People in Isaan have dined on the koi pla fish dish for generations. [Photo/Agencies]

Karma and convenience

Many villagers are shocked to hear that a beloved dish passed down for generations is a danger rather than a comfort.

Others are wedded to the convenience of a thrifty lunch they can whip up using fish caught in the ponds that border their rice paddies.

"I used to come here and just catch the fish in the pond ... it's so easy to eat raw," says Boonliang Konghakot, a farmer from Khon Kaen province, licking his lips as he sprinkled seasonings into a bowl of the finely chopped fish's pink flesh.

Since learning of the cancer link he has started frying the mixture to kill off the parasite－a method doctors recommend.

Yet not everyone is as easily swayed, according to Narong and his team.

Many villagers complain that cooking the dish gives it a sour taste.

Others simply shrug off the dangers and say their fate has already been fixed－a common belief in the Buddhist nation where karma can dictate decisions.

"They'll say: 'Oh well, there are many ways to die,'" laments Narong. "But I cannot accept this answer."

Catch it early

When it comes to changing eating habits, health officials are pinning their hopes on the next generation, targeting children with a new school curriculum that use cartoons to teach the risks of eating raw.

For the elderly, the target is to catch infections before it's too late.

Narong and his team have developed urine tests to detect the presence of the parasite, which has infected up to 80 percent of some Isaan communities.

They have also spent the past four years trucking ultrasound machines around the region to examine the livers of villagers who live far from public hospitals.

Thanin Wongseeda, 48, was one of the lucky ones, emerging from his ultrasound with a look of relief.

"I don't think I will eat (koi pla) raw anymore," he says with resolve. As for his neighbors?

"They will not quit it easily."

Agence France-Presse