order to bring Duang back to Vietnam.

Later in the year I attended a special dinner hosted by our Chinese client in their facilities at the job site.  The "Team Building" dinner was held on a Friday night and besides copious amounts of vodka and beer, there were many seafood dishes.  Some of the seafood was raw and we ate it without hesitation or concern.  After an uneventful weekend, I returned to work on Monday morning.  During the morning, I started to not feel very well.  After lunch, I was very sick.  Getting sick at work is never a pleasant experience.  Getting sick at this particular job site was extremely unpleasant.  Toilet paper was not stocked in the stalls; what you had to use was what you brought with you.  Worst of all, there were only squat toilets.  Western flush toilets did not exist at the job site.

Inside of each stall was a 8 inch high tiled raised platform.  A toilet bowl was built into the raised platform with the top of the bowl flush with the surface of the platform.  The contents in the recessed bowl were removed by opening a valve to let a stream of water flush the contents down the drain pipe at the bottom of the bowl.  I have used squat toilets but I am still fearful of two things when using them; dropping my wallet into the toilet, and soiling my clothes.  I address my fear of dropping my wallet into the toilet by removing my wallet from my back pocket and relocating it deep into a side pocket of my trousers.  As for my fear of soiling my clothing - I am working on convincing myself that the geometry as well as anatomy prevent such a disaster from happening.  However I am not a true believer - yet.  As an added precaution; after I get in the proper location, assume the squat position, I use my right hand to grab and pull my trousers as well as underwear forward out of any perceived danger zone.  To date I have always been successful so I doubt that I will change my practice.

Being sick at both ends is always unpleasant but in Vietnam using a squat toilet it was even greater challenge and even more unpleasant.  I did not manage to make it to quitting time.  I had the company driver take me back home.

Duang immediately wanted me to go to a doctor or to a hospital.  I had severe vomiting and diarrhea.  I was unable to anything down or in me.  I had had amoebic dysentery before when I lived in Algeria so I realized that I did not have dysentery.  I did not have a temperature so I suspected that I did not have food poisoning.  I suspected that I had a 24 hour virus that would pass without intervention.

I tried without any success to keep myself hydrated the remainder of the day.  I made a home made batch of rehydration fluid - boiled water, sugar, and salt, but like everything else my body quickly eliminated it.  At bedtime, Duang attempted once again to convince me to immediately see a doctor or to go to the hospital.  I was still convinced that I had a 24 hour virus albeit unlike any virus that I had experienced before.  My diarrhea had evolved to cloudy watery discharge with a slight fish odor.  Most alarming was that each discharge was about one quart in volume.  I finally relented and promised Duang at 10:00 P.M. that if I were not better the next morning I would go and see a doctor.  As I promised her I could see that she was very concerned and had two streams of tears silently running down her cheeks.

At 1:00 A.M. , I experienced my worst attack.  I sat on the western style toilet with a plastic bucket in my lap.  It was truly disgusting.  After awhile Duang entered the bathroom.  I told her to stay out.  I did not to be in the bathroom with myself let alone subject her to the situation.  She refused.  In the manner in which she refused to leave, I knew that further argument with her would be futile.  She stood by me wiping my forehead and neck with a cool damp washcloth while I suffered the ravishes of my ailment.

We spent a long and fitful night together, mostly spent in the bathroom.  At morning's first light, I called the Site Manager and informed him that I would not be into work that day.  Around 8:00 A.M. I called a Vietnamese friend and asked him to take me to a doctor or to the hospital.  I then checked the Internet for email messages.  As luck or good fortune would have it, there was a "Warden's Message" from the US Embassy in Hanoi.  The "Warden's Message" informed Americans living in Vietnam that the Vietnamese government had announced a breakout of severe diarrhea in northern provinces and that some of the cases had been diagnosed as Cholera.  That definitely piqued my curiosity.  I googled "Cholera" and researched the disease.

Cholera is a bacterial infection transmitted by fecal matter in water.  The most common means of becoming infected other than drinking contaminated water is to consume raw or improperly cooked shellfish. Yes, I had done that.  The incubation period for Cholera is 1 to 3 days after exposure.  Yes, I had eaten raw shellfish 2.5 days before the start of my illness.  Not everyone gets Cholera from an exposure.  The articles stated that several people could eat the same food and not all of them would be stricken with the disease.  Susceptibility to the disease was ties to acidity levels in the stomach, blood type, immune system vitality, and to a certain extent luck. Some people who live an areas where the bacterium Vibrio cholerae is widespread develop a certain resistance to the disease.  This appeared to also be my circumstance.  After exposure, some people will only develop a case of diarrhea while others come down with a very serious case of the disease.  A symptom of cholera is vomiting.  Yes I had that for sure and it was a reason why I knew that I did not have amoebic dysentery. The diarrhea associated with cholera is sometimes referred to as "rice water".  Yes, once again that applied to my condition.

One half an hour later, my friend returned to our home with a heavy set middle aged woman on the back of his motorbike.  He had gone to the hospital and brought back a doctor.  She had a small leather "Doctor's Bag" with her.  She was wearing a simple white head covering - the type that you used to see being worn by Russian or North Vietnamese Doctors or butchers in newsreels, documentaries, and films during the 1950s and 1960s.

The doctor examined me in our bedroom with my friend translating and Duang witnessing.  After checking my vital signs, she rubbed my temples with a medicinal oil and then rubbed some of the same oil on my abdomen.  Since I knew that she was either a Buddhist or an atheist, I did not panic in mistaking her oil treatment to be part of the Catholic Church sacrament of Extreme Unction also known as "Last Rights".  I was feeling bad; very bad but I didn't feel last rights were warranted at that time.  She then cut some white patches of paper and placed them on my temples.  I had seen that before - it is the method of giving people medicine for headaches.  The doctor gave me an injection to help stop my vomiting.  I told her that I thought that I had Cholera and as luck would have it, I had another episode while she was examining me.  She asked that I not flush the toilet until after she inspected the contents.  She confirmed that I did have Cholera.  She told me to return to bed and she would return at 1:00 P.M. and check on me.

As the hours went on, I could not keep anything in me.  Although I was no longer vomiting, my diarrhea was unabated.  I also realized that I was becoming dehydrated.  When I pinched the skin at the top of my hand it very slowly returned to shape - a sign of dehydration.  I was also becoming quite light headed - another sign of dehydration.  More importantly, I realized that I was developing a rapid pulse.  Light head and rapid pulse are also symptoms of electrolyte imbalance due to the flushing of essential mineral from the body by the profuse diarrhea.

As promised the doctor returned at 1:00 P.M. .  On this visit she brought some IV bags to infuse me.  After taking my vital signs she announced that I would not be going to the hospital.  She said that I previously had a lower than normal body temperature.  If my temperature had not returned to normal by the afternoon, she was going to admit me to the hospital.  Lower than normal body temperature can be a symptom of Sepsis (massive infection).  With that concern removed, she focused on treating the Cholera.

There is no cure for Cholera.  There is a treatment for Cholera which is to keep the patient rehydrated while the infection runs its course in 24 to 48 hours.  Since I was initially unable to keep myself hydrated orally and by the afternoon I could not physically drink enough to keep up with the fluid loss from diarrhea let alone make up for the deficit that I was experiencing, I needed to be infused with fluids and electrolytes.  The coat rack from our bedroom was brought to the side of the bed and used to hold the IV bag.  The doctor hooked me up to the IV equipment and watched over me.  When the second bag of IV fluid was completed, she left - around 6:00 P.M.  Talk about personalized medical care!  The entire afternoon, Duang remained at my bedside.  She wiped my brow and held my hand - the hand not associated with the IV.  A patient could not have hoped for a better nurse.

I spent the next day regaining my strength and was good as new the following day.

The medical statistics are that fewer than 1% of the people who get prompt, and adequate fluid replacement die.  However more than 50% of the untreated people with severe Cholera die.  Antibiotics are sometimes used to expedite the treatment but antibiotics are not required to prevent death.  Fluid replacement is essential to prevent death.  In severe cases of Cholera the patient needs to be infused with fluids to maintain blood pressure and electrolytes while the infection runs its course.

From my personal experience with Cholera, I have a greater appreciation of how people who are in prison camps or do not have access to medical care can die from this disease.  I believe that if I had not gotten treatment when I did, I would have died within 24 hours.  The insidious nature of Cholera is in how rapidly it can become fatal.  The symptoms are no more severe than a normal virus infection or case of food poisoning but it is rapidity that the infection dehydrates the body that is the major risk. To ignore it or to deny treatment for a short time is really a matter of life or death.

In the case of Haiti there also a problem of containing the outbreak.  Cholera is not passed directly from person to person.  It spreads through contamination of water and food consumed by others or I would imagine direct ingestion of infected fecal matter. In my case in Vietnam, I had access to adequate sanitary facilities.  We had plenty of clean water and soap for washing our hands and disposing of waste.  Duang and others in my presence were only at risk of infection by me if my fecal matter some how entered their digestive system - extremely improbable.  However living in a tent city or refugee camp in Haiti neither provides an adequate means for disposing of waste matter, preparing foods in a sanitary manner, or ensuring clean water for drinking.  There is no wonder that the outbreak continues and that it is spreading.

My experience demonstrated to me that you do not have to have multi-million dollar facilities to treat most diseases.  I was treated in my own home.  The victims in Haiti have neither which stacks the odds further against them.

My experience with Cholera demonstrated to me that promptly seeking medical attention can be a life or death decision.  I had waited perhaps too long but adequate medical care was readily available.  The people in Haiti do not have adequate medical personnel or sufficient supplies readily available.  Any delay on their part can have dire consequences.

It was this experience that I realized or perhaps it was that I accepted that Duang was truly committed to our relationship - for better or worse.

I had experienced her love during my time of Cholera.

Comprehensive Immigration Reform - Part 6 Medical Examination



Bumrungrad Hospital Heart Bypass Package Offer

 Last night we returned to our home in Northeast Thailand from one of our many trips to Bangkok as part of the process for applying for an Immigration Visa to the USA for my wife.

The application process commenced in July of this year and it appears that it will be concluded by the end of this year.  It will be concluded in the sense that my wife will either be granted an immigrant visa or will be denied an immigrant visa.  However the final determination for my wife to enter America will actually be made by the Immigration Authorities at her point of entry to the USA within 6 months of receiving her visa.

This trip to Bangkok which I wrote about previously was to receive a required medical examination prior to my wife's personal interview at the United States Embassy later this month.  I had chosen to have the medical examination performed at Bumrungrad International Hospital.

We had made arrangements over the telephone with hospital for an 8:30 AM appointment with one of the US approved doctors.  Since it was Duang's first visit to the hospital we were instructed to arrive at 8:00 AM to register with the facility prior to the examination.

We arrived at the hospital complex at 8:00 AM and we were immediatelyy impressed.  Bumrungard International Hospital is a huge facility celebrating its 30th anniversary.  The facility is a collection of tall modern skyscrapers.  Bumrungard was listed by Newsweek magazine as one of the top ten Medical-Tourism facilities in the world.  The international aspects of the facility were immediately apparent as we exited the taxi inside the guarded gates of the facility.  Looking around at the other patients and visitors to the hospital seemed to be like a visit to the United Nations.  There were many people from the Middle East and Africa using the hospital.

As instructed, we entered the Clinic and went to the 10th floor.  The "registration" area was located on the 10th floor and resembled more of a reception area for a five star hotel or a private bank lobby.  The room was very well decorated and relaxing.  The office furniture was expensive looking.  The women who handled the registration process, were all attractive, beautiful, and dressed extremely well in appealing business type uniforms.

We sat in very comfortable heavy upholstered chairs at one of the desks.  The receptionist took down Duang's information and entered it into a computer.  As part of the registration process Duang's digital photograph was taken and printed out as part of a traveler sheet which accompanied her with vital information through her examination.  The registration process was quick and extremely efficient.  We were sent to the 15th floor and arrived there at 8:25 AM.

At the 15th floor there were 4 waiting areas, A,B,C, and D.  We were instructed to go to "D"  Each of the waiting areas had a central station manned by several women.  Examination rooms and consultation offices were located behind the stations.  In front of the central stations were large upholstered benches and chairs similar to a typical airline business class lounge.  A large flat screen television provided entertainment as well as a rack of newspapers and magazines representing the major languages of the world.  The lighting in the waiting area was carpeted and very comfortable.  Once again there was a very relaxing ambiance. We turned in Duang's traveler sheet and we sat down to wait for further instructions.  As instructed by the US Embassy website "Packet #4", I had printed out the 6 pages of forms to be filled out.  I had filled out the general information on the forms but found out that it was not necessary since the hospital already had the forms and were filling out all information themselves.

At 8:28 AM Duang's name was called and the process commenced.  During the entire examination process we were accompanied by a hospital representative.  We did not get anxious or confused about where to go next during any of the steps of the process.

The medical examination was a fairly typical examination, blood drawn, weight, height, blood pressure, checking eyes, nose, ears, throat, listening to the heart, checking the abdomen for masses, personal interview and chest x-ray.

As part of the medical examination and evaluation process, there is a determination of vaccination requirements by the doctor.  Most of the vaccinations listed in Packet #4 are more applicable to children than to adults.  The doctor determined that Duang needed to demonstrate that she had been vaccinated for Tetanus, Diphtheria, Measles, Mumps, and Rubella.  Since she has no record of vaccination and I suspect that she was never vaccinated for these diseases, the doctor had her receive Td (Tetanus and Diphtheria) and MMR (Measles, Mumps, Rubella) vaccines.  She was injected in each of her arms; she quipped "Medicine for Thailand, Medicine for America" as she pointed to each arm.

Tuesday's vaccinations are only a start.  The Td vaccine requires three doses.  The next one to be 4 to 8 weeks from now followed by the third dose 6 to 12 months after dose #2.  The MMR vaccine requires a second dose 4 to 8 weeks from now.

The examination process lasted two hours.  We were told that the paperwork would be available in one hours.  The waiting area was so comfortable and interesting  that we decided to just wait for the documents rather than leaving and returning later.  Our wait actually ended up being 1-1/2 hours due to the delay in getting the chest x-rays delivered from the lab to the doctor.

We were given a two packets of x-ray films and documents to bring to Duang's interview.  The packets were thoroughly sealed with tape along with the hospital's stamp covering both the tape and an unsealed portion of the envelopes; high security measures to prevent tampering prior to delivery to the US Embassy.

We paid for the examination, 1,930 Baht ($64.33 USD) and first doses of the vaccinations, 1,408 Baht ($46.93 USD) at a station located on the same floor as the examination facilities.  Although we did not require any medication, there was a pharmacy directly across from the cashier.

$111.26 for two vaccinations and a medical exam including chest x-ray - another reason why I enjoy living here in Thailand.  Medical care is still affordable here for expats.

During the wait, I found some hospital literature for various services.

Total knee replacement at Bumrungrad International Hospital has a median cost of $15,014 USD.

Total Hip Replacement is a median cost of  $17,483 USD.

Heart Bypass surgery is a median cost of $29,198 USD however there is a special package available for $16,633 if you pay the hospital directly!  The package deal includes doctor's fees, up to 7 days hospitalization, and in hospital medicines.  Six years ago I had surgery to repair an umbilical hernia - In the hospital at 8:00 AM and out of the hospital at 2:00 PM the same day - $15,000 USD.  There is no wonder that some people decide to come to Thailand for medical treatment.

Completing our business at Bumrungrad International Hospital was not the end of our medical dealings during this trip to Bangkok.  For about a week Duang has been complaining about one of her eyes.  We decided that upon our return to Udonthani we would go to a doctor and have it looked at.  As it turned out, throughout our stay on our way to and from our hotel, we walked by a very nice clinic inside of the CRC Tower/Conrad Hilton Hotel associated with BNH Hospital.  On our last night in Bangkok, it occurred to me to get treatment there rather than waiting to get back home.  This is Thailand - no need for an appointment; just walk in.  We saw a doctor who examined her eyes and diagnosed that she had an inflammation of the conjunctiva but not infective conjunctivitis (pink eye).  The cost of the visit as well as for the two medicines was $40 USD.

So another important milestone in our quest for an Immigration Visa has been completed.  It appears that the process will take 6 months.  In a later blog I will share how much this process actually cost.  Once again I need to remind the reader that we are following the current process for legal immigration to the USA.  Because we are legally married, Duang is allowed to go to the head of the line so to speak - "At this point, you are 6 months from maybe getting a visa".  Because I have stayed in Thailand for over a year, our application is processed here in Thailand rather being processed at one of the regional centers back in the USA.  I believe that being processed in Thailand has got to be more expeditious than going through the regional centers based solely on the workloads for regional centers as opposed to a Embassy.

It has been 5 months and counting for a specialized case; the legal spouse of a natural citizen.

Thanksgiving

Today is Thanksgiving here in Thailand; a day like every other day here.

Thailand does not celebrate or recognize the holiday.

However we do not need government sanctioning of the day to contemplate, give thanks, and to rejoice for all that is good in our life.

Yes today is a day like any other day here in Isaan - for me.  Everyday I contemplate, give thanks, and rejoice for all that is good in my life.  But it is on American Thanksgiving that I celebrate, share, and publicize it with people other than my wife.

Thanksgiving has always been one of my favorite holidays even more so than Christmas and definitely more so than New Years - specifically New Year's Eve.

Christmas carries too much emotional baggage to truly be appreciated.  After perhaps spending more money than you should have on gifts for your family, if you are fortunate you only get to witness their suppressed disappointment at the results of your efforts.  If you are less fortunate, you are told what they really wanted or asked when along with where they can exchange the gift.  You are also often put into the same situation of having to express gratitude and appreciation for receiving things that you neither wanted or needed all the while feeling guilty in recognition of the donor's efforts and generosity.

However, Thanksgiving is a time for families to gather together to feast and celebrate the blessings of the past year.  I believe that I am an optimist so a day of rejoicing and celebrating the good in life is not difficult.  Some years are not as bountiful as others.  Some years are more challenging than others.  However Thanksgiving day is a day to be thankful for what we have and not what we wished that we had or to focus on what we do not have.  If for no other reason, being alive is reason to give thanks on Thanksgiving.  With life there is hope; hope for a better tomorrow or some day after.

This Thanksgiving I am am thankful for so many things that I have.  As much as I am thankful for what I have, I am thankful for the many blessings that I had and some that I no longer can enjoy.

As much as what we have today brings us joy and contentment, it was yesterday and our past that have brought us to today.  It our past that prepared us for today and for the days to come.

Today, as for all days, I am thankful for the love, experiences, and guidance that I have received from family and friends who are no longer in this world.  They have passed on and I can no longer enjoy their presence. They affected my life in ways that are impossible to quantify or for me to express into words.  Shared experiences with them taught me and assisted me in developing my personal values.  The memories of shared holidays, vacations, celebrations, and ordinary days with them remain both a comfort as well as inspiration to me.  The gift of family, companionship and friendship is reason enough to give thanks today as well as every day.

I am thankful for having been raised in a country and time where excellent quality free public education was available to everyone.  Going to school in Groton, Connecticut in the 1950s and into the late 1960s was a blessing.  I often think back to those school years and believe that there was a unique group of teachers back then.  As students we were challenged by our teachers to do more than our best.  A quality free education is a blessing to be thankful for.  Even today in many parts of the world, children do not have access to free quality education.

I am thankful for having been raised in a country where I was free to fail and much more importantly free to succeed to the extent that I, myself, determined.  My position and goals in life were not restricted by anyone or any institution.  My parent's education, occupation, economic, or social status did not limit my prospects.  Today this is not true even in some Western countries.

I am most thankful for the way that my parents raised me.  Too often today, people blame their problems on their parents.  They blame their current behavior on their parents.  Blaming their parents, to them. absolves them of their individual responsibility and accountability for their own actions.  I know that my parents did their very best in raising their family based upon what they knew and could at the time.  Should we expect any less or demand anything more? I suspect that most parents do the same.

I was taught manners. Manners and etiquette allow individuals to function, interact and thrive in a society with minimal conflict.  Manners and etiquette help to define our value and standing as an individual and to society.  The manners and etiquette that I learned as a child have allowed me to integrate into different cultures easily where I have worked and lived.  While these may not be a blessing, they are things that I am thankful for.

I was taught that I was not special.  I am not certain how well I learned that lesson.  I suspect that most people have not completely learned that lesson well.  However I learned to not expect or demand special privileges or preferential treatment.  I expect to treated the same as any other person.  An off shoot of this lesson that I was taught throughout my youth was the realization that as an individual I had certain responsibilities to the group.  I have the responsibility to not demand that the group conform solely to appease my wishes, practices, or beliefs.  I do not necessarily have to conform but that choice is mine to make and I should be prepared for and accept the consequences.

I was taught that I could have anything that I wanted; as long as I first had the money to pay for it. I was taught and more importantly demonstrated each day.  I was taught that anything worth having was worth working for.  I was also taught that I wanted something bad enough I would work for it.  If I was not willing to work for something, I did not need it.

Today I am also thankful for my families and friends that are part of my daily life.

Thank You - all of you.