In a small bowl, mix the soy sauce, fish sauce, water and sugar. Stir until sugar is dissolved. Set aside.
In a skillet add the oil and heat over medium high heat. Add the onion, garlic, and ginger to the hot pan and give a stir. Then add the ground beef and cook until no longer pink. Breaking up the meat as it cooks.
Add half of the sauce to the cooked ground beef and simmer for another minute or two.
Use a vegetable peeler to makes strips of carrot for garnish.
Serve the ground beef mixture in the lettuce leaves. Garnish with extra sauce and carrot strips.