Published: April 8th 2010April 8th 2010
In the city of Luang Prabang, there are a few hospitals. The major one, known to be the best, is called the Chinese Hospital, as it was built and donated by the Chinese. Unfortunately, the best hospital in town is far from decent.
In Luang Prabang right now, the outside temperature is about 100 during the day, eighty at night. There is one patient room with working air conditioning. If you’d like to stay in this room, as a Lao person, it will cost you $7 per night. If you want to stay in a basic room as a Lao person, it will only cost you $1.20 per night. But you will share the small room, 20 x 20, with another patient, and have only a small fan. Sometimes this fan is broken. If your family want to stay with you, they'll have to sit on the floor.
The hospital is not too old, maybe twenty years, but it has not been well maintained. Perhaps there was no money for maintenance. Perhaps the people paid for maintenance were paid so badly they have done a poor job. The place is falling apart. It doesn’t have the feeling of a
The Best Patient Room
the only one with working air conditioning. I would have liked to take photos of the worse-off rooms but didn't want to bother anyone already sick, as these rooms were all full.
sparkling, well-oiled machine, the feeling you get in American hospitals. It feels more like a deserted town, or an old library, a place where the staff is lethargic and bored, and the building is dirty and falling in to further and further disrepair and no one really cares.
There is no food or drink service. There is no soap or shower service. There is no toilet paper. The toilets are all broken, as are the showers.
Your family will have to take care of you, bringing you food and drinks, toilet paper, soap, a towel. There is one restaurant inside the hospital, and a little food stand just outside the hospital gates.
The toilets were designed to flush and the showers were designed as typical Western showers. Now, the toilets must be flushed manually, with a bucket of water, and the showers consist only of a big bucket of water that you dish over yourself. At some point these facilities broke, and instead of being repaired, they were just adjusted, changed to an easier method.
The Chinese also put in only Chinese electric plugs, not the same as Lao plugs. So to use any plug in
the hospital, a converter must be purchased.
The electricity is spotty, often not working. For days at a time, there is no water for washing or cleaning.
The bed sheets, blankets and pillows are spotted with visible dirt stains. The white walls are also stained.
The worst part is the medical care. If you come to the hospital with a visible wound or a broken bone, you will be treated and if released quickly, your stay may be fairly efficient. There is quite a bit of modern equipment including x-ray machines, ultrasound machines, oxygen tanks with which to treat easily resolved ailments. You may have a positive experience. But if your stay is extended, and if you have a complex or serious ailment, you will have too much time to witness the inadequacies.
The doctors come to check on patients infrequently. After the initial exam, diagnosis, and prescription of medicines, the nurses are left in charge. The doctor might come back once a day, or once every two days to check on patients. The nurses also visit infrequently. The use of an IV is the most popular prescription, but often when an IV finishes, a nurse
can’t be found to change the bag. There are nurse call buttons, but they don’t work.
Generally, if a nurse is needed, a family member goes to search for the nurse. Often, the nurse will come in to the room and berate the patient for bothering them, and for not knowing simple fixes to repair their own problems. But many patients are people from the countryside, with no exposure to medicine and thus no familiarity with the equipment.
The nurses are overworked and underpaid. They make approximately $25 per month for full time work. It’s no wonder they are impatient and provide infrequent care. For extra money under the table, the nurses offer better, more frequent care. Patients with more money pay this extra fee, patients with less money can’t pay the fee. The care of poor patients is of a much lower quality than that of patients with money. At eleven PM, the nurses lock the door to their air-conditioned staff room, and become unavailable until the following morning.
A friend, recently in the hospital for five days with what appeared to be malaria, was never told definitely what her illness was. Well actually, one day
she was told the blood test said she had malaria. The next day she was told the blood test said she didn’t have malaria. And the following day she was told it was probably malaria. Soon after, once her headache finally went away, she was released.
Foreigners visiting this hospital pay rates that would be considered cheap in America, but that are ten times the rates paid by locals. This would be just fine, as foreigners have more money than locals, if there was any evidence of the money being used positively. Where does this money go? If a Lao patient can be put up in the hospital, all medicines included, for $1.20 a night, and a foreigner is paying $32 a night, where is this $30.80 in profit going?
Last time I was at the hospital, a team of twenty crowded in to the small examination room, surrounding the bed where my friend was being examined, staring at her. They felt more like spectators, watching a show, then interested medical students. One was texting on his cell-phone, another cleaning her nails, a third, drinking a soda. When they heard she was refusing the medicine, they slowly trickled
out, to hang out by the front desk, seemingly with nothing at all to do.
If you have small medical ailments while in Luang Prabang, you will do well to visit a pharmacy. Most pharmacies are well stocked with drugs, and one, across from the Elementary School on the main street, has pharmacists speaking good English and French. If the pharmacists cannot speak your language, you might try politely inviting yourself behind the counter, and looking for the drug you need yourself.
If you are really sick in Luang Prabang, its best to fly to Bangkok or Udon Thani, cities in Thailand that have superb, top-quality medical care. Costs are higher than in Laos, but much lower than costs in an American hospital. The flight to either city is only an hour, and there are a few flights leaving here per day. I feel fairly safe knowing that for most illnesses I might contract, good care is only an hour flight away.
For emergency care here though, with no time to fly anywhere, your best option is the Chinese Hospital. You might have a better experience than the ones I've described.
There are two other main
hospitals in Luang Prabang, the Soldiers Hospital and the Foreigners Hospital. The Chinese and the Soldiers Hospital are each a few kilometers outside of town, while the Foreigners Hospital is right in town. Surprisingly, the Foreigners Hospital does not provide better care, and does not have English speaking staff. The Soldiers Hospital is considered to offer the worst quality of care.
There are more photos below