Earlier in this year I accepted an invitation from the Vietnam Heart Institute (VNI) to participate in the Association of Southeast Asian Nations (ASEAN) 17th Congress of Cardiology meeting to be held for the first time in Hanoi. I had worked with the VNI cardiologists at Hanoi's Bach Mai hospital many times dating back to my first trip back in 1997 and was eager to return to see my friends and colleagues again.
I decided to take this opportunity to visit Laos as well. Laos has always been somewhat of a mystery nation to me. Along with Vietnam and Cambodia, Laos was formerly part of French Indochina. Its' modern history has similarities to Vietnam: Laos was also severely impacted by the war in Vietnam and actually was bombed more heavily than Vietnam during that long and costly conflict; Laos became a communist nation in 1975 (several months after the Saigon government capitulated, ending the US-Vietnam war); and Laos has had a difficult struggle to rebuild itself politically and economically since '75.
However, unlike Vietnam, Laos is a relatively sparsely populated country with about 6 million compared to Vietnam's 84 million and the Laotian capital of Vientiane has only about six hundred thousand (Hanoi and Ho Chi Minh City boast about 4 and 6 million respectively). Economic development has lagged behind that of other southeast Asian nations with more poverty, worse living conditions, less industry, and more limited infrastructure and technology.
Anyway, given the fact that Laos remains underdeveloped economically, I was curious about the current state of health care, and specifically cardiac care in this country. Fortunately I was able to talk my wife Susan and our friends Teddy and Cindy Berenson into taking this "detour" to the Laotian cities of Vientiane and Luang Prabang prior to going to Hanoi.
We arrived in Vientiane yesterday midday via a smallish prop plane from Bangkok. The small airport reminded me a bit of our compact Palm Springs airport, quite a change from our embarkation point (the ultramodern and gigantic Suvarnabhumi airport) in Bangkok.
Unbeknownst to us, we had arrived right in the midst of the Awk Phansaa festival celebrating the end of the three month Buddhist lent. We could see, smell, and hear firecrackers and fireworks. Crowds of people milled along the banks of the Mekong river where numerous food vendors sold all kinds of exotic (for us) wares including whole grilled fish, pork, chicken, and duck; bamboo tubes filled with sticky rice; a variety of fried meats; dumplings; duck eggs; etc. It reminded me of the food vendors in the Sapa hill region of north Vietnam. Many sold beautifully crafted banana-leaf and bamboo boats filled with flowers and candles to be lit and released on the river.
This morning we visited several Buddhist monuments and temples. We drove down the Lane Xang boulevard in Vientiane modeled in a very limited way after the Champs Elysees. Vientiane’s version of the Arc de Triomphe is the Patouxay (Victory Gate) monument which compensates for lack of grace with tremendously refreshing candor, “From a closer distance, it looks even less impressive, like a monster of concrete” boldly proclaims a sign on the wall.
The highlight of the morning’s explorations for all of us was a visit to the local food market. Filled with hundreds of stalls, the market sprawled over about 3 blocks. My daughter Mai would have been fascinated by the pyramids of dragonfruit which she learned to love on her first trip to Vietnam eight years ago. The seafood stalls impressed us with the technology (hose bubblers pumping into vats), cleanliness, and surprising lack of smell – a sure sign of freshness I’m told. I only got a bit queasy when I looked into the thick dark liquid in the large vats of fermenting fish. The way the chicken and ducks were laid out with their feet extended made me think that they all died of fright.
This afternoon I went to visit the Mahosot Hospital, home to the Lao-Luxembourg Heart Institute. I had been given the name of Prof. Vang Chu, section chief of Cardiology, and he had arranged for me to come by the Institute. Unfortunately, these plans were made some time ago and apparently he had forgotten about the Buddhist holidays. Nevertheless I received quite a nice tour of the Institute by Dr. Tomkham in limited but courageous English. The Institute is extremely clean and bright. One enters into a large atrium with a seating area. A long hallway leads on the left to an outpatient clinic, an echo room (with 2 machines and the capability to do transesophageal studies), an ECG room, and the offices of Dr. Vang Chu and a few other cardiologists. On the right, the hallway takes one by a number of patient rooms which also seemed large, bright, and clean. At end of the hallway is a 4-bed combined neuro-cardiac intensive care unit. The ICU appeared to be the only air-conditioned suite. All 4 beds were occupied; the first had a woman with unstable angina, the second, a young man on a ventilator with a CNS hemorrhage; the third, a man in congestive heart failure; and the last a middle-aged man who had presented with a myocardial infarction. I saw many nurses but the only doctor there was the friendly Dr. Tomkham.
The second floor is for the cardiac surgery service. There are rooms for pre- and post-operative patients as well as the operating rooms. I was told that a team of French heart surgeons were there operating. Interestingly, although there is a cardiac surgery program in place, they do not have the capability to do coronary angiography or angioplasty/stent procedures.
All in all, the hospital visit was interesting but quite limited by the language barrier. Although I was unable to meet with any other cardiologists today, I might have an opportunity to do so later during this trip since ten will be attending the ASEAN conference in Hanoi. Perhaps I will get a chance to get more information regarding the current state of cardiology in Laos yet.
Anyway, tomorrow we leave for Luang Prabang.
I decided to take this opportunity to visit Laos as well. Laos has always been somewhat of a mystery nation to me. Along with Vietnam and Cambodia, Laos was formerly part of French Indochina. Its' modern history has similarities to Vietnam: Laos was also severely impacted by the war in Vietnam and actually was bombed more heavily than Vietnam during that long and costly conflict; Laos became a communist nation in 1975 (several months after the Saigon government capitulated, ending the US-Vietnam war); and Laos has had a difficult struggle to rebuild itself politically and economically since '75.
However, unlike Vietnam, Laos is a relatively sparsely populated country with about 6 million compared to Vietnam's 84 million and the Laotian capital of Vientiane has only about six hundred thousand (Hanoi and Ho Chi Minh City boast about 4 and 6 million respectively). Economic development has lagged behind that of other southeast Asian nations with more poverty, worse living conditions, less industry, and more limited infrastructure and technology.
Anyway, given the fact that Laos remains underdeveloped economically, I was curious about the current state of health care, and specifically cardiac care in this country. Fortunately I was able to talk my wife Susan and our friends Teddy and Cindy Berenson into taking this "detour" to the Laotian cities of Vientiane and Luang Prabang prior to going to Hanoi.
We arrived in Vientiane yesterday midday via a smallish prop plane from Bangkok. The small airport reminded me a bit of our compact Palm Springs airport, quite a change from our embarkation point (the ultramodern and gigantic Suvarnabhumi airport) in Bangkok.
Unbeknownst to us, we had arrived right in the midst of the Awk Phansaa festival celebrating the end of the three month Buddhist lent. We could see, smell, and hear firecrackers and fireworks. Crowds of people milled along the banks of the Mekong river where numerous food vendors sold all kinds of exotic (for us) wares including whole grilled fish, pork, chicken, and duck; bamboo tubes filled with sticky rice; a variety of fried meats; dumplings; duck eggs; etc. It reminded me of the food vendors in the Sapa hill region of north Vietnam. Many sold beautifully crafted banana-leaf and bamboo boats filled with flowers and candles to be lit and released on the river.
This morning we visited several Buddhist monuments and temples. We drove down the Lane Xang boulevard in Vientiane modeled in a very limited way after the Champs Elysees. Vientiane’s version of the Arc de Triomphe is the Patouxay (Victory Gate) monument which compensates for lack of grace with tremendously refreshing candor, “From a closer distance, it looks even less impressive, like a monster of concrete” boldly proclaims a sign on the wall.
The highlight of the morning’s explorations for all of us was a visit to the local food market. Filled with hundreds of stalls, the market sprawled over about 3 blocks. My daughter Mai would have been fascinated by the pyramids of dragonfruit which she learned to love on her first trip to Vietnam eight years ago. The seafood stalls impressed us with the technology (hose bubblers pumping into vats), cleanliness, and surprising lack of smell – a sure sign of freshness I’m told. I only got a bit queasy when I looked into the thick dark liquid in the large vats of fermenting fish. The way the chicken and ducks were laid out with their feet extended made me think that they all died of fright.
This afternoon I went to visit the Mahosot Hospital, home to the Lao-Luxembourg Heart Institute. I had been given the name of Prof. Vang Chu, section chief of Cardiology, and he had arranged for me to come by the Institute. Unfortunately, these plans were made some time ago and apparently he had forgotten about the Buddhist holidays. Nevertheless I received quite a nice tour of the Institute by Dr. Tomkham in limited but courageous English. The Institute is extremely clean and bright. One enters into a large atrium with a seating area. A long hallway leads on the left to an outpatient clinic, an echo room (with 2 machines and the capability to do transesophageal studies), an ECG room, and the offices of Dr. Vang Chu and a few other cardiologists. On the right, the hallway takes one by a number of patient rooms which also seemed large, bright, and clean. At end of the hallway is a 4-bed combined neuro-cardiac intensive care unit. The ICU appeared to be the only air-conditioned suite. All 4 beds were occupied; the first had a woman with unstable angina, the second, a young man on a ventilator with a CNS hemorrhage; the third, a man in congestive heart failure; and the last a middle-aged man who had presented with a myocardial infarction. I saw many nurses but the only doctor there was the friendly Dr. Tomkham.
The second floor is for the cardiac surgery service. There are rooms for pre- and post-operative patients as well as the operating rooms. I was told that a team of French heart surgeons were there operating. Interestingly, although there is a cardiac surgery program in place, they do not have the capability to do coronary angiography or angioplasty/stent procedures.
All in all, the hospital visit was interesting but quite limited by the language barrier. Although I was unable to meet with any other cardiologists today, I might have an opportunity to do so later during this trip since ten will be attending the ASEAN conference in Hanoi. Perhaps I will get a chance to get more information regarding the current state of cardiology in Laos yet.
Anyway, tomorrow we leave for Luang Prabang.
