Safe Eating while Traveling in Vietnam

We're heading into Vietnam's tourist high season. Visitors -- whether overseas Vietnamese or not -- flock to Vietnam when the weather is cooler and drier.  Of course this all depends on where you are. It's just less hot and humid in and around Saigon (Ho Chi Minh City), rather damp, cool and dreary in the Hue area, and downright wet and cold to the bone in Hanoi and its environs. As a long, skinny country, Vietnam's regional climates are as varied as its regional foods. If you're going soon, pack layers should you be traveling the entire country.

A trip to Vietnam is nothing without eating lots of Vietnamese food. Jason emailed last week about his upcoming trip and sent this query:

I'll be traveling to Vietnam this December for 2 weeks, and have a question.

I keep hearing about not eating uncooked vegetables, herbs, fruits etc. But I really don't see how that is possible and still enjoy the cuisine. Basically everything has some sort of uncooked herb or vegetable, which is what makes the cuisine so good. With the recent cholera outbreak this seems to be even more of a concern.

Given that I'm going in great part for the food alone, do you have any advice?

Ohhhh yeah. On my first trip back in early 2003, I resisted eating raw lettuces and herbs because I feared getting sick. A doctor in my hometown planted the seed by telling me about his 6-month bout with dysentery after working in Mexico.  My parents kept asking if my husband and I didn't want to go elsewhere -- Europe, Mexico (!?) -- anywhere aside from Vietnam where we could fall ill and have to rely on the local medical system. When my dad realized that we were intent on going back to the Motherland, he handed me a care package that included Cipro, a kind of  antibiotic that will kill anything.

So when in Vietnam, we'd stare down at a gorgeous plate of herbs that'd just been picked from a large bowl of water and had to force ourselves to pass on them. We'd eat our banh khoai crunchy rice crepes in Hue without herbs. In Hanoi, the pho joints we patronized served no garnishes (a traditional northern Vietnamese approach) and we ate the classic noodle soup just as other locals did -- sans any additions and savored the heady broth, fresh noodles and savory beef. On a daily basis, we loaded up on stir-fried water spinach with garlic (rau muong xao toi) to get our load of veggies.  We felt like wimps and occasionally got into fights over whether or not we should risk our lives for raw vegetables.  The doctor and my parents' admonitions loomed over us at every meal.

When we got back to the U.S. we felt like we'd miss out on a certain something by not eating the accompaniments. We NEVER fell ill during the trip. I checked in with others who'd gone back and they sheepishly admitted not eating the raw stuff too.

I've traveled in China and other parts of Southeast Asia and basically ate mostly cooked foods.  That's okay in those countries because there's little raw vegetables and herbs in their cuisines. The only time I got sick was in Hong Kong when I stupidly ate a salad at a Pizza Hut. Vietnam, however, is different, and what distinguishes Vietnamese food is the abundance of raw vegetables. In fact, herbs are called fragrant vegetable -- rau thom. Not partaking in the raw vegetables and herbs is indeed missing a huge point in Vietnamese cuisine, just as Jason suggests.   

Before our last trip back in January 2007, we got thinking and  decided to eat it all. Here are our strategies for dealing with food safety in Vietnam:

1) Start and stay healthy. We made sure we were in shape to travel by keeping our immune system up. We got lots of rest before departing and tried not to get stressed out about packing, getting visas, etc. As with any flight, we took Airborne at take off. To get sleep in flight, we took a natural product called No Jet Lag and wore earplugs; we slept with those ugly blow-up neck pillows to ensure we don't wake up in pain.  (After reading a tip in GQ magazine, my husband even talked me into wearing a mask but it was too hard to sleep with that on!)

On a daily basis while in Vietnam, I took a few drops of grapefruit seed extract diluted in water. It's bitter but it works for boosting your immune system due to its  anti-practically-anything properties. What I use is called Citricidal and it has been and continues to be great stuff  for me. It's available at healthfood stores and natural pharmacies. (It's also good for hangovers.)

2) Locals worry about hygiene too. It's always been this way in Vietnam. The billboards, food labels and vendors all worry about keeping things clean and healthy. An ill customer -- not to mention a foreign visitor -- can ruin your business. Wherever we ate, we watched the locals eat. If they set their cilantro sprig of garnish aside and didn't touch the lettuce leaves, we did too. If they dove into everything, we went whole hog.

3) Eat freshly prepared food. Vietnamese food and cooking is about freshness, not just for culinary purposes but for hygiene reasons too. So we made sure to see our being made in front of us. When that wasn't possible, we checked out the staff and joint to make sure things had a good vibe. Whenever possible, we made eye contact and smiled so that people knew we cared.

4) Trust the cook. An honest cook is more likely to not hurt you with bad food. Look her/him in the eye (and or the service staff)  before you sit down.

5) Enjoy ice judiciously. Beer on ice is one of my favorite beverages in Vietnam but I ordered my beer with ice in places that look like they got ice from filtered water. That meant that if I were in a village or small town on the square in a little plastic chair, I drank my beer warm from the bottle.  My husband came up with a clever strategy of drinking fast. This didn't apply to beer, but other refreshing drinks like delicious fresh sugarcane juice, which had to have ice. We sucked ours up through straws relatively fast to avoid the potentially unfiltered water from the melted ice.

6) Nature's protectors. All that lime, chile, vinegar, garlic, ginger, turmeric and galangal -- they're natural antiseptics. Know that all that comes together to kill potentially harmful bugs and bacteria. Along with the herbs, you've got a powerful phytochemical mix in your food.

7) Peel your own. Unless we were at the hotel's morning breakfast buffet spread where the fruit was already peeled, we peeled our own fruit. Vietnamese people, like many Asian people, peel their fruit. We eat lots of fruit so the nutrients lost in discarding the peel is negligible. My mother won't eat strawberries because it's fruit she can't peel!

8) Take it easy. You may get a little tummy thing that's a matter of your body adjusting. Keep hydrated with bottled water.

The cholera situation right now will make people in Vietnam extra alert so they'll be watching out for their health as well as yours.

Got any tips of your own? Let us know.

Comments

[Mike]

Well, Andrea is much more thorough than I. Let me just that in nearly 3 years of living Vietnam on and off between 2001 and 2006, I got sick twice. Once, I was at an American restaurant in Hanoi. Once, I was at a wonderful French restaurant in Saigon. Sure I had a loose stomach at times here and there but nothing too bad. I ate everything. Ice everyday. Fresh herbs. I ate streetfood and from small food stalls nearly everyday, for most meals.

I'm not trying to sound tough. Simply, take Andrea's advice and follow the locals. Eat at restaurants that are busy. Try to eat at mealtimes, rather than say having lunch at 230pm (unless the place is busy). But otherwise, you'll likely be fine and you'll be happy you sampled all there is to eat in Vietnam.

For a good guide to Vietnamese food, check out the archives at www.noodlepie.com

[Robyn]

Eat yogurt everyday. Little bottles of slightly sweet plain yogurt are easily found (in Saigon at least) and are delicious. All those good bacteria in your stomach can't hurt.
Eat at places that are crowded. As you said, the locals are concerned about hygiene too. If a place is packed (even if just a street stall) it's probably been tried and tested.
And carry cipro. If you develop a 'problem' that goes on for more than 24 hours it's very likely bacterial. Cipro works very well, and very quickly.

[Bri]

Andrea, what a wonderfully informative and personal post! I can't remember how I got to your site, but I'm glad I did. I have wanted to visit Viet Nam, but haven't yet. Once every couple years or so, I do find myself in remote areas of Mexico. I used to get sick every time, but since I started grapefruit seed extract, I've been to Mexico 3 or 4 times and haven't gotten sick. That stuff is awesome! I usually bring empty vegi-capsules and fill one with 10-15 drops of the GSE and take that before each meal. Then I just put a few drops in my 1 liter or so water bottle and nurse that all day. I so appreciate your tips, especially the one about paying attention to what the locals are doing. I don't know why that didn't occur to me. I am usually in Mexico with my dad, and take my cues from him, but he's in Mexico several times a year, and hasn't gotten sick from the food in years. So, I usually ended up getting sick, when he didn't. Thanks again for the great information. I totally understand feeling like you're missing out if you aren't a little adventurous, but at the same time, not wanting to come home with cholera.

[Andrea Nguyen]

Mike, that's a good tip on going at a busy time. So many of these thing seem like no brainers but when you're traveling and full of health-related trepidations, it's hard to make sound decisions.

Robyn, I love that yogurt and haven't had it in years -- since I was in Yunnan province in the early 90s and we'd chase down the bicycle vendor each morning! You're right, persistently loose bowels need attention. Creamy rice soup (jook/congee/chao) works wonders for recovering tummy problems.

Bri, grapefruit seed extract is an oddly miraculous little friend to have around. I'm astounded whenever I use it because I feel better an hour or so after taking it. It supposedly is good for floor cleaning in addition to keeping your body's immune system in good shape. Glad to know you've found it to be helpful.

[-tvu]

I just got back from Saigon on a two weeks trip! Didn't get sick once! My trick is to take Imodium D, during the first few days. I do this for all my international trips This is to let my stomach get use to all the local "bugs". After a few days, my system will get use to the local foods.

The banh pho in Vietnam is way better then banh pho used in Pho restaurants in Orange county. It was softer. I re-fell in love with Pho. Also, the best banh bao I ever tasted.

[Binh]

That's a very informative post you have. I recall my grandparents saying that most if not all the herbs in Vietnamese cuisine have medicinal qualities. I wonder if that's the way the local find the healthy balance in the middle of questionable hygiene condition. That being said, when I was young in Saigon, my parents didn't let me drink the sugarcane juice. The sugarcane juice is fine -- it's the swarms of flies that always gather around the piles of discarded sugarcane stalks.

[Andrea Nguyen]

Whether or not we have Asian DNA, we're all of Asian extraction on this blog. That said, it's apropos that we discuss digestive issues.

TVu -- your strategy is pretty innovative. Tighten up before you may loosen up. Glad to know that you rediscovered the pleasures of Vietnamese food.

Binh -- your grandparents were probably right. I have a book that lists various kinds of herbs and vegetables in the Viet repertoire, and there are folk remedies associated with nearly every single one of them. Sorry you didn't get to partake in more sugarcane juice in your youth. Flies are unappetizing.

[Nate]

On my trips to China I took along Pepto Bismol tablets which I ate before every meal to act as sort of a buffer for whatever strange food my come my way.

[steamykitchen]

Of all thing...salad at a Pizza Hut!!

When we went to China, we brought along my brother who is a doctor! Thats the best way to travel.

Hey, maybe I can lease out my cute, single, doctor brother to international travellers!!!!

;-)
jaden

[Andrea Nguyen]

Whenever I have stomach problems, I have no one but myself to blame...

[Jenn]

It may be an odd coincidence, but I was sick only once in Vietnam last December and made some changes in how I was eating and never had another days problem after.

The first few days there I was EXTRA picky about where and what I ate and I got sick...2 days of being ill, yuck. After that I made sure I was getting yogurt with breakfast every day and drank some sort of alcohol with every dinner and a coke with lunches. I did well for a week and started getting a bit broader in what I was eating. Slowly I branched out to some greens and eventually even ice. By week number four I was eating it all and didn't feel like I had enough time or free hands (I was there adopting twins) to make to all the local joints I wanted to. I can't wait to go back sometime and have a Tiger beer with supper, or a hot bowl of pho with chili's for lunch! I never did get any "street food" as when I was out towards the end I always had the twins with me and didn't have a free hand to purchase with. I have always wondered what those little "sugared donut"-looking things were and what they tasted like. Someday.

[Diana]

I just moved to hanoi and have been here for a week. I am amazed that I have not had any problems with the food at all! It has been exciting to try different dishes and still feel great. I had fresh spring rolls on our second and my husband had his friend. I felt fine. I have been eating at restaurants that look clean, and everything has been great.

[Andrea Nguyen]

Diana, thanks for your feedback. If you come across favorite eateries, do let me know!

[Noclegi Zakopane]

I like Vietnam food - it is so different then europian. Thanks You for this introduction by kitchen.

[Ustka]

Diana - dont you worry about gastric problems? How you resolve this problem?Any pils or diet?

[Wędkarstwo Morskie]

Great post Noclegi Zakopane. I was also had this gastric problem on vacatin in India last year. Two weeks i was in bad in hotel!!!
Wędkarstwo morskie
http://www.wedkarstwo-morskie.net

[Ustka Wczasy Noclegi]

[Noclegi Ustka](http://www.morzeustka.com"Noclegi Ustka")
Greate site with many useful tips. I try to use them in my kitchen , but probably I will a trable with ingrediens.So Thanks

[Ian]

I have been to Vietnam on several occasions actually and have always found the people to be kind, genuine and affectionate. The food is absolutely fantastic as you have noted Andrea, and the culture continues to amaze me everytime I go back. Great tips and hints for any travel to Vietnam. Well done.

[screensaver maker]

The food is absolutely fantastic as you have noted Andrea.

[jessica, nyc]

I just came back from a 2 week trip through the south and central part of Vietnam. The first day I was a bit careful. But after downing a warm beer, I decided to risk it with the ice. Then while driving through a small town our guide decided to treat us to hot vit lon (fetal duck egg) with fresh herbs, chili salt and lemon. This was in the middle of nowhere and it seemed a little bit less then hygienic, but we were guests and our guide was very happy to be sharing this with us. So we dove in, drank ice tea with ice, scarfed down the eggs and some fresh veg and herbs. Neither my husband or I had any digestive discomfort. After that, we ate everything. The fruits and vegetables were the freshest I've ever had. The garnishes for soups and bahn mi made those dishes. I couldn't imagine going to Vietnam and not eating the fresh stuff. I guess we were lucky. We are from nyc so maybe our stomachs were already used to eating whatever bacteria that might give others problems. Do not miss out, its too good and the plane ride was too long to miss out on anything.

[Andrea Nguyen]

Jessica, Thanks for sharing your story. That is quite something -- eating hot vit lot and drinking ice tea. The herbs may have helped thing a bit too.

[jessica, nyc]

It was a fantastic trip. I wish it were easier to get back to explore more of the country and food. We were only there 2 short weeks. I posted some of the food we ate on my flickr site http://www.flickr.com/photos/38542935@N00/sets/72157610529307058/
I am already missing the abundance of fresh produce and amazing street food.

[Tori]

Been to Vietnam about 5 times now, for about 3 weeks each time, and haven't been sick yet. I don't know why not, since I drink ice (not at bia hoi, but at better-looking places), eat fresh herbs/lettuce. But I generally avoid street food (except for vendors my husband's known for years), so maybe that helps? We generally stick to "busy" places, too. That definitely seems to help, and nets you the tastiest food, to boot!

I should amend the above: I got sick ONCE. I ate chao on a plane ride from HCMC to Hanoi and it gave me gastroenteritis. I don't think that counts, though, because I generally get sick from airline food (they use formaldehyde as a preservative on airline food, and I'm sensitive to it). So I shouldn't have broken my "don't eat airplane food" rule!

[Andrea Nguyen]

Tori -- LOL -- you got sick from eating at a 'safe' place. Thanks for sharing your experiences.