SARS, Bird Flu and Hemorrhagic Fever

Civet cat continues to be served in many restaurants in S.E. Asia, despite being the suspected source of SARS

Over the past several years, I’ve been at the heart of several internationally-feared viral outbreaks. 

I was in China during the height of the SARS epidemic in 2003. The outside world was lead to believe that the entire focus of SARS was in Guangdong and Hong Kong, but in fact the epidemic, and the resulting crackdown, spread throughout the country. I was in Sichuan and Yunnan much of the time, and there were rumors that local hospitals were full of patients. Most tourists fled the country by April, and volunteers for groups like the peace corps were evacuated. Traveling between provinces meant quarantine and compulsory health exams, including chest x-rays, blood tests and temperature checks. Public transportation stopped every 30 minutes for sanitation and health check-ups. The purposefulness of the checks was questionable however, as individuals with fevers were often allowed to continue on their travels. There was a complete crackdown on the flow of information, as the internet was shut down for more than a week during the worst part of the epidemic.

The bird flu epidemic stands in complete contrast. I was in Vietnam during the height of America’s hysteria, and while it topped headlines in the US news media, back in Vietnam it had little effect on our lives. For a brief period, restaurants did stop servicing poultry, and some locals briefly modified their diet to limit consumption of chicken or duck, but overall, no one really cared and paid little attention to the news. 

The one thing that really bothered me, was how health officials and the news media told the public that the bird flu was a serious concern, yet it was safe to eat cooked poultry (because heat killed the virus). While this might have been true to a point, it ignored the risk (in theory), that workers faced by handling the live poultry before it found its way to a tourist’s dinner plate.  

During this time, many of my Vietnamese friends went to a traveling health clinic to receive free vaccinations. I was shocked when I asked them what the vaccinations were for, and they told me they didn’t know. I’d never submit to “free medicine” without know exactly what it is—even back home in the USA. I suspect they were receiving experimental vaccines for the bird flu. 

In the end of course, the bird flu turned out to be empty hype. I believe it was a scare-tactic used by healthcare organizations to drum up funding for future programs. The news media was also happy for headlines during an otherwise slow news period. 

About two years ago there was a terrifying outbreak in Sichuan, China, of a little-known virus carried by domestic pigs. It was a hemorrhagic fever similar to Ebola, yet far worse. People who contracted the disease died from internal bleeding in less than 24 hours after coming into contact with humans or pigs affected by the disease. At first the disease spread rapidly. So aggressive were the government’s quarantine measures however, that the virus appeared to burn itself out due to a shortage of available victims. The government’s communication crackdown was also so effective that the story never appeared in the international media, despite the previous obsessions with the bird flu and SARS.

My experience with these outbreaks overseas has taught me several things. First, use common sense, and always practice good hygiene. Even just washing your hands with soapy water periodically makes a big significance. Secondly, don’t believe everything the government or media of any country says without question. There are motives beyond your individual safety, including national pride, preservation of the tourism industry, protection of healthcare agencies, and the prevention of widespread panic.  

Michael Palin at Tiger Leaping Gorge

I’m doing some background research for a chapter on my trek through the Tiger Leaping Gorge in China. I’m looking for filler information—facts, figures, culture and history—things I might have missed or forgotten. I’m surprised to find that despite being one of China’s greatest tracks, there is very little material out there about it or the surrounding area. Perhaps it’s because it’s such a difficult place to get to, and the hike itself is dangerous in spots.

I am pleased to know however, that veteran traveler Michael Palin (one of my heros, also of Monty Python fame), has not only hiked the gorge, but that I had the privilege of hiking it a few months prior. It’s always nice to beat someone you look up to at a notable accomplishment.

The inn where Palin and I had breakfast, on seperate occasions.

Palin is ever so gracious in that he posts all of his books on his website; allowing registered users to read them free of charge, with the benefits of extra photos and multimedia supplements.

As I was reading his chapter on the gorge, I was amused to find we shared the same sense of vertigo. In his book Himalaya, Palin writes, “Lunch is easily walked off on a thigh-stretchingly steep climb known as the 28 Bends. Trudging upwards in a tight zigzag, I count off each one carefully and still find another 20 left at the end.” He later writes “When I stop on a narrow ledge to look around me, I find myself having to plant my feet very securely, for it feels as if the soaring vertical walls across the gorge are exerting some magnetic force, determined to tear me from my flimsy ledge.”

I remember climbing this stretch all too well, on hands and knees the whole way. It was so steep, and I was so exhausted, that I could not bring myself to stand upright, for fear I would tumble ass over tea kettle over the cliff. Needless to say, along with my numerous spelunking expeditions in college, it was one of the most treacherous hikes I’ve ever done.

Palin and I have similar shots of pack mules navigating around a ridge on the trail. He comments "Have never experienced such vertiginous feelings as I have when sandwiched between the 13,000-foot-high (3960m) walls of the gorge. Soaring verticals seem to create some magnetic force which makes me think I might be able to fly. Fight to resist the urge."

Potty Talk

Everyone knows that in Asia, it’s common to squat and bring your own toilet paper. But what do you do when all you find is a cement slab and a bucket half-full of water?

In Vietnam it’s a common assumption that if you live where you can bury it or wash it away in a stream, then you don’t need indoor plumbing. My friends who live in the dunes around Mui Ne simply direct me up in the hills (by the way, never squat on an incline when you have diarrhea). My friends who live on the ocean-side direct me to the shore. I’ll never forget my first walk along the beach near the Phan Thiet wharf and wondering why so many people were sitting in the mud. My friends that live along the cemetery direct me to “unoccupied” graves. I found that after dark it’s hard to get the thought of ghosts pulling me back into an empty grave with my pants around my ankles.

When I first bought my house and was putting in the bathroom, I decided to put in a traditional squatty potty. I was so accustomed to it by then, that I saw no point in a Western toilet. Squatty potties are easier to clean, good for maintaining lower-body strength, and are better suited to the way the human body is engineered. The bathroom plumbing all worked by gravity, which was cheaper (and since I didn’t have a private well, my only real option), but in the end it was a big mistake because the water pressure wasn’t strong enough most of the time. Even so, my friend helping me was worried I was spending too much money. He tried to convince me that I didn’t need an indoor toilet. He could teach me how to use the stream below his house (he lived behind me), like his family does. Remembering that the stream was barely a trickle that seeped out from the bottom of the hill, I knew that would never work for me. What was worse however, was that the stream-toilet also doubled as the family bathtub and the dish washer.

Toilet paper is always in short supply. In a pinch I’ve found new uses for pages in books I’ve already read, socks, receipts, and low-valued Vietnamese currency when I’m really hard-up. Some people never find what the need. For this reason, never touch ANYTHING in public bathrooms.

Using the toilet is always an adventure in Vietnam, but it can be just as perplexing for my countryside friends when they encounter a western-style toilet. I’ve found a lot of footprints on toilet seats in hotels where someone climbed on top the seat itself and squatted. Eventually they seem to figure it out, but I’ve still not solved the cement slab with that bucket of water.

Cay Trung Ca

A Fish Egg Tree, or Cay Trung Ca in Vietnam, is known as a Jamaican Cherry Tree in much of the world (it’s scientific name is Muntingia calabura). Although I’ve read it’s a native of the American tropics, it’s found frequently lining streets in Vietnam. It’s a small tree with branches that spread out like an umbrella, creating a thick, tightly woven canopy that’s perfect for shade from the sun and shelter from the rain. The flowers are white and quickly producing small, red, edible berries which look like fish eggs. The tree produces fruit perpetually once it is just a few months old. It thrives in poor soil with little moisture, and grows rapidly, even where other plants will not grow at all. For all of these reasons, it is my favorite tree in Vietnam.

Fish Egg Trees grow in many places that have been memorable to me as well. They grow in front of my friend Khiem’s house, where I meet him to drink beer and eat dried squid and stuffed crab at the harbor. They grow in front of the district police station where I always pick a few berries before I go inside to renew my residence permit every month. One grows above the stand in Mui Ne where I eat banh canh and drink peanut milk with my friends after work. They grow all along the streets and markets of Phan Thiet, and in front of the home of many of my closest friends.

I planted three in front of my house in the graveyard, where I anxiously watched them grow day by day. The sun baked my house in dry season, making it unbearable in the afternoons. I hoped their bows would absorb some of the heat. The lorries sped by every morning, kicking up dust that settled in my living room. I hoped that they would buffet the filth and save me some cleaning. The mourners on their way to the cemetery every day would peer into my windows and chatter about the strange foreigner living in the cottage. I hoped the trees would finally give me some privacy. The birds and bats nested in the holes in my roof, dropping babies in my shoes. I hoped the trees would provide them with a new home and forget about mine. Even with a new brick wall around my front yard, the neighbors still snuck in at night and stole my orchids and water jars. The trees finally give me a place to hide things out of view. I took great pride in the Fish Egg Trees as they thrived and met all the hopes I had for them.

Fish Egg Trees to me, are a symbol of comfort, the best of my life in Vietnam, and the dreams I’ve had living there.