Visiting Laos: Healthcare Edition

 Hey everybody, and welcome back to the jungle! This post is about another technical topic that we might not think about, but it is a huge part of our lives. Before writing this post, I thought healthcare was pretty straightforward, as many of you likely do. When you get sick, have pain, or else something else isn’t quite working right, you probably call up the proper medical practitioner and get whatever you need. Once you’re done, you hope that the insurance covers it, or else you have a pretty hefty bill to pay. Or if you’re in Canada or another country with socialized medicine, you don’t owe a dime since the government covers everything. However, health and wellness is a lot more complicated than that. Besides how the bureaucracy is set up, there is also the treatment method. I’ll briefly go over the three main schools of thought when it comes to treatment, how Laotians approach health, and what you should expect if you find yourself in a healthcare situation while in Laos.

The health approach most of us Americans are familiar with is biomedical. When something goes wrong, we immediately assume it’s a bacteria, virus, genetic, or else there is another scientific explanation for it. At the other end of the spectrum is a supernatural approach. You can think of this as believing in spirits, gods, or else another world that is ‘out there’ that influences our health. In a culture that takes this approach, you would go to a witch doctor, shaman, healer, or someone who has a similar title. They may say an incantation, give you a potion or something to eat, or tell you which god/spirit you offended. In between these two, you have a holistic approach. This school of thought looks at the body and mind as influencing each other. While they use scientific explanations, they look at your lifestyle as well.

Laos has traditionally had a supernatural approach to medicine, and in many areas they still do. However, modern medicine has been finding its way into Lao culture. Unless you live in a remote village, chances are any malady will result in a trip to the doctor. Even in areas where doctors are available, many families and communities still participate in a ritual called su khuan, or ‘soul-calling’. It’s quite common for a family do this before and sometimes after any medical treatment. This ceremony is not just for illness, but other major life events such as a new job, marriage, or death. When something is wrong or when there is a transition, the Lao believe your souls are out of balance, or they need to continue to be balanced. The entire family, and sometimes the community, participates in this ceremony where everyone is literally bound together, using string. Usually, a Buddhist monk or an elder presides over the ceremony in an incredible show of community support. Words can’t do su khuan justice, so I’ve included a video about it here.

While we’re talking about health and wellness, it is worth mentioning death. Unfortunately, it is one of the more difficult parts of life that we don’t like talking about, at least in the Western world. In Laos, that view is quite different. Since the majority of Lao believe in Buddhism, they often take that approach to death. It is viewed as a natural part of life, not as a sad or happy thing, but just a thing. We all eventually die, so it is not something to be feared or dreaded, but instead seen as the next step in the circle of life. Buddhism and Lao culture both have an appreciation for the present moment, which carries over into how they think about death. The only exception to this is some believe that if a person died accidentally, either by violence or an accident, they won’t be reincarnated and then it is the end for them. This could be an entire post on its own; unfortunately I have neither the time nor the space. However, if you want to know more about death and funerals (which tend to have more cultural traditions and superstitions attached), you can check out this article here.

Finally, if you or someone you know wishes to go to Laos on a mission or for a humanitarian organization, it is quite valuable to keep the Lao perspective in mind. While you may come across someone from time to time who has a viewpoint different than what we discussed, you should be able to get by if you keep a few things in mind.

·       Lao culture is extremely collectivistic, as we’ve seen in previous posts and the su khuan ceremony. When someone comes seeking care, they may want their entire family with them. Having a large space would be helpful, as well as several more private areas where people can hold a su khuan nearby.

·       Death is something that is seen as natural and not to be feared or put off. When in doubt and there is no directive, treat a dying patient as a DNR (do not resuscitate), meaning allow them to die. The only case in which you would take lifesaving measures is if they were injured in an accident or from an act of violence.

·       Lao healthcare has transitioned from supernatural to holistic fairly recently. Remember that their beliefs, while they may seem strange, deserve as much respect as ours do. Respect your patients and their families.

I hope you all learned something new about Laos or healthcare that you didn’t know about before. I’d love to see you back in the jungle soon!