Doane gazes down at her son Jonh in hospital having his lungs drained of fluid, Vientiane, Laos.
Doctors consider Jonh's xrays of his lungs which are filled with fluid, Vientiane, Laos.
Doane gazes down at her son Jonh in hospital having his lungs drained of fluid, Vientiane, Laos.
Dr Sisouphanh Vidhamaly speaks to her patient Jonh about the condition of his lungs, Vientiane, Laos.
Pulmonary specialist Dr Sisouphanh Vidhamaly poses for a portrait.
Outside Vientiane's Mahosot hospital.
Patuxai Monument, Vientiane.
Mhai, a construction worker, who smokes a pack of cigarettes a day, sorts through construction equipments in the back of his truck in Vientiane, Laos.
Mhai, a construction worker, lights up a cigarette.
Mhai, a construction worker, smokes a pack of cigarettes a day. An X-ray showed he had recently lost half his lung capacity.
Mhai's son, Anouluk, is also a construction worker, grew up fetching cigarettes from the store for his heavy-smoking father. He's now trying to cut back on his own smoking.
Khamphuvanh smokes two packets of cigarettes a day and has severe health issues.
Khamphuvanh's 11-year-old son Souksavanh has started experiencing shortness of breath from spending so much time around his smoking.
Khamphuvanh's smoking has creating friction in his marriage with Khammond who is the main breadwinner for the family.
Khammond, Khamphuvanh and Souksavanh have dinner together. The family is struggling financially and concerns over the potential cost of any health-related diseases due to Khamphuvanh's smoking worries them all.
Tuktuk driver pause for a cigarette break in Vientiane, Laos.
A view of the Laos Tobacco Company headquarters, Vientiane, Laos.
A display of cigarettes inside a Laotian convenience store, Vientiane, Laos.
A convenience store worker with cigarettes brands displayed behind her, Vientiane, Laos.
Youth gather on a banks of the Mekong River, Vientiane, Laos
How a Secret Tobacco Deal in Laos Enriched a Political Insider
Jonh is just 20 years old yet he lies wheezing in a hospital bed; tubes from his chest lead to a plastic container on the floor which has collected half a liter of milky, pink liquid. Dr Sisouphan Vidhamaly inspects his x-rays. The diagnosis: pleural effusion and empyema, or an accumulation of pus and fluid in his lungs. “I am not sure if he will recover,” said Dr Sisouphan, “I advised him to stop smoking. But once he leaves the hospital I won’t know if the patient stops or not.” Jonh’s mother Doane looks on, concerned. She has already had to borrow 19M kip ($875) from friends and family in order to pay for his treatment.
A secret, 25-year-long contract between British tobacco company Imperial and the Laos government resulted in a family member of Laos’ former president pocketing more than $28M USD. A clause in this agreement also bars Laos from raising excise taxes, making it the producer of some of the world’s cheapest cigarettes. This has had jarring local health impacts. Smoking is linked to 1 in 7 deaths in the country. Shot and contributed additional reporting for The Examination and The Diplomat, supported by The Pulitzer Center.