In early May I took my first trip to the far west of Cao Bang province - the real backwater of northern Vietnam. Bao Lam district is the furthest west district in Cao Bang, and while Cao Bang Province is 96% ethnic minority, the ethnic minority make-up of this district and the neighboring areas is completely different from that in the areas that I am used to working. This area is home to the White and some H'Mong - these are the cousins of the H'Mong that now call Wausau and LaCrosse areas home in Wisconsin.
We came to Bao Lam to do a follow-up assessment for a safe motherhood (maternal health) project and a water project for the hospital. The district hospital is relatively new and very nice, but the water system can only provide water for the operating theater and the emergency room - leaving the routine care and families of patients in a real bind for assuring cleanliness after critical care. Traditional birth attendants in the villages have never received any formal training and many don't even understand the basics of hygiene for preventing infection. These are the true front lines in community health care delivery.