We're home

We arrived back in New Zealand on 26th August, and with that ended our 3 months of travel. It was certainly an epic adventure, that we will reminisce about for many years to come. Its been back to work for us over the few weeks we have been back, with Matt doing Surgical Relief at Auckland, and Jill back at Mercy Hospital.

To our friends overseas, new and old, thank you for making our trip what it was. It is the people you spend time with, and not only the places you visit, that makes traveling so special. To those who let us use a spare room or air mattress, an extra special thanks!

To our friends in New Zealand, we look forward to catching up soon.

Ka kite ano; thats all for now.

M+J

Vietnam: Hanoi and Ha Long Bay

One piece of advice we were given before setting off on our journey, was to fly between destinations in Asia wherever possible. Although the 36-40 hour train journey north to Hanoi was tempting, we opted instead to fly directly, taking a significantly less 2 hours. This enabled us to spend more time exploring the city of Hanoi before travelling on to Ha Long Bay.

Hanoi is Vietnam's capital, and its second largest city after Ho Chi Minh City. We stayed in the Old Quarter, which keeps the original street layout of old Hanoi.  Each street was represented by a different trade, and the names today still represent the original guilds. The narrow streets are lined by the traditional 'Tube' houses, named so because they are tall and skinny, resembling a tube, perhaps 2m wide, but up to 60 deep. The reason is that historically the land was taxed according to street frontage, hence the houses are built as narrow as possible, and the style of building has continued today.

The Old Quarter is situated around the beautiful Hoan Kiem Lake, which acts as the focal point for the day to day life of Hanoi's residents. In the centre of the lake lies the 'Tortoise Tower', which relates to an ancient legend of a magic sword and a golden turtle god, and near its northern shore, the 'Temple of the Jade Mountain', in honour of a 13th century military leader.

 Hoan Kiem Lake at sunset from our hotel balcony

Vietnam: Ho Chi Minh City - Reunification Palace and War Remnants Museum

The first thing you read in the guidebooks when in Vietnam is to forget the war, and to embrace the rest of the Vietnamese culture. However, as the war really wasn't that long ago (and our armed forces in NZ are still using same the aircraft we did during the war), there are some sites worth a visit.

One of the most interesting places we visited, during the entirety of our trip in fact, was the Reunification Palace, previously known before the war as the Independence Palace. It was the home and workplace of the president of South Vietnam during the war. It also has historical significance as the site of the end of the Vietnam war, with the fall of Saigon on 30th April 1975, when a tank of the North Vietnamese Army crashed through the palace gates.

The original palace had been bombed in 1962, and the new Independence Palace commissioned the same year. When the war ended in 1975, the palace was left exactly as it had been on that day. As you walk through the building, it really does feel like everybody has suddenly upped and left (as they did). The 1970's decor is interesting in itself. You can tour the president's office, the various official reception rooms, private quarters, cabinet room and ballrooms. Fascinating are the assorted gifts that the president had acquired from dignitaries, among them a stuffed leopard, and elephant hooves. Some parts of the palace, such as the conference room, are still used today for diplomatic functions.

One of the most fascinating parts of the palace is the basement, where a labyrinth of rooms and tunnels make up the war command HQ. Among the old communications equipment, rooms with huge charts and maps and escape tunnels, are the President's War Room and Wartime Sleeping Quarters. It was amazing to think that some huge decisions, and ultimately the fall of a country, had originated in that room.

In the President's War Room, dwelling on the fact that loss to the North is imminent

Another engaging site is the War Remnants Museum, which documents the Vietnam War (known here as the 'War of Resistance Against America', or more commonly, 'The American War'), and also the First Indochina War of 1946 to 1954, when Ho Chi Minh's Viet Minh gained independence from the French. Also featuring strongly are the effects of Agent Orange, with galleries dedicated to the after effects of the chemical. The museum is still heavy with propaganda, which makes for an interesting look at the other side of the story, with posters encouraging civilians to 'Destroy the American Infidel' and talk of the 'Puppet Regime'. The museum was actually previously known as 'The American War Crimes Museum' as recently as 1993, when improved relations with the USA led to a less accusatory name.

The end of the Vietnam War, as the North Vietnamese tank crashes through the gates of the Reunification Palace in Saigon

The history is fascinating, especially history as recent as this.

Vietnam: Ho Chi Minh City

The trip from Phnom Penh into Vietnam saw us board our trusty stead, the Mekong Express (bus) and venture towards the border towns of Bavet (Cambodia) and Moc Bai (Vietnam). Here, armed with our visas that we had obtained in Singapore, some sort of chaos ensued whereby our passports were passed back and forth numerous times between ourselves, the bus stewardess and various Cambodian and Vietnamese officials. This culminated in a rather stern looking Vietnamese official calling out what somewhat resembled our names, handing us back our passports, and just like that (over an hour later) we were in Vietnam. So back on the bus, where Ho Chi Minh City lay a few hours ahead.

On the drive to HCMC, it was immediately striking that Vietnam is much more developed than Cambodia, and much busier. Ho Chi Minh is the city of many, many motorbikes and scooters, which are really the only feasible way of getting around in this city of 8 million.

Known previously as Saigon, HCMC was the capital of South Vietnam from 1955, when it became independent from the French, until it fell to the communist North and the Vietnamese People's Army at the end of the 'Vietnam War' in 1975. Today, the locals still use the name 'Saigon' to refer to the city's central district.

We were lucky enough to stay with a GP from the UK, who is working in a teaching role at the medical school. Having been in Vietnam for over 3 years, she was able to give us an insider's guide to the city, including all the best spots to eat. Just around the corner, literally, from where we were staying was probably the best restaurant we have encountered during our entire trip, so good in fact that we went twice. For some fresh, authentic Vietnamese food, we cannot more highly recommend Cục Gạch Quán (http://en.cucgachquan.com/).

The city itself is an eclectic mix of French colonial architecture, traditional Vietnamese 'Tube' houses and shops, a smattering of communist propaganda, and did I mention many motorbikes?

The Notre Dame Cathedral in central Ho Chi Minh City. Remarkably resembling Notre Dame in Paris (see earlier blog post), it was built by the French between 1863 and 1880. All the building materials were imported from France, including the red brick, which came from Marseilles.

The constant stream of motorbikes which await you

The shopping district in downtown HCMC, one of the more picturesque parts of the city. The building in the background is Bitexco Financial Tower, Ho Chi Minh's tallest, which the locals found ludicrous due to the helipad sticking out to the side, similar to Dubai's famed 'Burj Al Arab' hotel. This can be seen just above the building in the foreground of the picture. The reason such a helipad is laughable is the fact that there is only one private helicopter in Vietnam.

Cambodia: Phnom Penh and National Highway 6

The National Highway 6 connects the northern town of Siem Reap with the capital Phnom Penh. Although it is sealed, in some places this means just one lane is sealed. Thus, the oncoming traffic ends up playing a game of chicken to see who will stay on the sealed part, and who gets run off onto the gravel shoulder. It is a game where inevitably, the biggest vehicle, or occasionally the one with the loudest horn, wins. Needless to say, we felt much safer the first time we drove from Siem Reap to Phnom Penh in a large coach bus, and much more vulnerable the other times when travelling for our clinic in a minivan.

Whenever we stopped along the way, we would be met by a throng of locals wanting to sell us their wares - usually bags of fruit, post cards or drinks. As soon as the van stopped, a mass of bodies and arms pressed themselves up against the windows displaying what they had to offer. We had the opportunity to sample some of the local delicacies - the locusts were actually quite nice, crispy like potato chips and not mushy in the middle as you might expect. But we did not feel obligated to try the spiders.

Just whipped up a batch of locusts

Ended up buying a bagful of the locusts, they were that tasty. Of course, Jill was pressured into trying one.

Phnom Penh, a 6 hour bus ride from Siem Reap, is a cool capital city, owing a lot of its charm from the French colonial buildings which herald from the time of French Indochina (The French controlled Cambodia, Laos and Vietnam from 1887 and the colonies became independent just after WWII). With over 2 million people, it is by no way a small city, but easy enough to get around by Tuk-Tuk.

One of the more interesting places we visited in Phnom Penh was the Killing Fields at Choeung Ek, where about 17,000 people were executed and buried in mass graves by the Khmer Rouge regime between 1975 and 1979. Overall, an estimated 1.7 to 2.5 million people from a total population of 8 million died as a result of Khmer Rouge policies. At Choeung Ek, you are able to walk amongst the mass graves, some of which are yet to be unearthed.  Occasionally, when it rains, bones and items of clothing are revealed showing the location of yet to be discovered mass graves. There is also a memorial filled with skulls of victims which have been recovered. The site is eerie, moving, and it is quite difficult to begin to contemplate the nature of the genocide that occurred here. Though the photos we took here are interesting, we have decided not to post them on this blog.

Cambodia is a beautiful country, and it is sad that so much of its recent history is taken up by the atrocities that occurred during those years. It is still very much a young country, and one that we recommend you visit to see for yourself.

Next stop, Vietnam.

Cambodia: Kdam Ha Village Medical Clinic

One of our goals for this trip had been to use our knowledge and skills, to help the local people that we meet. Through some contacts in New Zealand, we were able to link up with a lady called Adono who works as a missionary in Cambodia, working with the Girls Brigade. They run an organisation called Village Works (http://www.villageworks.com), in the small Baray village in central Cambodia, more or less halfway between Siem Reap and the capital, Phnom Penh. Village Works provides work for the local women, where they weave and sew handicrafts. At the same time, they are able to break out of the poverty cycle that sees so many women head down the wrong track.

Near Baray is the even smaller village of Kdam Ha, about 15mins off the main road. The Girls Brigade have been running outreach classes teaching English to the local school children, and with the help of Adono, we were invited by the village chief to run a medical clinic for the villagers.

Kdam Ha is about as rural as it gets. A rutted dirt road, wet with the tropical rain, leads through rice paddies to traditional Cambodian wooden houses on stilts, complete with cows, chickens and goats, and villagers peering out to see what these foreigners are up to. The village marketplace consisted of a couple of stalls selling packaged goods, and 3 ladies sitting in the centre on the dirt; one selling fish, one raw meat, one vegetables. There was a pagoda (temple) with reclusive monks, and a small school, where we were to conduct our clinic.

News of our clinic must have traveled fast, for as our white van (which looked as foreign as we did amongst the dirt road, ox-drawn carts and bicycles) drove along the road towards the school, we were followed by a stream of potential patients.

The local fish lady

The local BMX bandits - you gotta pull the bike cos it ain't got no chain

Ladies waiting to be seen by Dr Andrews

Village kids waiting to see the doc

Typical village house, no running water, just one well.

We came with our textbook knowledge, a year and a bit of experience as a house surgeon and three years of nursing,  and a box of various medications that we thought we may need (mostly antibiotics). Knowing that we certainly weren't going to be changing the world, or anything heroic given we had no IV access, imaging or other diagnostic tests at our disposal, we set about as village GPs, seeing patients who came to us with various complaints. Some had never seen a doctor before.

For the medically minded - there was a lot of basic stuff: UTIs, discharge, dehydration, lots of what sounded like sciatica and arthritic knees (from the charming old ladies who have carried water from the well to their homes for the past 70 years). In the more exciting category would be being asked to separate a boys legs that had been fused from birth (like that was going to happen on the desk in the schoolhouse!), TB, some paediatric congenital heart disease, Dengue, big tumors. It was great for history taking practice (through an interpreter), as that's all we had to go on. 

Even diagnosed some Myasthenia Gravis - a middle-aged lady with ptosis, inability to elevate her eyes, diplopia, change in speech, which were fatigable. The diagnosis was confirmed when she pulled a small pill bottle of pyridostigime, and she told me she saw a doctor in Vietnam who did some tests and gave her the pills to take. We were then able to work out how much pyridostigime she was on (which was way too small a dose anyway) and upped her dose a little, encouraging her to see a local doctor for ongoing management. It made me realise just how lucky we are in the developed world, for the management of such chronic conditions.

At the end of our time in the village, we ran a public health seminar, covering basics from what we had seen were the main health problems the locals encountered, including hygiene, the need for clean water and to drink adequate amounts of water when working in the hot sun. We had brought toothbrushes which we gave to all the villagers, and taught the children how to brush their teeth. The kids had never used a toothbrush before, and the looks on their faces when the toothpaste foamed up in their mouths was hilarious - they didn't know what to do!

Cambodia: Siem Reap - Chong Kneas Floating Village

Being a touristy town, the floating village on the nearby Tonle Sap lake and river system has been set up (apparently by some enterprising Koreans) as a tourist destination. The people living on a mixture of floating houses and boats are largely ethnic Vietnamese, and the area is interesting for the fact that twice a year the flow of the river changes direction, and the lake level changes dramatically, so the people tow their houses either up the river, or down onto the lake twice a year. Most of the people are fishermen, catching their livelihood on the lake. There are also a few floating shops, schools including a school of Vietnamese orphans, a church, and even a floating basketball court.

Not too sure if it was worth the US$20 each for the village tour by boat - unfortunately that money probably goes straight back to Korea and not into the village itself

Caching! 20 tourists, $20 each...

However, it is amazing to see how the village people live. Kids float by in buckets or washbasins with a paddle. Ladies pull up the the tourist boats selling cold coke and water. Fishermen fix their nets, whole families lying outside in hammocks. We didn't really know what to make of this tourist exploitation, but the villages were obviously very used to having the daily load of tourists ferried up and down outside.

Before visiting the school for Vietnamese orphans, we were "encouraged" to buy them noodles for lunch by our guide.

Someone must have bought them rice earlier

Crocodile farm - seeing this makes you not want to buy that croc leather wallet or bag

Notice the satellite dish? They ALL have satellite TV. How? They use car batteries for their electricity. And in order to charge the batteries, they hook them up to the motor of the big tourist boats which head down the lake from Siem Reap to Phnom Penh, and when the boat comes back your battery is charged. 

Genius.