what's been happening ....

..... well

i've had my half birthday, forty-seven and a half on March 18th

blimey, I think I'll start celebrating quarter birthdays too, there must be benefits to getting older

at work, I saw 2 cases of Perthe's disease in 1 day, had  previously only read about this condition. The boy was fascinated with his Xray and asked if he could take it home. We needed to keep the XRay for his records but in a modern world he could take photos of his Xray with his mobile. He had been treated with antibiotics on and off for the past 6 years, unfortunately these do not help! And now there is a 3cm disparity in his leg lengths, his leg muscles are waisted on the affected side and his pelvis and body is asymmetrical. We walked over to another NGO who provide physiotherapy and prostheses, they agreed to make him a built up shoe.

The next day he came back to show us his new shoe and a bag of oranges to say thank you. A great shame he has this disability, good that we were able to offer some help and in the future he probably will need a hip replacement, a big operation which is usually not needed in the west, a different story in Laos.

Adri, who makes all the informative films for the hospital, is film-making once more so we all needed to be interviewed about achievements and plans! I always get stage fright and go completely blank. I sat down, heart racing, mouth dry, Adri did a screen test, he popped his head up and said 'Michael, can you go and wash your face'.

I can't bear it!

It was a busy week for street consultations with the expats. One who I've met a few time waved me down as I was cycling to work and launched straight into her back pain problem. Two had numb body parts, maybe there's something in the water. There's been gastritis discussed over dinner. A midnight visit to my house, they had abdominal pain, but I was fast asleep so didn't hear the door or their text messages. When I spoke to them in the morning they said they were speaking to me from beyond! Next day I was woken at 5 by my phone, one of my colleagues had abdominal pain, I went to his house, he was in agony, I thought he had bowel obstruction and we'd have to get him to bangkok. The only transport was a tuktuk, bugger I thought this is going to be a difficult ride but all the pot holes sorted his pain out!

The Laotian nurses at work have also been needing advice from rashes, toothache, headache, allergies, and my favourite moment was when Kongsai announced he had buttock pain and dropped his trousers and pants to show dr dorkeo and me.

I banned Ovaltine at work! Nestle advertise in Laos that Ovaltine is a complete meal, our staff consume vast quantities of the stuff. I suggested we needed to replace it with a healthier snack as a health organisation should be promoting health and try to avoid inducing diabetes. Everyone else thought I was being a baddie and that happy staff was the priority so I suggested we also provide cigarettes for break time! It turned into comedy argument but I was like a dog with a bone and now ovaltine will be replaced by fresh fruit everday!

My lovely friend Kathrin left Luang Prabang this week, I was sad. I love Kathrin, she's a very special lady, I will miss her warmth and kindness, her gentle energy is wonderful. We had lots of hugs, she's starting the next epoch with her husband in Sydney and I have inherited Cookie. He's been very noisy this week, he's missing Kathrin too! 

I've been house-siiting for Christine and John for the past fortnight, they live around the corner and have a beautiful home. To start I would go to put the lights on, water the plants and relax in the lounge, reading and looking at the stunning view of the mountains. Everyone was concerned they may be burgled and said I needed to sleep over, what about my house I may be burgled, "yes but their house and things are more valuable"! Anyway now I'm sleeping over, Christine asked which side of the bed, I had hoped hers but I've been on Dad's side.

Wendy returned for her holiday in Oz with a double pack of tim-tams, yummy, they didn't last long, ooh i need more chocolate.

At work we are planning the next steps, the ward will open in June/July. The management team decided to meet after work, my job was to host and get booze, easy, jenn and jess cooked, rod prepared the agenda, good team work and a productive session ending 11.30 pm.

We've have a volunteer form the UK who is setting up the laboratory and she was our guest speaker for the grand round this week.

I managed to split my time between the office and the clinic this week. I especially loved being in the clinic seeing patients with the Laotian doctors, one boy wanted to hold my hand as we walked down the corridor, sweet. I'm enjoying getting to know the Laotian doctors idiosynchrosies, they're great, I think we are slowly making progress

very cute

very cute, I especially loved his belt! he was very brave so I wanted to find him something for being such a star, all I could find was a plaster with picture on it, he was very grateful and we are ordering stickers for the kids

gearing up for Pi Mai

the next festival here is Pi Mai, Laos New Year.
the town is getting ready to party, 10 days of Beer Lao and a huge water-fight!
and at Wat Na Luang the novice monks are quietly preparing the vessel to wash the Buddhas

another day at the office

it's lovely and cool cycling to work in the morning
the frangipani trees are in blossom so luang prabang smell and looks great

busy days at work so am always having lunch on the run
there's plenty of yummy, spicy food being offered and shared

families sit and wait patiently to be seen, the waiting room is packed
and then suddenly i go outside and there's only one family left to see

another relaxing Sunday

first, breaky by the Nam Khan with Julie and Jochem.
next, a bit of shopping at the traditional arts and ethnology centre
they're making me a man bag from the blue batique
and i'm match making, he's now got a date with our accountant
then, it's time for chatting and chanting at Wat Pasaviet
always heaps of fun being with my Son, Novice BigVahn
and finally, dinner with pals
what more could a boy need
another lovely day, life is good, thank you Buddha

I'd like to be a yogi

I loved the yoga retreat, feeling like I could be a full-time yogi

Phrase of the week; nowhere to go, no one to be

connected with the earth and nature 

I'm now enjoying being in the moment of every moment

Vikasa Yoga

The teachers are fab, George and Kosta are my favourites

2 days and 8 hours of yoga later I'm not looking like this

How disappointing! I'm a wreck, eek, getting old a creaky

Nevertheless in a few days I'm confident I'll be doing the splits too

Until then I'll live in the present moment of relaxation; am alternating classes with massages!

flying to Kho Samui

A week off, time for yoga and total relaxation

I flew with Bangkok Airways from Luangers to Kho Samui

Flicking through the inflight magazine I saw a very familiar photo

I looked closer and it was an article by our founder, Kenro Izu

Word is spreading about our new hospital

Jenn's Den!

The expat team at work are great fun and totally dedicated.
Jenn is a real favourite of mine, she's a superstar and has been promoted to deputy director

the first weeks at Lao Friends Hospital for Children

It's so good seeing patients with the Laotian doctors. I've spent most of my time mentoring Dr Baoher and Dr Thongher, they are new graduates and are very kind and enthusiastic. They enjoy learning and I love working with them. I'm impressed with their ability to discuss the complexities of patient care when English is their 3rd language.

Baoher and Thongher are both from the Hmong ethnic group, names ending in Her are Hmong names so that makes Dr Maher the 3rd Hmong doctor. Hmong people have a reputation of being hardworking and Baoher and Thongher are great examples of that work ethic.

We are busier than anticipated so have already outgrown our out-patient clinic. We are recruiting 2 more Laotian doctors and thinking of ways to adapt the hospital's room plan.

We see lots of common conditions and we've also see some rare and very complex cases, the challenge is we don't have many investigations to help make a diagnosis, also we only simple treatment options so unfortunately we can treat every child as we'd like. Patients seem to be leaving very happy, it's obvious we are trying our best.

The clinic is full of life and very noisy, some children are completely terrified and scream loudly and are unconsolable. I ask why, my laotian colleagues have suggested maybe because they've never been to hospital before, that children are expecting a 'shot' as this is a common practice, or they're not used to foreign doctors, especially tall, pale ones with a big nose.

What's really affecting me are the children with malnutrition and thalassaemia. I was examining an 8 year old malnourished boy and tears started to run down my cheek, it's heartbreaking.  In Laos 50% of children are malnourished and 40% have stunting, while in the UK we more used to the problems associated with obesity. There is so much inequality in the world. To add to my frustration we cannot find a supplier of nutritional supplements.

The children with thalassaemia arrive pale and have huge splenomegaly, their haemaglobin levels usually are 2-3, rather than a healthy 12. In the UK we would transfusing at 7-8. Here we need to balance under-treating and risk fatigue, infections and poor growth etc with over-treating which overloads the children with iron as we don't have the chelation agent which is routinely used in the West. It's very upsetting seeing these sick children, their needs are huge and treatment is limited, I'm comforted observing how precious these children are to their families.

And there's always some funny moments, one of the town's expatriates is 70 years old, they arrived and asked to be seen. The nurses advised we see children until their 15th birthday, but they were  determined so Nurse Somchit arrived at my office with our oldest patient!

It's hard work but rewarding. I've been having to use my brain heaps and look things up. Despite the occasional tear, I'm happy and feel very privileged to be helping Laotian children and working with such a great bunch of people.

the locker room at work

also functions as a canteen
the guys taking it in turns to buy lunch and share with each other
a big container of sticky rice accompanied by many spicy favourites

busy busy

it's hectic at the hospital, we are busier than anticipated .
arriving at work at 7, have not had a lunch break since we opened and getting home after dark.
this week i ran out of washing powder, no time to get to the shops so washed my clothes with washing-up liquid, we need some volunteers to help with mentoring and training!
next drama, my bike had puncture and being not very handy had to ask for help.
Lunag Prabang is a small town, nothing is far away and I have amazing friends, Wendy took me to work, and Christine & John got my puncture sorted. Thanks guys

a morning with Carol Cassidy

This was a real treat for me

Carol Cassidy is an amazing women

She has been weaving since she was 17 years old

Carol learned her trade in Norway and Finland

Worked in Africa for years before arriving in Laos 26 years ago

She is the Queen of Weaving in Laos

I first came to Carol's shop when I was travelling with Gracie, Ricky and Niamh 6 years ago

It's a beautiful French colonial house, originally owned by a Prince.

I loved it then and bought some of her silk textiles.

Carol knows Kenro Izu, our hospital's founder, very well

She supports our work and came to the opening of the hospital a few weeks ago.

She's great fun and we were all full of admiration.

So when I was in Vientiane last weekend I thought I'd treat myself to a silk scarf

I walked in and there was Carol, big smile and an invite to a personal tour through the weaving process.

It was a wonderful morning, she's great; strong, quirky, confident and wise

I loved listening to her life story, leaving the US so young to follow her dream, and about all the families she's supported through her work and the extended family she has through bringing up her own children. Fascinating to listen to how she's navigates the bends and curves of life in Laos, she has a big brain, a big heart and a great sense of fun.

A weekend in Vientiane

I love living in Luang Prabang and rarely have the urge to leave and have a weekend away.
However, Louise is leaving Lao soon after about 8 years of working with Save the Children. Wendy and I headed to the dusty, sticky capital to say farewell.
Stayed at Louise's lovely colonial home, walked the dog, and chatted, my favorite things she said were that aid workers were either misfits, militants or missionaries, I know which I am, also that when we'd told what Wendy to do with her life, Louise reminded me what I should not do, and that's to tell everyone of Wendy's private plans. I'm a bad boy, I must put my filter on.

Loved eating our way around the city, French (butter), Italian (pasta), bacon and eggs, yummy. I filled my bag with cheese and chocolate for the return flight home to keep me going.

The Novices' photography trip

Novices BigVahn, Somchit and Jasmine headed up the river with their cameras
They try everything, this is their latest in a long line of extracurricular activities.
Carol from @mylibrary has been talking to them about how to critically review photos
And they are practicing on my pictures, they don't hold back

nights out in Luang Prabang

Whenever I think it would be good to go for a drink and a chat I head to Icon

Lisa makes the best cocktails and sorts the world out, love her quirky ideas

And tonight these 3 gorgeous ladies were there for hugs and fun

It's a good life in Luang Prabang