Vietnam – The DMZ and Hue

IMG_3724It was a 4 hour drive to the city of Hue from our last stop in the central highlands. Multi-hour drives in Asia are never easy on busted roads and always seem to involve a surprise 40 minute bathroom stop at the driver’s “cousin’s” pearl/jade/silk store. We opted to take a semi-private tour of the former Demilitarized Zone instead with the hope of making some of the stops more meaningful.

Our first stop was the IMG_3655incredibly impressive Vinh Moc tunnel complex when we reached the coast. During the war the US suspected that this village was supplying Anti Aircraft weapons and ammunition to a small island, which they were, that was shooting down planes flying north from Da Nang to bomb Hanoi. The town was north of the DMZ so was out of the reach of Marine or Army patrols making it a target of Naval Warships and Aircraft. An unbelievable amount of firepower was unleashed, up to 3 hours a day, causing the villagers to begin moving their village underground. The initial complex was 30 feet under the ground and was mainly a bomb shelter during attacks. The advent of American bunker busting bombs which could penetrate 10 meters into the earth before exploding rendered this depth up safe and the villagers would dig, with their hands, picks, and shovels, another 60 feet down for a total of 90 feet. There was a school, kitchens, a hospital and delivery room with 17 births during the war, guard houses and  homes for families. An entire family would live in dug outs along the corridors maybe 8×5 feet in size. While there were two wells for water there was one bathroom for several hundred villagers. All three levels of the tunnels stretched 1800 meters in length with exits in the village above, where a network of trenches connected houses, and at the beach below where they were resupplied by boats from the north. Not a single person was ever killed in the tunnel system during the war despite warships and planes dropping massive tonnage of ordinance, and they effectively disrupted US flights the entire time.

 

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Spending 15 minutes bent over double moving in those dark tunnels and thinking about all dirt above us was enough for Vanessa and I. We were very happy to emerge at the beach and breath fresh air.

After the tunnels we visited the memorial at the crossing of the Ben Hai River which the was traditional border of the north and south. Attached is a picture of how extensive the bomb damage was to the north where the tunnels were. The meuseum had a collection of US relics from captured pilots and a large collection of American weapons and explanations of how they were used to kill Vietnamese. A sobering experience to say the least and not as overtly propaganda driven as the Chinese museum in Tibet that we visited last year. Just uncomfortable in your face images of Americans waging war that needed to be looked at even if it smarted a little bit.

We arrived to the beautiful city of Hue and the not-so-perfume-smelling Perfume River. The dominating center of town is the old capital complex called the Citadel which was fashioned after the forbidden city in Beijing. A sprawling complex of ruins in various states of repair with some very nice exhibits of old imperial life. During the 1968 Tet Offensive Hue was over run, almost every single US outpost in Vietnam was attacked overnight, and the Vietcong held the Citadel for 4 weeks against the full US military. Hue saw the worst fighting along with the fire base Khe Sanh, and nearly all of the Citadel was destroyed by plane and artillery bombardment. Evidence off machine gun and grenade damage was everywhere along the walls and buildings and the battle was well documented by US journalist whose pictures were displayed thoroughly the exhibits. Projects supported by Dutch, German and Japanese grants are restoring many of the buildings to their former states but probably 50% is completely leveled. It was a great on your own tour and about 3 billion times

Less crowded than Beijings version!

Following a classic Dempsey Deathmarch to a pagoda, “come on honey the map says its only 4k”, we called it a day. The pagoda was a operating temple which was also the sight of the famous Monks self-immolation during the war in protest to the regime of South Vietnamese president Diem. One of the most published pictures of the war, it was hard to imagine as we sat looking out over the river, surrounded by Buddhas and the sound of monks gently ringing bells.IMG_3712

Our second excursion was by bike out to the suburbs and the old imperial tombs of the kings. They are vast and gaudy tombs with amazing architecture and sculptures. Some became castles of sorts after the people grew rebelliousabout the amount of money, and forced labor, used to build them. They represented the height of the great Nyugen Dynasty which ruled for much of the past thousand years. About 90% of the people carry that last name in Vietnam as a result we are told. Needless to say, biking through a Vietnam city in rush hour was a wild experience, especially when the breaks on your bike necessitate putting your feet on the ground to be effective, and we felt very accomplished after living through it.

Hue was a great city to spend a few days. For some some reason many Vietnamese had told us to blow through or skip it but we had a wonderful time. There was a great old city and backpacker seen there and it was fun to drink some beers, eat some pizza and watch all the grubby, bearded, and fresh dressed in “yes I bought these yoga pants in Thailand” outfits.

Now for a few days at the beach and then on to the great wonder of the world Angkor Wat and Cambodia.

Vietnam – Phong Nha Farmstay

IMG_3621We are wrapping up three days on a Farmstay in Phong Nha which is located in central Vietnam, about 50k from Laos and a few hours drive to Da Nang and the ocean.

Watching the sunset over an ocean of paddie fields from our hammocks, roughing it with a Mojito, listening to the water buffalo groan on their walk home, I think back on the two experiences we had here and how they were so different from each other in the emotions yet provoked but so interconnected through the people who showed their mountain homes to us.

Phong Nha is a 80k long river cave that starts on a smaller branch of the main river which runs through this valley. Three British explored the entire length of the cave in the 90s but no one has made it trough since then. During the flood season the water can rise to 90 feet high in the cave which shockingly does not even come close to touching the ceiling. Some of the larger chambers can fit a 40 sorry building, or the Statue of Liberty inside without touching the roof.

We took a boat into the mouth of the cave, which is very large itself, an then climbed into a beach and entered several larger chambers where massive stalagmites and stalactites grew and dropped from the floor and ceiling. Some 30-40 feet high. All the mountains here are limestone remnants of the ocean that once covered Vietnam and their signature shape can be seen from Southern China to Southern Vietnam. Water slowly works through the cracks and creates some of the largest caves in the world here.

Recently a cave called Hang Son E was discovered here and was found to be the largest cave in the world in volume with whole Forrest living inside beneath sink holes of collapsed stone. People repel down into the 300 feet deep pits and spend days inside the dark exploring. Maybe next year!

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Our second day took us on a tour of the Phong Nha national park which spans the border with Laos. Our guide had grown up here and his family has lived here for generations. It was on this tour that the trip became much more contemplative and often sad. The road we drove on was part of the Ho Chi Minh Trail during the war and for this reason was very heavily bombed during the final phase of the war under Nixon. Knowing that we were pulling our forces out shortly, we began a massive air campaign called Operation Linebacker, the same campaign I referenced in the Hanoi blog, which involved the greatest use of air bombardment in history. 600 tons of bombs were dropped from B52s per person in this area. Knowing that the HCM trail could not be located concretely, the planes were ordered to fly in lower that normal and bomb not only the fields but also the mountain in the hope of causing landslides which might block the road south or east into Laos.  Because our bombs were developed for use in industrial Europe in WW2 they very often landed without exploding in the soft mud of the paddies and jungle. It’s estimated that 30% of all the bombs did not explode in this area of impact. Our guide told us of many his childhood friends who were killed either by stepping on bombs while watching buffalo in the fields or by picking up the small cluster bombs and playing with them causing them to explode. There have been some 10,000 post war deaths in the areas along the DMZ since the war to date. We saw a number of bomb shells stacked in front of homes and many cluster bombs piled up which have been pulled from the fields. The beautiful lakes we can look out at here are actually not naturally formed but are  bomb craters which remain to be filled.

Phong Nha cave itself was a hospital during the war where they also hid a large pontoon bridge during the day. At night they would float it out and a convoy of trucks from Haiphong Harbor, carrying Soviet and Chinese weapons and diesel, would drive south towards the DMZ or into Laos. Once we found out about the cave we tried many times to get a direct hit into the cave with small jets with one successful hit. The cave is so deep and vast that it caused no damage but last year that American pilot actually came here and stayed at the farm where he talked with the farms owner, a woman who maned the AA guns shooting at him, On that same day. Must have been an interesting conversation to listen too. By the end of Operation Linebacker, 17 B52s had been shot down, little had been accomplished to disrupt the HCM trail.IMG_3610

War cemeteries are everywhere here and the incense burns non stop. We are invited in to pray and it is a surreal experience. While only 25% of our soldiers who faced combat here were drafted, despite the huge myth of disproportion that Hollywood had made us think, 100% of the people who lived here fought in the war and everyone has a story. They seem forever able to forgive and welcome us back to Vietnam. Maybe that comes from having driven out so many Monghols, Chinese, Japanese and French before us. Maybe it fosters a mentality of moving forward, of firmness in belief that only the Vietnamese with govern this land. I hope that perhaps the Afghanis will one day feel this way as their story is not so different than Vietnam’s. An endless stream of empires passing in and inevitably out of their lives.

Our stay here at the farm has been truly unique. Far off the beaten path, surrounds by water and rice, the sound of motorcycle and car horns replaces by the tranquil sounds of buffalo and cow in their perennial battle with the plow they are attached to. Children on bicycle ride by on muddy roads, immaculately dressed, and endless streams of attempts at, “hello, where are your from and Hi Five!” In the distance the long low profile of the fishing boats slide quietly upriver towards the moth of Phong Nha and the sun sets toward our destination.

The Perfume River and Hue lie waiting.

Vietnam – Sapa and the high country

So, the train ride up to the mountains was basically the equivalent of the Thunder Mountain Roller Coaster at Disney Land. I am certain that I actually lifted off my bunk on a couple of those drops. It became clear why they had installed railing along the side of each bunk to keep people from flying out! We didn’t see much of anything during the night but the few glimpses of lights we saw were of houses set no more than 5-10 feet off the tracks. We were literally barreling through people’s yards at what seemed like a terrifying speed. Probably for best they only run the trains at night for that reason. When we left the station in Hanoi it looked as if they just line several trains up and do kind of a Cannonball Express to Laos.

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Sapa is at about 4,500 feet elevation and is much more wet and cold than Hanoi. It’s been misty and in the 50’s with light rain starting today. Basically Vanessa and I feel we are back in San Francisco summer conditions. “Goodbye flip flops, we had a nice couple of days together”. The mountains around Sapa are the highest in Vietnam with Mt. Fanistan rising to around 14000 feet. A three day epic adventure to reach the summit we hear…with a wide variety of poisonous snakes along the way. Come to think of it, I have never seen a Cobra up close, well, maybe next time.

The valley drops a thousand feet or more below us to a series of rivers an waterfalls with villages nestled along the slops above. We hiked 18k along narrow paths and wider roads to the villages of Cat Cat and Lao Chai. The Black Hmong people live here along with many other ethnic minorities which can be differentiated by clothing colors and styles. The Black Hmong are named after the dark black/purple clothing they are wrapped it. They grow indigo here and use that to create the dark purple color for there clothing which they wrap head to foot with many layers of vibrant colored needle point stitching worked into their accessories. The “Baby Bjorns” are the most beautiful patterns and colors and the have the baby cocooned into a hand made one-zy which straps them onto the women’s backs for the entire day.

There are no men here, or boys older than 10, which we are told is because the men live in the mountains hunting and collecting medicinal herbs all year. Many of the herbs i recognize in the market but many I do not. I get looked at strangely when I mention Chinese medicinal uses. Its apparent that herbal medicine varies greatly country to country and i am told again, “the Chinese are not popular here.” Because the Rice is planted in May and harvested in August, only one cycle a year here due to the cold, the women have nothing to do this time of year and are forced by the men to hike up to Sapa every day to try and sell small crafts to the tourist. Despite the absence of men we are told life for women is very hard, marriage is done through a type of kidnapping of a young girl for three days. Then her father comes and asks if she wants to marry the boy. She can say no but would be an outcast with little chance of marriage in the future if she did so. After hearing this I kept a sharp eye of Vanessa since we were hear for exactly three days making her perfect bait for a Hmong kidnapping! In truth, after one suspiciously long trip to the bathroom after lunch our guide suggested the possibility to me that she had been taken, I assured him that she had way more sass in her than Hmong men were prepared to take on!

There are no men here, or boys older than 10, which we are told is because the men live in the mountains hunting and collecting medicinal herbs all year. Many of the herbs i recognize in the market but many I do not. I get looked at strangely when I mention Chinese medicinal uses. Its apparent that herbal medicine varies greatly country to country and i am told again, “the Chinese are not popular here.” Because the Rice is planted in May and harvested in August, only one cycle a year here due to the cold, the women have nothing to do this time of year and are forced by the men to hike up to Sapa every day to try and sell small crafts to the tourist. Despite the absence of men we are told life for women is very hard, marriage is done through a type of kidnapping of a young girl for three days. Then her father comes and asks if she wants to marry the boy. She can say no but would be an outcast with little chance of marriage in the future if she did so. After hearing this I kept a sharp eye of Vanessa since we were hear for exactly three days making her perfect bait for a

Hmong kidnapping! In truth, after one suspiciously long trip to the bathroom after lunch our guide suggested the possibility to me that she had been taken, I assured him that she had way more sass in her than Hmong men were prepared to take on!

With marriage as early as 14 and 4-5 kids on the way life revolves around rice here. Each Hmong person will eat up to 2-2.5 kilos of rice per day. This means that they eat as much or more than they can grow despite the land being completely covered in a network of terraces. Hemp for making the clothes and Indigo for dying seem to be the only other cultivated crops. Bamboo and a very bountiful and wide variety of vegetables grow around the homes. Pumpkins dry of the roofs while women work turning the bamboo, after being hardened under the mud for 3 months, into everything from irrigation piping, to fencing, to roofing and ladders. Each home has a stand of Banana which they use for fruit, Banana blossom dishes, and for feeding the animals. Young children run through the streets rolling old motorcycle tires with bamboo sticks or sit and extract the young bamboo shoots for eating…which they seem to eat one of for every three that go in the basket. Big potbellied pigs and piglets wander everywhere, mixing it up with the dogs every house owns, and fighting for bugs with a wide variety of ducks and chickens. All of which, dogs too, go into the cooking pot when they grow old enough. The king of the land here is the water buffalo which roam through the paddies eating the weeds and fertilizing the fields. When they  can no longer plow the paddies they too go into the food cycle but at 15 dollars a kilo they are sold to the more wealthy Viet majority who can afford them. Invaluable as a natural tractor for the farmers, they are members of the family, who until recent health education programs, have lived in the homes with the farmers. What few old

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men we saw in the village were gathered around watching a Cock fight which we joined for a few minutes. I was invited to lay some money down but when I was told that neither of the birds were named “Little Jerry Seinfeld” I was lost as to who I should bet on.

Schooling is frowned upon here despite the work of many NGOs and expatriates. Parents see it as pointless since all the children return to the village life/culture afterwards. We were told that only 2 children have ever made it out of the village to university so far, the pressure to stay is so strong.

The town of Sapa is a old French resort town, they came in 1908 and were kindly asked to leave in 1978, with Alps style hotels looking over the valley. The tourist here seem overwhelmingly French with a smattering of Aussies, Germans, and Brits. There is Northface clothing sold everywhere and is very good knock off quality. Owning the real thing myself at home, I cannot tell the difference, all goretex and all very quality. We got a $250 parka for $38 dollars here and it seems to be a perfect copy. For my birthday Vanessa gets a present??  They also sell a great deal of the bright clothing and needle work here for very cheap. It’s seems to be way too much inventory for the women to make and we wonder if there is a factory nearby cranking it out under the allusion of being local. We got some things in the small village with the hopes the money would stay there.

The village has changed dramatically in five years and no doubt will continue as more tourist visit in the next five. The highway to Kunming, China, will be complete in two years and that brings a whole lot of Chinese money with it, for better or more likely worse. I think the European/Australian investment here is very good as they are committed to Eco-tourism and local food culture as the way forward.

Tonight we ride the roller coaster back to Hanoi and fly straight on to Dong Hoi in Central Vietnam. For the next 3 days we explore the largest cave system in Asia while staying at the Phong Na farm exploring with bike, boat and Headlamps. Back into the 80’s, hello flip flops.

With marriage as early as 14 and 4-5 kids on the way life revolves around rice here. Each Hmong person will eat up to 2-2.5 kilos of rice per day. This means that they eat as much or more than they can grow despite the land being completely covered in a network of terraces. Hemp for making the clothes and Indigo for dying seem to be the only other cultivated crops. Bamboo and a very bountiful and wide variety of vegetables grow around the homes. Pumpkins dry of the roofs while women work turning the bamboo, after being hardened under the mud for 3 months, into everything from irrigation piping, to fencing, to roofing and ladders. Each home has a stand of Banana which they use for fruit, Banana blossom dishes, and for feeding the animals. Young children run through the streets rolling old motorcycle tires with bamboo sticks or sit and extract the young bamboo shoots for eating…which they seem to eat one of for every three that go in the basket. Big potbellied pigs and piglets wander everywhere, mixing it up with the dogs every house owns, and fighting for bugs with a wide variety of ducks and chickens. All of which, dogs too, go into the cooking pot when they grow old enough. The king of the land here is the water buffalo which roam through the paddies eating the weeds and fertilizing the fields. When they  can no longer plow the paddies they too go into the food cycle but at 15 dollars a kilo they are sold to the more wealthy Viet majority who can afford them. Invaluable as a natural tractor for the farmers, they are members of the family, who until recent health education programs, have lived in the homes with the farmers. What few old men we saw in the village were gathered around watching a Cock fight which we joined for a few minutes. I was invited to lay some money down but when I was told that neither of the birds were named “Little Jerry Seinfeld” I was lost as to who I should bet on.IMG_3553

 

Schooling is frowned upon here despite the work of many NGOs and expatriates. Parents see it as pointless since all the children return to the village life/culture afterwards. We were told that only 2 children have ever made it out of the village to university so far, the pressure to stay is so strong.

The town of Sapa is a old French resort town, they came in 1908 and were kindly asked to leave in 1978, with Alps style hotels looking over the valley. The tourist here seem overwhelmingly French with a smattering of Aussies, Germans, and Brits. There is Northface clothing sold everywhere and is very good knock off quality. Owning the real thing myself at home, I cannot tell the difference, all goretex and all very quality. We got a $250 parka for $38 dollars here and it seems to be a perfect copy. For my birthday Vanessa gets a present??  They also sell a great deal of the bright clothing and needle work here for very cheap. It’s seems to be way too much inventory for the women to make and we wonder if there is a factory nearby cranking it out under the allusion of being local. We got some things in the small village with the hopes the money would stay there.

The village has changed dramatically in five years and no doubt will continue as more tourist visit in the next five. The highway to Kunming, China, will be complete in two years and that brings a whole lot of Chinese money with it, for better or more likely worse. I think the European/Australian investment here is very good as they are committed to Eco-tourism and local food culture as the way forward.

Tonight we ride the roller coaster back to Hanoi and fly straight on to Dong Hoi in Central Vietnam. For the next 3 days we explore the largest cave system in Asia while staying at the Phong Na farm exploring with bike, boat and Headlamps. Back into the 80’s, hello flip flops.

Vietnam – Back from Ha Long Bay

Back in Hanoi from Ha Long Bay. The drive out there was a 4 hour kidney busting ride in a van with the obligatory stop halfway at the jade/silk/jewelry factory. Identical to the stuff we saw on China so no big purchases. We were shockingly re-introduced to full scale white tourism with hundreds of vans dumping bewildered Euros, Aussies, and Americans into the waiting hands of an army of Vietnamese handlers working for the factory. Vanessa and I quickly fought through to the back door and camped out back with the other underfunded backpackers. We didn’t see as many big buys go down like we saw in China so it must not have been just us who weren’t impressed. Maybe the silk just wasn’t as appealing to the tourist or maybe they had it right in china and people want to buy the story as much as the item. Having a tour of the jade or silk factory makes buying in the shop at the end a lot more appealing than just dumping people into the shop floor in mass.

When we got to the bay a few hours later we were thoroughly shaken by the constant games of chicken all the drivers were playing on the road. An endless stream of busses and trucks trying to pass each other on a two lane road with a few Vespas buzzing around each larger vehicle.IMG_3444

The boat we were water taxied to, the Bhaya, was really nice. A world apart from the Yangtze river boats in China. Very clean boat, small private white table cloth tables open to self choosing. Inside or outside seating and a host of waiters with a full bar. The landscape and water was so beautiful it made me wonder if this is what the Three Gorges on the Yangtze looked like before they f’d it up with that dam. The rooms were small but looked very clean and had none of the mildew smell of the last boats. Dark hardwood furnishings (and even a door on the bathroom! This is a first for us here!) and nice big windows with amazing views of clean water and sky with the limestone mountains rising out of the water everywhere. Only about 20-25 guests per boat so there was plenty of room at the bar and dining area.

The boat took us after lunch for a tour of the islands and a rowboat tour of a fishing village at dusk which was a really beautiful hidden cove in the islands. The dinner was an over the top try at western gourmet that flopped, sea bass or steak, but the service was great with lots of fresh fruit cocktails to try. Vanessa is now addicted to passion fruit-martinis:)

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We were up at 5am for sunrise which was amazing! Skipped the Thai chi to have coffee alone on the back deck. Gross honeymooners. The boat took us to a giant cave you hike into with very high ceilings and lit with many different colors. A definite tourist trap but very impressive to see. Of course, there was the Asian tradition of trying to convince the tourist that “that rock looks like a turtle, that rock looks like a women, that rock looks like a dragon”. Nearly everything looks like a dragon in Vietnam…maybe after breathing enough diesel fumes…. IMG_3471

The weather was sunny and hot for the way home and we wishes we had booked the two night cruise. Another vicious ride back with a stop at…yep…the very same jade/silk/crap shop. This time for 40 minutes! Even though we had been there yesterday! Oh well, good excuse to get some fried noodles and kill time.

We are now back in Hanoi, fresh from a hike way off the grid to sample the overwhelming sounds and smells and foods.  I don’t think I will ever forget the sheer noise of this place or the friendly “look at those silly lost white people” looks of all the locals. I am very taken with this city so far.

Night train leaves for Sapa at 10pm. They say, “you will feel every inch of the track’s history”. All aboard!

Hanoi Day 2 -All on our own now

Woke up at 4am thanks to the lingering jetlag. Decided to head out to the Hoan Kiem Lake to see what the geriatrics were up to. Answer = getting busy. Cycling, dancing, soccer, badminton, weightlifting, everything. We walked around the lake and took it all in. Old lady’s shaking the hips in a semi-suggestive manor, younger ladies hooking their knees under benches and doing sit-ups while in a squat! I can’t even do that! Lots of gringos out running too, made me itch for a jog, only 1 kilometer around the lake, wonder if they have a marathon. Might be a deal breaker with Vanessa considering this is the honeymoon.IMG_3410

Took a cab to the Ethnology Museum in the suburbs. Very nice design and presentation of the 80 or so ethnic groups here. 80% are Viet which is obviously high but not quite the 98% Han dominates China. It was a good intro before we head into the highlands in Sapa. Out back they had reconstructed whole villages for each ethnic group you could visit. You had to respect the cultural norms of each. Taking your shoes off at some houses…dealing with angry goats at the entrance of others. Side note, Vanessa does not like angry goats staring her down.

Walked the 6 Kilometers home and saw huge statues of of Lenin and Uncle Ho’s tomb. Gigantic like Mao’s was in China. Lots of soldiers marching around but with many trees around which made it more pleasant than the paved over Tian’amen square. Didn’t feel the need to see Ho Chi Mihn’s embalmed body so kept walking back to the market.

We wanted to try and find the place we had pork Pho the day before but it was so overwhelming without our guide. Que the Anthony Bourdain scene, dark ally’s, chickens and dogs running at our feet, minced pork ground into the broken concrete under our feet, strange fluids (water I hope) running across the ground, and grandmother watching me as she swings the butcher knives efficiently into the pigs body, smaller and smaller pieces. The chicken ran over my foot and my stimulus reached max, “Vanessa abort the mission!”

We dove down a side street until we saw a bakery with foods we understood. Motorbikes bearing down from every direction, Vanessa bought me a piece of cake which I shoved in my mouth, restoring my blood sugar, as the fresh MSG flooded my system. With my bravado back I challenged Vanessa to try the crowded buffet style street food next to us.

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Rice with scallions, pork and wood ear mushroom egg rolls, the best part, and we stayed away from meat given the recent carnage we encountered at the market. (Yes Mo, we have come back to the vegan dark side after blood on the streets).

Our energy restored we pushed deeper into the market and found our Pho palace. Behind the Halloween decorations and Santa cards, yes, the Halloween decorations and Santa cards. Sweet sweet smoked pork pho. In a heart beat the vegan lifestyle went back into the shadows.

Went to the Softihotel for the 20th floor roof bar and “Rusted Nails” cocktails. Vanessa had some sort of passion fruit vodka nonsense. Tasty though. The view of the Tay Ho/west lake and the Red River was epic. Felt very swanky up there.

Back home to the old city for Bahn Mi sandwiches…50 cents each…had to have several on principle of the price. Enjoying a Tiger beer under a giant hand drawn portrait of Snoop Dog. Yes, Snoop Dog is in the house.

Ha long bay tomorrow…off the radar for a bit as we head into the highlands after that. But, way ahead of the USA. WiFi is free everywhere here.

Is hand sanitizer helpful, dangerous, or somewhere in between?

Recently news coverage has focused on the dangers of hand sanitizer, or the over-zealous use of it, in both the healthcare and home environments. It is a product the now seems so commonplace that we hardly notice it when the dispenser is mounted to the wall in a mall outlet or airport terminal. Any ride on the San Francisco Muni system displays a hilarious rush of hands into purses as the passengers unload, all leading to the retrieval of small plastic bottles of sanitizers, and quick squirts of purification from the taint of public transportation. People even offer their supply of sanitizer to strangers and I usually see it gratefully accepted. On a visit to UCSF Hospital you will see sanitizer used everywhere, in addition to constant hand washing and clean sterile technique, and I admit it is comforting to see when you are a patient. It, like the white walls and muted music tones, makes the environment feel safe, clean and protected from the world of invisible bacteria that lurks around us.

Is all this use of chemical sanitizers without risk? Are their merits more valuable than their potential drawbacks? Let’s start by looking at what is in many hand sanitizers.

Triclosan is a commonly used anti-bacterial agent in hand sanitizers. It does work well to kill bacteria but some animal studies have found it to be a hormone disruptor leading to endocrine issues in the animals. While animal studies often do no translate into the same effect in human bodies there have been enough of these animal studies done to raise the attention of the FDA which is looking into re-examining Triclosan as a safe ingredient.

Parabens are used in a wide variety of liquid products in the home and can be found in a number of hand sanitizer brands. Parabens have long been suspected of being linked to cancers and disruptions in the reproductive and endocrine systems of humans. You can look for any ingredients on the labels of your products ending in the suffix ‘paraben’.

Fragrances are included in many products to give them a pleasant smell. Something we often crave with hand products so that we have a re-assurance of the clean factor with a clean smell. Fragrances in any product are far removed from natural smells we might find in our environment and are recreated through a concoction of chemicals which are hard to even pronounce.

What about the health care setting? I think it is the best option that we have in many settings for the prevention of disease in crowded clinic environments. While there may be drawbacks to the use or make up of sanitizers they are still needed and valuable to the health worker. Think about field hospitals with no running water, battlefield environments, clinics without access to running water. These are all setting that need and should have access to hand sanitizer because they lack the traditional hot water and soap option that hospitals have.

Should we be using sanitizer during the day while we go about our errands or play with our children? I think the verdict is still out on that and each person needs to decide for themselves about the costs and benefits. We do know that bacterial resistance is growing all over the world and hand sanitizers are contributing to this. We know that children grow stronger through the gradual exposure to the many illness and bacteria in the environment and if we do too much to deny them this exposure they actually become more vulnerable to infection I the future and respond more slowly to medications.

It is a complicated issue that I hope the FDA will continue to review and each person should do there best to get all their options from accredited websites like the CDC, NIH or FDA and not from general websites, even this one. Go do your own research and decide for yourself what is best for you and your family in good health.

Vietnam Day One – Hanoi Food Tour

Hit the street food hard today. Perfect weather, low 70s and a breeze, lots if lakes here throughout the city and the Red River.

IMG_3383Started with a few black coffees and some nice dark bread with a jam that was almost more of a chunky chutny of mango and cinnamon. They seem really proud of their coffee here, it’s ok, but not the Peets hard stuff I needed to get going after the jetlag. But, combined with the 7 hours of Ambien sleep it got us out the door. Hanoi is very beautiful so far. None if the pollution of china, a fraction of the number of smokers, and virtually zero people trying to sell you crap on the street. You can walk up and look at shops and buy or not buy with no hassle. The architecture is much more simple, nothing much over 3-4 stories, all in a sort of pleasant state of southeast Asian decay. We are staying near a small lake in the old quarter with lots of people jogging and doing exercising. Another sign the pollution is not bad.

Our food guide named Tu was incredible. Great English and very open about all things Vietnam. A former chef at a top restaurant in town now making a very good living doing food tours for gringos. Crossing the street here is total f’ing chaos! 4-6 lanes of interwoven traffic and that’s not even the intersections. They have great side walks but they are unless since there are thousands of motorcycles parked on them. So walking in the street was constant. Tu said the general rule was to walk slowly and calmly, ignore the three ton truck coming from the left and the Vespa with a family of four coming from the right, make no eye contact and whatever you do don’t alter speed at all…because you might make THEM nervous!

Our first meal was pork belly cooked over wood charcoal on a small ground stove and a bowl of pork pho that was incredible! Tu pleaded with us not to finish everything since we had 6 stops but I couldn’t hold back. Nobody stares at us like in china either, maybe one of the benefits of all the backpackers, just some more strange white people trying comically to squat on tiny plastic stools.
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Second stop was sweet young rice cakes filled with mung bean and tea. Very nice and sweet after the MSG rush we just had.

Third was sweet potato and fried shrimp cakes dipped in a vinaigrette/sugar/fish sauce with chillies and papaya. New for me to eat the whole shrimp with the shell but tasty though pointy in parts.

Things got real at the next place. Black small chicken/possible a sparrow or pigeon, cooked inside of a beer can with Chinese herbs. Very smokey, very salty, and very small bony. We both tried it and the vendor was watching us closely. Things were going well until I pulled the head of the bird off and Vanessa shut down. Haha. Next stop we both needed to pound a cold beer. The worst part was that they had small parquets in a cage in the food stale that were about the size of what we were eating…cheep cheep cheep as we ate the “chicken”
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After the beers we had another bowl of pork pho with smoked pork at a ally stall that was run by a third generation pho family. Incredibly good.

MSG brain was setting in and we needed more coffee. We had iced coffee with whipped egg/sugar/condensed milk. Basically iced coffee with custard on top. With a bowl of cold tapioca and fried bananas. Vanessa had already forgotten about eating lil woodstalk.

Then crab and sweet rice fried in packets and chicken with sticky rice served with green cold honey tea. Vanessa had slowed down by now but I was plowing ahead.IMG_3400

One last iced coffee ended our three hour tour. I felt victorious. We walked home alone, surviving several more life threatening street crossings which required another cold Tiger beer.

Checked at the Hoa Lou prison “Hanoi Hilton”. Super downer/funny. Lots of classic commie propaganda. Many pictures of McCain having a nice stay, plus his flight suit/parachute. Looks like the boys had a good time playing cards and getting on shape while they were here. Cough/bullshit…though the pictures of Nixons carpet bombing of the city during operation linebacker are pretty extensive here. They had creepy shindlers list music playing through speakers in the whole place. I left depressed with a bad case of swamp ass to boot.

Nap time and the hope that my back pack will arrive today from Korea as the Korean air t shirt I am wearing, a gift that they felt makes up for leaving my bag behind, has food all over it.

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Is running bad for my knees?

“Is running bad for my knees?”

I often get asked this question by patients who are attempting to add running into their weight loss regime but who are being told by others, almost always non-runners, that they are putting themselves at risk for a future of damaged and arthritic knees. This has to be the most common misconception about running within the general public. It is a great example of something once claimed, but not researched, becoming a fact which we cannot seem to ever escape.

There are a number of reasons a person who previously did not run could develop knee pain after starting. The purpose of this blog post is to show that arthritis is not one of them. If we take a person who previously had no knee pain or medically diagnosed bone disorders and have them start running they may develop pain first and foremost from poor running technique.  If you think about it, running is one of the few athletic activities which we feel we can take on without some kind of training or coaching. We take swim lessons, surfing lessons, and skiing lessons but very few of us ever take running lessons. I believe a great deal of the discomfort people experience when they first start to run could be avoided by taking advantage of a good coach or running club for beginners advice. Next time you run, take a look at the other runners around you. You will see people leaving forward, leaning backward, and even to the side. Often one shoulder is hiked up higher or the foot kicks out to the side each time it comes back. All these technique issues can lead to knee discomfort but the activity of running itself does not.

Additionally, much of the discomfort people mention in their knees is actually muscular soreness radiating in from a different area. Their tight IT Band could be pulling on its attachment and creating pressure in the knee. Their tight quads maybe pull the kneecap to the side when they run creating patello-femoral syndrome.  Maybe they just bought minimalist shoes and are running a few miles on them without ever building up to the switch from normal running shoes. The bottom line is that there are a number of reasons a person’s knee might hurt while learning how to run, almost all are correctable through a good coach, and rarely if ever is the cause the osteoarthritis your non-runner friend/family swore you would have because you started running in your 40s or 50s.

Train smart, run well, and read this NY Times blog about this subject and the study that shoes running does not cause knee arthritis. It was the inspiration for this post.

http://well.blogs.nytimes.com/2013/09/25/why-runners-dont-get-knee-arthritis/?smid=pl-share

Do I need to drink alkaline water?

When faced with the many different approaches towards dietary advice, which we are faced with daily, many of us end up feeling like we have more questions than answers. A philosophy that I commonly hear in the alternative health community involves the concept of our body’s PH being a cause of our illnesses. Foods, drinks, and environment can all affect our body’s acid/base balance and this in turn can lead to a life of disease. While it is true that blood or urine tests which reveal a body whose internal environment is either too acid or too alkaline can be indicative of serious lung or kidney disease, it is also true that our belief in our ability to manipulate our PH may not be as extensive as we think. Our body has a beautiful and complex system in place to control the PH in different parts of our bodies through our respiratory functions balance of oxygen intake and carbon dioxide output. Simply by putting in the proper ingredients this system should be competent in maintaining our health. Any time our body has an effective system in place we should not try and tamper or overload that system by pumping in excess amounts of alkaline foods or fluids, thinking that as amateur chemist we can do it better. As I have said in many of my posts, Chinese Medicine is about the concept of balance, which when held through the duration of our lives will allow the body to achieve proper health on its own.

One of the emerging theories revolving the alkaline diet trends focuses on water over food. It is said that food alone cannot provide a diet rich enough in alkalizing vegetables but that our water much also be alkaline in order to further protect us from the ever present menace of those ambiguous toxins. I encourage everyone to read the in depth article in the link below from author Jane Lear, in a recent post for Takepart.com. It covers the issues, potential, and concerns of these high cost water regimens in a well cited article that sheds a lot of light on the subject. It was the inspiration for this blog post.

http://www.takepart.com/article/2013/09/25/alkaline-water-not-fountain-youth?cmpid=foodinc-fb

Fearing our foods

I have witnessed a growing number of patients who are taking on diet modification to treat their chronic health conditions. Faced with the myriad of fad diets out in the media, each blaming a different food group, for all our health woes, people are not sure what to eliminate or how to go about eliminating it. They know that they currently do not feel well, often experiencing chronic pain, allergies, or digestive distress, and they know that their relationship with food has not always been a healthy one. So, like a bad relationship, they reach a point when they want to cut off ties with that troubled boyfriend named dairy, wheat, meat, or beverage.

The first two on that list, dairy and wheat, are the most commonly chosen food groups to eliminate in the hopes of improving one’s health. Many American practitioners of Chinese Medicine cite dairy as a fundamental source of evil in the body, often making claims that it produces large amounts of mucus which gum up the works of our natural physiology, and then connect this to nearly every health complaint imaginable. Wheat is perhaps the second most commonly blamed food group among American practitioners of Chinese Medicine. Wheat is claimed to cause widespread inflammation in the body, chronic fatigue, gas and bloating. These claims identify with a huge swath of the American public. 10% of Americans suffer from symptoms of IBS alone and some claim that up to 30% of the public is now seeking to reduce or eliminate wheat from their diets.

There is no belief among the Chinese practitioners, both in the U.S. and in China, that I have spoken to that support these claims (I have not spoke to everyone). Professional Chinese Medicine has its foundation in the Doctrine of the Mean which is the idea of balance in all things. The body should be able to tolerate all foods but never in amounts that are too rich or excessive, causing disease, or too little, causing nutritional shortfalls. Used moderately, milk products are believed to be supplementing and nourishing to the body. They are never referred to as “phlegm or mucus forming” substances in the professional literature. Wheat, likewise, is a warming and digestive strengthening substance and has been used in its fermented form for as a digestive regulating herb for centuries. I been told on several occasions by patient’s that their practitioners of Naturopathy, Chiropractic, or Acupuncture explained to them that ethnic Chinese do not have Gluten intolerance because they eat only rice in China while Europeans have predominantly eaten wheat. A truly generalized stereotyping of Chinese people since Northern China is the largest producer of wheat in the world and rice has only been a staple of the warmer climates in the south.

These claims, though valid for many patients and many health conditions, are troubling in the way they are being presented to the general public. A very tiny percentage of people have the medical condition called Celiac Disease, a serious health concern, while the majority are suffering from food sensitivity. The question is, is it the individual proteins, of which Gluten is one of many, or is it what we are doing to wheat which is making us sick? Is it the cheese or coffee which are to blame for all our illness? Or is it what we are doing to our cheese and coffee that is leading to disease. Wheat is split apart and broken down into its parts before its remaining white flour is used to produce fluffy, soft, and long shelf life breads. This end product is so nutritionally deficient that they have to add low quality Vitamin B back into it so that the public does not have potential nutritional deficiencies if all they can afford is to eat is bread.Dairy is heated to high temperatures to kill all the bacteria which make it both healthy and at times potentially harmful. Non-fat dairy products further reduce the quality down to broken proteins and water which hardly resembles the thick nutritional substance which came out of the cow. Coffee is served in America now in all forms except “black” it seems. People say they are drinking too much coffee but it only takes a little questioning to discover they mean frappucinos, sugary lattes, or the decadent caramel macchiato. Thousands of calories and hundreds of additive ingredients are going into these traditional food sources and fueling the illness and disease which people are now associating them with. One look at the “Gluten Free” aisle at Whole Foods shows the predatory way that food manufacturers are jumping on people’s search for healthier foods. Gluten free seems to equal cookies, cakes, chips, pizza and even beer. Hardly the food groups that those with dietary and health concerns need to be tempted with.

Perhaps we need to return to a system of food production that does not strip apart the essential structure of our foods. Eating as low on the food chain as possible. Think about it, whole stone ground wheat with all parts of its original self kept intact during the creation of our bread (modern whole wheat products, a nebulous term, are often split apart for processing and then mixed back together in the end product). Sea salt that contains all of its minerals and does not need to have iodine added to make it beneficial. Coffee that is black and oily, true to its roots as a medicinal product in Africa and Arabia, and unadulterated by creams and sugars. Dairy products that are safely regulated and ethically produced so that they can be served unpasteurized to the public. Above all, moderation in what we choose to eat! The Chinese Medicine principle of the Doctrine of the Mean. Let cheese be a special treat not a every meal additive. Let our meats be a dinning out, or a few nights a week centerpiece rather than a breakfast, lunch and dinner focus. Use sea salt as a delicate ingredient and not a cover up for bland food. If you have to add sugar, caramel and syrup to your coffee, making it as unhealthy for you as McDonalds, then maybe you do not actually like coffee to begin with and it’s time to switch to tea. Eating in moderation, as low on the food chain as possible, allows food to become life’s greatest pleasure and not the cause of our disease.