Day Five

Today my post is going to have a bit of medicine-chat to start with, but lots of non-medic stuff too!

I’m feeling really happy today! The day has gone very well, right from beginning to end. I woke up at 7am, got dressed, had a speedy breakfast, and got to the hospital for 7.45am to meet Dr Hoi (a doctor who speaks wonderful English because he spent a few years training in the States). Dr Hoi, myself and the Swedish students all chatted for about 10 minutes in the courtyard of the hospital, and it felt so good to be able to communicate properly. We all had so many questions about the hospital, the Vietnamese healthcare system, Obs & Gynae practices in Vietnam (e.g. local views on abortion, Vietnam’s 2-child policy, how much healthcare costs)… So we were all firing questions at poor Dr Hoi, who had to stop us after 10 minutes because his clinic was starting. We went with him to the ultrasound clinic. It was such a good morning, and we continued asking our many questions about Vietnamese healthcare practices.

I am still shocked by the lack of privacy in Vietnamese hospitals! These women were havng trans-vaginal ultrasounds behind a frosted-glass screen, with three other women queuing, and one woman next-in-line stood by the bedside getting undressed. I also continue to be shocked by the speed of clinics… Dr Hoi saw between 40-50 patients this morning! Phenomenal! The other thing that shocked me was that ultrasounds were being performed for reasons that wouldn’t warrant an ultrasound in England. After seeing so many unnecessary scans, I asked Dr Hoi why these women were being scanned. He explained that during pregnancy, all women have a scan every 4 weeks here!! Every 4 weeks! In England you get 2 scans (one at ~12weeks, and an anomaly scan at ~20 weeks), and only if there is a good clinical reason do you get scanned more regularly. However, here the women are paying for their scans (60,000 dong – not very expensive, but still).

We also got onto the topic of treatment costs, and what happens to those who can’t pay! Patients pay for their healthcare, and if they can’t afford it, there is a seperate section of the hospital (At the O&G hospital this separate section is called the A Block) where they receive subsidised treatment. (An ultrasound scan for example is only 30,000 dong in the A Block – but I’m going to check out the A Block on Monday to see how things differ over there!)

Here is a photo of me, Anna and Emma at the hospital:

Anyway, enough medicine for today… Time to get onto another favourite topic of mine, FOOD!!!

As I mentioned in my blog yesterday, I’ve been hoping to start meeting more people! So, I decided to try something new… The New Hanoian is a website for expats new to Hanoi. On the website, I saw a post from a woman called Annett who was looking for people who work near her to go for lunch with. I checked out the address of her office, and it’s only 2 streets away from the hospital… so I messaged her a few days ago and said I would be happy to meet her for lunch, and we spoke on the phone, set it all up, and met today! I went to Pacific Place Building to meet her at midday… and guess what?! It turns out she works for PriceWaterhouseCoopers, which is the same company that Will works for! We went to a great upmarket food court called Quan An Ngon. It serves up typical Vietnamese street dishes, but cooked in a clean environment, and eaten at nice tables in an open air courtyard. We shared our food, and had these great wrap-your-own rice paper pork and noodle rolls, spring rolls and crispy fish noodle soup, yum! Annett was really nice, and it was interesting to find out what Hanoi-life is like for someone living here more permanently. She’s been here for a few months, and is out here on a 3 year contract. I think we’re going to meet there for lunch again on Tuesday. 

Well, after lunch, I went to the bank to change some more money before the weekend, and then met the Swedish girls at Hoan Kiem lake for some ’studying’! We all took along medical books (they took O&G because they have an exam coming up, I took Surgical Talk…) But the whole studying thing didn’t really materialise, we just chatted, sunbathed, and fended off booksellers and postcard sellers!!

In the afternoon I went back to my hotel for a bit to do some laundry. I washed all my hospital clothes, and some other things, and it’s all drying out on my balcony! (I bought a travel clothes line before I came out here, great buy! It is made up of two pieces of elastic wrapped around each other, so you don’t need any pegs, you just push the clothes through the two bits of elastic!)

This evening, to celebrate Matilda’s birthday (yesterday), we went out to a fancy restaurant called Au Lac. It’s a Vietnamese restaurant in a beautiful colonial French villa. We sat out on the terrace, and felt very proper!

 

We had wine… and spring rolls, seabass in orange citrus sauce, sauteed beef in lemon grass and chilli, tofu and vegetables in clay pot, prawns in coconut (literally 6 prawns sat in a coconut shell) and steamed rice. Then for dessert, we had banana fritters with caramel… MMmmm. The bill came to 200,000 dong, which seems sky high when I think in dong, but no doubt Will will helpfully provide the conversion to pounds for me and explain that I spend as much in Wagamama’s in London or something! Since we were feeling so lavish with our money, we splashed out and got a taxi home!!

Had a really lovely day!

Day Four

I’m going to avoid hospital chat today… Today, I’ll focus on some other things.

Last night, I didn’t end up going to see Tsotsi. The Swedish girls were feeling pretty tired, and decided not to go. I was still going to go (jotter pad ready!), but then changed my mind at the last minute. I went and had dinner at a restaurant called Nha Hang Phu My, which pretty much only serves one dish (Pho Xao Bo), but they do it well! Pho Xao Bo is a beef noodle dish, but instead of being soup based like Pho Bo, it is a plate of sauteed beef served on top of noodles with a thick starchy gravy poured over the top, and some veg thrown in too. It reminds me of Beef Kway Teow. It was yummy! Hanoi has a lot of specialty restaurants that only serve one dish. An article in The New Hanoiain explains the concept of one-dish restaurants nicely, it seems that in years gone by, it was difficult to find/buy enough ingredients to provide a full menu. Additionally, a large choice of meals on a menu was deemed to be an unnecessary luxury, and so the one-dish restaurant was born, and now they do their dishes so well, that they continue to thrive!

Anyway, I was the only foreigner at this little Pho Xao Bo place, and the owner seemed excited to have me there. With my phrasebook and my limited Vietnamese, we had a little conversation, and smiled politely at each other! She was very pleased that there was not a morsel of food left on my plate at the end, and made lots of enthusiastic comments in Vietnamese!!

When I got back to my hotel, these two Aussie girls were at the reception desk hiring a DVD player. When they asked where the DVD collection was, it seems that the hotel hadn’t thought the whole DVD player rental thing through very well because they didn’t have any DVD’s to rent out!! I said to the two girls that I had a bunch of DVD’s (courtesy of Sandia), and after looking through my collection we decided to watch some of my Grey’s Anatomy. We tried the DVD player first, but as it was a different region we ended up watching it in my room on my laptop. They were really sweet girls, but I can’t remember their names for the life of me. Hanoi is their first stop on a S.E.Asia 2 month journey, and we chatted about places they are going along the way (Laos, Cambodia and Thailand), and then watched lots of Grey’s Anatomy!! It was fun having company, they brought a whole box of Choco-Pies to my room, and we pigged out in front of the tv (laptop) for a few hours!

This morning, I went to the hospital, and then at about 11.30am (since not much was happening), I went to register at the British Embassy (just so that they have a record that I’m out here until February, in case of national disasters/war breaking out/some other reason). It was quite nice, they gave me an info pack for Brits that are new to Hanoi (contained info on supermarkets, clubs & societies, health services, lawyers, estate agents etc), and took details of where I’m staying, my Vietnamese mobile number etc.

After that, I went to this awesome little Vietnamese vegetarian restaurant run by Buddhists. (Seriously, all I seem to do here is eat, and everything I eat is amazing (apart from the pig ear… which actually tasted amazing, but once I knew what it was, became a bit gross).

I went back to the hospital, but as I got back to the hospital gates I saw the Swedish students (who were taking the afternoon off), so I decided to do the same!! I decided that I would try and take some pictures with Will’s camera (he loaned me one of his smaller camera’s, Canon EOS 400D). My brief hour or so of photography has made me develop new-found respect for Will and Matthew and the wonderful photo’s that they take. I visited a temple, and I was probably trying to run before I could walk, but I was playing around with the ISO to avoid having to use the flash… and out of 20 or so photo’s (yes, I know Will, digital photography means I can probably afford to take more than 20), I only had 1 photo that came out well… and it’s actually a really boring photo. Here it is *Nat chuckles to herself thinking what sarcastic comments Will would make if this was submitted to photogalaxy or EarthShots!*:

This evening hasn’t worked out as well as planned! Linh came over to my hotel briefly. She wants to teach me Vietnamese, and started with a brief lesson this evening!! Apparently my pronunciation is really good… I can copy the sounds she makes really easily, but 2 minutes later I will have forgotten how to recreate the sound. Anyway, the reason the evening didn’t work out well wasn’t because of Linh’s vietnamese language help. It’s because of touch rugby, or the lack of it. I found out about an expat touch rugby club here in Hanoi, and emailed the guy a few weeks ago to say I was interested in coming along. He said newcomers were more than welcome and told me where it was etc. They have social games on Thursday nights at 7.30pm, so I decided to go along today and check it out. I put on my sports clothes, packed a change of clothes and got a xe om out to the sports grounds (Hoang Cao Sports Centre in Dong Da). I was a bit early, but a member of staff at the sports centre said that the rugby should be happening, so I just sat and waited… At 7.30pm, nobody had showed up… and 7.40pm, still nothing. Two of the staff members at the centre had been chatting to me… the usual stuff ‘Where are you from? Look like from Vietnam!… etc’ And by about 7.50pm they agreed that rugby probably wasn’t happening this week, and I got a taxi home (Yes a taxi… The meter was on, and it came to 30,000 dong!! That’s double the Xe Om price… but I was feeling too disappointed at my wasted evening to be bothered with Xe Om bartering out at the sports centre). I should have re-emailed the guy to check that it was on this week, but oh well. I have just emailed him now, and asked for a mobile number, so hopefully I’ll get to go to the rugby soon.

Now I think it’s more Grey’s Anatomy for me… this time, solo! I was really looking forward to the touch rugby because I thought it would be a great way to meet more people… The Swedish girls are lovely, but they have to sit an obstetrics exam when they get home in a few weeks, so they’re actually having to revise while they’re here, and so I’m not really seeing them much outside the hospital. And everyone I meet in the hotel seems to leave the next day. I think that meeting expats or volunteers is the way forward. I do have an idea up my sleeve… hold on for tomorrow’s blog post!

Day Three

It’s 5pm, and I’m back at my hotel after my first day at the Obs & Gynae hospital. My timetable is pretty flexible, but the general outline is that until Friday I’ll be doing Gynaecology, and then next week I’ll be doing Obstetrics.

I’ll talk about the hospital in a moment, but first I wanted to write about what I was up to last night… I went to the Hanoi Cinematheque on Hai Ba Trung. I read about it in the Lonely Planet, it’s a cinema that shows English and French films. Anyway, I went along not really sure what would be showing, and just by chance, this week happens to be the UNFPA (UN Population Fund) Annual Film Festival. Each year they pick a theme, and this year it’s on Urbanisation & Population Growth (The theme is called ‘Tales of the City’). So each night they show a film related to the topic of urbanisation, and then after the film they invite a speaker from the UN or NGO’s to talk about related topics. The films are all free (yay!), and the cinema is so lovely… there’s a courtyard with a restaurant, very nice setting…

Anyway, last night, the film being shown was quite random, it was called Koyaanisqatsi. It was a film from 1983 by Godfrey Reggio, it is a non-narrative documentary to music (really awesome music by Philip Glass). Koyaanisqatsi is a Hopi Indian word meaning ‘Life out of Balance’, and the film portrays how the urban world of technology is out of balance with the untouched environment. It’s really stunning, and for a movie without a single word, it was incredibly captivating. Here’s a link to a website about it http://www.koyaanisqatsi.org/films/koyaanisqatsi.php

After the film, a woman from a Hanoi based NGO and a man from the UNFPA came to speak about the issue of urbanisation. The main topic of discussion was how long Hanoi has left before it crumbles. It was quite a depressing discussion… Rural to urban migration into Hanoi is huge, and the population is exploding. The city planning that was done many years ago was done for a population size of 500,000. Today the figure is said to be 10 million. Pollution, infratsructure, healthcare, housing, sanitation… these were just some of the issues covered. Hanoians in the last five years have made the transition from bicycle to moped, and now they are moving from moped to car… it’s just not sustainable. But how can ideals about cutting carbon emissions and recycling waste be sold to your average Hanoian? We watched a small film by the NGO called ‘Who does Hanoi Belong to?’ They interviewed local people on the streets about their views on Hanoi. The NGO is trying to make Hanoians realise that it is the local people that own the city, and the local people that need to take responsibility for Hanoi’s future. (Being at the talk kind of made me feel like I was back in London at a Medsin Global Health Forum! It was nice!! I’m missing AIDS Week at Imperial this year because of my elective in Hanoi, so this film festival was a good event for me to stumble upon).

It was also nice to be at the film showing/discussion because it made me feel like I had company, even though I was actually a big loner at the movies on my own! I keep this little notepad with me where I jot down addresses of places where I’m headed, or note down the name of nice shops that I want to return to etc… So I kept pulling out my jotter pad to make notes about the discussion, and then I wondered if people thought I was a journalist! Hehe… I always used to want to be a journalist when I was little (mostly because of The New Adventures of Superman, with Teri Hatcher as Lois Lane, and Dean Cain as Superman!!).

Today the film being shown is Tsotsi… I’ve already seen it, but I think I will go again. The Sweedish students that I met today are keen to go too, so I won’t be a loner pretending to be journalist this time!

So… onto my first day at the hospital. It’s so different to West Middlesex Hospital (where I did O&G in London). I started the day in Gynae outpatients. The three Sweedish students (Anna, Emma and Matilda) are all doing Obstetrics, I’ll join them next week.

In Gynae clinic, I was in a room with the consultant (Consultant title: Tian Si), who spoke more French than English, so I struggled along with my high-school French with him! There were also about 8-9 junior doctors (doctor: baak si) in the room. There was a screen, and behind the screen was an examining bed and a clothes stand. The door to the room was always open, and about 3-4 patients were stood at the desk in the room waiting to be seen, while 1 patient was on the bed being examined (e.g. naked from the waist down having a speculum and bimanual examination), and 1 patient was undressing ready to be the next one examined. It was the least private thing I have ever seen… and I did more cuscoe speculum examinations this morning than I did in my entire time at West Midd! It was insane… the turnover of patients was crazy. In London, I thought 10 minute consultations were brief. Here, it was 1 minute per consultation. The doctors pushed me forwards each time to do the examination first, half the time I didn’t even know what the patient’s history was, but I would put the speculum in, at least 5-6 doctors would then take a look at the patient’s cervix, then I would do a bimanual, and 5-6 of them would follow and also do a bimanual. The patient’s were not really consulted in the matter. It made me feel a little bit uncomfortable not to explain to the patient first, so I would hold up the speculum beforehand to signal what I was about to do… but none of the Vietnamese doctors seemed to explain their actions to the patients. I think healthcare out here is a pretty paternalistic. Well, I got to see some interesting things in clinic… there were several post-menopausal bleeds, a choriocarcinoma (apparently molar pregnancies and trophoblastic disease is really common out here), and some cervical cancer.

After clinic I was shown around the ward, and met another doctor (Dr Thuy) who spoke English very well. She told me to come back after lunch to observe some D&C’s (Dilatation and Curettage). I went for lunch with the Sweedish students in the hospital canteen (10,000 dong for a full meal). Then after lunch I couldn’t find Dr Thuy. I got a bit frustrated because the nurses said she was in theatre, but when I went up to theatre none of the nurses up there would help me find the changing rooms. In the end, Dr Thuy happened to walk past and took me to find scrubs.

In theatre, I watched a lap & dye (to check patency of tubes). Then after that operation, I went with Dr Thuy to watch the D&C, and that was all I did this afternoon. I’m going in tomorrow at 7.45am to meet Dr Thuy.

All in all, I’m quite pleased with everything in the hospital so far. I think language is a bit of a barrier. Although I can communicate with most of the doctors, I can’t really talk to the patients or the nurses, which is frustrating. I’ve been using my vietnamese phrasebook like crazy, and I think that everyone appreciates my effort (although the tones are so hard to get right). Surgery is good because there’s no talking involved, and emergency medicine will also be good (again, no talking). However, everyone who knows me, knows that I love to talk to patients… the social aspect of medicine has always been really important to me, and it feels wierd not to be able to connect with patients. Alas… perhaps it’s good for me to be working on surgery and practical skills rather than spending hours chatting to patients about their emotions and things! 

(P.S. I know most of my blog-readers are non-medical… Sorry if this post has been too boring and medical for you. I’ll try and limit the medic chat in future. I just thought it would be good to document about the hospital on my first day!)

Day Two

It’s late-afternoon on my second day in Hanoi, and after a morning of activities I’m back in my room for a little break and thought I would write about my day so far (I figured that my blog readers are all just starting their day in England, and they’re going to want something to read!)

My last blog left with me saying I was heading out for dinner with my new friend (Linh). Linh came to my hotel at about 5pm, and I had a terrifying journey back to her house on the back of her moped. Basically she came straight from the university to pick me up, wearing her work clothes (a skirt-suit), and when riding her moped in the short skirt she couldn’t put her foot down on the floor because the skirt would ride up and expose her knickers! So, we travelled an entire twenty minute journey without her putting her foot on the floor once. This meant that whenever we approached a red light at a junction, she either had to slow down an weave amongst other mopeds to avoid having to stop, or she would just go through the red light weaving through the oncoming cars, mopeds, buses… you get the picture right? Although she had a nice new shiny moped, I was favouring the Xe Om (moto-taxi) drivers at that point, with their old, chuggy mopeds… at least the xe om drivers use their feet!

Anyway, we arrived at her house in one piece! Linh is 26 years old, and has recently moved back to live with her parents because her husband passed away. She has an adorable 2 year old daughter, and also living in the house is her brother and his family. The house was three storeys high, I think they’re quite a wealthy family in Vietnam, they had satellite tv, nice rosewood furniture, leather sofa’s… Last night, it was her sister-in-law’s turn to cook dinner. Dinner consisted of about 5 dishes with rice… belly pork, two types of fish in sauce, veggies, and a soup. I wasn’t sure whether to drink the water or not because I didn’t see whether it was from a tap or bottle. I felt a bit rude, but I just left it to be on the safe side. During dinner the discussion moved onto the recent cholera outbreak in Vietnam (mostly rural areas, but also some cases in Hanoi). This discussion further persuaded me to leave the water to one side, and also made me wish I’d gone to get the Cholera vaccination course in London. (Mental note for my time in Hanoi: go crazy with the alcohol gel, and don’t get complacent about water/food).

After dinner, we went out with Linh’s cousin to a karaoke bar… The bar was in a part of Hanoi called Iceland, which is basically like the HDB estates in Singapore. It’s a little town on the outskirts of Hanoi which is a brand new development, with high rise apartment blocks that all look identical, lots of little shops and restaurants at the bottom of the apartments, and the Karaoke bar where we ended up.. As most Asian’s seem to be, everyone in the Karaoke bar sounded as if they deserved a recording contract. There were about 15-20 people in the bar, and when everyone noticed that I was English speaking, they all urged me to sing an English song. I begged someone to sing with me, but they said they were not able to keep up with the rolling words. So, from a list of pretty ancient english songs, I chose It’s In His Kiss, because I remember singing it with Meg in London. But when it started, I realised that the reason it sounded good in London was because I let Meg do all the singing. This time, I had twenty expectant Vietnamese faces looking at me hoping for a super English song in their karaoke bar. My god did I disappoint them! It was horrendous. My stomach was in knots at how badly it was going, I really really really cannot sing… But I soldiered on, everyone clapped politely at the end, and I quickly passed the microphone along! (Mental note: Avoid all karaoke bars unless I have a fellow English speaker to do all the leg-work)

Anyway, after staying up late on Skype with Will (who is very impressed that I created a blog), I had a lie-in this morning, which was lovely! Then, I headed out to te Dong Da district on a Xe Om (getting really good at discussing prices in Vietnamese… Muy-ee (10,000 dong), Muy-nam (15,000 dong). I am only willing to pay Muy-ee for short journeys (under 10 minutes), and Muy-nam for longer journeys. I am very insistent on this, and will walk away if the driver does not agree!) So, i took the Xe Om to the Temple of Literature (massive tourist area), but didn’t actually go into the Temple today. I’ve been before with Will, and I do intend to go again, but not today. Instead, I went to some lovely little NGO shops/cafes (CraftLink and KOTO), and then had my daily shot of Pho Bo noodles!

After lunch I went to this place called Maison Des Artes, which is a tranquil little place that seems to do everything (cafe, art gallery, shop, and massages). I decided to get an hour-long full body massage! So good! The only bit I didn’t like was when she tried to pull out my fingers and toes, I know that some people’s joints click when this is done, but mine don’t. My fingers and toes enjoy being in their sockets… Luckily, she only tried once, and when there was no click, she left my digits alone, and continued with a really good massage!

Anyway, now I’m back at the hotel… Tonight I’m planning on going to the Hanoi Cinemateque (It’s a little cinema that shows english and french films). There’s a 7pm english film, so I think I’ll go to that. I’m gonna find a cafe/restaurant nearby for some dinner first.

Tomorrow morning I start at the Obs & Gynae hospital at 8.30am. Mrs Thanh Hang (from the International Cooperation Department at the university) called me today to let me know that 3 Swedish students are also here on elective, and when they found out that I was doing Obs & Gynae, they asked if they could join me. I think it’ll be nice to meet some other elective students. They’re starting at 8.30am tomorrow too.

Let’s hope that by my next post I will have delivered a little Vietnamese babbby!

Day One

So… Today is my first full day in Hanoi. I’m a final year medical student from London, and I’m here in Hanoi until February 2008 for my medical elective. I’m going to be spending 3 weeks working in K Hospital (Obstetrics and Gynaecology), then 3 weeks off for Christmas and New Year (travelling to NZ to meet my family and my boyfriend), and then back to Hanoi for 1 week in a rural health clinic, and I’ll finish up with 3 weeks doing emergency medicine at Bach Mai Hospital. I’m here on my own in Hanoi. I thought it would be good to go off alone for my elective, and do what I want to do. I must admit, beforehand, I didn’t really think about how it would feel to be out here alone. Now that I’m here, although I’m not lonely or anything, I would have loved some company for dinner last night!! It’s pretty exciting though being here alone… and I feel like I’ll learn a lot while I’m out here (general life stuff as well as medicine).

I’m staying at the Tung Trang Hotel in the Hoan Kiem area (Old Quarter). It’s a really great location, right in the thick of things in the Old Quarter (a myriad of shops, restaurants, little pavement-eateries and market stalls). The hotel is actually on a quiet pedestrianised back alley, slightly removed from the craziness of the main roads. Although I’ve been to Hanoi before, I think I’d forgotten just how many mopeds there are here, and just how bustling the streets are. My heart stops every time I have to cross a road… The method seems to be shut your eyes, walk, and the mopeds will avoid you (fingers crossed). Anyway, here is a picture of me in my room at Tung Trang, I love the little balcony, it gets so much sun in the afternoon!

Yesterday, I was shattered from my flight, but I walked out briefly to check out some shops and wander the streets… I also managed to unknowingly feast on fermented pig-ear! It’s called Nem Chua, and in my guidebook Nem translates to spring roll, but when I googled Nem Chua, it turns out that the Chua bit makes it a pig-ear roll. Yummy!!

Today was great, and I’ve eaten some really awesome food! I started out the day by going to the Hanoi Medical University to meet the administrator and plan out my timetable. I won’t be starting in the hospital until Wednesday, so after a campus tour, I had the rest of today free for sight-seeing. I started out by walking to Café Pho Co (a beautiful café with the most stunning view over Hoan Kiem Lake) where I had a Vietnamese coffee (with condensed milk… so tasty).

Then I walked along Hoan Kiem lake to Fanny’s Ice Cream where I had Com (Young Rice) ice-cream (tasty tasty)… Then I went to some shops (bookstore, art gallery), and used the lovely toilets in the very swanky Sofitel Hotel. Then for more culinary delights, I had my lunch at Pho 24, an amazing Pho Bo restaurant… I was reminded how tasty Pho Bo was, and am planning on having at least one bowl of Pho Bo each day!!

After lunch (by this point, I was stuffed), I walked to the Hanoi Hilton (Hoa Lo Prison). It was such a funny museum, they basically show how appalling the French treated the Vietnamese prisoners during the Indochina war, but then at the same time try and show how nicely American POW’s were treated by the Vietnamese in the Vietnam war, with photo’s of the POW’s playing cards, receiving gifts from the prison officers etc!! Made me smile!

And now I’m back in my room trying out this blogging-lark before I go out for dinner with a girl from the university… She’s invited me over to hers for dinner! Yay, I have a friend!!