Myanmar: Shrimpers of Inle Lake

For a period of 2-3 months just after the end of the rainy season, the rice paddies that border Inle Lake produce a different crop - freshwater shrimp.

Shrimping is usually carried out by a two-woman team. The pair of young women we encountered in this flooded rice paddy were both in their 20's, unmarried, and friends as well as colleagues.

Shrimping is not a very well-paying occupation, but neither is anything else in this country (except possibly acting as a guide for tourists). This pair of women will earn approximately 3,000 Kyats (1,200 Kyats = US$1.00) for a full day's work, most of it performed while standing waist deep in weed-choked water.

Their day starts with a 90-minute commute (by canoe) from their homes to the shrimp bed

The women were wearing a form of sunscreen that is unique to Myanmar (at least among the countries that we visited). It is made by grinding thanaka bark on a flat stone, and mixing the powder with a bit of water to form a paste that is smeared all over the face.

Some of the Myanmar people, including this shrimper, are quite creative in their application of this Myanmar make-up, and apply the paste in interesting patterns.

Once at the shrimp bed, they drag a fine-mesh net, which is mounted on a horseshoe-shaped frame, through the weedy water for about 30 minutes, until it is filled with floating weeds and debris. Then they hitch their net onto the side of their canoe and spend an hour or more carefully separating the inch-long shrimp from the weeds, debris, and leeches. If they are lucky, they'll also find the occasional small fish trapped in the net.

When we arrived, the women had already worked their way through most of the material that they had collected in the net

Although they never stopped working, they were quite gracious about answering our questions

Once the net has been emptied, the process starts all over again. This pair of shrimpers is able to fill and sort three nets-worth of shrimp per day. Their day doesn't end with their 90-minute commute back home. Once home, the shrimp must be spread out in the sun to dry.

These shrimpers work seven days a week for the 2-3 month season. Except for an occasional festival day, they take no days off. Shrimping season ends when the water level in the paddy has dropped low enough for planting rice.

More Worries For Hungry Hospital Patients

Yesterday, I reported on the results of an audit of hospital kitchens in New South Wales, Australia. Now, it's the turn of hospitalized New Zealanders to think twice before eating their dinners.

Leonards Superior Smallgoods, a producer of cooked, ready-to-eat meats, today asked supermarkets to put a hold on its products after a batch of packaged cooked corned beef was found to contain Listeria monocytogenes. The contaminated product had been shipped to North Shore Hospital and to cafés on New Zealand's North Island.

Last week, Leonards was forced to recall a batch of packaged roast beef after it was found to be contaminated with L. monocytogenes. That product had been supplied to Waikato Hospital. Leonards has quarantined all of its existing stock pending determination of the extent of the contamination problem.

The possibility that hospital patients may have been served meat that was contaminated with L. monocytogenes is especially worrisome, as this pathogen typically targets the elderly, immunocompromised individuals, and pregnant women.

A Leonards spokesman told The New Zealand Herald that the company spends $3,000-$4,000 per month on product testing. Nevertheless, the contamination was detected as a result of tests carried out by the distributor, and not by Leonards.

This incident is a reminder that product safety cannot be achieved simply by testing the finished product. Listeria monocytogenes is a common environmental contaminant. The microbe is cold tolerant, and lurks in drain lines and other moist areas. Perhaps the time has come for Leonards to review its entire food safety and sanitation programs?

Sunflower Seeds Recalled In New Zealand

A quick word of warning to New Zealanders.

Ceres Enterprises and several bakehouses have recalled sunflower seeds and a variety of products that contain sunflower seeds due to the presence of glass particles. Please read the recall notice for details.

As If Being Hospitalized Wasn't Bad Enough!

According to a report in today's edition of The Daily Telegraph, patients in many New South Wales, Australia hospitals have to worry about the safety of the food they are served. A recent audit found that 166 out of 171 hospitals were out of compliance with new hygiene and safety laws. Four of the hospitals failed the audit completely.

Infractions documented at the participating hospitals included poor control of food storage temperatures, use of foods beyond their "best before" dates, unclean can openers, and a lack of pest control records.

The New South Wales Food Authority released the results of this "voluntary" audit as the result of a Freedom of Information request. But the government agency declined to name the hospitals that had failed the audit, on the grounds that this might interfere with the "business affairs" of those hospitals and might make them less willing to participate in future audits.

It's bad enough when restaurants are guilty of hygiene and food handling infractions. It's infinitely worse when hospitals neglect their responsibility to their patients by preparing and serving food that could make even a healthy person ill.

Myanmar: Fishing Inle Lake

Fish and rice are the mainstays of the Inle Lake diet, and of its economy. Fishermen spend three or four days at a time on the lake on their canoes. They work, eat and sleep on the boats. Every morning, wholesale fish merchants travel the lake on their larger boats to purchase the previous day's (and night's) catch.

Inle Lake is shallow - no more than 4 meters (13 feet) at its deepest. The shallower parts of the lake lend themselves especially well to cage fishing, which combines elements of net fishing and spear fishing.

The typical cage is taller than the average Myanmar fisherman, and its use requires a good eye for fish, and a keen sense of balance. The usual target for the cage fisherman is carp.

The carp hunter finds his prey by rowing slowly while looking for tell-tale trails of air bubbles rising from the lake bottom

One he spots the bubbles, the carp hunter carefully maneuvers his cage into position

Then he lowers the cage directly over the trail of bubbles and traps his prey

Once he has trapped his prey inside the cage, the carp hunter plunges his spear through a hole in the top of the cage and kills his catch. He then lifts both the cage and the speared carp into his boat and starts his hunt again.

Other parts of Inle Lake lend themselves to fishing with drag nets. Often, several fishermen work together.

This man is casting his net

Herding a school of fish into their nets by hitting the water with their oars

Success! Hauling a net filled with fish into the canoe

School Kids And Salmonella: A Follow-Up

Last December, I mentioned a Salmonella outbreak that hit 14 students attending St. Benedict's School in Whitehaven, Scotland. It now seems that health authorities suspect a pre-Christmas turkey dinner might have been the source of the outbreak.

Nevertheless, according to the article which appeared in The News and Star on February 23rd, the source of the outbreak might never be confirmed. Health inspectors pronounced the school's kitchens to be "clean". The investigation is continuing, but the scent is growing colder by the day.

On reading this news article, I decided to check the UK Food Standards Agency web site for their advice on how to cook turkey safety. To my dismay, I discovered that their directions omit any mention of a meat thermometer. Here is what the Food Standards Agency says:

If you're checking a whole chicken or other bird, pierce the thickest part of the leg (between drumstick and thigh) with a clean knife or skewer until the juices run out. The juices shouldn't have any pink or red in them.

Perhaps the British "stiff upper lip" is a result of eating undercooked meat and poultry?

Food Poisoning in China?

It would appear that China doesn't export all of its contaminated foods.

Channel NewsAsia reported today that 2 people died, 19 were hospitalized in critical condition, and an additional 42 people were under medical observation as a result of what is suspected to be food poisoning. The 63 victims – all employees of the same company – fell sick after lunching together at a local eatery near their place of work in southern China.

The local health department is investigating the incident and has taken samples of food and water from the restaurant.

Pork Sausage Recalled Due To Salmonella

If you love dry pork sausage and live in Greater Montreal or Greater Quebec City, you'll want to check your refrigerator. Diffusion T.G.V. Inc. of Boisbriand QC has announced a recall of Maison de Savoie brand Sarment courbe (pure pork dry sausage) due to the possibility that it may contain Salmonella.

The imported sausage is sold in 250g packages, and carries lot number 02 51 29. The packages are labeled with a "best before" date of 13.04.08. While there have not yet been any illnesses associated with the sausage, please do not eat the recalled meat. Either discard the sausage or return it to the store for a refund.

Myanmar Food Processing: Inle Lake Saké Factory

Rice is ubiquitous in Southeast Asia, so it should come as no surprise that the people of Myanmar ferment some of their crop to produce rice wine, or saké. We had the opportunity to visit a typical saké factory on Inle Lake during our visit to the area.

In a country where transportation by road and rail is limited, manufacturers must rely on local resources as much as possible for their raw materials and their equipment. One of the villages we visited near the shore of Inle Lake specialized in producing clay pots, some of which are used in the production of saké.

Here, a villager pounds clay into a fine powder.

This villager showed us how she shapes her pots on a hand-driven wheel.

This potter is putting some finishing touches on the top rim of his pot.

Rice farming is a mainstay of Inle Lake agriculture. Villagers mill their rice in factories like this. Some of this grain will find its way to the saké factory.

Saké production begins by cooking the rice in water. Other ingredients, including yeast, molasses, and sugar are added to the cooked rice, and the entire mixture is poured into clay pots. The pots are covered with cloths, and the mixture is left at room temperature to ferment for one week.

At the end of the week, the contents of the clay pots are poured into stills, and a glazed clay pot is inverted over the top of each still.

The stills are heated to boil off the alcohol from the fermented mixture. Steam is trapped by the inverted clay pots and flows through the black hoses to the condensers.

The condensers are double-walled clay pots. The outer wall of each pot has two openings - an inlet for the steam, and an outlet for the condensed saké. The body of each condensation pot contains water. The steam flows out of a tube, which is connected to an inlet hole in the outer wall of the pot, and the saké condenses between the outer and inner walls of the clay pots. The condensate is collected in plastic jugs.

The finished saké, which has an alcohol content of approximately 25%, is poured into bottles and sold to wholesalers for resale in markets and to local restaurants.

UK Salmonella Food Alert

The UK Food Standards Agency has alerted consumers to a recall of Premier Quality Seed Mix, manufactured by Imperial Snack Foods Ltd. The 150g packages are being recalled due to the presence of Salmonella in the seed mix.

Consumers who purchased Batch Code 7236/7236f IM should return the product to the store for a full refund.

Today's alert doesn't describe the contents of the seed mix, but readers will remember that there have been several recalls in the past few months of Salmonella-contaminated sesame seeds in Canada, the US and the UK.

Raw Milk Strikes Again...And Again...And Again

Earlier this week, the Kansas Department of Agriculture alerted residents of the Garden City area not to eat home-made soft cheese being offered for sale in the area. The cheese, which was made from raw milk by an unlicensed individual, is contaminated with Salmonella.

The maker of the cheese sold it to neighbors, to co-workers at a local Tyson plant, and to two stores in the area. The Salmonella contamination was uncovered as part of a Kansas pilot project to probe the safety of domestic and imported food in the state.

This is the second recent consumer alert associated with raw dairy products in Kansas. Last fall, raw milk was the source of two outbreaks of Campylobacter gastroenteritis in the state. Nineteen people became ill after drinking raw milk purchased from a dairy in one part of the state, and 68 people were infected with Campylobacter after eating cheese produced from raw milk donated to a community celebration by a second dairy. Two of the victims of the second outbreak needed hospitalization.

Pennsylvania also reported an outbreak of food-borne disease associated with drinking raw milk and eating cheese made from raw milk in early 2007. This time, the culprit was Salmonella Typhimurium. Twenty-nine consumers fell victim to the contaminated milk, which was confirmed as the source of the outbreak when the DNA fingerprint of Salmonella Typhimurium from the milk was a perfect match to the fingerprint of the Salmonella recovered from some of the victims.

Raw milk advocates continue to deny the risks of drinking unpasteurized milk and of eating dairy products made from unpasteurized milk. Some of their rationalizations can be found in comments added to my posts of December 19th and December 20th.

According to an article in Time Magazine last March, dairy products accounted for 168 outbreaks of food-borne illness between 1990 and 2004. Nearly 1/3 of the outbreaks were due to consumption of raw milk or dairy products made from raw milk, even though raw milk products represent a very small fraction of the total dairy market. That, alone, speaks volumes for the relative risk of consuming raw versus pasteurized dairy products.

Mainly Because Of The Meat?

While US consumers are dealing with the unsavory thought of meat from mistreated "downer" cows in the food supply, Sweden is experiencing its own meat scandal. A Swedish supermarket chain, ICA, has been systematically regrinding and relabelling out-of-date meat.

The story first broke last December on Swedish Television (SVT). The investigative program Uppdrag Granskning reported that ICA stores routinely engaged in several deceptive practices to change or extend "best before" dates. These practices included repackaging meat that had already been on display, regrinding and repackaging ground meat, and rinsing and repackaging old or sticky sausage meats.

The deception is apparently long-standing. Hans Hallén, a former quality control manager for ICA who was responsible for monitoring the performance of the chain's stores in southern Sweden between 2003 and 2005, claims that he informed ICA management of the practice during his tenure with the company. His position, along with that of the seven other quality control managers, was terminated in 2005.

Public prosecutors are preparing to lay charges against the stores that were identified by the SVT program's investigation. Prosecutor Solveig Sörlien is hoping to achieve more than a slap on the ICA wrist by imposing what is known as a "company fine" – a fine that is based on the extent to which the company profited by its illegal activities – rather than the very minor fine that is usually associated with an infraction of food safety regulations.

Swedish food inspectors had uncovered of more than 30 cases of mislabeling – ten of them involving ICA stores – even before Uppdrag Granskning broke the story. Nevertheless, after the scandal became public, ICA management denied any knowledge of the problem, while claiming at the same time that the practice was "...not systematic or widespread."

Maybe the Myanmar butcher shops aren't so bad after all?

Norovirus - The Nursing Home Nemesis

Hong Kong has been struggling with the problem of Norovirus-caused gastroenteritis in its elder care facilities, nursing homes child care centers and hospitals. In 2006, there were 269 recorded institutional outbreaks of Norovirus, affecting approximately 3,250 people.

The scope of the problem was somewhat less in 2007, but still significant. The Centre for Health Protection (CHP) reported 93 institutional outbreaks, involving 921 victims by December 21st. One subsequent outbreak, reported on December 27th, brought the year's total number of victims to 36.

The problem shows no signs of abating in the near future. In January 2008, the CHP reported three outbreaks of gastroenteritis in Hong Kong seniors' residences. The 64 victims of these outbreaks all experienced typical symptoms of Norovirus infection - diarrhea and vomitting.

While investigations are still in progress, the initial reports, issued on January 4th, January 7th, and January 9th, describe symptoms to the confirmed outbreaks of last year. A fourth outbreak, involving 25 residents and 2 staff members in another seniors' residence was announced earlier today.

This problem is not unique to Hong Kong. Institutional outbreaks of Norovirus gastroenteritis are common in many parts of the world. In the last couple of years, for example, nursing home outbreaks have sickened 176 residents and staff of a nursing home in Spain, 52 staff members and patients in a nursing home and a hospital in Austria, and 25 residents and 5 staff members of a Slovenian nursing home. Three institutions in Japan experienced an outbreak that affected a combined total of 108 individuals, including patients, staff members and outside contacts of outbreak victims.

The United States has been wrestling with Norovirus, too. In the last quarter of 2006, long term care facilities in the US reported 762 confirmed outbreaks due to this virus. This total, which included information from only 24 of the 50 states, is an understatement of the problem, since not all of the 50 states routinely tested clinical samples for Norovirus.

Prevention and control of Norovirus presents special problems in the close quarters of health care, child care, nursing home and elder care facilities. Onset of the illness is sudden, often resulting in virus-laden vomit or feces contaminating public areas. The virus is also highly contagious - a dose of just 100 particles can cause disease. And Norovirus is more resistant to freezing, heating, and many disinfectants than either bacteria or some other viruses.

Norovirus outbreaks can best be controlled by paying careful attention to personal hygiene – especially thorough hand-washing – and disinfecting all potentially-contaminated surfaces. In some situations, isolating patients suffering from gastroenteritis may be desirable.

Chlorine bleach is an effective tool for disinfecting Norovirus-contaminated surfaces. Quaternary ammonium disinfectants, commonly used in food-service areas, do NOT work. Phenol-based disinfectants can be effective, but must be used at a higher concentration than what is recommended by their manufacturers.

For more details on dealing with Norovirus, check out the web site of the Centers for Disease Control and Prevention.

Tasmanian Government Lays An Egg

Recently, the Australian state of Tasmania was hit by an outbreak of salmonellosis. The outbreak, which affected more than 80 people, has been tentatively linked to sauces made from raw eggs sold by one producer - Pitt's Poultry.

In response to political pressure, the government of Tasmania has decided to require raw eggs to carry a warning label. But the only eggs to be affected by this new requirement will be those produced by Pitt's Poultry.

I have to admit that the logic of this ruling escapes me. It isn't news to anyone in the food safety profession that raw eggs - even those still in clean and intact shells - carry a risk of Salmonella contamination. This is true for eggs produced in North America, where USDA estimates the risk at one egg in 20,000. It's true in the United Kingdom and the rest of the EU. For more details on this problem, read Chapter 3 of my book, Food Safety: Old Habits, New Perspectives.

If one egg producer in Australia is experiencing this problem, others will surely follow. The only sensible thing to do – assuming that a warning label is warranted – is to require that ALL raw shell eggs carry the same warning. Anything else, in my opinion, is simply pandering to political pressure.

Food Safety: Where the Candidates Stand

As a follow-up to my post of yesterday, I decided to Google the various Presidential Primary candidates who are still in the running, in order to find out what they have said and done about food safety issues in the past, and where they stand today. Within each party, I have listed the candidates in alphabetical order.


The Republicans

Mike Huckabee: Former Arkansas Governor Mike Huckabee has been silent on the issue, as far as I can tell. His official website lists Agriculture as a policy area, but he makes no mention of food safety. Governor Huckabee's focus is on self-sufficiency in food and energy supplies, encouraging young people to consider agriculture as a career choice, and providing subsidies to help American farmers.

John McCain: Senator McCain has been a Washington political fixture for many years. He was present during the major food recalls of the 1990s, as well of the more recent outbreaks and recalls of the current decade. Yet, I have been unable to find any mention at all - either on his official Senate website, on his official campaign website or on his list of news releases - of the importance of improving and maintaining the safety of our food supply.

Ron Paul: Congressman Ron Paul proposed House Resolution 4077 to permit the interstate shipment of raw milk, and opposed the National Mandatory ID system for farm animals.


The Democrats

Hillary Clinton: Senator Clinton has a long history of advocating improvements to the national food safety system. In 2001, she co-sponsored an amendment to the proposed 2002 FDA budget to increase funding for food safety activities, and argued against a move to exempt meat from federal inspection. She has also called for an investigation into outbreaks of E. coli O157, has urged the FDA and USDA to form a joint task force to examine ways to improve food safety, and has pushed for implementation of Country of Origin Labeling of imported food and feed. Senator Clinton's campaign web site outlines her food safety policy proposals, which include consolidating federal food safety responsibility into a single agency.

Barack Obama: Senator Obama released a statement in reaction to the recent recall of meat by Hallmark/Westland, following the Humane Society's report of animal abuse at the slaughterhouse. I have searched his official senate web site and his campaign web site, but have been unable to find any other policy statements or significant actions relating to food safety.

With the occurrence of an estimated 76 million cases of food-borne illness and 5,000 deaths in the U.S. annually, food safety issues deserve to be on the radar screen of every serious candidate. Please post a comment if you have any additional information on the positions or actions taken by any of these candidates.

International Year of Sanitation

In December 2006, the United Nations General Assembly declared that 2008 would be the International Year of Sanitation. The worthy goal of this body is to cut in half by 2015 the proportion of the world population that is without access to basic sanitation.

As is the case with most "International Years", the purpose of the UN declaration is to focus attention and energy on a specific problem and its possible solutions. One success story is unfolding, bit by bit in Nigeria.

In 2003, the government of Niger State in northern Nigeria partnered with the United Nations Childrens Fund (UNICEF) to bore two wells in order to provide clean drinking water for the village of Lokoto. But, as reported yesterday on allAfrica.com, the project organizers didn't stop at simply providing a source of clean water.

Realizing that education was essential to improving hygiene in the village, UNICEF and the state government enlisted the assistance of the local school headmaster, who now teaches village children the importance of hand washing. They also convinced the village residents to install latrines, and taught the villagers how to use and maintain them. And a local "wash" committee was formed to take responsibility for building and maintaining refuse pits. These pits now produce compost, which the village farmers use as fertilizer.

The project has yielded a major improvement in community health. According to the report, infectious diarrheal disease has almost disappeared, and school attendance is up.

Last month, we visited several areas in Southeast Asia that could benefit from improvements in basic sanitation. Especially, the Inle Lake region of Myanmar cries out for this type of assistance.

Most of the villages of Inle Lake are built on stilts over the lake. This is a typical house. The extension built from thatched panels at the right-hand corner is the outhouse, which empties directly into the lake.

This is one of the outhouse toilets

And an empty slot that lost its toilet.

The waters of Inle Lake serve many purposes beyond that of being a communal latrine. Some of activities carried out on and in the lake include:

Washing cooking pots

Fishing

And shrimping

The government of Myanmar might be an international pariah to much of the world, but the people of this region need all the help they can get.

Democratic Presidential Candidates: On Food Safety

Bill Marler posted this morning Hillary Clinton's policy proposals for our food safety system. The Clinton campaign press release , issued yesterday in the aftermath of the 143 million pound meat recall, covers several aspects of food safety, including mandatory recall authority, consolidation of responsibility for food safety oversight into a single agency, and carrying out an immediate audit to find the weaknesses in our present system.

I looked for, and found, Barack Obama's statement, also released yesterday, which I have quoted in full below.

Chicago, IL - Senator Barack Obama released a statement on the Department of Agriculture's decision to recall 143 million pounds of frozen beef that came from "downed" animals. The consumption of downed cattle can pose a higher risk of contamination from E. coli, salmonella or mad cow disease.

Senator Obama released the following statement:

"Senator Barack Obama released a statement on the Department of Agriculture's decision to recall 143 million pounds of frozen beef that came from "downed" animals. The consumption of downed cattle can pose a higher risk of contamination from E. coli, salmonella or mad cow disease.

"Senator Obama said: "Although the Department of Agriculture has now recalled the tainted beef, an estimated 37 million pounds has gone to school lunch programs, and unfortunately, officials believe that most of the meat has already been consumed by schoolchildren. This incident demonstrates yet again the inadequacy of the food recall process. Far too often, tainted food is not recalled until too late.

"When I am President, it will not be business as usual when it comes to food safety. I will provide additional resources to hire more federal food inspectors. I will also call on the Department of Agriculture to examine whether federal food safety laws need to be strengthened, in particular to provide greater protections against tainted food being used in the National School Lunch Program.

"As the parent of two young daughters, there are few issues more important to me than ensuring the safety of the food that our children consume. I commend the Humane Society of the United States for bringing this important issue to the public attention and believe that the mistreatment of downed cows is unacceptable and poses a serious threat to public health."

It would be nice to know what the co-sponsorship and voting records of both Senators has been on the various food safety bills that have been presented in Congress while they have been in office.

Cholera Strikes Again - This Time In Kenya

According to a report today on AllAfrica.com, cholera has claimed the lives of six people in Kenya's Mandera district. During the past week, 130 people have sought treatment for cholera in the district, and 60 have been hospitalized.

The public health officer for Mandera town has ordered 25 food kiosks closed due to poor hygiene. According to him, the outbreak could also be due to contaminated water in the Dawa River that flows nearby.

An unnamed source has said that the Mandera hospital has asked for additional supplies of drugs to treat the cholera patients.

Rat Dim Sum?

According to a February 15th article in the National Post, Toronto health authorities have closed down a Chinatown restaurant after a passer-by photographed live rats in the restaurant's picture window and posted the picture on a Toronto city blog site.

The manager of the Dumpling House restaurant was quoted in the article as saying,

"In this city, rats are a huge problem. It’s a city problem, not a restaurant problem. I don’t think the city has a plan to fight the rat problem."

Perhaps Toronto should export its rats to Bagan, Myanmar, where they are considered a delicacy.

Myanmar Refreshment Stands

Back in the days of my grandparents, when refrigerators hadn't yet replaced iceboxes in the kitchen, the iceman's visit was part of the morning routine. In Yangon (Rangoon), as in many other parts of Southeast Asia, the iceman still makes his morning rounds.

This video, which was taken in the Yangon's city centre market, shows how - and where - the iceman prepares to make his deliveries. First, he saws the large blocks of ice into smaller pieces. Then, his helpers stack the smaller ice blocks, separating the stacks with sawdust to help insulate them and to prevent them from sticking to each other. He's now ready to undertake his daily deliveries to the local market stalls, or to any household or business on his list of customers.



The ice blocks, which are made from non-potable water, are used in numerous ways by the Myanmar people. Those who are lucky enough to have iceboxes will use a block of ice to keep perishable food cool.

Some vendors crush ice and add it to fruit juices to make a refreshing beverage.



One popular beverage in the Bagan region of Myanmar is lime-flavored sugar cane juice, squeezed fresh while you wait. We watched the process at a roadside refreshment stand.



The juicer's assistant takes a small block of ice in hand, crushes it by hitting it with a wooden stick, and puts the crushed ice into a glass mug.



In the meantime, the juicer grabs a handful of sugar cane stalks and proceeds to feed them into a hand-cranked crushing machine. He feeds the stalks through several times, in order to extract all of the juice. On the last run-through, he sandwiches a couple of wedges of fresh lime between the stalks.



The juice collects in a small bowl, which the assistant empties periodically into a pitcher.



Finally, the assistant pours the juice into the ice-filled mugs.


A side note about Myanmar attire. Most men and women wear a traditional "skirt" known as a longhi. This is a long piece of fabric (typically cotton for everyday wear) sewn into a tube. Men tie the tube in a large knot in front, whereas women tie or tuck it on the side. It's not unusual to see men undo and retie their longhi as they walk along the street.