Emergency Health Care in Vientiane

I needed to visit the health clinic here in Vientiane, Laos today. Like going to the Hua Hin Emergency Clinic, (see Travelespresso in February 2008), my visit was for a minor condition but nonetheless, I fervently hope this is my last brush with medical services during my trip.

When I was pitched off the boat into the water in Sihanoukville, I hurt myself and still, two weeks later, my upper rib cage is sore so I decide to check it out before leaving Vientiane (population 234,000) and going north to Vang Vieng (population 30,000).

It’s Saturday and my tuk tuk driver drops me off at the International Hospital (where foreigners are told to go). I am informed that there are no doctors on duty today unless required to attend an accident, heart attack or high fever. I calmly advise the nurse (whose understanding of English is reasonable) that my reason for visiting doesn’t fall into any of these categories. I tell her that my upper rib cage is sore but it is not an emergency.

I was preparing to leave when she says "if I want to see a Doctor now it will cost you $20". Huh? (No point going down the “I thought you just said….…..). Instead I say “OK I’ll pay”.

I’m taken immediately into a consulting room and she instructs me to sit on a bed. To my surprise another woman is led into the room and put on the other bed beside me. The linen looks fresh (but later I notice that it’s not changed between patients). However, the rest of the room isn’t all that clean. Tied to a sink, are a couple of old 2 litre water bottles loaded, almost to the top, with used syringes. The metal side table is covered in rust.

No curtains divide me from the other woman but her consultation is conducted in Lao so I have no idea of her problem, although if I want to watch I can see where the Doctor prods her. After she’s had her diagnosis, she leaves and a man is led in. Because he’s an American I can understand what he’s saying and he’s worried that the needle they’re about to use to inject him is not new. It is, but I too, had been warned to always check this point should I need an injection. Later he told me he had a rabies shot because he was scratched by a cat.

There’s no hand washing between patients but now it’s my turn. The Doctor is a very pleasant woman with a passable command of my language. She presses here and there to confirm the area of pain and concludes it’s not bone, so no broken ribs. However, she informs me, I have strained some muscles. She prescribes massage ointment and time.

I’m directed along a corridor to an outside veranda area where there are two small windows (think TAB). Behind one sits a cashier and the other the pharmacist. I’m waiting in the cashier line, when suddenly the nurse, with the Doctor nipping at her heels, rushes up to me. “You, no pay” the nurse says to me. “Just for today the Doctor says you no pay”. I look at the Doctor but she's just nodding in agreement. I’m confused but say “thank you very much”.

After I collect my ointment, I go on my way.

I stroll back into town, in the sweltering heat, along the Mekong river bank taking the side of the road with the grassy verge which offers a little shade from the overhead trees. Occasionally I glimpse the water in the river some distance from the edge of the bank. The river level is low at this time of the year – nearly the end of the hot dry season.

It’s a relaxing walk and I watch youngsters in groups; in couples, enjoy each other’s company. When I reach town I sit down at a table in one of the air conditioned rooms at JoMa Café, to read, eat and drink. The weekends here at my favourite café are busy, but, the begging lady who always sits right outside isn’t here today. Actually she is just one of two beggars I see around here.

Earlier in the day I spent time at the Post Office where I sent a parcel of goodies home and was asked to pay a “customs” fee (what for or upon what basis the price was calculated, I’m not sure). They helped me to pack the box. I thought I was packing from the bottom up (you know - heavy things on the bottom, light things on the top) but no – that’s not how it’s done. You pack and then tip the box upside down and that’s the top, so then all my easily squashed items where on the bottom!

My visit to the hospital and the Post Office has ensured that again today, I’ve had another interesting morning “on the road”. Even though, at times, I don’t know what’s going on or why. Most times I just go with the flow, remember to smile and forget about how things are done back home.


Taste sensation…….chocolate chip cookies. They’re the best I’ve ever tasted (sorry NZ manufacturers). The chocolate chips are huge and plentiful. I get a solid chocolate fix with just about every bite. Yum Yum. Brand: Pepperidge Farm and made in the USA. I tired to buy some more yesterday but then I remembered that I’d purchased them in Cambodia. Another reason to go back there?

I’m loving……….getting my laundry done by someone else. It costs $1 per kg and it’s returned to me at the end of the day smelling fresh and beautifully folded. This could be the bargain of the moment.

Bargain of the moment……the massage cream for my strained muscles. It cost about 70cents. I imagine I would pay about $20 in NZ, so why is it that we pay so much for this type of product in good ole NZ? On a more positive note, silver is incredibly cheap here and very plentiful.

I’m surprised…..at how I’m stared at. The blond hair? They also love to watch me write. Not quite so much here in Laos but in Thailand and Cambodia they did. In Siem Reap one man stood on the side of the road and watched me for ages as I wrote and had a cup of coffee. He then commented that I must have gone to a good school. I said yes I had. He then said “good….you write more….you write good things about Cambodia” and proudly rubbed his hands together in glee.

I’m missing…..beetroot. Don’t ask me where that came from but suddenly I really miss it. I haven’t seen anything like it so far.

Am I Slumming it?

Am I Slumming?

Here are a couple of photos of the hotel I stayed at (twice) in Phnom Penh. This is the Sokha Heng Guest House and at $20 per night it is a bargain. I’ve had emails from several people asking about the standard of accommodation and hoping I’m not staying in “grot boxes!”.
This hotel is new and it’s very quiet and in a great location. It’s just across the road from the National Museum and not far from the Royal Palace so it’s ideal for me because I love to walk places. Mind you, after the first day, because of the heat, I decided to take a tuk tuk, regardless of how far I was going.
Located in Street 178, this is also is also referred to as “Art Street” due to the proliferation of art galleries, carving studios and silk retailers. The Mekong River is lined with riverfront bars and restaurants are also very close. A couple of my very favourite cafes (B3 and Café Fresco) are within 50 metres of my hotel.

Idyllic Bamboo Island

I am at writing this from Sihanoukville which is a popular beach area a 4/5 hour bus ride from Phnom Pehn and close to the southern Vietnamese border.

Clearly it is too long since I’ve been out on a boat. I was off for a day trip to Bamboo Island (one of the many islands just off the coast here at Sihanoukville) and to board the boat I had to wade into waist deep water.

Already the boat is full when it’s my turn. I climb up the rusty metal ladder (boating friends I cannot even remember what this is called!) which is positioned very close to the bow. Once I am on the top rung a lovely man holds out his hand for me to grab so that he can help to pull me over the top. There’s nothing else to hold onto on the flat deck. The boat pitches awkwardly and rolls, my hand slips, I am thrown, from the top rung, rather ignominiously, into the water, back first! My back-pack and I are fully immersed. It must have been a very funny sight to all those on board already.

I am very concerned and as I hit the water and I’m sure several choice swear words escape my delicate lips. My back-pack holds many of my valuables – passport, money and camera!

My next boarding attempt goes smoothly and I quickly delve into my pack to check the damage. I am surprised to see that my camera is totally dry. Phew….the relief. Thank goodness for Kathmandu’s great gear, and my good sense, for buying the water proof pack. A chap sitting next to me on the narrow wooden planks, our seat for the day, checks out the zips and expresses surprise that they are water proof too.

It is only later that I realize the bottom of the pack is not waterproof and some of the things I packed first got wet, but nothing much that mattered and my camera and passport are dry!

We get underway and stop at an island for some of the passengers to snorkel and then we chug noisily to Bamboo Island. What an idyllic paradise this wee island is. There are a couple of places to stay and it looks divine. The beach is nice and long with squeaky white sand; the water very warm and inviting.

Lynda (a lady I had chanced upon the day before) invited me to join her on this trip and we spend a wonderful day together. Just as well we have each other for company as there are very few other English speaking people aboard. We meander through a bush track to reach the other side of the island and an even nicer beach and go for a lovely pre-lunch swim.

This is truly a wonderful place to go for the day or even better several nights.


Taste sensation…….lunch on Bamboo Island which is included in the $10 ticket price. (Breakfast was too!) I relish my lunch - a long crusty roll, marinated then barbequed barracuda and salad cut up like coleslaw. Superb. We sit on woven mats on the beach under the filtered shade of casurina trees. Life is great.

I’m enjoying………chatting to Lynda – another traveler from Canada. Meeting up with her is like talking to an old friend and aside from the day trip together, we have dined out too. Tomorrow we go our separate ways, she back to Thailand and me to Laos via Phnom Pehn.

I’m reading………..Lonely Planet Laos so I have some idea of where and what I want to do while I’m there. I’ve added Laos to my original plans so I’m playing catch up. I need the title/author of a great yarn I can read….any ideas anyone? Do let me know.

I’m missing…………not much at all………….

Bargain of the moment……Dinner last night. I had a glass of red wine (only my second glass the entire trip!), barbequed vegetables and fish (OK it WAS barracuda again). I ate this sitting on the second story of a restaurant having climbed up the rickety wooden stairs. The sea is at the bottom of the road, I have stimulating company and I watch an orange coloured full moon rise high in the sky. Price $4.75 but really the overall experience is priceless.

Best coffee…..yes….yes…..YES….I’ve found some here! Starfish Café who serve Bon coffee which is from Thailand. It is excellent coffee.

I’m surprised…….that I’ve been on the road now for about seven weeks without a backward glance or a single doubt about what I left behind (aside of course from the givens - family, friends and my pillow – oh and the certain knowledge of where I can get a great coffee).

How to Give?

How Should I Give?

Poverty here in Cambodia is noticeable in many ways. Children, adults and many with physical disfigurement do it. They all want money, or food.

Ladies about my age approach and their signal is to hold out an empty bowl and/or motion with fingertips at their mouths imploring me with big sad eyes to give. Mothers with tiny wee babies sit on the footpath waiting, hoping.

People in wheelchairs – missing arms or legs or both (the war has left a shocking mark on many people) wave a cap at me as I stroll past.

Kids, some as young as five or six wander the streets in dirty clothes. Often a young child will be in charge of an even younger one (the latter usually naked) held on by a cotton wrap and they want money for food too. Sometimes the child is thrust at me.

Yesterday from the lovely breezy comfort of the Foreign Correspondents Club (made famous during the war), I sat up high and nursed a lovely cold beer and indulged myself in some overpriced spring rolls. From this great vantage point I had a wonderful view over the Tonle Sap River. Across the road there’s a nice stretch of green grass adjacent to the river. From here I watched a young girl (maybe 10 or 11) bath herself and her 18 month old charge in the river, then stretch out on the grass. As each tourist stopped to see the view, she got up, positioned her sleeping charge on her hip and approached them for money for food. Eventually one gave. She left immediately – to buy food – to give it to the beggar-master (it’s said they exist) I couldn’t be sure as she went out of view.

It’s terribly sad. There’s no social welfare here. The NGO’s (Non Government Organisations) are doing a great job but the problem is immense. My dilemma is, should I give and encourage a dependency on begging? Yet I have a conscience, my western wealth is immense (comparatively) and there is an immediate need.

Personally I’ve decided on two approaches. I patronize stores (and put money in the donation boxes there) where and when I can because I know they are training people for fair trade employment. They help to give individuals skills and perhaps assistance to help them start up a business. Then, I give away a certain amount of money each day.

Of course, whatever I do, it’s never enough, but I’ve decided this is what I can do for now.

I’d be really interested to hear some feedback on the approach others have (or would) take when traveling in a developing country.

Children of the Temples

The Children of the Temple Ruins

The second my tuk tuk stops at any one of the larger temples I am surrounded by many children beseeching me to buy from them; bracelets, small bronze statues, postcards, scarves, shirts, books, DVD’s, hats, water, anything…...to buy something. They each want “madam” to buy from them.

Although young, they are highly skilled, tenacious and have many selling techniques. “Where are you from?” is a common question.
I reply, “New Zealand”.
After the briefest of pauses the reply comes, “the capital of New Zealand is Wellington”.
“Yes, that’s correct and you are very clever”.
“OK…I know the capital of your country……you buy from me now.” That may or may not be followed with “then I can go to school”.
Another technique is to say “what’s your name?” and then they follow me along saying “Joy, you buy from me…..Joy you buy from me”.

Some visitors are clearly irritated by the vendors and the beggars and I can see why because it is very wearying. Personally I think that these are just kids out trying to do the best for themselves and their families. I find it difficult to ignore them. I want to engage with them and sometimes I do.

Sometimes I buy. I’ve purchased many packs of postcards and some scarves. Far too many to send or bring home, but hopefully the donation helps some family because $1 is a lot of money here and that amount of money will probably allow a family of three to eat for a day.

One young boy waiting, hiding in the middle of a temple whispered to me to follow him and after several persuasive attempts I went with him. He tempted me with the offer of a good spot for a photograph. He was perhaps eight and said he had no mother or father. Although I had some difficulty understanding him, he launched into a history lesson on all the temples around him, pointing enthusiastically this way and that. His knowledge was clearly outstanding. When it came time for me to pay for the knowledge he wanted $10. He said “it’s for my school and they can only take $10”. He had several strong arguments, all aimed at tugging at my heart strings.

Many children out here beg. Temple guards sometimes chase them away. A couple of times I saw a mother get all of her children into a temple early in the morning. Sheer joy and satisfaction lit up her proud beautiful face.

I took the photograph of the little boy with the dog at Banteay Srei Temple. He was just sitting there looking very plaintive; his tiny dog snuggled into a crack in the stones. I stood and watched for some time and many people gave him things – some gave sweets, some wee books or pencils and some money. With every donation, he put his hands up to his face (prayer style) as a thank you. The second the visitor moved on, he quickly hid the money, out of sight, between the folds of his dirty cream trousers then waited, patiently, silently, for the next person to come along.

One young girl who was probably about 10 or 11 (the hat maker) wanted to sell me postcards. I could tell that her heart wasn’t in it as all the other children are unbelievably persistent. But she was lethargic. I went around the corner and sat amongst the ruins so I could have some quiet time and write in my diary.

She got up and hid her stash of postcards and disappeared for a time. When she returned I could see that she had collected a pile of large green leaves and some thin dry twigs. She took up a position just along from me and humming happily she used these rudimentary tools to construct a hat for her bald head. We laughed and laughed as she tried it on only to find it was too small. The moments we shared were precious. I asked permission to take her photo and she obliged so as I left I gave her one dollar but she wouldn’t accept charity, insisting instead that I take a pack of post cards.

Later I asked Cambodians why she was bald and was told of two possibilities. The first was that her head had been shaved so her hair could be sold to raise money. The other possibility was that one of her parents had died and so it was done as a mark of respect.

Of course these are times when the children should be in school. I asked many different people including the children themselves about school and received many and conflicting answers. I got the feeling that they were irritated at being asked such a question.

Responses ranged from, “no school today”, “I go this afternoon”, “the teacher is sick so no school” etc. I have been told that school is free but at other times told that there is a cost. Some say that when the family has enough money the child will go to school but if not they must sell goods to eat.

I am in conflict; do I give and allow them to eat or does my giving encourage begging but I have written about that in an different article.

It’s very likely that these children are the descendants of the kings or the people from this truly amazing period in their countries history. Yet they are forced to beg to live. These temple sites get over one million paying visitors to their ancient home. The order of things doesn’t seem right to me and I can’t help but think there must be a better way.

Terror on Tonle Sap Lake

When I planned a late afternoon visit to the most productive fresh water lake in the world; the home of many people who live on the water, the last thing I thought I needed to consider was my safety. Afterall, this is a very popular tourist attraction, and yet, this trip was extremely scary.

Access to the lake is via an extremely rutted dusty red road and for the first time in many days of travel on my tuk tuk I grab the holds with both hands to try to steady my body from being thrown out of the cab. Buses, going too fast for the conditions, pass us stirring up a thick cloud of dust. The air is disgusting with a nasty cloying fishy smell.

The poverty here is heart wrenching too as, lining the road on both sides, are one roomed shacks made of thatched leaves, some in a poor state of repair. I see the families belongings piled up on the raised floor.

We stop and a young man meets me – about 14 years old I guess. He directs me and I follow him down the hardened bank of mud, littered with rubbish, and climb over several long boats to get to the one I’m to go out on.

When I get to the boat I am worried. The boatman is already pulling and I move very quickly as the distance between the two boats widens. I am shocked to see the age of the “skipper” – he is a child and I am the only passenger. Too late to act, we are underway.

To get to the lake we navigate a muddy and confused water way. The skipper keeps stalling the motor. This is definitely not to be recommended in swift, swirling and confused water. I am even more worried with the company of three lads – the skipper aged 16 and his two companions 15.

They are hoons and keep larking about as though they are on a school trip. As I am the only person on the boat I feel rather insecure. My feelings of unease heighten when a machete drops down from somewhere. I take a little comfort in the fact that there are many other boats around us and I feel that if I need to, I’ll yell for attention.

But, when we reach the main body of the lake, they want to drop me off at a floating restaurant out there on the water (many people live on the water here) but I don't want to stop. The lads are not happy and confer in an agitated manner amongst themselves. From the truculent body language the skipper makes a decision - he takes the boat far away from everywhere and cuts the motor! I decide to play it cool and try to look like I’m not worried while we drift for a time.

Eventually the “skipper” starts the motor again (mind you he still keeps stalling it) and we do a little tour around the floating shacks on the water.

I am relieved that soon we turn to go back. Then they start hassling me for tips. They want money for school, they say. Although still concerned for myself .....I say "later".

He repeats and repeats his demands getting right up against my face so that I can feel his putrid breath on my cheek and I pull away a little. He says, rather crossly “do you understand what I’m asking? You pay me now!”

I nod. Then another of the threesome said “do you understand what he said?” nodding towards his mate.

I reply with much more bravery than I feel "yeah I understand really well....do YOU understand…..we are not back at shore yet."

I remind myself to breathe deeply. Where is the rescue remedy when I most need it?

I feel like I am in no win situation. I don’t want to tip them – the scumbags don’t deserve it. But I also feel that if I give them money and they think it’s insufficient they will make it difficult for me.

We make it back and they pull the boat up on a muddy bank. I see my lovely tuk tuk driver, the same one I’ve had my entire time in Siem Reap, and feel huge relief. He comes down and takes my bag and camera so now, unencumbered, I can easily leap off the bow of the boat.

Meantime the money I pulled out of my purse (in case I had no option but to tip) was still in the palm of my sweaty hand. I walk away, very quickly, grasping it and I feel much satisfaction that I've outwitted the young shites!!!

However, I was very cross and rather shaken. I told my driver and the people at the hotel. They said that I should have reported it to the water police out at the lake - but who would know! I was too shaken to do anything but feel relieved I had gotten away safely. It’s a shame because this behaviour does little for a region trying to grow tourism. I was happy to be back at my hotel and able to strip off all my clothes for washing and to take a shower to get rid of the nasty lingering smell.

Bye Antipodeans...for now

Bye Antipodeans…for now….

It’s my last day in the antipodeans – for awhile anyway and I’m sitting at Sydney airport with a glass of champagne. Well…a girl’s has to treat herself once in awhile!

I’m excited and looking forward to the next part of my trip. Its been wonderful to catch up with friends in Sydney but the reality is that my trip starts now because from here on in I leave behind many comforts – the ease of communicating, being able to read the signs easily, social mores etc. But this stepping out into the unknown is the wondrous part of traveling.

I met some friends of Pam and Allan’s – who have traveled extensively throughout Cambodia, Vietnam and Laos. They were extremely enthusiastic about all three countries and gave me many ideas. Several people have suggested I extend my itinerary to include Laos, this couple included. Right now anything is possible so watch this space.

I’m missing….. Aside from family, friends and my pillow – all a given really – I’m missing internet hotspots in cafes and the ease of access to the net from my home. I hadn’t quite realized how dependant I’d become on regular updates. As an “ideas person” my mind is always busy (something I want to calm down) and so it’s been very easy to fuel my “ideas appetite” with a flick of the internet search button. But once I get to Vietnam, most of the hotels offer free internet access – take note NZ and Australia!

The biggest surprise…..So far in planning my trip the biggest surprise (aside from the length of time it took to pack up my home and finalise the myriad of detail necessary to leave NZ for a couple of years) is that you can get a Cambodian visa online. It was so easy to do too and it arrived in my inbox within the day – very efficient. Who would have thought! http://evisa.mfaic.gov.kh/.

The biggest challenge…..I have always been a light traveler and I usually go away for a week or so with not much more than a day pack. But for this trip I’ve packed, repacked and repacked, each time eliminating things I thought were essential. What concerns me is that I have very few clothes left but my bags at 17kg are still too heavy. What have I packed? Perhaps I’ll do a list later. So aside from leaving behind really important baggage my other challenge has been negotiating rush hour Sydney commuter traffic as I transferred from Pam and Allan’s divine home on the water at Cammeray Marina (up 106 steps) via bus and train to my next stop.

Taste sensation…..the superb BBQ (pork chops, apple, vegetables) and salad cooked by Pam and Allan and eaten by the marina in the company of many yachties from around the world. Thankfully there was overhead cover because it rained non stop but the company was warm and friendly.

Favourite Coffee…..Well I AM a caffeine addict! None. The coffee’s been extremely disappointing.

Photo is.....The view from the deck at the marina house (Cammeray). Pam and Allan gave up their bedroom for me (how special) so that I could have this view upon waking. What a treat!