Life in Laos!
Hannah Lewis (C12) from UK
EPIET fellow from 2006-2008 in Copenhagen, Denmark
Currently (March 2009) working in Vientiane, Lao PDR as an epidemiologist for WHO
"I don't really know where to start with describing life here. It all feels so normal now I'm 5 months in - seeing frogs and chickens on the road in the capital, cycling a bike on the busy streets and the dirt track to our house, grabbing a tuk tuk whenever we have too much shopping, having a driver to take me to meetings outside the office! However, now and then I take a step back and realise it is all a bit crazy and certainly different from life in northern Europe...
As we are living in the capital, we are living comfortably and can get most Western products, especially French and Australian as most of the expat community is from there. Town is small and sociable – always bumping into people at the gym (yes, there is a gym in town so I'm happy!) or shopping. Christian arrived 2 months ago and we are now set up in a lovely 2-bed Lao-style wooden home which isn't too big and has a lovely jungle garden with birds and butterflies, and life is starting to have a bit more of a routine.
At the weekend, we relax in Vientiane (swimming, tennis, golf - we're so expat!) or leave town – by bus or motorbike (we own our own moped - how exciting is that!). As soon as you're 20km from the town, it's rural Laos which means it is easy to explore the country and see how people live outside the capital. The country is developing fast though and although most tourists are currently limited to 3 towns, I think that'll change very soon. There is construction work going on everywhere. However, many Lao people live in very basic villages with water from wells or streams and without a sewage system.
So, onto work! My colleagues are fantastic and inspiring. I'm in a team of half Lao and half expat (Japenese boss, 2 Australian, 1 American, 1 Belgian). We all get on well and given independence with work. Being back in a policy environment, it took a while to find my feet but now I'm feeling confident I can make some progress with surveillance (based on clinical signs/syndromes) and pandemic planning, my main two responsibilities, while I'm here. Stata is a distant memory but I'm applying the more basic epi skills every day and getting a lot of satisfaction in passing them onto my national counter-parts, especially the newly recruited Lao FET students.
Currently I'm on the way to an outbreak in the south of the country. There is an ongoing outbreak of acute diarrhoea, mostly in children with 6 deaths in <1 year olds. My role is to support the national outbreak response team to describe the outbreak, try and find the source and help put interventions in place. Could be Cholera or rotavirus or ??? – the laboratory capacity is very limited so we have to rely on a clinical diagnosis and the epi picture. I'm flying to Pakse (for those who Know Laos) and then we will drive to the southern most province in Laos, Attapeu. We stay the night in the main town and then drive together with the District and Provincial response team to 5 remote villages fairly near the Vietnamese border. I think we will have to hike to some of the villages as the road access is so poor and as it is the end of the dry season, the rivers are too low to travel on. As you can imagine, outbreak response isn't always timely! I'm feeling a little unsetteled as this is my first outbreak here without the help of another WHO colleague but I know my Lao colleagues are capable, I have excellent back-up at the office and I'm likely to simply need to offer some direction now and then. I've got some bags of super noodles with me just in case and we'll take our own water supply. The car is packed full with ORS, chlorine tablets and Berberine (a Chinese herbal remedy). The villagers are an ethnic minority and apparently it is taboo to defecate in the village so I'm not sure where we'll be going to the toilet – maybe at the edge of the forest - glad I remembered my torch!!
That basically sums up life here at the moment. Very exciting and I'm in my element when in the field. Time is flying by though, probably because I'm always on the move. Hopefully next time you hear from me I can tell you the source of the outbreak...
Oh, and finally, Pernille (Ch 11) is also in Vientiane at the moment working on a malaria project with the MoH and Lee Lior from the Canadian FET was visiting a few weeks ago - the epi world continues to be very small and sociable!"
