Experiencing Health Care in Rural Laos

Upon returning to Pakse that same evening, the Dutch team and myself walked around the town of Pakse, raising money by requesting as many donations from all foreigners in the city centre. The ultimate aim was to pay for not only the x-ray, but for all medication and hospital after care. Initially we budgeted for an overnight stay following the operation, although we were prepared to accept the possibility of a much longer stay if doctors requested time to monitor the recuperation process. Within three hours, a total amount of $195 was raised. The vast majority of donors expressing sympathy for the plight of the woman, but not everybody believed in the necessity of donating aid, with some criticisms being directed over the provisions of a band-aid solution that would not actually benefit the family in the long run and encourage a cycle of dependency.

As expected, coaxing the lady to attend a hospital in a major town required extra assistance. Covering our bases, we were accompanied the following day by two uniformed police officers, invited to help transport the patient and provide “protection for the foreigners.” Later in the day, I learned of why the officers insisted upon coming along; to place psychological pressure on the woman and her family to accept any assistance being offered to her through gentle persuasion, and prevent her from having a change of heart by refusing to come along to seek treatment.

Eventually, the lady did agree to accompany us with her husband in tow. He carried several blankets and clothing items, and it seems that he was prepared for a lengthy stay, as well as providing moral support. As the tuk-tuk made its way along the bumpy roads, he sought to smother his wife’s nose with a rag containing methylated spirits for short lengths of time. This helped to contain her painful screams as a result of the growth inside her mouth. For that afternoon, the discomfort showed on everybody’s faces; the husband spent much of his time praying to Buddha as he tried to comfort his wife.

Inside Pakse Hospital, the doctor confirmed with us that the woman had an infection with her cheek muscle. He immediately announced that there would be no need for an x-ray and set to work at the operating table, making an incision where an operation would take place. Following the operation, and most probably against the husband’s wishes, the lady was ordered to have a 10-day resting period, firstly in the traumatology unit alongside victims of motorcycle accidents, amputees and patients waiting for skin grafts, then intensive care, and finally in a private ward.  Just having located a bed within the hospital proved to be an achievement. In 2005, the World Health Organization reported that just over 5,000 beds were available throughout Laos, with the country in the grip of a bed shortage, and it seems that the situation had changed little over the time that I was in the country, something most evident in Pakse Hospital.

The resulting breakdown of costs is as follows, with the exchange rate at the time being 8,800 Lao Kip to $1 U.S. Dollar.

Transport – 550,000 Kip

Hospital surgery after care and initial 1 night stay – 260,000 Kip

Extra 10 days hospital accommodation – 500,000 Kip

TOTAL COST – 1,310,000 Kip ($USD150)

The remaining $45 was donated to a local village school for minority groups in Kok Phong Tai.

Since the operation, news has filtered through that the woman has returned to the family tea and coffee plantations near her home village. Giving the gift of renewed hope towards recommencing a livelihood need never know any boundaries.