Tuesday, November 22, 2011

The Cultural and Political Implications of Eating in Vietnam

Good Morning Vietnam!!!!!

Four AM in Hochiminh City is a strange and memorable time. 

Though the city is pitch black, it is more awake than most cities at noon.   I am not so awake, but I have no choice.  Today we will be working in Ca Mau, Vietnam's most Southern province.  We are expected to be at Binh Thuan Province Hospital when the Children's AIDS Clinic opens.  Ca Mau is 340 kilometers Southwest of Hochiminh City.  If we catch the six AM flight out of Tan Son Nhat Airport we can make it to the clinic opening by eight and maybe even get a cup of Vietnamese coffee (Cafe sua da) or a bowl of Pho' along the way. It's going to be a full day on the run. 

I'm not great in the wee hours of the day. You'd think that  traveling for a living would make one tolerant of shitty early morning travel, but   it just gets worse as one gets older. Waking up earlier than seven-thirty is physically painful like having to remember to forcibly breathe every breath.  I've always been a big believer of easing into the day for the sake of health and sanity.  Go to sleep when it's dark and wake up when it's light.  It's not rocket science.  This character restriction of being an effective early riser is the only thing that stood between me and an exciting life as a talented surgeon.  I like to cut.  I've always liked to cut. Honestly, I was pretty good at it.  But a surgeon's work day starts at six AM and my ability to be an asshole is inversely proportional to the time of day I'm encountered.  I was on the path towards being a surgeon as a young man, but the hours killed me.  I found myself saying the most horrible things to people who didn't deserve it. All because of  sleep deprivation and my inability to adapt.  The guys I worked with weren't much better, but they were able to embrace their inner-asshole.  I was not.  I switched out after my first year.  I still regret it sometimes.  I think I did the right thing, but there's no room for reflection this early in the morning.

I dragged my suitcase down three flights of hotel steps. I made no attempt to do this quietly. As a charity worker you get used to staying in hotels without elevators.  I was a tired, aggravated and vindictive early morning bastard.  In the lobby the receptionist slept on a couch in a dirty tee shirt and blue bikini underpants. He pretended to sleep through my suitcase banging rather than deal with me or my silly checkout needs. He had pulled his fifty cc motorbike into the lobby for the night and inconveniently parked it in front of the stairs.  I squeezed around the bike, threw my room key behind the desk and walked out to the early daily chaos of Hochiminh City.  

The District One streets were already busy.  The high-pitched whirrrrr of 50 cc motor-scooters came from all directions. The shop next to my hotel was stocking orchids for the day.  A boy  carried wet armfuls of flowers wrapped in newspaper from a rusty truck parked out front.  An old barefoot man in short pants dragged a wooden cart of coconuts down the middle of the street.  This was the only chance he had to make his deliveries  before motorcycles  filled every inch of road with morning traffic. I felt like the only thing on the street standing still while everything moved past me in random directions.  After a few minutes my taxi came.  I was on the move, like everything else in this city at four AM.  Thirty minutes later I was at Tan Son Nhat Airport.

When I was a kid, I loved airports.  I didn't even mind the check-in line.  I watched the other passengers with a death-grip their ticket like it was the only thing standing between them and their next adventure.  I don't feel like that anymore.  I get anxiety the moment the foreign taxi driver gives his first negotiated extortion-priced airport taxi fare.  I just want to get where I'm going.  This trip to Ca Mau is the fourteenth city, the ninth flight and the twentieth day of this work cycle.  This trip involves work  for an ex-president's HIV/AIDS Foundation. We are teaching government doctors how to treat children with AIDS.  A worthy project.  Our projects go through Vietnam all the way from the far north border with China and down to Ca Mau in the middle of the Gulf of Thailand.  This trip  is my last place of work for two long weeks of rest before another job in Ukraine.  I can't even bring myself to think about these two weeks.  All i can think about is the ten hour, five AM flight from Bangkok to Kiev after the  two weeks of rest are over.  I'm travel weary.  My chest feels heavy, I'm hungry and I badly need coffee.

The restaurant at Than Son Nhat Airport serves up some amazing Pho Ga (the Viet version of chicken soup with hot sauce).   I bee-lined to the cafe and met our local Vietnamese staff.  They were trying to have a friendly conversation with me, but all I could do was nod my head while stuffing my face with Pho Ga.  Unfortunately it was too early for the restaurant to serve coffee (is it ever really too early for coffee?) so I just added extra hot sauce.

Next I did something that I feel particularly obliged to pass along to anyone and everyone who's ever left civilized Western roots.  This one is a pearl.  Pay attention:

Big fan of this guy.
I stopped in the nearest food kiosk and bought a large tube of Pringles potato "crisps."  As it turns out you cannot call them "chips" because you can only identify 42% of what is inside them.  Personally I don't care what you call them or what is in them.  In fifteen years of international travel they have literally saved my life and provided travel comfort more times than I can count.  Pringles crisps are the perfect weapon. Stay with me here.  My theory is that the chemical and structural constitution of a Pringle is nearly identical to something called Diatomaceous Earth.  For those who don't know what this is (or never owned a swimming pool):  it is a fossilized algae with mild abrasive, insecticide and absorbent capabilities.  It is frequently used as a filtering medium for swimming pools, a growing agent for hydroponics and as a stabilizing component of dynamite.  You can also find it in kitty litter.  The Pringle IS intestinal Diatomaceous Earth (and it comes in Halal and Kosher forms).  Five Pringles will fill the belly and suck up even the most horrible food-borne viruses, bacteria and poisons and eventually drag them safely out of your ass. In 1998, while working in Tibet, I  lost over twenty pounds from a vicious bacteria contracted somewhere in China.  This forever solidified, in mind and intestines, certain feelings about mainland Chinese and their food.  Still, I was miraculously able to find a regular source of Chinese-copy Pringles in small shops along the way. Half a pack daily kept me alive and functional until I returned to civilization and took the cure.  The Pringles people have caught a lot of shrapnel over the years from busy bodies complaining that Pringles are unhealthy and not a real food source.  I submit to them that not only is it a food source, it is also potential antidote for biologic weapons.  If they are looking for a spokesperson, I'm their guy.

Our forty-five minute flight was on time and we arrived at the Anh Nguyet Hotel, central Ca Mau, at seven AM.  The Anh Nguyet was a basic box shaped Vietnamese hotel with a fancy neon sign and a lobby that smelled of cigarettes and automobile air freshener.  It did have wifi though, so nobody there cared how it smelled.  The lobby was decorated in lavish white and yellow flowers and banners in preparation for a Vietnamese wedding. I was given a room across the hallway from the grand ballroom. I assumed the starting time for the wedding would be thirty minutes after I fell asleep.  The receptionist handed me two things:  a breakfast buffet ticket  and my room key which was attached to large ball-peen hammer.  There would be no running off with an Anh Nguyet room key.  At the breakfast buffet I ate whatever was identifiable or fried.  I finally scared up a cup of Cafe Sua Da.  It was deep brown, thick as motor oil and sweet from too much condensed milk. It did the trick. In reality my belly was still full from the airport Pho, but the rules of international work deem that you should eat what you can eat, when you can eat it.  You never know when or what is coming up for lunch.

We made it to Binh Thuan Province Hospital sharply at eight AM and the patients and their parents patiently lined up outside the examination room. The day went smoothly and successfully.   We worked straight through lunch. Writing about treating children with AIDS is a story unto itself which  I'll tackle  later, but our early afternoon lunch was when everything started to go down.

A half-sized green and white taxi in the shape of an egg picked us up at the hospital.  All my foreign paranoia told me that this was a ploy to make the foreigner feel special, but it was just  the popular taxi in town.  Ninety-five percent of the vehicles on the the narrow Ca Mau roads were bicycles and motorcycles.  My taxi driver took full advantage of being the relatively largest vehicle and plowed through the roads. He ignored all the stop signs and took privilege of being the big dog on the highway.  Rows of bicycles parted when he hit the horn.  A row of young girls peddled their bikes out of a school yard.  They were  dressed in the same bone white Ao Dai traditional dresses.  The long tail of the dress was held in one hand against the handlebar to keep it from dragging in the road.  They rode one behind the other in rows of two.   It was like a painting.  

We arrived at the restaurant.  The place was a local eatery chosen by our hosts, the hospital administrators and heads of the local communist party. There was a large open-air dining room with metal fold out tables and hotpots.  We were shuttled past this room to a corridor in the back with five private rooms marked only by numbers on the door.  If this was my first time in Vietnam I would have begun to think I was headed for interrogation.  The room, number 3, was ten by twenty feet long.  The walls were painted blood-red and had the texture of a highschool cafeteria wall.  The ceiling was low and a single  orange, plastic fan jutted out with no housing and an exposed, frayed electric cord.  The wrappers, toothpicks, bones, pork fat and general debris from the previous customers had been left on the ground and pushed out to the periphery of the room.  There was a one meter "green zone" clean area between the debris and a long square table in the center of the room.  I suppose it made practical sense:  why clean the room 4 times when you can just do it all at once later?

This is how these lunches work:  At the end of every work day we are obliged to go to a celebratory lunch hosted by the local medical society and local communist party. There is a lot of jostling behind the scenes to be included in this lunch.  This is not only for the political clout and photo opportunities, but also because they will pick the most expensive restaurant in town.  We are expected to pay. 

A  woman stands in the back of the room.  She is Miss Tuyet and she is our hostess.  Miss Tuyet looks to be about thirty-five years old with an unusually curvy body and a look on her face somewhere between bored and severe. I notice that her thick eyebrows have been deftly painted on. I think anyone dumb enough to point this out to her is a dead man.  She walks over to a rusty grill in the center of the table and viciously squeezes a bottle of lighter fluid into it.  Flames burst out like a small napalm explosion and I felt my forehead get warm.  I think my eyebrows got singed.  Perhaps this is how Miss Tuyet lost hers.  

Next she turned her attention to a ceramic bowl next to the grill.  It was crammed full  of creamy grey baby octopuses, each one no more than six inches long.  The tentacles hung over the side of the plate and rested on the dirty table.  The heat in the room was starting to make the legs curl.  Miss Tuyet picked one up by the head. It's tentacles stretched like a cartoon octopus umbrella, the legs still attached to the plate and the other octopuses.  They finally gave way with little popping sounds.  She changed her grip and elegantly held the floppy bulbous head between her thumb and forefinger.  With her other hand she pulled out a pair of sheet metal scissors, cut the thing to bits  and dropped the parts into a boiling hot pot.  The legs turned red and curled into tiny circles.  I frantically looked around the table for something remotely edible--rice or fruits .  There was nothing.  I had just started to weigh the benefits of insulting my hosts by not eating versus not vomiting or getting diarrhea. Soon introductions were made.  My translator sat next to me and mitigated what needed to be said and what needed to be heard.  My head was spinning and all I could think about was that pack of Pringles back at the hotel.

Saigon Beer Tall-boys  were cracked open and placed in front of us all.  This was a Friday at noontime, but that didn't matter. This is how it was done in each Vietnamese city, on each day of this week, at each  hospital where we worked.  Lunch hour is happy hour--even if you are going back to  work in the ER or going to do surgery . Toasting over Tall-boy beers is a universal language. Lunch is the time for breaking down barriers and getting to know each other in a culturally melded, relaxed, alcoholic state.  You can’t fault the practical genius of this.  If you do get sick in Vietnam, however, I suggest that you try to see certain doctors before noon or wait until the next morning.   

I'd rate Saigon beer as a good one in my experience with Southeast Asian beers.  I'd have to put it somewhere above Singha, below Bintang, but not even approaching Beer Lao.  The problem today is that this Saigon beer is warm and has been sitting in this hot dirty room all morning. Miss Tuyet to the rescue.  She produced a  big plastic mop-bucket full of large, questionable ice chunks.  She stopped at each person's glass and depth-charged an ice block into each beer with a splash.  This was the Viet version of a frosty mug.  When the ice began to melt she would show up again, pull the cube out of the beer with large meat-tongs and put the ice back in her bucket. Then she would take a random ice block back out and drop it in the beer.  This essentially recycled everyone's ice into everyone else's beer.  I made a mental note to look into post-meal antibiotic prophylaxis.  This was not my first trip to the interrogation room.  

Somewhere around the fourth beer, Miss Tuyet leaned over me and accidently pushed her left breast into my ear and I smiled.  The communist party member sitting across from me saw this.  He smiled and gave me the thumbs up.  It's  really all about common ground, isn't it?

The beer flowed and more food made its way.  Behind me sat 2 more cases of Saigon beer and one case of Heineken, my translator’s beer of choice.  No beer shortage today.  The doctors  toasted each other and then me and then each other……..and then me……and this went on every five minutes for the next two hours.  Sometimes we toasted across the table, sometimes just to the person next to us. Not knowing who and when to toast is culturally stressful, but I just went with it.  I have another American colleague with whom I travel  occasionally and I noticed that he never drinks with the doctors at lunch time.  I see the polite, distrustful way they regard him, regardless of his personal choice for his own personal reasons.  Walls are constructed, assumptions are made and words are spoken after the meetings.  Not me.  I’m a company man and a team player..  I"m up for whatever it takes for the foundation. In for a penny, in for a pound.  

I’m still not drunk enough to dig into the baby octopus.  You can drink with these committee members, but you must remain a few  degrees less sloppy than them.  It's political.  Have to stay sharp.  Also have to restrict your food choices to  those that will not make you lose face by vomiting  or shitting yourself  (though in certain circumstance this can be an ice breaker).  I know what to do.  This isn't my first dance.

Miss Tuyet, one more block of bacteria-laden ice please, my beer is getting tepid.

"Not bad with a little hot sauce."

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