Thrills! Chills! Taiwanese dentistry!

So, right on the heels of this post (yeah, I know, I'm linking it but it's right below, whatevs) I started to feel a vague ache in my jaw. I figured, as usual, it was a wisdom tooth coming in and so it'd hurt a bit for a few days and then go away, just like with the other ones, which came in normally.

By the end of Brendan's birthday party it was a bit more serious, but I'd had three cocktails and could still eat, though it was hard to open my mouth fully, so I figured I'd sleep on it (not that I had much choice; by that time there were no realistic medical options beyond an emergency room run for prescription pain medication). Deep down I knew that this was more serious, but didn't really want to admit it. I'm the author of this old Lonely Planet classic from 2003 and as a result of that experience I'm a bit wary of dentistry generally, at least when it involves more than a filling.

This morning it was worse, and by 2pm I was seeking out a dentist, with a growing fear in my heart that this would not end well. And it didn't: I did have an impacted tooth, I did need it removed, and the pain wouldn't go away until it was removed. So I had it taken out. Once again, I didn't have much choice: it was so bad I could barely eat, and if I wanted the full general anesthetic I'd have to make an appointment and go to the hospital, which would have to wait until Monday at the earliest.

This brought me in touch with yet another aspect of Taiwan's health care, so I figured I'd write about it here.

The bad parts were (mostly) not the fault of the Taiwanese system or the dentist:

- I had it done with just Novocaine (or whatever they use now), not general anesthesia. Apparently that's normal for fully erupted wisdom teeth. I'd assumed that one got put under because, hey, it's a pretty medieval procedure when you think about it. It's basically the same thing as Ye Olde Tooth-Puller, except more sterile and with local anesthetic instead of local moonshine. This surprises me - if I ever have to get this done again, goshdarnit, I'm going under! Waking up from general anesthesia is not as horrible as being fully conscious when they do...that...that...twisting forcep thing to you.

- My tooth was more firmly embedded than most, so it took longer and was more painful than it normally would be.

- The ginormous forceps. The pressure. The blood. That crunching sound as they widened the socket and maneuvered the tooth out - I admit that I started sobbing. I'm not even embarrassed about that. It was thoroughly horrifying. (I have kind of a fear of crunching bone and have never had to face it, as I've never had a broken bone, so there's that too). Why don't people go under for this?

- I had to do it all in Chinese. My regular English-speaking dentist closes at noon on Saturdays so I went to the first dentist I could find, and he didn't really speak English. Considering the circumstances I think I did pretty well. With a wad of bloody gauze in my mouth, I managed to say "給我你們最強的藥。鴉片，大媽 － 都可以！"

- The horror of the procedure was kind of low-balled, in my opinion. I was told "It's OK to get it without general anesthesia. It's a little uncomfortable but I promise it doesn't hurt". Yeah, uh, it's true that it's not "painful" but they clearly have a different threshhold of what constitutes acceptable discomfort! I thought "OK, maybe that means the tooth just comes out" but no, it means "we get to squish your skull and move the tooth around in the socket, which causes bone trauma, before extracting it with the biggest forceps you've ever seen, and you'll feel it in your EYEBALLS".

- I do feel that partly because of the language barrier, I wasn't given enough prep on what to do afterwards. For example, they didn't tell me not to drink from a straw, so I started out doing that (then found out I wasn't supposed to, and stopped). They told me not to spit, but they didn't tell me how to properly brush my teeth and rinse. They didn't tell me about the importance of not dislodging the blood clot. They didn't tell me to avoid solid foods for two days (although I kind of assumed that). They did say "only eat food you feel you can comfortably eat. If you feel wary, don't eat it", but that's it.

- The painkillers they gave me? Yeah, so not strong enough. I've been supplementing with Panadol.

...but there were some good parts, too - somewhat attributable to the Taiwanese healthcare system.

- The entire thing cost three US dollars. Yes, $3. US. No missing zeroes. Fo' shizzle, to steal an outdated '90s slang term. A friend of mine broke her ankle in January and it's not healing, and has to have surgery. She is currently waiting for insurance approval to have the procedure and is living a very limited existence while that approval goes through. She'll still be in the bag for several hundred, if not thousand, after it's approved (which it had better be). I walk into the dentist, no appointment, pay THREE DOLLARS, and get a wisdom tooth out. It really throws the two systems into stark relief, when you put it that way, and it's clear which system comes out on top.

- General anesthesia is a covered option: I'd have to go and stay in a hospital and it would be delayed and take longer generally, as well as cost me a bit more, but it is a possibility. I'm hoping there's no next time, but if there is, I'll take this option. No way will I be conscious if those terrifying tongs of terror come near me ever again. Not every American insurance plan offers that for an erupted tooth.

- I was able to make a follow-up appointment for Monday. Not all American dentists do that - if you think you're healing fine they don't worry about checking on you a few days later. You only go back if there's a problem. In Taiwan, I'll go back on Monday, pay another $3 and get checked to make sure it's healing smoothly, which is a good way to help prevent possible dry socket, something I'm at elevated risk for.

- No appointment necessary! Try THAT in the USA without a severe emergency (mine was an emergency in that I couldn't eat, but not so severe that an American dentist wouldn't have minded if I'd shown up without calling first).

- My sweet and wonderful husband, who came immediately out to the dentist's when I texted him with the news, was there when I started sobbing (which I did - that crunching bone sound really freaks me out and I think I'm going to have nightmares about those massive glinting forceps), went out to buy me more gauze, soft food and Panadol, made me a smoothie and has generally taken great care of me.

- Millions of people suffer from far worse pain than this and have chronic conditions, or can't afford treatment (ahem USA....ahem), or have no access to treatment (much of the Third World). I have led a relatively pain-free life with the one exception of my severe slipped disc, and really, I'm quite lucky. So please don't take this post as pure complaining.

Anyway, my advice: no matter whether the tooth has erupted or not, go ahead and get general anesthesia. This is one heck of a traumatic procedure when you're conscious.

Improving Taiwanese Health Care: Some Suggestions

As most Taiwanese and expats in Taiwan are aware, our fair country boasts one of the best healthcare and health insurance systems in the world. We have care that is comparable to that in a Western country - I've never felt as though the care I received in Taiwan was substandard or not as good as what I'd get back home. We also have a government-sponsored insurance program that, while expensive for the government, is not nearly as expensive as for the Canadian and British governments, who control care as well as payment - or for the USA, where we bear the cost of a broken insurance system and astronomically priced care later on, in the wasted money of inefficient and unproductive workers who can't perform better because they can't afford treatment for what ails them. It may cost Taiwan a lot of money to run its program, but it's still a step ahead of the USA where even greater costs are invisible (or at least we'd like to pretend they are).

It was wise for Taiwan to have a public insurance plan but allow for private care clinics that do accept insurance, alternative plans and non-insured clinics to exist. It takes the burden of paying to build the infrastructure off the government and allows basic supply and demand to determine the availability of care. As such it's less expensive and there are more care options without long waiting periods.

I'd like to see the USA adopt a system similar to Taiwan's, which does mean that everyone would be obligated to have insurance, just as everyone pays taxes to fund education and then has access to that educational system. Generally, we have a great system in Taiwan that deserves accolades, study and emulation globally.

There is definitely room for improvement, though. There are a few aspects of the system that I would like to see changed...now. Here are my thoughts:

- Women's health: cover more reproductive health options and preventive osteoporosis testing.

In terms of women's health in Taiwan, there is a striking dichotomy. On one hand, pelvic exams for women over 30 are covered at a rate of one per year. OB/GYN services are covered, birth in a hospital costs a bit more but does receive coverage, prenatal care (I believe) is covered, mammograms and other women's health issues are covered and there is excellent coverage for treatment of illnesses that affect women.

On the other, birth control is not covered. This is ridiculous, seeing as it's a $450-$600/month proposition, or more - that's more than you'd pay for a weeklong hospital stay if you have a shared room! Granted it's still only US$20 a month, but it should still be covered. I've heard two reasons as to why it's not: the first is that contraception is "elective" (excuse me?!) - you don't "need" birth control, apparently (yeah, you don't "need" it according to people who are deeply out of touch with modern society). The second is more sadly pragmatic: the government wants to increase the birth rate - something I personally don't think they should be encouraging, in fact, I think it's short-sighted and idiotic - so they are happy to push women to become mothers in any way they can.

This second reason is downright sexist: if a woman is sexually active, as most adult women are, she has to bear the full price of contraception. For me, NT$600 is not a lot of money but for a college student who doesn't feel she can talk to her parents about the issue? A new graduate in her first job earning NT $25,000/month? A working-class woman, whether foreign (such as a domestic care worker) or Taiwanese who may earn far less? A foreign bride who can't or doesn't want to communicate with her husband on the issue? NT$600 is a bigger burden for them, and yet the government doesn't seem to care. Considering the general attitude towards condoms in Taiwan, that's hardly a solution.

It also pushes women who can't afford the pills to risk pregnancy when they are not necessarily in a position to become mothers.

Abortions are only covered in certain circumstances (in the case of rape, incest, a health threat or "seduction" - whatever that means - I believe it does receive coverage, but if you claim "psychological duress" it's not, as far as my research showed). They should receive coverage regardless.

Osteoporosis preventive testing is only covered after a fracture, and you are only covered at a rate of 2 or 3 for life. It's not an expensive exam, and should be covered for women over a certain age.

Also, cover iron supplements (NT$800 per bottle, generally) for menstruating women and calcium supplements for women at risk of osteoporosis. This is an important component of good female health. Many women suffer from anemia during certain points of their cycle and this is a simple way to boost overall health and as a result, productivity (a woman who is not anemic is going to be more attentive, alert and efficient at work than a woman who can't think straight and feels dizzy, as I used to before I realized that it was caused by cyclic anemia).

- Have a payment plan offering so that those who need an emergency procedure but don't have the money can pay it off gradually.

Right now, if you need a procedure you're expected to pay for it more or less immediately. If you can't pay, in theory you can't get the procedure. For those who need immediate care and have no money, there are charities that can help pay or defray the cost. Generally if you have family they will also step in to help if you don't have the money. This is insufficient, however, and not always available to foreigners. A system in which, if you require expensive treatment (or inexpensive treatment but you happen to be below the poverty line), you can get it and pay it off in regular monthly installments would be a great improvement in terms of health care availability for the poor, working class and struggling.

- Pay for the most effective procedure or medication, not the cheapest

Also not necessarily the newest, most expensive or most advanced: do more objective research into the most effective procedures and cover those, even if they are not the cheapest option. This will save money down the road, as people who receive more effective care generally need less care later. This includes procedures or medications with the least side effects or recovery time.

Here's a real life example: when I first came to Taiwan, I ended up with a severe herniated disc in my lower back - so severe that it required surgery. There are two surgical options: a multi-hour ordeal with a full opening of the back and two-month recovery period, and microsurgery, which takes an hour, has a one-week recovery and is easier on everyone from doctor to patient to employer. NHI only covers the first option, which seems downright medieval when better technology exists. The second option is out-of-pocket and costs NT$80,000. Still cheap by American standards (that's what it would cost in the USA with many insurance plans) but still a few thousand US dollars.

I had the microsurgery. Rather than keep someone out of work for over a month and have the doctor do an operation that takes up half a day when he or she could be seeing other patients, I truly do not understand why they don't just cover microsurgery. In terms of economic productivity, someone who can be back to work in a week and a doctor who can see more patients is better in the long run, even if microsurgery is more immediately expensive.

The same is true for medication: for septic shock, the most effective medication costs NT$300,000 a dose (I believe it works in one to three doses) - NHI doesn't cover it unless the patient has suffered two organ failures. If they covered it before the organ failure(s) though still as a second-string option, sure it'd cost a lot up-front but in the long run, you'd have two less organ failure treatments to deal with - and those can get expensive.

Along these lines, cover procedures that greatly increase patient comfort, even if they cost more. Obviously some are more effective than others, but occasionally a slightly more expensive procedure can drastically improve patient comfort, especially for the elderly. A more comfortable citizen is a more productive citizen.

- Cover preventive care.

A popular new benefit offered by Taiwanese companies is an annual check-up. As a foreigner, I have to get a check-up on my own dime every year to renew my work permit. I don't mind this, as physical exams are good to have regardless, and by American standards it's not that expensive (NT$800-$1600 depending on the hospital). Preventive care for Taiwanese should be covered - one inexpensive check-up per year could save thousands, if not millions, of NT dollars per patient down the road. I'm happy that many people have this option through work, but many don't, and most don't want to pay out of pocket so they simply forgo preventive care. This really ought to be addressed.

- Cover better dental care.

Cleanings and fillings are covered, but root canals and crowns are not. Why? How is that "elective" in any way? If your tooth is abscessed or infected and you need a root canal and crown, how can you not get it? As someone with three crowns (I blame the water in China), I can say that you really can't eat or do much of anything without one, if you've undergone a root canal.

Why on earth is this not covered?

At least vision care receives pretty good coverage.

- Consider not covering certain elective Chinese medical practices.

I don't mean "stop covering Chinese medicine" because, while I do believe it's a good holistic method of preventive care and yet not good for acute treatment, it is a part of local culture and as such deserves respect and coverage for people more comfortable with that option. Chinese herbal medicine should definitely be covered (especially for preventive care). Things like suction, acupuncture etc. have not been proven to work, however, and don't deserve coverage while other important things, such as more effective procedures, women's reproductive health and preventive care are neglected.

Friendliness vs. Manners in Taiwan

-->

Sometime last year, in the middle of that big yellow dust storm that blew in from China, I met a friendly acquaintance for coffee. He was handing over a short-term gig as he and his partner were soon leaving Taipei, bound for the hard glitter of Hong Kong.

“What caused you to choose to leave, if I may ask?” I said while trying to manage my grossly oversized latte.

“People here are just…rude” – the word hit the table with a clang. “They have no sense of manners.”

I thought about that for a minute.

“Well…from the perspective of American etiquette – yeah, you’re right. But…they’re friendly! You’ve gotta give ‘em that much! They may push on the bus, never RSVP and stop in the middle of the sidewalk to answer their cell phones, but nobody can say they’re not nice people, under all that.”

“Yeah, I guess so,” he remarked, unenthused and unconvinced.

I did mention, but didn’t linger on, the fact that Hong Kong people can be just as rude if not worse, and that where they have a stronger sense of Western-style etiquette, I don't find Hong Kong as friendly or kind as Taiwan. I figured, maybe Hong Kong will be more to his liking - and that’s great. Everyone deserves to like where they live. I also figured, if he prized good ‘manners’ over friendly openness, well, that’s fine too. Not my business. Diff’rent strokes and all that, to use an old cliché.

I’ve mulled the conversation over since then and come to this conclusion: Taiwan is a friendly place – Thailand may be famed for its smiling locals (many are genuinely nice, some are smiling because they’re thinking of ways to take your money) but, honestly, in all my travels in Asia I haven’t met a general population as welcoming as the Taiwanese (although I also found Bangladesh to be especially welcoming - perhaps because it doesn't have a tourist industry per se). A genuine sense of welcoming pervades Taiwan, not the kind where you have to watch your back for that kid who seems nice but really just wants you to buy something from his cousin’s carpet shop.

I have noticed that a lot of the foreigners who leave Taiwan feeling as though it’s a lonely, uncaring, monolithic and monolingual place – or worse yet, leave thinking that the Taiwanese are mannerless boors (which is only true insofar as you believe American etiquette to be the pinnacle of good taste), do so because they are wrapped up in specific ideas of how social etiquette works, and aren’t necessarily open to it working a different way. That’s not to say that the person I met for coffee was close-minded or unwilling to try – I didn’t know him well but he didn’t seem to be.

Just that there is a big difference between “being friendly” and “having good manners”. Friendliness is, to some extent, universal. Having good manners is not, or at least is not measured on a universal standard.

I have come across many foreigners who confuse the two and, as a result, dismiss the Taiwanese as “unfriendly” simply because they have a different approach to etiquette – not because they are actually unfriendly.

From my perspective, the Taiwanese are (generally) eager to welcome and befriend foreigners, and not in a “Speak, English Monkey, speak!” way, at least not nearly as often as you’d think (yes, it does happen, but it’s not as common as some expats allege it is). If you look remotely confused while outside, someone will drag out their best English, come up to you and ask if you need help. Forget your purse in a taxi (I’ve done it)? A staff member at Ikari Coffee, of all places, helped me call the police, who put out a taxi radio-wide notice and I got my purse back - with all the money in my wallet still there (frankly I was more concerned as my passport and all other ID cards were in that purse). Show that you speak Chinese and taxi drivers are the chattiest people you’ll meet – and if you don’t speak Chinese, they’re not silent because they want to be: they just may not speak English. While hiking in the Pingxi area, thirsty and a bit overheated, we walked down to what we thought was a café (old house with lots of chairs and tables around). It was a private home, but the owners – who were hosting friends and family – ushered us in and fed us and gave us water anyway, even as we protested. Everywhere I go people strike up conversations – even when I had first arrived and had few (or no) friends, I was never lonely. Someone would always talk to me, even if it was superficial chat between strangers.

Anyway. I have a million stories like this from my time in Taiwan. The flip-side stories about people being mean, distant, apathetic or cold are few and far between (I could tell you about this one horrid taxi driver who insulted me for making one mistake with a tone while giving him an address…but he’s in the minority.)

And yet…there’s a huge etiquette gap between the USA and Taiwan. Here, it’s fairly normal to leave cell phones on through class (I allow this only because the people I teach have demanding jobs and really do need to pick up if the boss is calling), temples and museums…and to answer them too. People will wander down the street looking at something on their smartphone or just chatting, not paying attention to any other pedestrians. Bike riders don’t pay attention to pedestrians and scooter drivers, while they are more attentive, hog sidewalk space that they really shouldn’t. Pedestrians stroll at impossibly slow speeds with their friends or on the phone, often blocking the entire thoroughfare in both directions…and pay little attention to anyone who wants to get past. Scooters park in the most irritating places. Yes, people push to get on buses and more than once I’ve had someone cut in line to board the MRT.

No, they don’t write thank you notes (or e-mails) and no, they often don’t RSVP on time if at all. Yes, they do cancel plans even after saying they’ll be there – if Grandma wants to go out to dinner or Auntie Chen stays in town a few extra days, long-held plans with friends are canceled, often with less than an hour to go.

All of these things are true – not true of everyone, and not true all the time, but true enough to be observed frequently and remarked upon.

None of them mean, however, that the Taiwanese are “unfriendly” or “rude”. I define “friendly” by how receptive people are to being friends – real friends, not “gossip behind your back” friends, not by cultural standards of when it’s OK to cancel your plans with someone, or realizing that you’re supposed to RSVP. I define “rude” by somewhat subjective cultural standards and while a lot of the above behavior can be irritating, it’s not a marker of friendliness or unfriendliness.

So while I wish all the best to that person in Hong Kong – he probably will like it more than Taipei given his preferences regarding social behavior, and I have no problem with that – I’ll take friendliness over etiquette any day. As such, I’ll take Taipei over Hong Kong any day.

Made in Taiwan...And Proudly So

In the not-too-distant past, I've seen several references to Taiwan's old reputation as the font of all consumer junk. You know, the way Taiwan used to be, with it's clogged skies and sooty factories, turning out cargo ships worth of Barbie dolls, second-rate microwaves and vacuum cleaners, cheap clothing and plastic items - basically all the stuff that's now Made in China, busy across the strait ensootening China's air.

There's this post on Regretsy: "Eventually. Hot Topic starts making their own version in Taiwan, and the circle of ****ery is complete".

There's this post, clearly confusing "Made in China" with "Made in Taiwan" - a recurring theme I saw when planning my wedding - people either praising or complaining about knock-off items "Made in China" or "Made in Taiwan". I've seen this on older forum posts, including in private forums (from which I don't feel comfortable taking quotes - if people prefer to keep their forum private I will respect that).

Here's the thing - all of us who've been to Taiwan, or even follow global economics, know that while you can still find consumer products Made in Taiwan, really, the vast majority of them are now Made in China, or Made in [Insert Southeast Asian Country/India/Bangladesh Here]. Taiwan's gone from making the world's cheap pens and plastic dolls to making the world's semiconductors, research and development heavy ODM computer products, high-end whiskey (I'm not sure it's as good as they say it is, though) and top-rate tea.

So...what is it with people back home still associating Taiwan with, well, cheap pens and that Dustvac they once had that broke after six uses? Is it that they're just not aware that little bits&bobs and shoddy electronics are no longer made here, or do they not care, or worst of all - do they think that Taiwan and China are basically the same place? Do they really think that all of their super-fancy computer products are made in the USA and that Taiwan is stuck with flashlights and knock-off handbags? Heck, the super-fancy computer products are often designed in Taiwan and yet, like your umbrella, also made in China (not always, though - some Taiwan design manufacturers do have Taiwan-based fabs).

I don't really have an answer to that, but wanted to comment on the phenomenon.

And yet...here in Taiwan I'm seeing a move in the opposite direction.

There are tons of indie designers here that are gaining a lot of local support, both for their talent and for the fact that they are Taiwan-based. The weekend market at the Red House Theater is packed, and a similar (but pricier) marketplace set up in a building at Kaohsiung's Pier 2 was equally crowded when we were there. I'm a big fan of the handmade soaps, locally-designed and made earrings and necklaces, reprinted vintage advertisement postcards and locally designed and printed postcards and notebooks to be found all about, as well.

I've also been hearing more and more, as my years in Taiwan march on, from friends and students that they purposely buy and prefer to spend their money on products Made in Taiwan - that rather than treat the label with derision, as many in the West still do, they treat it as a source of pride. As the quality of Taiwan-made products has increased quite a bit, this makes a lot of sense. If you look around, it's rarer to see "Made in Taiwan" stamped surreptitiously on the underside of something, a little half-embarrassed mark in plastic where it's hoped that nobody will catch a glimpse.

Now, you see it sewn right on the side of hiking boots (my old pair, which were worn through due not to lack of quality but simply how much I wore them, had just this label prominently displayed). You see it stamped on the front of food products in proud sans serif. You see it on stickers announcing that these batteries or that scarf were made not in a dodgy factory in China - which is fairly often run by a smarmy Taiwanese boss, but we won't go there today - but produced in Taiwan and therefore of superior quality.

I have students who always buy I-mei sweets ("guaranteed to be made in Taiwan", said one), who give their college-bound children, nieces and nephews Datong electric cooking pots ("it's kind of a tradition. Every college student has one. It would be so sad if they stopped making them"), purposely choose a Chimei TV even though other brands seem more prestigious, and are happy to say they own an Acer computer - which, while not as durable as the competition, do make up for it in price. The other day I was given an ice cream sandwich (probably I-mei, but I'm not sure) in class - they had hundreds of extras in their freezer, left over from a trade expo - with "MADE IN TAIWAN" printed in huge white letters in a black circle on the front.

"Made in Taiwan is a sign of quality," one student remarked, "although I'll buy imported products as long as they're not..." (shudder)..."made in China. Of course sometimes I can't avoid it, but I try."

I'm no social scientist, but I'm going to put my neck out there and say that this feels like a trend to me - just like the old "Made in the USA" or "Buy USA Made" hullaballoo back home.

I, for one, am happy to see it.

Taipei Mooching

I thought bajiajiang could only be men, but this one looks female to me. Also, note the green colored contacts, making it extra cool.

I STILL have a bit of a headache so I'm not posting much in terms of writing today. Sorry!

Yesterday, Brendan and I went on a long walk around northwest Taipei - we started at Xingtian Temple, walked up Linsen to Chengde and up Chengde to Kulun and then Hami Street, where we stopped in at the Confucius Temple and Bao'an Temple. We also stopped in a few bookstores (Caves, the Hess bookstore) just for fun.

We then walked down Dihua Street for a stretch, then down Yanping to find a snack, then over to Anxi and back to Dihua where we had dinner. While having dinner, a group of bajiajiang unexpectedly came up on the City God Temple, so we took some photos of that before walking back to Zhongshan for coffee and then heading home.

I took this set of photos, despite the bad weather, while doing that walk, and posted the best ones end-to-beginning below.

Enjoy!

Another shot of the green-eyed bajiajiang (array of 8 martial guards found in Taiwanese temple parades, wearing face paint and other accoutrements)

Bajiajiang inside Xiahai City God Temple with the leader, who did a dance outside that involved kicking burning ghost money.

This troupe was friendly (as friendly as bajiajiang are allowed to be in costume/in part) and eager to be photographed. I suspect, with the age and the enthusiasm, that this is a new troupe.

I enjoyed the chance to take photos of them taking off their costumes - note weapons going down, makeup coming off, hats and wigs lifted off. Mircea Eliade would have called the bajiajiang, in costume, as being in a "sacred" act - that's why they can't speak, they will maul you if they are doing a martial demonstration and you are too close, they can't eat, talk or drink in sight and have to cover themselves with a fan if they do any of these things. To do those human things while acting as a non-human entity is forbidden.

But here, they're leaving that state and becoming young boys again, and it's interesting to see the transition between sacred and "profane" (normal life).

This well known old hospital building is on Yanping N. Road and is a fine example of Japanese-era architecture in Taiwan.

Recently restored windows at the Taipei Confucius Temple

A young girl at the Confucius Temple - just then I was hanging my little plaque, which you can buy in the gift shop, asking Confucius to help me get into and get through grad school successfully.

Temple decorations on a dreary day (it became sunnier later on) at Taipei's Confucius Temple

Handing out incense at Xingtian Temple

Prayer and offerings at Xingtian Temple on Tomb Sweeping Day

Picnicking family at Xingtian Temple's (Xingtian Gong or 星天宮) outer gate.

Man-Child Brownies

A not-very-good picture of a Man-Child brownie - I tried for a lovely sky blue icing and it ended up looking like toothpaste. Oh well!

As a follow-up to my previous post on baking, here's my recipe for insipidly sweet Man-Child Brownies (I call them Man-Child brownies because they're the sort of thing a five-year-old would go for in terms of sugary awesomeness, but a bit of whiskey thrown in there, and some wheat flour substituted for health, makes them a bit more grown-up).

Ingredients:

8oz baking chocolate - if it's unsweetened, add 1/8 to 1/4 cup confectioner's sugar

1 stick (1/2 cup) unsalted butter

1 1/4 cup regular sugar

1 1/4 cup flour (can substitute up to 1/3 with wheat flour)

3 tbsp ground flaxseed (optional but reduce liquids if you skip)

3 eggs

1/2 shot of your favorite whiskey

2-3 tbsp cocoa powder

tiny pinch of salt

a few handfuls of mini-marshmallows

crushed walnuts

half a bag of chocolate chips

1 tsp vanilla extract

1 tbsp honey (optional)

Icing

Another stick of butter

1 1/2 cup confectioner's sugar

1-2 tbsp milk or whipping cream

food coloring if desired

1 capful vanilla extract

Sprinkles!

Pre-heat oven to 190C (giving directions in C because it's Taiwan). Grease 8 or 9 inch baking pan.

Heat water in a pot with a bowl over the top (or use the metal in-pot steamer stand as I do and put the bowl on that), in bowl put entire cut-up stick of butter and 8 oz broken up baker's chocolate. Heat and stir constantly until melted together, adding confectioner's sugar if the chocolate is unsweetened (this is technically not necessary if you want less sweet brownies).

Pour that mixture in larger bowl and beat in 3 eggs, one egg at a time. Add sugar and flour slowly and mix well. Add flavorings (vanilla extract, cocoa powder for extra chocolate punch, pinch of salt, honey for chewiness) and continue mixing - do not over-mix once flour is added.

Fold in marshmallows, walnuts and chocolate chips. Spread into baking pan. Try to keep marshmallows away from the top (but don't sweat it if some are at the top). Bake for 25-35 minutes or until it looks done at the sides and a fork stuck in the middle comes up clean.

Allow to cool completely.

In bowl, use fork or whisk to beat butter until fluffy. Slowly add confectioner's sugar, vanilla and a bit of milk. Soon it will turn into icing and it should be easy enough to figure out when. Add food coloring if desired. Don't over-refrigerate before use, but don't let it get all melty either. You want it room temp and spreadable.

Spread on cooled brownies and top with sprinkles.

Yum!

These brownies are gooey, heavy, chocolatey and will put you into diabetic shock if you eat too much at once. They're also delicious. Enjoy!

GET BAKED: Baking in Taiwan

Man-Child Brownies baked in my new-ish oven with my new baking dish from Nitori

Even after four and a half years, I get culture shock in some odd ways. Until recently, one of these was feeling irritated at my inability to bake.

Or maybe they're not that odd: in A Taste of Home (the second story in the book Expat: Women's True Tales of Life Abroad, which I thoroughly recommend), the writer has similar cravings, but for roast chicken, not Christmas cookies or truffle cake.

Back in the USA I was a baking dynamo: I made muffins every weekend - and banana bread when I didn't feel like muffins. I baked tons of cakes, from blueberry to pumpkin to black forest cherry to red velvet to chocolate truffle. I baked cookies every Christmas (and occasionally for the office) and while I didn't make them often, I was able and willing to make crepes, Levantine farina cake, Greek-style baklava and coffee cakes. I made some pretty mean pies, too.

So it was a bit of a shock to me to end up in Asia with a kitchen that had no oven. Like so much with culture shock, intellectually I knew that kitchens in Asia don't typically include ovens, but I never anticipated the feeling of loss that came with it. In India, I didn't stay long enough to try and bake (and it was too hot to bother, really), and in China, ingredients to bake and freestanding ovens were hard enough to come by, and if found, expensive enough, that I didn't try.

But I've been in Taiwan for far longer - I hadn't anticipated staying on this long when I first moved here but I'm happy I have - and the lack of baking was really getting to me. We were home for Christmas 2009 and I baked literally hundreds of cookies - sugar, gingerbread, chocolate melt, chocolate chip, "Swedish almond cookies with jam" (probably not really Swedish) and nutty oatmeal cookies. Even hosting a Christmas party of 14 people, including three kids, we couldn't finish them all.

So, after four years of feeling deprived, we went to Carrefour and bought an NT $2900 oven. Yay!

With an oven, though, one needs supplies. That's where this post comes in - it's taken me months to assemble various things for baking, and I'm still not quite done. Jason's and City Super sell a lot of this stuff, but mostly for jacked-up prices. You can do better.

Here's a reference guide of the best places to buy baking goods for a reasonable price:

DIY Baking Stores: A list from Forumosa

(the one off Heping Road is closed)

I go to this one: Roosevelt Rd. Section 5 Lane 218, Number 36 / (02)29320405.

MRT Wanlong Exit 4, turn right to Cosmed, turn right again and it's down the lane next to Family Mart.

Scattered about Taipei, these stores sell all the things that the big department store supermarkets don't, or that they sell too expensively. Some comparisons: sprinkles at Jason's are NT$200+ for some German brand, and it's all they stock. Sprinkles of varying kinds and in varying sizes cost a fraction of that. Candy molds at City Super - NT$300-NT$800. Plastic candy molds at the baking store - NT$30, or silicone molds for NT$350. Icing bags and tips at the supermarkets - hundreds of NT. At the baking store? NT$70. Baker's chocolate is far less, seasonings are far less (at least NT$100 in savings per bottle), vanilla extract is a fraction of the cost, and they stock mid-range baking supplies whereas the department store supermarkets only stock high-end, highly-priced goods. You won't feel guilty about throwing away an NT$50 whisk from the baking store - why pay NT$800 for a fancy European one that you'll now feel you either have to keep or sell, seeing as it cost so much? Cookie cutters: NT$75 at City Super with little selection, NT$20-$30 at DIY baking stores with a huge selection, including little Taiwan-shaped cookie cutters!

In short, don't shop for this stuff at Jason's or City Super - don't let the greedy idiots win.

The DIY tores also sell hard-to-find items such as food coloring, icing gel (I saw it in pots only, not tubes), certain ingredients otherwise hard to come by and for cooks, they sell things like capers and tomato paste for far less than the big supermarkets.

You can also buy items like flour and confectioner's sugar in bulk. These are sold at regular supermarkets but usually in smaller packets.

By the way, you'll have to make your own icing - you can buy gel icing, but if you want royal or buttercream, you're on your own. Nobody sells it. Fortunately, it's easy to make.

Other items you can get here: mascarpone, light sour cream, flour in bulk, candy melts and flavorings beyond vanilla and almond.

Sheng Li

Corner of Heping E. Road and Fuxing S. Road - it's the big green 'everything' store

The third floor of this catch-all discount store sells kitchen supplies - get inexpensive whisks and rolling pins here. I got my super-simple rolling pin for NT $30.

IKEA and Nitori

Asiaworld Shopping Center, Corner of Nanjing E. Road and Dunhua N. Road, basement

IKEA is the place to go for springform-style pans (the kind you use when you need to turn a cake upside down after baking it), coffee cake and bread pans and other baking items. Nitori sells glass and ceramic baking pans - including the old Corningware style baking and souffle dishes, perfect for a chocolate souffle if you think you can handle it. Both of these stores sell baking items at far less than the department stores.

If you need regular, not baking chocolate, the own-brand candy bars sold at IKEA are your cheapest bet for acceptable chocolate.

The Indonesian store in Taipei City Mall

Great for coconut spread if you are too lazy to make icing (this does work, by the way - buy Indonesian coconut spread and add a bit of food coloring if you want, and use that instead of icing), colored and chocolate sprinkles and interesting ingredients you may find you need such as powdered ginger in good quantities at affordable prices. You can also get coconut flakes at a good price.

Trinity Superstores

Zhongxiao E. Road, ahead of City Hall Exit 4, near Dante Coffee, 2nd floor of a bland unmarked building

Great for coconut flakes, dates, tamarind pulp, almond and rose flavorings, occasionally saffron/safflower (better for color than flavor), jaggery and other elements for Asian baking. You can also get stick cinnamon, whole nutmeg, cardamom and other useful spices for interesting cookies and muffins.

Jason's and City Super

all major department stores

Really only recommended for chocolate chips (often whitened and old, but if you use them to bake they become good again once heated up), mini marshmallows, baker's chocolate. Jason's sells "Almond Dew" which is basically almond extract, and if you're in a pinch they do sell vanilla extract at exorbitant prices. Otherwise don't bother with their crappy baking aisles.

Wellcome

all over Taipei

Believe it or not, Wellcome does stock decent supplies of spices, kinds of flour, egg white powder （蛋白雙), molasses, confectioner's sugar, unsalted butter, cream cheese and other kinds of sugar. You can get a lot of what you need here.

Health Food Stores

I recommend the one on Roosevelt Road between Gongguan and Taipower Building. Get off at the Taipower Building bus stop (after Gongguan) and walk south - you'll see it.

This is a good place to get flaxseed, instant grains/oats as well as whole, non-instant oats that you can use in oatmeal or multi-grain cookies. Also good for flavored oils, healthful flours, organic raisins etc..