From cramp that kills to bubonic plague that doesn’t, with a potential cancer in between: another dull month in Laos.

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It had been an early night. Ali was reading whilst I monitored the on-going Test Match. A curse from my side of the bed and she turned to face me, although her gaze immediately drifted beyond. “Yeti, why is it orange outside?” There was indeed a strangely flickering glow and, equally flummoxed, I jumped up to draw the curtain. Shit, we were alight. The bin on the wooden balcony was spewing four foot flames, flames only several feet shy of the rattan sub-roof. I say “bin” as this was now a molten, spreading, tar-like mass. The contents of the dogs’ water bowl and several rapid, overly exposed, dashes to and from the bathroom for refills saw all under control, but it had been a close call. No doubt a smoldering cigarette butt had remained in the ashtray that, tidily (foolishly), was emptied just prior to slumber. People in wooden houses cannot afford to be careless. Lesson learnt.



With the first anniversary of our time in Laos rapidly approaching Ali began to feel increasingly guilty at our lack of language ability. Thus she started to follow an on-line spoken Lao course and to encourage those at Sipasert to translate words and various basic phrases. Almost immediately there was mirth: “Khoy” pronounced with a rising intonation equates to “me” or “I”, without this inflection “penis”… Our attempts at “I’m very tired” (Khoy hownon lai) is a particular favourite.



The “loop” takes you around the periphery of the Bolaven plateau. Tad Lo sits at approximately ten to the hour and Paksong, the market garden/organic farm centre of the province, several hours away at half past. Mathilde knows of several establishments where exotica such as basil, rosemary and parsley plants, not to mention mature leeks and beets (sadly it wasn’t avocado season), can be obtained straight from the earth, whilst Martin had been loaned the school bus (a modified truck) for the weekend. Thus a two day jaunt was planned: we’d visit some farms, stay overnight in Paksong before continuing on to Pakse for some western staples shopping and then home.



Of course accessing said farms necessitates negotiating bone-hard, rutted mud trails and on arrival at our second detour it was readily apparent that we had gained a flat… and then, soon after, that the jack was broken. Oh, and regardless, there was no spare. We’d have to hobble to the nearest mechanic, fortunately only five kilometres away. And this is an Asian thing: almost every tiny village has such a man-who-can and if you’re driving a common old jalopy they’ll inevitably be able to fix it. Thirty minutes later, with a new tyre in place, we were off once more. Serendipitously there had also been a little store selling baby new potatoes for a pittance a few yards along the road.





Meanwhile, on the vegetable garden theme, Sipasert have developed a patch of land into a bountiful green oasis with lettuces, bok choi, spring onions, aubergines, chilies, coriander, dill, mint (hence herbs we didn’t have to acquire on our wander), and a forest of tomato plants – the latter of which we, once they were getting rather out of control, staked up (amidst total bemusement – it was, at the task’s initiation, midday and nudging 40C) to prevent them totally smothering all else. Plus there is the odd diversifying planting interspersed – no more than three mind. We also have ducks, although one did contribute to a rather fine soup the other night.



Months into the pandemic it became evident that Laos was likely to remain one of the safest places to shelter. Yes, we weren’t testing to anywhere near the extent of wealthier developed countries, but our positive rates were still leagues behind even our most benign neighbours. The borders have remained closed to all but a few returning nationals (who are immediately quarantined) for almost a year now and, as I type, Laos has a per capita record unmatched anywhere on this inhabited globe: 49 cases and zero deaths among a population of 7.1 million. What has always worried though is not the virus per se. You are locked into a very poor and medically limited country; and, consequentially, do not want to require anything more than the most basic treatment for the most basic of conditions.



Ex-pat Jonathon, a rheumatoid arthritis sufferer, fell and grazed his elbow. Several days later he just happened to be visiting M&M who duly summoned Ali: his elbow was a pussy mess. Following sterilization, some minor surgery, further sterilization, dressing, and with likely suitable broad spectrum antibiotics recommended we hoped all would resolve well. It didn’t and several days later Ali was called for again; the infection was tracking up his arm. He needed to get to a hospital, get the bacterium cultured, identified, and a targeted intravenous antibiotic initiated as soon as. Thus he headed to the military hospital in Pakse, some three hours away, where they proceeded to chuck a miscellany of further antibiotics down his throat. After almost a week as an in-patient (with no typing having been performed and no i.v. initiated) we were all, as chance would have it, in Pakse (at the end of our little jaunt) and so dropped by for a visit. Holy shit. I was reminded of images of buboes from the Middle-Ages, most famously linked – hence the name – to Bubonic plague. Apparently junior staff had wanted to excise the angry boil-like lumps although, fortunately, the intervention of the US embassy and an examination by a more seasoned head prevented this stripping of his arm’s lymph nodes. Ali rapidly contacted medical friends in Australia and the UK, all of whom were primarily concerned with the potential for rheumatoid sepsis: it would be very bad indeed if the infection were to infest his metal implants. Clearly the facility had neither the ability to perform cultures or a plan of how best to proceed. In Laos this leaves only the Alliance International Medical Centre in Vientiane, some ten hours (on a good day) up the road, with the last ditch option of a desperation run (hardly straightforward during these times) to the more developed Thailand. Yikes… Yes, the capital’s premiere medical facility (even this – currently - without an operating theatre, or the ability to administer general anaesthetics) does appear to have it covered and he is – after almost a month of daily visitations - slowly improving, but the potential for tragedy here is very real.



And so Ali discovered a breast lump. Oh, and an increasingly painful rib that – to our recollection – hadn’t experienced any trauma. The only mammogram apparatus is…. in Vientiane… thus we booked an appointment with Alliance and headed northwards; our eldest student Kita having been charged with nurturing the herbs. We’d contacted our insurers (Trailfinders) who were passably helpful, but they – merely the brokers – immediately advised contacting the underwriters themselves, Campbell Irvine. We didn’t want to make a claim, our excess pretty much matching the current anticipated costs, but we did need to register the – heaven forbid – possibility of further tests/procedures, or far worse, that would definitely require assistance, both financial and logistical. Whilst we have absolutely no problem with out-sourced call centres for most communications we weren’t, given the circumstances, best pleased when our contact person happened to be a charming though none too English-fluent lady residing, no doubt, in Bangalore.



We’d yet to spend any time in the capital – accommodation is not cheap - having merely flit through, skipping between bus terminals for onward journeys, on this and our previous visit to Laos. And… why do so many cities insist on positioning these hubs so far from the centre of town? In Vientiane both the northern and southern stations, for buses headed in those directions, are each approximately eight kilometres out. The massively more expansive and safety risky airport is literally downtown. A public songthew (open minibus) costs 30,000 kip for the fifteen minute ride in, the same price as a bus for the three hour journey between Tad Lo and Pakse.



Now that we know something of Vientiane we are aware of a wonderful alternative, but no one – known to us – mentioned this option. There are local buses (bloody air-conditioned) that will run you from either to where you want to be for… 4,000 kip, if you know where to catch them. For two the saving equates to over five dollars: more than half the price of a night’s accommodation, a fine local meal, a cheap (an amazing misnomer – there is no such thing) pizza or five beers…



Meanwhile those (by their own choice “entrapped”) non-expat, local bus shunning, westerners now huddled together in Vientiane are totally focused on… money. Why? Because the government has become heartily sick at their recalcitrance to actually re-new their visas when due. For many months the penalty fees for late payment were waivered, but a large number (possibly most) simply decided that they would ignore this necessity and will – when finally leaving – argue that they are without funds and expect to depart scot free. Hell, on social media, there are many reports of those – now having departed – who managed to do just that. In response the government have reintroduced penalty fines (still less than they used to be) and these will be backdated, leaving many of those negligent individuals now owing hundreds of dollars, if not three figure sums. Processing in such cases must be performed in the capital, hence the panicked corralling. We heard of several individuals whose passports have actually been confiscated. Sympathy? We have little. Yes, the government may have taken a different view, akin to Thailand’s (temporary, now rescinded) approach, and suspended the requisite for visas. This would have equated to something like the USA’s stimulus packages with that additionally available money still finding its way into the economy: less strapped for cash you may well have eaten out more and supported those struggling businesses in need. Still, that wasn’t their view and you ignore the rules at your peril.



Anyway, our visas are good and, regardless, they were furthest things from our minds. The evening before Ali’s appointment Alliance contacted us: their mammogram machine had broken; but fear not, Mahosot hospital has one and Dr. Savina was expecting Ali in the morning. Upon meeting the Dr. we were informed that, yes, she could do the mammogram, but not prior to an examination (and letter of recommendation) by an Obs./Gynae. (ladies’ bits) specialist… and they don’t have one… Alliance does. Equally they have no one qualified to actually read the results and these would need to be sent back to Alliance (or the UK) for interpretation. Trudging the five kilometres back to Alliance we received a new message: the machine had (miraculously – we’d expected a hiatus of weeks) been fixed; they could now do everything, tomorrow. And that’s where the melodrama – please, no tempting of fate - ended: Dr. Chan had a good feel, but was unimpressed (steady on sir); he recommended an ultrasound over a mammogram in the first instance (getting us to marker pen the area that we deemed of particular interest; evidently he wasn’t detecting anything that overly concerned him) and this duly revealed nothing untoward. Scrutinizing the monitor in real-time I had to concur that there was no apparent bilateral difference. Tempered relief… A chest X-ray similarly discovered nothing amiss and the rib pain was attributed to torn intercostal muscles. Our supportive expert in Australia subsequently chirped “that diagnosis is simply because they can’t pin it on anything else…”). Nevertheless, as far as Laos’ expertise is concerned, there is nothing to worry about on either count. You can only hope they’re right.



Having partaken of several pizzas – and a carafe of semi-palatable Italian white – we planned our return home (to Tad Lo). Cue another phone call and health scare, back on the plateau. Following a heavy day’s labouring and a subsequent liberal intake of lao lao, Sivalay had merely been walking when he was stricken by an almighty pain in his calf. Such was the agony that “he died”. The villagers carried him back to his house where upon “he came back to life”. Mathilde, notified at the time by phone, was concerned about the possibility of a TIA (transient ischemic attack) / a stroke and he was rushed to the nearest “hospital”. His basic Obs., notably his blood pressure, were fine and they could offer no explanation as to causation. After a phone conversation with a majorly recovered Sivalay the following day we proffered the tentative diagnosis of severe cramp (something he’d never heard of, let alone experienced before and duly had no idea how to deal with: “so, your calf twitched uncontrollably, before tightening into a knot; and your toes curled downwards? Have you never watched a football match in extra time?”) / panic attack / fainting spell. He was somewhat reassured, but still Katu culture required the slaughtering of several chickens and the subsequent consumption of their blood. Not quite the isotonic fluids we might have employed…



Ah, overly preoccupied with health issues, I’ve neglected to mention a new culinary delight; equally I cannot recall the occasion that merited such a delicacy: calf penis (not a whole one, I’m not greedy) with cow dung sauce. Ali now reminds that it was International Women’s Day; no great surprise, a holiday event here. But why such an occasion would merit eating the genitals of male beasts I’ll leave you to figure. It was the chewiest, least edible thing I have ever had the misfortune of placing in my mouth and, embarrassingly, I was unable to swallow. To have done so would have only led to a description of yet another medical procedure – the Heimlich manoeuvre.



Last April, at the zenith of Covid panic here, Laos New Year (Pi Mai, our biggest celebration) was cancelled: there were signs prohibiting any gatherings; there were road blocks preventing movement; and largely all complied (it is a communist country after-all). This year we are expecting some 10,000 visitors to our sleepy little village and its revered waterfalls across the five day festive (party) period, so I’m told. Given the dearth of revenue during the last twelve months businesses and individuals are going all-out to make a kip. The tourist office and several wealthier locals have constructed an array of temporary wood/bamboo bridges that crisscross the river beneath the falls; a mini village of party huts and vendors’ stalls have been / are being erected on the linked islands within the river; and a twenty foot high bamboo water wheel built for those much needed selfies. Sipasert now has three aluminium-framed (Toy is a god with a spot welder), raised, wooden floored, thatched chill/eat-outs on our bank and our friend Somphone (with our labouring aid) is making wholly bamboo-constructed (Katu style) relaxation gazebos for the revelers.



The skill required to make flooring from seven feet lengths of giant circumference bamboo cut hundreds of times until you can roll them out linearly for flat, comfortable matting is astounding. We weren’t, primarily for our own safety, allowed to partake in this task. Equally our machete finesse didn’t enable us to contribute to the manufacturing of the thin bamboo ties used for binding raised structural elements: there are no nails, rope or string involved in our constructions. In five long days, initially with Somphone’s brother’s help (until I had mastered enough to become his trusted replacement), we built five structures with increasingly elaborately modelled roofs for the grass thatch.



Several days ago there had been an unannounced visit by the provincial governor himself who was most surprised, intrigued and delighted to see a falang strapping roof struts to ridge poles in a manner that has been little practiced for a generation or more.



Now, with our mission accomplished, I sit with throbbing bamboo-lacerated fingers (ten, thankfully) feeling rather goodly. That was the first real physical labour I’d performed in almost two years, and I have learned some amazing skills (these being a mystery to most rural Lao themselves).



Beginning tomorrow, the Saturday preceding Pi Mai, Somphone will be able to charge 20k (non-bankside) or 30k (overhanging the river) for the privilege of lazing/partying – for as long as you so wish – in our efforts.



All this warms the heart. Hopefully, presumably, they will come; indeed the number of day trippers is already ballooning. And a mini fun fair, noisily right on our doorstep, has also just rolled into town. If Somphone can earn something like 2 million kip ($200) over the period it will make a huge difference to his (his family’s) financial wellbeing.



Mathilde has been baking/freezing in earnest and Ali – amidst her endless rounds of litter collection – will act as serving assistant on her stall in the coming days.



The only down note is the flare-up of new variant Covid cases in Thailand and the fact that there are a sizable number of itinerant workers who may attempt to illegally cross back into Laos for the celebrations. The lengthy border is not easily policed and so - never be too complacent - we may still join the rest of the world in its prolonged suffering.



As always, time will tell.



And… on a last medically-associated note... Luckily Ali spotted the little scorpion lurking in our bathroom who was duly dispatched before one of us accidentally trod on him resulting in misery for all concerned.

And, and, breaking news... Doh... Ali has just re-ignited her Rinjani descent-initiated lower back problems so it looks like I am now the sole litter police.





Our apologies for lousy photos this month… Ali gained a new phone cover that unknowingly interfered with shots and I – really? - failed to notice a dirty lens on the real camera until too late for many in-progress shots… Still, first world concerns….

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Photos

Two of the gazebos that we built.
Today, happily (still three days prior to Pi Mai), they and their three neighbours were all rented out.

These, those, his, hers, ours, their, mine work sheet
Top right would be "Those are hers" and bottom left "These are his cheeks" or "These are Khamlar's cheeks". The number of word spaces provided enforces the answer targeted.

First attempt at stove-top bread.
If we'd desired English muffins then they were an amazing success.

Comments

[Kenneth A Lipson]

Wow....
what an adventure.... so glad things seem ok with Ali and your friend.... what an adventure you guys are having.... think I'll pass on the calf penis and the cow dung sauce doesn't seem to make it any more palatable.... sure do miss you guys.... stay healthy and safe. Ken & Diana

[Yeti]

Thanks
Hi to you both. Yes, all settled down here again.... just in time for Pi Mai. Hope all well back in State College. Best wishes, A&A.