Baby Hat

Baby Hat was born with a congenital heart disorder, in the West this would have been picked up antenatally, she would have surgery soon after birth as without surgery most infants die within a year.

The first sign of problems emerged when baby Hat was 7 months old, she was extremely breathless. Luang Prabang is a relatively small, remote town in the mountains in the north of Laos, Hat and her family live a 6 hour drive, on a dirt road, away. The doctors there advised she had a major heart problem and that nothing could be done.

Her uncle knew a Lao-Australian family living in Luang Prabang, Hat's family wanted to do everything to save her. After some phone calls the family decided they would travel here to seek more expert medical help. When she arrived at a local hospital I was asked to see her, she was very unwell, her heart was failing. The only life saving option was urgent surgery, however there are no heart surgeons in Laos. I was out of my depth so emailed doctor friends at home and at MaeLa refugee camp for advice.

Word spread amongst the local ex-pat community who gave emotional, practical and financial support to Hat and her family. There are specialist paediatricians in the capital Vientiane, I spoke to them and they advised transfer in order to stabilise her heart failure in ITU and then to arrange surgery in a Thai hospital.

I was concerned she was not strong enough to survive the journey, 10 hours by road or an hours flight and I didn't want her to suffer. The ex-pats and the Friends Without A Border raised money swiftly so that was not a problem, her family were aware of the risks and decided if there was even small hope they wanted to try everything to save her and would fly to Vientiane.

We tried to arrange a nurse to travel with the family to monitor her oxygen levels which kept falling from normal levels of 95% down to 20-30% and to have a oxygen on stand-by to treat if Hat became hypoxic. The airline would not allow oxygen on the flight, the family decided they just had to get to the specialist help asap. Baby Hat arrived in Vientiane and was admitted to ITU. But sadly the next day had cardiac arrest and later died.

It felt pretty helpless, frustrated and sad. Where you're born is a lottery and there are huge health inequalities in the world. If Baby Hat was born in a developed country, the likelihood is that she would have a relatively normal life. She was born in a poor country where there is limited healthcare and what is available is often unaffordable. In this setting Hat lived a very short life of 7 months, it's tragic, unfair and heart-breaking for her family.

I was inspired by the sensitivity, thoughtfulness and action of the ex-pats. When I first met baby Hat I had a feeling the outcome would not be good, I wasn't sure whether I was being a pessimist or if I was being realistic, it was good to listen to other views - to do everything possible to save her life. Once Hat's family made their decisions we were all collectively willing her on, she was a fighter. I had just met this group of people and was grateful for their support and admired their passion and compassion.

I've been reminded why I'm here, even small changes will make a huge difference to the heath and well-being of the children of Laos. In the future babies like Hat need to be treated by specialists near to their home, I really hope this happens.

If you'd like to know more about Friends Without A Border, who I'm working with, check their website www.fwab.org 

Luang Prabang is a very special place ....

.... and at the moment I'm loving the smell of the frangipani trees, it's the smell that I associate with the tropics and especially Laos, the air is really fragrent with frangipani and mango, the cicadas are manic too

enjoying the banter with the market sellers

the novice monks

the novice monks are one of the reasons I'm here, they're amazing young men.
their english has improved since I last saw them 6 months, i'm very impressed with their work ethic and desire to learn, combined with their sensitivity, generosity and a great sense of fun.
i love spending time with them, i find it calming, we practice English under the shade of the trees, giggle, i listening to some of their life difficulties and dilemmas, and join them praying to the Buddha. their chanting is very relaxing, i love the way is reverberates through me and gives me time to stop and think about what's important in life

breaky by the river

I liked having breaky with louise michin and charlie stayt but this is heaps better

my walk to work

stunning view as i stroll or cycle to work, feeling lucky

the office

the office is in the centre of town and the hospital is on the outskirts about 4km away, spending most of the time in town at the moment preparing the curriculum. When we need to head to the hospital I either cycle (arrive dripping - it's 50% humidity), go by tuktuk (have to wake the driver - he enjoys a snooze between trips), golf buggy (cheapest option - we are a charity, wish he'd take us to the clubhouse!) or on the back of Somlith's motorbike (my favourite - speedy, exciting and scary, am holding on). We share the building with other organisations, I like popping into the tradition Lao medicine shop, their teas and chilies are a panacea, getting use to the communal toilets, can I entice any volunteers!? When peckish I pop out for some fruit, would prefer chocolate but you need to make the most of what's on offer, a branch of rococo arrives soon !! Should get my official work permit soon

getting use to having a lunch hour, yippee!

I can't remember the last time I had a lunch hour, it's a lovely change after years of working an 11 hour day with no break, eating my sandwich on the go at my desk, and now we all have lunch together. We usually head to the stalls outside the office, the staple is sticky rice, i go for tofu and veggie dishes and we all come back and share, a favourite is meekong snails but i had to pass on those, not very adventurous! instead I ensure we all getting plenty of fruit for afters, now that I've been here for a few weeks the price is going down, a bargain at around 15,000 kip. Just noticed me on the picture, I am a giant in Laos, no wonder the child at the fruit truck was hiding behind his mum!

friday night, after work drinks

at the end of the week we all head off for a few beerlaos on ice! very handy for washing down the local cuisine, this weeks treat was duck prepared 10 ways including duck gizard in raw duck's blood, squares of duck blood cooked in broth, side snacks of duck feet and duck's head. I'm reverting to vegetarianism,  loving the beerlao

ex-pats

the ex-pats are a great bunch, they're very supportive, it's a small town so people knew that a new boy had arrived - have been invited to parties, dinner, drinks, went over to wendy's for a curry night, she's a great cook, has a stunning view from her veranda and shared all her tips for finding wine, cheese and snacks, now all i need is a branch of rococo! It's diverse bunch, all ages and backgrounds, mostly working for NGOs, I'm really impressed by people's passion and altruism in wanting to help the people of Laos and it's also been interesting listening to some of the frustrations faced on a day to day basis.

big belly

back at villa ban lakkham, great to see them all, they feel so comfortable with me they are happy to point at my belly and say "bigger", Gordon Bennet !!!! cheeky but true so went for a run today, it's 40'C and sweaty betty humidity, the belly has got to go .... love the view from my window

Lao Friends Hospital for Children

Currently a building site, due to open in February 2015, loving the view from my future office, until then it's classroom teaching, but today I was asked to see a 7 month old at the Provincial Hospital, she had a heart murmur and the Laos doctors wanted me to suggest a treatment plan! She might need to be flown to our sister hospital in Angkor for surgery

new colleagues

they're a happy bunch, very welcoming, we share lunch and they sort out everything; new mobile phone, post office deliveries, translation, snacks, lifts on the back of their motorbikes, IT - everything a boy needs

a new epoc

As I head to Luang Prabang to work with Friends Without A Border my overwhelming feelings are of excitement and it being the right thing to do. People have said I'm brave, maybe I'm naive but I don't feel brave, I feel fortunate to have this amazing opportunity to do something worthwhile.

I will miss things, mostly my pals, friends are very important to me and I have wonderful friends who I admire and love, but the world is a small place now and if I get my head around technology you won't be able to escape!  and when you visit please bring chocolate and Neil's Yard! I have left  a fabulous lifestyle working 3 days a week with heaps of time for friends, godchildren, yoga, holidays, London's culture, cooking and vino collapso! After eight years in a practice you build up so much trust with loyal patients, it gets easier and more fun, I didn't realise quite how much loyalty and trust until I left, the last couple of months I've been hugging patients and getting tearful when they have thanked me for being kind and compassionate or saying I had become a friend as well as their doctor.

Life is short, I loved having six months away last year, I was so happy getting to know the Burmese at Maela Refugee camp and the novice monks in Luang Prabang. The people of Laos are gentle and generous and the culture is geared around the community, sharing and looking after each other, living day to day calmly and gracefully. I want to experience more of that and  at the same time share my experience of teaching, doctoring and dentisting. Laos is one of the poorest countries in the world and there is little healthcare so I think even small changes will make a big difference. It's great to be able to get involved with a project building and equipping a hospital in Luang Prabang and developing outreach clinics to improve healthcare and to teach Laotian doctors the values of quality improvement in patient care and life long learning.

It was incredibly romantic arriving yesterday in the late afternoon sunlight on a propeller plane descending into the valley of limestone mountains carved by the Meekong and to be met by a familiar face in a red tuktuk, I just smiled broadly and thought yippeeee.