Wisconsin students sponsor surgery for a child with a birth defect.

n Laos, a lot of babies die before anyone gets to know them well. Statistics compiled by the United Nations indicate that nearly one out of every ten infants born here will die within the first year of life; eighteen percent of babies born in a given year will die before their fifth birthday. Laos has the highest rate of infant mortality in South East Asia, lagging behind impoverished neighbors such as Viet Nam, Burma, and Cambodia.

The grim statistics, while high, do not capture the full extent of the problem. The figures do not include many infant deaths that occur in the remote countryside. The figures for the nation as a whole are an average combining data on births within cities where medical care is available for infants with that of villages that lack even the most primitive health services. In the cities, women have access to birth education, prenatal healthcare, better diet, and the services of hospitals and clinics. In the villages, first-time mothers are younger, less educated, and more likely to be both overworked and malnourished — all factors that bode ill for the likelihood of their bearing and raising healthy children. If Laos could calculate and report figures for the rural villages alone, the rate of infant mortality would be abysmal.

Vieng’s mother, Vee, had ample experience nurturing babies: throughout her own childhood, she cared for younger siblings while her parents worked in the rice fields. However, she had no experience with breastfeeding, and her baby’s malformed lip and palate created problems that even experienced mothers in the village had not seen before.

I asked Vee to recall Vieng’s birth. She rolled her eyes, shook her head, and then described days filled with both fear and frustration. She said Vieng was hardly able to nurse; he couldn’t purse his lips to form a proper seal on her breast, and therefore couldn’t draw milk. When the little guy did succeed in getting milk into his mouth, most of it ran out his nose — a consequence of the hole in his palate. Vee resorted to expressing milk from her breasts by hand at each feeding and carefully spooning it into her baby’s mouth.

Vieng is an active toddler now — alive, but not entirely well. Wisely, his mother continues to breast feed him; they’ve found feeding positions that work reasonably well. Still, Vieng isn’t out of the woods. At first glance Vieng looks round and full — not fat, but easy to squeeze. A more careful look reveals alarming characteristics: his distended belly is out of proportion to his thin arms and legs; there is a dull brown cast to his underlying black hair, a tint that I first attributed to the dust that covers everything in his roadside village.

The distended belly, the thin arms and legs, and the dull hair are all signs of malnutrition, a condition that leaves Vieng susceptible to every virus and bug that passes through his village. Hardier, better-nourished children who got off to a better start in life might easily survive common childhood illnesses, but Vieng will go into those battles with his strength and immunity compromised.

I got to know Vieng before I met his parents. He is the nephew of the “naiban,” or chief, of Nakai Tai, one of the resettlement villages that I visit frequently as part of my work with the UXO Response Team. We go into villages looking not for malnourished children, but for leftover bombs and landmines. Still, we get to know a lot of villagers and their problems.

I’d seen Vieng around the village, playing under the watchful care of older children while his parents worked. From conversations with his grandparents I’d already pieced together most of his life story. Then, one day I happened upon Vieng as he played in the mud with several other toddlers. I stooped to pick him up, wanting to estimate his weight. Suddenly, out of the corner of my eye, I caught sight of a young woman dashing toward us. The woman scooped Vieng off the ground and bounded two steps beyond before spinning around to confront me.

The first words that popped into my mind were “mother bear.” I immediately realized my mistake. Vieng’s mother was naturally protective of her child, and I was a strange if not threatening figure about to lay hands on him. From my years as a school principal, I know that there are parents, protective parents, and protective parents of disabled children. You might win a fight with either of the first two groups, but you do not want to get into a scrap with protective parents of a disabled child.

I followed Vieng’s mother to her home, where her older brother explained that he knew and trusted me. I can’t claim that Vee warmed to me that day. If I read her eyes correctly, they didn’t convey anger or distrust as much as simple fear. Throughout this first visit she continued to hold Vieng close. It wasn’t until my third visit to her home that Vee finally released Vieng in my presence and permitted me to cradle him in my arms. The better I have come to know Vee, the greater my appreciation for the sacrifices that she has made on her son’s behalf; I join her family in crediting her for his survival.

I left Wisconsin in March of this year carrying some “good deed money” raised by the students at Madison Elementary School in Stevens Point, Wisconsin. Madison School has a large enrollment of Hmong-American students whose families once lived in war-torn Laos. The students had seen educational displays that my wife and I share with schools throughout Central Wisconsin, and were moved to help people affected by the Indochina War.

The students at Madison School are returning from summer vacation now, and will soon learn that their good deed money is going to help turn Vieng’s life around. I’ve made contact with a doctor who comes to Laos once a year to do surgery on children born with a cleft lip or palate. The doctor will be in the capitol city for just seven days this coming October; he will have a busy schedule, but there is a good likelihood that he can fit Vieng in. But for Vieng to be accepted for treatment, he must be in better shape physically than he is right now. If he’s found to be underweight or anemic, he will be rejected as a poor candidate for surgery.

Madison School funds paid for Vieng’s first-ever visit to a doctor’s office. Like all Lao toddlers, Vieng runs naked most of the day. Tropical heat makes clothing unnecessary; given his family’s poverty and his village’s lack of clean water, diapers are out of the question. But for this special occasion, Vieng’s parents dressed him up in oversized shorts, a baggy T-shirt, and around his neck, a colorful bandana. He looked ready to go to town!

At the clinic Vee reluctantly turned her son over to nurses who proceeded to poke, probe, weigh and measure. Vieng was wide-eyed but cooperative. I felt a surrogate grandparent’s pride when the nurses drew blood and the little guy never flinched or fussed. Tests showed that Vieng carried a whopping load of parasites in his digestive tract, a problem that accounts in part for his malnourishment. The nurses explained to Vee that her son needed medicine to rid him of all the parasites, and then a steady diet of high-protein foods supplemented by regular doses of vitamins.

I hit the Madison School funds to buy the recommended vitamins and medicines. For the past six weeks, the students’ money has been providing Vieng with nutritious foods: peanuts, bananas, mangos, pineapple, and other tropical fruit. Every Sunday I take his mother seven eggs so he can have yolks as a daily high-protein supplement to his usual meals of rice.

Vieng’s surgery is still more than a month away. I’m hopeful that by screening time he will be a better candidate for treatment; however, I worry. I know, from having raised two kids of my own, that children always seem to catch a cold or come down with the flu at the most inconvenient times. If Vieng misses this chance for surgery, it will probably be a year or more before he has another opportunity. My fear is that if I’m not still working in Laos, his family may have no way to learn about the next visiting surgeon.

Lao people are exceedingly patient. They often use an expression that defines how they face the future. They say everything has to happen “teau la bad kao,” or “one step at a time.” I’ll just have to be patient and see what happens in October. Thanks to the students at Madison Elementary School, there is a good chance that little Vieng will be able to take a big step toward a healthier life.