An Early Christmas in Da Nang



Last Saturday, I woke early to the sound of motorbikes zipping past our Da Nang townhouse. What would I see when I looked out the window? The previous day, scarcely any riders had worn helmets in town, but this day--15 December 2007--was slated to be the first day of Vietnam’s mandatory universal helmet law. Both the Vietnamese government and international groups such as the World Health Organization have long been aware of the on-going tragedy of Vietnam's insanely high rate of traffic fatalities—among the highest in the world. The Vietnamese government and various NGOs (non-governmental organizations) have made repeated attempts to resolve this problem over the years. Back in 2000, Bill Clinton, during his final trip abroad as president, helped kick off the “Helmets for Kids” project, presenting Vietnamese school children with specially-designed motorbike helmets, produced by the Asia Injury Prevention Foundation-supported ProTec helmet factory of Hanoi. Over the years, various helmet laws, limited in both scope and enforcement, have come and gone. Public awareness projects have flared up briefly and then subsided. Seven years after Bill Clinton’s historic visit, motorbike helmets on city streets are still rare enough to attract notice and derision. And even though most Vietnamese are aware of the prevalence of deadly motorbike accidents, that awareness is not sufficient to convince them that they, personally, should be wearing a helmet as they travel the streets of the city. The excuses they offer are astonishingly varied—but it all boils down to the fact that they would never wear a helmet unless they were forced to do so.

So, finally, that’s what the Vietnamese government decided to do. For several months, short and poignant public awareness spots on TV have dramatized the often tragic aftermath of traffic accidents. Since the imposition two months ago of a new and stricter helmet law affecting the main roads outside of town, television news shows have highlighted the vigorous and effective work of the police in enforcing that law. Also featured on local and national news have been the helmeted workers of the Da Nang Health Department and interviews with yours truly at the Da Nang Rehabilitation Hospital along with video images of brain-injured patients at our hospital.

Local shops have offered heaps of brightly colored helmets for sale in recent weeks, yet they seemed to be worn primarily by travelers entering and exiting the city—rarely, if ever, by locals. It’s really hard to believe that everything could change overnight.


But it did.

I padded over to my window on Saturday morning, with all the anticipation I’d felt as a child on Christmas morning. (Would there be snow on the ground? Presents under the tree?) Gazing out my third floor window, through tears of joy, I saw that every single rider passing by was wearing a brand new, brightly colored protective helmet.

For me, it was Christmas.

 

A View From Outside the Box



Here’s a confession: the person who most captured my imagination during the 2004 American presidential campaign was Teresa Heinz Kerry. She was attractive, out-spoken, and very, very rich. And her job was to distribute the assets of the Heinz Family Foundation in ways most calculated to benefit humanity. How cool was that? Wow, I thought, I wish I could be a billionaire--I wish being a philanthropist was my job! It didn’t seem like a reasonable goal at the time, but it was heartfelt.

That wish came true.

To be completely honest, I’m a billionaire in terms of Vietnamese currency (at an exchange rate of 16,000 Vietnamese dong to one US dollar), and I don’t draw a salary in my new role as “professional philanthropist”—but I do run a US-registered non-profit organization from my new home in Vietnam. I am certainly rich by Vietnamese standards and my family lives quite comfortably here, while I am free to do the work of my new organization: Steady Footsteps. How cool is that?

What would you do if you realized that, compared to most of the world’s population, you were very rich indeed? What would you do if you decided that the things that you were clinging to –job security, rising home equity, readily available health care, and a democratic government—were illusory? Would you hold fast to your present lifestyle—or would you consider doing something “radical”?

American Physical Therapist Runs Amok



Well, here’s something I didn’t see coming: I’m now doing speech therapy for Vietnamese patients. How strange is that?

I’m not an Occupational Therapist, but I play one in Vietnam. Now, it appears that, by default, I’m playing Speech Therapist as well. Weird, when you think about it, especially since I can barely pull together enough Vietnamese to order banana pancakes and tea in the morning! More prosperous countries have highly trained, experienced physical, occupational and speech therapists. Here, in Central Vietnam, minimally qualified PTs are the only therapists patients will ever see. There just aren’t any OTs or speech therapists here.


Lately, I’ve been luring therapists and patients away from the high, narrow treatment tables of the crowded “PT” area of the hospital and into the newly provided “OT” room in order to get them to try more functional upper extremity activities. There, we work on hand-eye coordination, trunk stability, combination hand-and-arm movements, and bilateral upper extremity function. Having a cabinet full of donated wooden puzzles has allowed us to see that some of the non-verbal patients have pretty sophisticated problem-solving abilities. We’ve also uncovered previously undetected visual and perceptual deficits in this setting. We check patients’ ability to follow verbal commands versus visual demonstrations. Today we experimented with one-step and two-step commands to look into memory issues. And we asked some patients to verbalize about their activities--what color is this?—and so forth. I couldn’t do any of this, of course, without Mieng, my trusty translator. This weekend, Mieng is stocking up on large-print and picture books, markers and notepaper. We’re going to see what we can do with a post-meningitis patient who, we now realize, has double vision and a stroke patient with right-sided paralysis who has word-finding issues and difficulty reading.

I always urge my student therapists to take a functional approach when evaluating and treating their patients. But “activities of daily living” in Vietnam do not necessarily equate with ADLs in my former home country of America. Today, for example, I learned I’ve been operating under a mistaken assumption. I didn’t realize that most families in Vietnam sit and eat their meals on the floor. Many of our patients have difficulty feeding themselves in the hospital when they sit perched on the edge of their bed, without a table in front of them. I thought that issue would be resolved once they returned home, as long as the family ensured that they sat in a chair at the family table. Not necessarily true, if there’s no table or chair at home, eh?

Earlier, I was stunned when a right-handed woman with a paralyzed left arm told me that she could not eat rice.

“Why not?” I asked.

“Obviously,” she told me, “because I can’t hold my rice bowl in my left hand!”

I thought, at the time, that I’d resolved that issue by instructing her to set the bowl on a table with a little piece of rubber mesh under it to prevent it from sliding around while she scooped up rice using a spoon in her good right hand. Now I realize that she probably never eats at a table at all.

Live and learn.

HELMETS IN THE NEWS



Two years ago, as we sat in a little restaurant in Da Nang, Vietnam, the proprietor walked up and offered us his sincere condolences on the unfolding tragedy in New Orleans. That’s how we learned about Hurricane Katrina. George Bush, apparently, didn’t get the message until some time later.

We were visitors to Vietnam in 2005, just finishing up a short stint as Health Volunteers Overseas (HVO) volunteers at a rehabilitation center in Da Nang. Now, here we are, two years later, living and working in Vietnam and participating in a great national effort to stem the rising tide of death and disability resulting from motorbike accidents.

There are, today, 3401 employees of the Da Nang Department of Health who wear helmets provided by Steady Footsteps to work every day. They do this in order to protect themselves and because their co-workers wear helmets, too. But—bottom line—they do it because the Da Nang Health Department now mandates helmet use and employees may not report to work without them. This is the essence of the agreement that we signed with the Department of Health: Steady Footsteps would supply the helmets if the DOH would mandate their use.


Beyond the immediate effect of ensuring the safety of those 3401 employees, however, this project serves as a model for other governmental groups and businesses. Our project has been featured repeatedly on Da Nang TV News, as well as VTV1, based in Hanoi. Footage of my address to the officials of the Department of Health (my mouth moves, but the TV anchor supplies the words), images of brain-injured patients at the Da Nang Rehabilitation-Sanatorium Hospital, and interviews with helmet-wearing workers arriving at Da Nang General Hospital are combined with media exhortations to be safe and wear a helmet.

On the horizon, now, is a new national law which will mandate helmet use by all motorbike riders by the end of this year--an enormous milestone in a nation where 38 people die and many more are permanently disabled every day in traffic accidents. Compliance, though, is not guaranteed. To that end, the next project for the Steady Footsteps crew is to translate and print booklets based on the text of my August 5 post and then to distribute them to the 30,000 students of the University of Da Nang. We thought we’d back up the letter of the law with some vivid descriptions of what happens if your brain is injured—but you survive. We’re planning to include a University of Da Nang helmet sticker with each booklet. These high-achieving universty students are role models for all the younger kids. Whatever they do—whether they flaunt the law or wear their helmets proudly--will have an enormous effect on what other young people decide to do.

The $25,564 USD cost of the Department of Health Helmet project took a big chunk of our personal savings. Printing up 30,000 booklets and stickers is going to take even more. Any contribution you might feel led to make to Steady Footsteps to help in this work would be hugely appreciated. It is a rare and wonderful thing to be able to make this big an impact on a society. Please consider helping us to continue in this work.

 

Traumatic Head Injury As Literary Device



I wrote this essay in response to the shock and dismay I felt when I learned that helmet laws in America are being systematically challenged and rescinded through the work of (fill-in-expletive-here) who utilize the internet to spread disinformation claiming, among other things, that helmets are dangerous.

I learned about traumatic head injuries in the usual way—by watching Saturday morning cartoons. I learned from Tom and Jerry that, if an anvil drops on your head, a tall bump will immediately emerge and little chirping birds will circle about your head until the next scene, when you will be fully recovered and ready to chase that mouse again. I learned more from watching movies. I learned that a blow to the head could cause amnesia—which could only be reversed by another blow to the head. And, as any fan of action flicks knows, a sharp thump to the back of the head will knock the hero out, but he’ll awaken 30 to 60 minutes later (whatever the plot demands) ruefully rubbing his head and muttering, “What happened?”

I didn’t learn much more about head injuries until I went to physical therapy school. I learned even more by working with head-injured patients over the next thirty years. Now I live in Vietnam, where traumatic head injury is one of the leading causes of death and disability. This is because, in Vietnam, motorbikes comprise 90 percent of road traffic and helmet use is rare. Thirty-eight people die everyday in Vietnam in traffic accidents—mostly head injuries from motorbike mishaps. But many, many more suffer head injuries and survive. Those survivors fill the hospitals and rehabilitation centers in Vietnam.

Phuong was a bright high school student--one of the few in Da Nang who was fluent in English and confident enough to speak to American and Australian visitors. One day she slipped off the back of her boyfriend’s bike and struck her head against the pavement. Now, a year and a half later, she can walk again and her hair has grown in enough to camouflage the deep depression in her head where her scalp lies directly over the right half of her brain. She even recalls a few words of English. If she concentrates really hard, she can stand at the sink and wash dishes under her mother’s supervision. But her bright academic and professional future is gone now and her mother has grown to accept the idea that her once brilliant daughter will always remain an impulsive child.

Dr. Lam has spent the three years since his motorbike accident searching for the Holy Grail—a therapy that would give him back the use of his left hand so that he could resume his work as a surgeon. Ours was the third rehab center he had tried. He arrived with his youngest son in attendance and was delighted to find a foreign-trained therapist. He offered me his wizened left hand to examine. “I’m so sorry,” I said, “but when we see no evidence of muscle return after all this time, I have to say that I see no hope that you can regain enough use of your hand to do surgery again.” I talked to him, instead, about teaching medical students those skills that he could no longer perform himself.

Mr. Cuong was an engineer and the father of three until a van made a right turn from a left lane and knocked him from his motorbike. His younger sister has been by his side for the three months he’s been hospitalized, while his wife cares for their children at home. His sister spoon-feeds him soup between his chokes and sputters. His progress in therapy has been slowed by recurrent bouts of pneumonia, caused by his inability to consistently direct food into his stomach instead of his lungs. Mr. Cuong can’t speak and can’t understand verbal commands either, which makes teaching him exercises and understanding his concerns difficult. One day last month, his sister, his therapist, a student therapist, my translator and I encircled him as he sat in a straight-backed chair and tried to puzzle out why he appeared to be so agitated. Failing that, we elected to go on to the most basic non-verbal exercise I know: Stand Up! With his therapist on one side and me on the other, we hollered, “MOT, HAI, BA!” and hoisted him up onto his feet. Mr. Cuong grimaced and grunted and stood up--and dropped a steaming load of shit from his shorts onto the floor. Nervous giggles all around. Oh. That’s what he wanted to say.

Identity Shift



Another essay written while I attended the Iowa Summer Writing Festival last month.

A year ago, my American family and I crossed the international date-line and stepped into Vietnam with new identities.
 My Vietnamese-born son was raised in the US and speaks only English. In crossing that line and returning to the land of his birth, his identity shifted from “short, funny, confrontational Asian dude” to “tall, rich, good-looking mute American.”

My tongue-tied, under-employed house-husband became a strong, silent American philanthropist.

And I, a relatively tall, middle-class, politically progressive physical therapist, became a gigantic, wealthy, authority figure with an enviable nose.

It’s an odd experience to have lovely, leggy Vietnamese barmaids walk up to me and stroke my nose in admiration. Odder still to have become a frequent guest lecturer at the University of Da Nang, based solely on my ability to speak English fluently. I’ve become a valued resource for international humanitarian groups and traveling surfers—just because of where I live.

What determines value? Location, location, location!

VORTEX



I was sucked into the Vortex gift shop one Sunday evening while I was visiting Iowa City. I returned again on Monday to make sure I had not dreamed it.

The Vortex is exactly the sort of clever, crafty gift shop where I would once have stood and agonized over which clever novelty gift to get for whom. Who would best appreciate the Marie Antoinette action figure with “ejector-action” head? Could the Nelson Mandela combination finger puppet/refrigerator magnet be given alone, or would it go better, perhaps, with Joan of Arc or Karl Marx? Would a $2.95 tin of peach-flavored “ImpeachMints” with an enameled image of GW Bush make a nice stocking stuffer? Maybe the box of “IndictMints” with VP Cheney and Karl Rove in black and white prison garb would be a better choice?

These whimsical novelties still tickle me, but the context of my life has shifted dramatically since last I perused an American gift shop. My refrigerator now is in Da Nang, Vietnam. And the friends who visit me in my home, while they can speak and understand basic English, would be completely mystified by these artifacts of American culture. And, even if I could, with painstaking effort, explain the elements which combine to make these visual jokes work—there is absolutely no way that I could explain why I had seen fit to spend the equivalent of a month’s school tuition just to make a joke by purchasing an item that has no practical use.

The joke implied in the purchase of these items is that we feel that we are exposing the superficiality of American consumer culture. The larger joke, of course, is that we are making our statement by buying more stuff. Read the small print on each package. It says, “Made in China.” Who’s laughing now?

Nostalgia



I 've just returned to Da Nang following a month in the American Midwest where I attended the 2007 FGC Quaker Gathering in River Falls, Wisconsin, as well as three weeks of workshops at the Twenty-First Annual Iowa Summer Writing Festival in Iowa City, Iowa. What follows are a few essays that I wrote during that wonderful month of July 2007.

I’ve come home to Iowa City. The little restaurants peppering the streets serve all my favorite foods, prepared just the way I like them. The quirky gift shops lining each block of the downtown commercial district offer items that suit my taste and my sense of humor to a tee. I can visualize my father walking home along the tree-shaded sidewalks in his grey fedora. On N. Gilbert Street stands a sturdy stone house with a brass plaque that proclaims it to be the Wentz House. My father’s name was Wentz, as was mine, before I married.
 But I’ve never been to Iowa City before. I grew up in a split-level home in the suburbs of Washington, D.C., surrounded by other split level homes and just-planted trees that cast very small shadows. My dad, who did wear a grey fedora, drove to work in an Oldsmobile. His name was Wentz only because he’d rejected the family name of Wasiewicz as being too ethnic and too cumbersome. Our family was still in Poland when the Iowa City Wentz House was built.

I felt that same sense of homecoming when my husband and I moved to a little farm in the Shenandoah Valley. It reminded me of the family farm described in my first grade reader. I'd always envied John, Jean and Judy their trips to their grandparents’ home to visit with the pony and the geese and the cows. That’s the way life should be, I thought. My grandparents lived in Jersey City.

I’m a sucker for historical recreations and spent my college years in Williamsburg, Virginia, at the College of William and Mary. When the academics got too intense I would nip over to Colonial Williamsburg and hang out in an herb garden and watch the sheep in a nearby pasture. But places like Colonial Williamsburg are scrubbed-up, Disneyland versions of history. In colonial times, the cobblestones were covered with a thick layer of horse manure. And if the historic smells of a whaling port like Mystic, Connecticut, were recreated, I’m sure it would dampen the tourist trade. We see only the elegant, bleached bones of history, like pure white Greek statues that bear no trace of their original garishly painted surfaces.

I live now in Da Nang, Vietnam, a vital city with a population of one million. Bus loads of tourists pass my home daily, heading for the near-by tourist town of Hoi An. Hoi An is full of shops that offer “traditional crafts” like wood and stone statuary, silk embroidery, and lacquer-ware wall installations. You won’t find any of these in a Vietnamese home. If my Vietnamese friends had that kind of disposable income, they’d buy a used computer, complete with pirated software. Their parents would have bought an electric fan or a television.

We long for a history that never existed.

What Season Is This Anyway?



It’s that time of year when the women of Vietnam bundle up with hats, scarves, face masks, opera-length gloves, heavy socks, slacks and denim jackets. Colorful Christmas lights festoon the thatched-roofed bars and medleys of traditional Christmas songs waft along behind the pedal-powered vending carts. Is Christmas approaching? Sorry, no. If it were, the fifty-foot tall Christmas tree constructed entirely of dark green Heineken beer bottles would still be standing in front of the supermarket on Le Duan Street in Da Nang and Santa would still be flying in a reindeer-drawn Heineken bottle over the streets of Hanoi. If it were New Year’s, we would still have an orange tree standing in the middle of our living room, next to the motorbike. It isn’t Halloween either, although the sight of gangs of Vietnamese women dressed up like gunslingers from the American Wild West might give you that impression.
 
 Summer has arrived in Vietnam. And all prudent women who care about preserving their pale good looks will stop at nothing to protect their skin against the intensified rays of the tropical sun as they travel about on their motorbikes. Ironically, many of these same women balk at wearing a motorbike helmet to protect themselves against possible death and disability from head injury because they think helmets look too strange!



Speaking As An American



I’ve just read the most wonderful article in CommonDreams.org, entitled, BEING HOPE, by Kathy Kelly, in which she talks about an address she gave at the request of the American Friends Service Committee at the conclusion of the recent Chicago display of the AFSC’s EYES WIDE OPEN exhibit. After finishing Kathy’s article, I read the comments that various readers had posted. One, in particular, caught my eye, and I felt led to respond. Here’s the text of the response I posted on CommonDreams.org:

Virginia, June 1st, 2007, 9:02 AM

I love this article. In the parlance of my Quaker tradition, “It speaks to my condition.” Kathy Kelly is certainly someone with her “Eyes Wide Open.” How fortunate for us that she is also so gifted in expressing the truth as she sees it.

In reading through the comments that followed the article, however, I came across this statement:

I always lie about my nationality when abroad for the purpose of safety, and I encourage others to do so as well.
I could not disagree more strongly with this position. I am an American, living in Vietnam, engaged in humanitarian work. People here are emerging from a bleak and isolated period of history and–what is the light that they see at the end of this tunnel?

Capitalism and American style consumerism!

And what is the ultimate dream for many Vietnamese?

Moving to America and finding work as an acrylic nail technician.

SUVs have been popping up in Vietnam like mushrooms this year. Frozen American chicken is sold in the new supermarkets. You need to buy health insurance or be rich to ensure your access to adequate medical care—in the SOCIALIST Republic of Vietnam. People with credibility— Progressive AMERICANS—need to stand up and say, “Hey, wait a minute! Let me tell you some of the downsides of capitalism and the American way of life.” You can’t do that if you deny your nationality and, believe me, these things need to be said. Books about Bill Gates and Lee Iaccoca fill the bookstores. Cable TV has arrived, with all the capitalist propaganda that involves. There’s nobody to counter the seductive siren of American-style consumerism if you don’t raise your voice—or at least turn a thumbs down when a Vietnamese taxi driver shouts, “George Bush, Number One!”

When I am invited to speak at college English classes–they like my clear American pronunciation—I make a point of talking about the hopeful changes that I see in Vietnam and of the diminished expectations we now have in America.

Here’s a telling quote from Vietnam Investment Review:
GE could exploit opportunities in infrastructure, health care, finance and human resources.


American corporations are pushing their version of reality with all the slickness that Hollywood and Madison Avenue can muster. Can you imagine how powerful and seductive their visions are to people just emerging from decades of poverty and cultural isolation? We, as concerned individuals, need to counter that. And, in the more intimately personal social encounters that are common in countries where people are not cocooned in cars and suburban fortresses—we can have an enormous impact. But our credibility arises from the fact that we are American—and we know whereof we speak.

By the way, I suppose that I have more credibility than most because I let go of my American life. It totally blows Vietnamese minds when I say that I have no intention of going back to the US. And then I tell them why . . .

Letter to Cindy Sheehan



I read Cindy Sheehan’s sad, bitter letter of resignation from her de-facto position as the face of the American anti-war movement and felt led to mail Cindy this letter from Vietnam.

30 May 2007

Dear Cindy,

Thank you so much for the energy, devotion and imagination that you have devoted to the cause of Peace. Your efforts have been magnificent. I am so very sorry that they were not more effective in changing the direction of the American government. I, too, have lost hope for America. I worked hard in the days leading up to the 2004 Presidential election and was absolutely floored when King George was re-elected. I know that the election results may have been tampered with in some localities, but the fact that something even approaching 50% of the American electorate chose to re-elect him staggered me! With a public that brainwashed and a “free press” that deeply enmeshed in the brainwashing process, how is any positive change possible? Even so, my hopes were re-kindled when the Democrats won control of both houses of Congress and we seemed to have some savvy leaders in charge. What a disappointment! This system is so distorted that it is impervious to meaningful change. And I agree with you about the divisiveness of the Left. When I read “liberal” responses to Rabbi Michael Lerner’s call for a new, compassionate approach to counter the politics of fear that Bush and Cheney endorse, I am horrified at how tone-deaf and self-righteous his agenda-driven “left-wing” critics are. How can we possibly build a consensus when good-hearted people who reach out to us all are attacked from both the Left and the Right?

Let me tell you what I did to lift myself out of the feelings of despair and hopelessness that I experienced in the aftermath of the 2004 elections:

I left America and moved to Vietnam!

There were quite a few intermediary steps—a short-term volunteer trip to Vietnam; establishing my own non-profit organization (Steady Footsteps, Inc.); deciding to quit my job and sell my house and then—taking the money and heading to Vietnam to live and to do charitable work where people still suffer from the results of a previous American adventure, but where life is now peaceful enough that a middle-aged American woman can live securely and do meaningful work.

You have done so much good work and endured so much negative crap! Can you imagine a life where you could use the positive contacts that you have to do meaningful work in an atmosphere of appreciation? Consider this: the cost of living comfortably in a peaceful third world country is very low, compared to America. Likewise, the cost of making meaningful changes to poor people’s lives is very low, by American standards. The trick is to actually live in the poor country, rather than travelling to it now and again and relying on quick visits to figure out how best to help people.

I am not rich by American standards at all. I am living and operating my modest charity on the proceeds of selling my American house. You might not be so fortunate as to own a house free and clear, but I’ll bet that you have the potential for generating a decent advance by committing to writing a book. Consider taking that sum and starting a new life and a new humanitarian organization outside of the US. It doesn’t have to be a huge operation at all. My own organization consists of me and my husband and the young woman that I’ve hired as a translator. I volunteer as a physical therapy clinical instructor at a rehabilitation hospital in Da Nang three mornings a week. The remainder of my time is free for reading and writing and working on other projects that interest me (like getting all the health care workers in Da Nang to wear motorbike helmets when they travel in town). I don’t cook and I don’t do much shopping. My life is far more relaxed than it ever was in the US—and much, much cheaper! I keep in touch with the world and with my friends via high-speed internet—whenever I’m in the mood.

Again, thank you so much for all you have tried to do for America—and for the people of Iraq. You have been an inspiration to me and to many others. But consider, now, an alternate life. Consider leaving the US, not because you despair, but because you can find a new way of leading a meaning-filled and peaceful life.

All my best thoughts are with you,

Virginia Lockett, PT
President and Founder
Steady Footsteps, Inc.

Stepping Out on Faith



My husband Dave and I returned from breakfast this morning to find a large envelope from the Vietnam Office of the World Bank on the doorstep of our Da Nang townhouse. In English, atop the single enclosed page were the words: "Innovation Day, Traffic Safety," so we know that this message refers to the grant application we submitted a month ago requesting assistance in covering part of the expense of providing motorbike helmets for each of the 3079 employees of the Da Nang Health Department. However, the text of the message is entirely in Vietnamese. Dave and I can identify some words: "I", "we", "very", and dates—but the bulk of the message is a mystery to us. Dave is attacking it now with the aid of his pocket Vietnamese-English dictionary and I am sitting across the room, writing and reflecting on how we arrived at a situation in which we have committed to a twenty-three thousand dollar project on behalf of Steady Footsteps, an organization that is, at the moment, without funds.

This episode is consistent with what Dave and I have been doing for the past year and a half: Stepping Out on Faith. In 2005, we took a big step in deciding to quit our jobs, sell our home and move to Vietnam. Committing to the legal process and expense of setting up our non-profit organization, Steady Footsteps, was another big step. And yet every day, here in Vietnam, I find myself taking small steps on faith. Each day I arrive to volunteer at the Da Nang Rehabilitation-Sanatorium Hospital without a specific agenda. Every time I insert myself into a specific situation there and open my mouth to speak, I consciously try to center myself and be a channel for truth and for blessing. That might sound pretentious, but it's true. This was not the way I was living back in America. But here, I can be my own best self. Not so much by intention but, rather, by following incremental leadings-- step by step--I've developed a lifestyle which allows me to live a better centered and more conscious life than I ever did in the US.

 Life in Vietnam, for me, is less stressful than was my previous American existence. I no longer have a house to maintain. I don't cook and I rarely shop. I don't even drive. My commute to work is one mile each way, seated on the back of my translator's motorbike. There's a lot to be said for simplicity. A less cluttered life allows me more time for reflection; for reading and writing. And I find that when my own life is not so pre-programmed and anxiety-driven, that it's easier to pay attention to, and act upon, feelings of empathy and generosity.

 I work limited hours at the rehabilitation center. I set this up intentionally as I want to be a mentor for the Vietnamese physical therapists and physical therapy students, but I don't want to assume primary responsibility for the care of their patients. I want the therapists to learn to be better clinicians; I don't want them to abandon their patients to my care. Another result of this more limited schedule at the hospital, however, is that my work never becomes routine. I am able to observe and respond to situations there with a fresh perspective.

 I am not scheduled by supervisors, nor am I responsible for revenues or documentation at the hospital. I can move about and interact with whatever therapist, student, patient or family member seems to need my help. This, more than anything else, I believe, allows me to be in the right place at the right time.

 I can't speak casually with any of the hospital staff or patients as none of them is fluent in English and my command of Vietnamese is not remotely equal to the task of communicating what I know about the art of physical therapy. I must rely on my translator. I have to carefully consider how my words might be interpreted and there are long pauses in any discussion to allow for the translation process. These pauses and this awareness of the tenuousness of verbal communication give me a lot of time and opportunity to "Be Here Now." I have much more opportunity and incentive to study people's body language and facial expressions.

 I have been amazed, for example, at how easy it is for me, even as an English speaker, to recognize when a brain-injured Vietnamese patient has receptive aphasia (difficulty understanding his own language). I can even distinguish between someone who has dysarthria (difficulty producing the sounds of speech) vs. expressive aphasia (difficulty recalling words). And yet what seems obvious to me, as an experienced therapist, is not at all apparent to the minimally experienced PT's with whom I work.

 It occurred to me yesterday that the essence of what I want to teach is not in any physical therapy curriculum. I didn't even articulate it very clearly when I wrote the original mission statement for Steady Footsteps. Here's what crystallized that realization for me.

Yesterday morning, I walked into the physical therapy gym and saw a young man with a deformed skull strapped down on a high, narrow treatment table. His therapist, a tall, handsome young fellow named Lam, was vigorously and repeatedly flexing his patient's leg. The patient's face was twisted with pain; the therapist was staring off into space.

"Hey," I said, "do you realize you're hurting your patient?"

"Well, I told him to tell me if it hurt him. He didn't say anything," responded Lam.

"Is this man really able to speak?" I asked, looking quizzically at the young man who was obviously paralyzed on his right side. (Right-sided paralysis is often associated with language difficulties.)

"Well, no, he doesn't talk much," admitted Lam.

"So how is he supposed to tell you that you are hurting him? I don't speak Vietnamese, but I can look at his face and see pain there. How can you know what is going on if you are not even looking at him? You are trying to increase his range of motion. In order for you to effectively stretch his tight muscles, he must relax. He cannot relax if he is in pain. Watch his face as you work with him and you will learn how to help him without causing him pain."

I felt that I had made my point and went on my way. Later, however, I returned to find the patient, again strapped down on the table, looking more distressed than ever. This time, his therapist was looking directly at him and laughing.
 
"What are you doing?" I asked. "You know that this brain-damaged young man does not understand why you are doing these things to him. He is feeling discomfort and yet you look at him and laugh! What can he be thinking? Does he think that you care about him and that you are trying to help him? I don't think so. When he is strapped down on that table he feels helpless and frightened and, to be honest, I don't think that performing passive range of motion is the best use of your limited time with him. Let's try something else."

With that, we helped the young man off the table and sat him down on a straight-backed wooden chair. I pulled up another chair directly in front of him. Lam and Mieng, my translator, stood to one side. Looking directly into the young patient's eyes, I smiled and held his hand gently. He smiled back. I helped him arrange his unruly feet flat on the floor. And then I pantomimed that I wanted him to stand up. Counting loudly to three in Vietnamese, "MOT, HAI, BA!" I helped him rise to his feet. I held him there and helped him shift his weight so that it was more directly over his relatively strong left leg. After about 30 seconds, we sat down. Each time we stood up, he seemed to "get it" a little more and make a more effective effort to arise and find his own balance. And each time I smiled at him and praised him profusely. It didn't matter that I was prattling on in English—he understood that I cared about him and that I was pleased with his efforts and, by the time we had completed our session, he was beaming broadly.

So what were the lessons of the day? "Being Present in the Moment." "Compassion." Traditional concerns in both my own Quaker faith as well as in my husband's chosen path of Buddhism. You won't find them listed in any physical therapy curriculum, but what other lesson could be more essential for a therapist—or for any other human being?

Addendum: Dave's translated enough of the World Bank letter for us to realize that we are out of the running for the grant money that we had hoped would help cover the twenty-three thousand dollar cost of the Da Nang Health Department Motorbike Helmet Project. Oh well. We still feel led to complete this project. We still believe that this project has the potential to help stem the epidemic of traumatic head injuries that is sweeping across Vietnam. So we will, again, "Step Out on Faith" and order those helmets from the ProTec factory in Hanoi. We would like to invite anyone who feels led to do so, to please contribute to Steady Footsteps, in order to not only help us finance this specific project, but also our other, more modest ones: providing plastic ankle braces (AFOs) and other assistive devices for disabled patients and providing the services of a reliable translator for any therapist who is willing to come and volunteer with us here in Da Nang. And if you should happen to know of any compassionate, functionally-oriented physical or occupational therapist with a ready ability to "think outside the box" and a special affinity for upper extremity rehabilitation of brain-injured and quadriplegic patients, please suggest that they contact me at valockett@gmail.com I would welcome their insight and, should they be adventurous enough to visit Vietnam, I'd be glad to help them arrange a meaning-filled visit with the rehabilitation community of Da Nang.

One Week in Da Nang



This week, at the far western end of our street, where the newest bridge in Da Nang crosses the Han River, a mismatch between a motorcyclist and a truck resulted in the cyclist sailing over the rail and into the river. His body has yet to be found. Later that same day, my son Tim and a fellow surfer from France helped drag a drowned Vietnamese schoolboy from the surf at the opposite end of our street (a second missing boy has yet to be found). That evening Tim said, “He was just green, man, and water kept foaming out of his mouth. I wonder if we could have saved him if we saw him earlier.”

In my Vietnamese class this week, we’ve been learning words for colors and animals and body parts: “I have a crab. It is purple. It has small eyes. It is delicious.”


Today brace-makers came to the rehabilitation center where I volunteer to fit six people for new leg braces that will, hopefully, enable them to walk with the “Steady Footsteps” that are the goal of my little non-profit organization. Six hemiplegic people, five paralyzed on the left side and one on the right, ranging in age from 27 to 80, watched apprehensively as the two orthotists casted each affected leg in turn. Next week we’ll see if the plastic leg braces (or AFOs as they are commonly called) will combine effectively with the new functional exercises I’ve been teaching the Vietnamese therapists to get these folks walking safely and well.

I bit the bullet and wrote a check to the IRS to cover the balance on my 2006 taxes, even though I have grave misgivings about the purposes to which the US government puts our tax dollars. The phrase, “Render unto Caesar the things that are Caesar’s” had risen, unbidden, to mind as I pondered what to do. Ironically, the amount that I sent to the IRS was offset this week by the rise in value of the non-US currencies in which we had invested the proceeds of the sale of our American home. There’s some poetic justice there, I suppose.

We found a local source for dried oregano and basil and parmesan cheese so that our best friend Tam, who has a little restaurant that caters to foreigners, can make spaghetti sauce that smells “just right.” “Wow, “said Tam, examining the plastic bag of dried oregano leaves, “that looks just like marijuana!” It did. I’m so glad that I don’t have to try to finesse a bag of oregano through customs for her on my next return trip from the US!

We got an official notice from the People’s Committee of Da Nang that the request of the Da Nang City Health Department that I be allowed to continue to volunteer at the Da Nang Rehabilitation-Sanatorium Hospital had been approved. Now, it seems that matters have been forwarded to the Da Nang Department of Foreign Affairs, regarding approval of my organization, Steady Footsteps. We’ve gone about our whole move to Vietnam completely backwards and yet, for us, in these uncharted waters, that’s the only way it seems to work. I’ve encountered organizations that have spent years waiting for official approval, collecting funds and building infrastructure before they did anything to actually help Vietnamese people. We did not. We just incorporated our little NGO, sold our house and moved to Vietnam with tourist visas and got to work. I have been called, as I blundered from one Da Nang government office to another, “The Woman Who Did Not Plan Ahead.” But there was no way for us to accomplish what we did sitting safely back in America. And there was no way we could afford to travel back and forth, building this endeavor up incrementally over several years. We felt led to make this giant leap—quitting our jobs, selling our house and packing ourselves and a few personal items up and heading for Vietnam. And it has worked out well. We are living comfortably in a pleasant corner of Da Nang, two blocks from the South China Sea.

Our son surfs daily and is enrolled in an accredited American high school via the internet. We use the internet also to maintain connections with friends and the news of the world. We have found wonderful friends here in Da Nang who guide us through the mysteries of life in Vietnam. Our cars are gone, we have no heating bills, and our expenses are low. We are doing good work here--at a slow enough pace that we can see what works and what doesn’t and adjust our methods accordingly. I’ve got time to read and to write. Who could ask for anything more?

Life As We Know It

 

There’s been a free-wheeling discussion going on in the pages of the beautiful environmental and literary magazine, ORION. It was inaugurated by the publication in their January/February 2007 issue of James Howard Kunstler’s article entitled, MAKING OTHER ARRANGEMENTS. Kunstler lays out the proposition that there is no magic technological bullet that will allow the continuation of the American suburban lifestyle in the face of declining oil production. He states:
American suburbia represents the greatest misallocation of resources in the history of the world.
And he pulls no punches in detailing the profound changes that the end of cheap and plentiful oil and natural gas will engender. He concludes by saying:

It’s a daunting agenda, all right. And some of you are probably wondering how you are supposed to remain hopeful in the face of these enormous tasks. Here’s the plain truth, folks: Hope is not a consumer product. You have to generate your own hope. You do that by demonstrating to yourself that you are brave enough to face reality and competent enough to deal with the circumstances that it presents. How we will manage to uphold a decent society in the face of extraordinary change will depend on our creativity, our generosity, and our kindness, and I am confident that we can find these resources within our own hearts, and collectively in our communities.
Kunstler’s article drew over 120 comments from readers, many of them quite thoughtful. One writer, though, I thought entirely missed the mark, and seemed to attribute the entire predicament on lack of population control. I felt led to post the following response to her comment in Orion:
 
No, no, no . . . it’s really not that simple at all. I am an American who has recently moved to Vietnam and I’d like to offer you the view from my perspective. I live in a relatively up-scale corner of Da Nang, Vietnam, a city of one million people. Here’s what I see out my window: one trash can per city block for everyone’s refuse. (The trash is collected daily after the “recycling ladies” pick through it for resalable items.) Fresh vegetables delivered to the market by farmers on heavily loaded old motorbikes or via city bus. A fisherman’s wife delivering the catch of the day in a Styrofoam box lashed to the back of a bicycle. Kids bicycling and walking to the local school. Adults travelling, two to a motorbike, to and from work and market. Hand-washed clothing hanging to dry on the balconies. Folks dining at open-air soup stalls with the proprietor hand-washing the bowls between customers. Buildings designed to maximize the cooling effects of shading and breezes. Delivery drivers pedaling their three-wheeled cyclos loaded with locally manufactured furniture. The population is not the issue. It’s that consumer-culture, petroleum-fueled American Dream that’s the issue. Waste and increased consumption of resources are becoming evident here in Vietnam--but only in direct proportion to the degree to which the population becomes more affluent and more enamored with American-style consumerism.