An Impactful Week in Laos

Last week was our week long international comparison study with my public health management in Thailand class. The goal of this trip was to compare the health systems of two different countries in Southeast Asia. We were staying in a hotel in Vientiane, the capital. During the day, the public health program would go on site visits – a central level hospital (in Vientiane), district level and a health center for the villages. The central level hospital is the highest level of care in the country, which was shocking due to some basic health care not available. Very few surgeries are performed because there are three operating rooms and only one is sterile. The wards are crammed with 40 beds per room. This hospital is the only one in the country that provides chemotherapy. They are severely understaffed, with only one doctor working on one of the inpatient wards (about 30 patients). The district level hospital and health center were more remote, with more limited and poorer quality health care given.

Laos is classified as a least developed country for many reasons but one of those being their health care system. The Lao government spends 1.4% of their GDP on health care. The leading cause of hospital visits is infectious disease as opposed to noncommunicable disease as in most developed countries. A big issue in Lao is peoples’ accessibility to health care. Some villages don’t know that there is a nearby health care center due to poor communication systems. It’s common for villagers in more rural areas to never have seen a doctor in their life. Even if they are aware of a center nearby, the country’s lack of infrastructure can create a barrier. The roads are poor and are usually washed out during rainy season.

The 4 bed emergency room at the district hospital

Another site visit was to COPE, which provides physical rehabilitation, orthotics and prosthetics. Most of their patients are those who have suffered from the unexploded bombs that were dropped in Laos during the Vietnam War. President Obama visited here during his presidency, recognizing the work they do. We went to the visitor center, which went into detail on the impact the bombs have had on the people of Lao. It is the highest bombed country per capita in the world. In 7 years there were 580,000 bombing missions on Lao, primarily along the Ho Chi Minh Trail. Not all of the cluster bombs that were dropped exploded, so even decades later they are still exploding. This visit was eye-opening to learn about this overlooked part of history and also to see COPE working to provide these services free to people.

While I wasn’t going on site visits during the day, we had free time to explore Vientiane. It happened to be a holiday the week we were there. The street along the river was packed with vendors and games. One night we went down to the Mekong River because part of the holiday was the Lao people were setting off homemade mini boats with candles into the river. It is a tradition of good luck. On Friday morning we visited Buddha Park, an area with a bunch of different sized Buddhas in different stages of life.

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