Thailand post 6

Sorry it's been a while, they're keeping me busy here, as usual. I'll just pick up right where I left off, in Mae Sot:
After a free Sunday, I was able to spend another morning in the Mae Tao clinic, in the surgical department. I also took a break at one point to visit the Acupuncture Department, and it was really quite amazing. A German doctor runs the unit, and they see ~50 patients a day with quite a lot of successful cases. We met a man who a few months ago had a cement wall fall on him, breaking his back and severing his spinal cord near the bottom, leaving him paraplegic. He was early on in his treatment (only several days I think), and he was already moving his legs. It was more than incredible to hear story after story about these unbelievable recoveries that would never happen in the Western Medicine world, but here these patients were, coming back day after day to prove that whatever the medics were doing was working when nothing else had.
Later that day, we headed across the border into Burma. We got there at about 4pm, only to learn that the border closes at 5:30pm. We loaded into 2 tuk-tuks, and booked it to a few temples, in the pouring rain, before racing back to the border into [of course] sunny Thailand. Home sweet home =)


The next day, we left Mae Sot and headed north to the Mae La refugee camp, the largest of the Thailand camps for Burmese refugees. It was weird to be there, as an outsider peering in on the lives of people who are suffering, and for what? The camp is occupied by as much as 100,000 people (this is one of the NGO's estimates, although the boy who showed us around said 30,000, and the principle of the school said 70,000. A lot of the refugees don't register, and just sneak in, so no one really knows). Looking around, it was strangely beautiful-- with the green mountains jutting into the air serving as the backdrop for thousands of handmade thatch-roofed bamboo homes-- until you realize what injustice has created this place. Our plan was to work in the camp clinic during our visit, but when we arrived, the clinic director had left for an emergency and the visiting doctor in charge was afraid of getting in trouble (with reason: the Thai gov't has been very strict about visitors lately, ever since a group of journalist came through and bashed them for the conditions). Honestly, I was impressed (?) with the set up of the camp-- it really was more like a village than the shambled slum I had pictured in my head (it's been established for something like 30 years).


After that, we began our drive back to Bangkok, stopping in Kamphaeng Phet to sleep. When we continued our journey, we stopped in Lopburi (where monkeys have taken over the downtown ruins, seriously), and also Wat Pra Bhat Nam Put AIDS Hospice, which was quite nice as far as those things go.



We finally arrived back to the lung-destroying city of Bangkok, and have been going non-stop this week. We hit up the Department of Traditional and Alternative Medicine (part of the Ministry of Public Health, which is awesome), the Chest Disease Institute (TB is very common here), Songdhammakalayani Bhikkhuni Arama (a women's Buddhist monastery), and more. Right now, we're heading downtown to visit the Chinese Traditional Medicine Hospital, and tomorrow we'll be at the Dermatology Hospital learning about leprosy.


I was telling Warren that yesterday I felt pretty out of my league at the CDI. We met with a couple pulmonologists (chest Drs.) and went over chest x-rays of several cases in the hospital. They would ask for abnormal findings in the film, differential diagnoses, recommended treatment, etc., and I had nothing to give. It was definitely a humbling experience that showed me how much I have left to learn. Yikes.


But I cannot emphasize how much I have learned on this trip. And laughed. And been in awe [of landscapes, architecture, etc.]. The other day we ate dinner atop the tallest building in Thailand, and I realized just how large Bangkok is. No American city knows this scale (maybe LA?); it just never ends. So like I said: a learning experience (I've decided I don't like big cities…).

In a few short days, I will be in New Jersey visiting family, and this experience will be behind me. Thanks for the prayers and support-- it's been an amazing journey!

Thailand post 5

Except for a few minor things, these past several days since my last post have been incredible. I'll get the negatives out of the way:
1. I am sitting here in bed, at 3:15am, sweating with khakis and a rain jacket on because i left my insect repellent in the car. I got probably 20 mosquito bites during my 3.5 hour nap before waking up for the game, which is bad news in the North where malaria and Dengue are floating around on the wings of these little annoyances...
and 2. USA is still tied with Ghana after 93 minutes of soccer...

But besides that, life is great! I left you with stories of night markets and pollution-filled runs, and now can add tales of elephant rides and clinic work.

So where did I leave off? On our day off after learning about occupational health in the Lampang Hospital, we ventured over to the Thailand Elephant Conservation Center to see some pretty amazing animals. Seriously, elephants are ridiculous, and we were only hanging around ASIAN elephants, which are much smaller than their African relatives. We couldn't leave without taking a ride, of course, and that was a lot of fun. To ride, two people get in this chair that sits atop the 'phant, and the only form of security is a little rope that goes across the front of the thing (think roller coaster, but much less secure). With every step I felt like I was going to slip off the seat and die. It was a lot of fun =)




On Friday, we drove up to Mae Sot, where I am currently sitting. After arriving, we went over the the Mae Tao Clinic (www.maetaoclinic.org), a displaced persons clinic (we are right near the Thainald-Burma (Myanmar) border, and there are a lot of displaced people, migrants, and refugees due to the ongoing political turmoil in Myanmar). Afternoons are slow at the clinic, so we took the opportunity to get a tour and get acquainted with the area.

We got back to the hotel, and Juriaan, Joey, and I borrowed bicycles to ride over to a soccer field for a pickup game. I think that was the funniest thing I've experienced in a while-- those were the crappiest bikes I've ever touched! Joey's was literally squealing as we rode the long 3 miles through town to the clinic, where we left the bikes and decided to go to a closer field than originally planned. oh my goodness, I laugh just thinking about his crooked back wheel and busted bearings...


So we walked over the the field where a few people were, and Juriaan's like, "okay, now we wait for a ball..." Haha. 20 minutes later, a ball and 10 more people arrived, and the 7v7 game began. I was the only female playing, and one of 2 white people (Joey Pedersen being the other), and I don't think I totally let my gender (nor nationality) down. Not TOTALLY. I mean, in no way could my performance be considered impressive, but I made a few steals and some good runs, so I'm happy. They definitely noticed I was playing. It was a lot of fun, and my knee didn't hurt a bit (YES, I thought of that before i started playing. I thought of it, and quickly decided not to worry about it. You only live once, right?)
After the game was tied 1-1 (probably...20 minutes?), the teams switched out (about 20 more people had arrived) and Juriaan and I headed to the volleyball court. This was a ton of fun too-- MUCH more laid back and much less competitive than the soccer. And it was probably 50/50 males and females. I should also mention that all [or most] of the people playing [both sports] were workers in the clinic, and almost all of them were Karen (a Burmese ethnic group). So even with Juriaan there to translate Thai, we couldn't communicate verbally, since they all speak some form of Burmese (Burman?) and practically no Thai at all. Regardless, it was a lot of fun, and a truly neat experience to be able to relate to people of a totally different world through sport. (also, after soccer, Joey went on picture duty, but, if I may say so myself, could have done a better job of capturing the experience...oh well, you can still see the people, the dirt field, and get the general idea)



Then today, my friend Laura and I woke up early and went with Juriaan to the clinic. He worked there for 6 weeks last summer, and I think 2 weeks at the beginning of this summer, and was heading over before the rest of the group to get a full day's work in. We went to the surgical department, where she and I helped dress wounds for the rest of the day. It was pretty crazy. So much for that whole See-one-do-one-teach-one thing. It's just Do one here.


By 10am when the rest of the group arrived, and Catherine, Laura, and I probably worked on 15-20 patients from 10am-12:30pm. Mostly, we changed dressings (gauze, etc.), cleaned the wound (saline and/or Provodone), and put on new dressings, but there were also a decent amount of abscesses in need of lancing, draining, cleaning, and/or packing. Those were the worst, because you could just tell it was dreadfully uncomfortable for them. [[[parental advisory. skip next sentence if desired]]] There were also 3 men who came in to get bandages changed after deciding that an injection of coconut oil (i think) into their penis would result in enlargement...I'm not sure if it worked or not, but I'm pretty sure that after this ordeal they would much prefer a small penis than one with a skinless shaft. Yeah. Sorry if that was too much info for you non-medical folks.

But the day was pretty great. I was incredibly thankful for my prior experience in a non-American clinic (Honduras, last summer), because it made the adjustment much easier. The environment is so different-- can't speak with the patients (or the medics, really), don't have the same materials/instruments, nor anywhere near the level of sanitation-- but it's still medicine when it comes down to it. I also had the opportunity to walk around and talk to a worker about the water purification/drainage system, which was pretty interesting from a public health standpoint. It really is a vital aspect than many people overlook.

Well, I think I'm just going to stop apologizing for the long posts; I don't think they're going to be a rarity at this point... But it's 4am, and USA just lost, so I'm going to bed. Peace and love.

Thailand post 4

Don’t worry guys, I AM alive, I just haven’t had any internet for a while, so strap in— this is probably going to be a long one. The past several days have brought us out of Bangkok into the Northern region of Thailand. We flew into Chiang Mai for the weekend, which is the main city in the North (Thailand has four Regions: North, Northeast, Central [where Bangkok is located], and South).

On our last night in Bangkok, we went into Chinatown (yep, they’re in other countries, too) and walked around foreverrrr. We were in search of this one Indian restaurant that was recommended in someone’s little guidebook and was supposedly next to Chinatown, but finally gave up. Unfortunately, we had walked so far that there weren’t really any restaurants around, so before attempting to eat at a roadside vendor, but you can see how thrilled everyone was to be eating at the food stand…(that’s my roommate making the face, haha)


So we loaded into 2 taxis to head to a mall to eat. My rule of thumb with taxis has always been to always get in the taxi that Juriaan is in (he’s our new best friend; see earlier posts for info), and boy did it pay off. As we were driving, we stumbled upon the Indian district, hopped out of our taxi, and called the other group. But with phones dying, and a maniac taxi driver on the other end, they were never able to make it back to us and ate at a KFC. WE, on the other hand, ate an absolutely fantastic vegetarian Indian meal (Zack, Caroline, Joseph, Warren, Lacy, Hilary, etc: think Daru and FSU’s vegetarian lunch, but better). Afterward, Juriaan took us to a street lined with vendors and restaurants, where we bartered a little bit, and even caught the USA vs. Slovenia game on TV.

Then we flew out in the morning, and once in Chiang Mai, had a break from lectures and field visits. On Saturday and Sunday, we just toured around and shopped (in markets, as well as in various factories [silk, laquerware, silver, gemstones], which were all pretty interesting). The first place we went was Doi Suthep, a well-known mountaintop temple, where I had to rent a piece of cloth [there’s probably a real name for it] because my shorts didn’t cover my knees.

Chiang Mai is famous for it’s night markets, and they have them all over the city. Saturday night we went to one next to our hotel, which was cool, until we found out that the REAL markets—with actual local handicraft and not just touristy junk—is on Sunday nights. Woops. So Sunday night we went to the “Walking Street” night market, which is basically over a mile and a half stretch of road just completely lined with food, clothing, and knick-knacks. My most exciting purchase there was probably the bamboo worm, which actually didn’t taste too bad… (along with this ice cream on a stick thing, which (for Joseph) was milk tea flavored and was amazing.



On Monday, it was back to business, and we went to the Office of Disease Protection and Control for that district. We learned [again] about vector control [aka, mosquitoes] and also learned to make slides to test for malaria. Don’t worry guys, no parasites in me yet!


After that session, we drove further north to Chiang Dao, where we stayed at this really cool hotel—beautiful landscaping and architecture, but unfortunately our room (which was oddly and literally half the size of all the other rooms) had a bit of a bug problem. But we deal, right? I also got to run here (for only the second time this trip), and the quiet little mountain roads were so much better than the awfully polluted streets in even the small-ish city of Chiang Mai.



In Chiang Dao, we went to the Community Hospital and learned about the HIV and TB programs that they have (two very prominent diseases in developing countries around the world). I was actually quite impressed—they have a great community outreach program for HIV, for example, that involves HIV+ volunteers that can use their experiences to educate and empower other patients. After that, we took a trip to Baan Mitratorn, a Catholic orphanage (only the 3rd Christian establishment I’ve seen so far) for children who either have HIV, or whose parents died because of HIV. We brought them toys and snacks, and played with them for a couple hours. What an incredible thing. The orphanage seemed like a really great establishment, as far as those things go, and the kids loved us, even though we couldn’t even talk to them in the same language…



Right now I’m sitting in the hotel in Lampang. We went to the hospital today and did a daylong session on occupational health. it was super interesting, and probably my favorite day. Besides talking about all the occupational hazards that people in the community encounter (exposure to many physical, chemical, and biological agents from long days of hard work), we did a tour to see what kinds of things the hospital itself is doing to care for its employees. We completed one of the checkups they offer, involving flexibility, strength, endurance, lung capacity, body fat, and vision checks (the last of which ended with the woman telling me, “Be careful when driving car; you cause big accident.” Great…). We also completed physicals for several employees who work in the laundry and supply departments who had complaints of things like back pain and rashes.



A million years later, I think I’ve gotten you all caught up. Thanks for indulging in my long-winded storytelling : )
Till next time…

Thailand post 3

Hello again! This post will be divided into three parts: 1. disclaimer, 2. activity recap, and 3. random comments. Let the fun begin...

1. As I blog about my Thailand adventures on this site devoted to all of these amazing Summers of Service, I can't help but feel guilty, because physical service is quite a limited aspect of this trip. Maybe the Bonner Foundation will find this blog and take my credit away, and maybe not, but I still want to argue why this summer of mine should count. These time of health care involvement and education is kind of like one big Training and Enrichment session (Bonners will know what I mean; family and friends, I apologize) for future service to come. This Thailand program is teaching me how to devote my future to a lifetime of service, and I think that is much more valuable than helping a couple of patients who will never see or think of me again. Right? Maybe I'm wrong, but I think this is legit.

2. Yesterday we went to the Ministry of Public Health (which made me think I was living in a Harry Potter story [Ministry of Magic]), and it was...interesting. We had several guest speakers talk to us about what the MOPH is doing to eradicate diseases spread to humans via insects and animals, like malaria, chikungunya, dengue, rabies, leptospirosis, etc. I learned a few things: "zoonoses" are diseases transmitted to humans from animals. fun word. Also, candy placed in front of me stands no chance when my energy is fading and I don't know anything about leptospirosis and can't really understand the presenter anyway. And, I learned that candy isn't really a great source of energy...Woops. Really though, it was a lot of good information, and we had Pad Thai at lunch-- Sue Snyder, your Bahn Thai dish totally dominated this one, so don't worry.
After the speakers, we went to the helminthiasis lab (parasitic worms) and got to play with infested poopy. yay. here's me examining the slide i made. and no, i don't mean i actuallllly made it--gross--I just prepared the slide from an already provided sample =)



then today, we visited the Children's Hospital and learned from this amazing 82 year old female pediatrician about Dengue Fever, Dengue Hemorrhagic Fever, and Dengue Shock Syndrome (in order of increasing severity). We saw a few cases in the hospital, and I really feel like I left with a much deeper understanding of the disease. I also confirmed my observation that Thais switch their "L"s and "R"s when speaking English. It was kind of funny to hear them talk about birilubin levels.
Then we visited the vaccine development center at Mahidol University and met Dr. Sutee, who was the most hilarious tiny Asian guy I've ever met. Not comedian funny, but I guess I was just getting to that loopy-tired stage and was so giggly when he was talking. It really is quite incredible the kind of work they're doing to figure out a way to protect against this emerging disease. Here's a scientist inoculating a "giant mosquito" with the virus, followed by me doing my part to eradicate the disease...



3. These are all very unrelated, so I think I'll do bullet points:
-Correction on previous post: I was wrong about the ages of the group. Besides myself, age 20, the other members are 21, 27, 27, 27, 30, 30, and 42. But you get the idea.
-Last night, I went to bed, only to discover that the maids had taken my white pillow case (actually, my mom's white pillowcase) and replaced it with one of the hotel ones when they were changing the sheets. funny, but kind of unfortunate.
-on that note, the beds here crack me up, mostly just because life is too short not to laugh at things. they are rock hard. i mean seriously, the only advantage to sleeping on the bed as opposed to the floor is that the raised platform allows one to tuck sheets in. really, that's it.
-Dunkin Donuts is definitely not as good here. if you can imagine a chewy donut, that's what i was given today.
-Bangkok is a huge city. I mean, I knew it was going to be crazy busy like any other big city, but no, the geographical area is also huge, which I wasn't expecting for some reason. Today when we left the Childrens Hospital and headed to the university, we were traveling via van on a highway, with generally smooth traffic (50 mph average, maybe), and it took us 40 minutes to get across town. i thought the 20 minutes it takes to get to FSU was annoying. geesh.
-Mom, I think I accidentally grabbed your camera charger...But it seems to be working. Hope the one I left there works for you!
-since this website is the Thai version, I can't figure out a way to have cool font or colors, or even italicize anything, so you'll just have to deal with the template version =)
-love and miss you all! till next time...

Thailand post 2

First things first: It is so inconvenient not knowing Thai, mostly because it takes me ten minutes to figure out how to post a new blog on this darn page! Besides the stuff the students post, all the writing is in Thai script…iy yi yi! In all seriousness though, it’s quite humbling to be in a country where you can hardly communicate. Humbling, or frustrating, whichever way you want to look at it.
Second, you'll have to forgive me if the excitement of blogging has faded rather quickly...With two journals (one for a personal keepsake and one for the program), notes during the lectures, notes back home, and a blog, the writing thing gets pretty old. how many times can I write down what I've done today, really? But I'll try to save the fun stuff for here. You can be the judge of that comment.

So, where did I leave off? {{It is so hard to keep track of the days here-- my roommate and I had to draw a calendar on a piece of notebook paper to tape to the wall so we could "X" off the days and stay sane.}} After the welcome dinner, it's all business. Sort of. On Monday, we had our first lectures. Quick random background info first, if I haven't already said it: Doug is married to Noi, and he and Noi pretty much organize the whole program-- set up all the speakers and field trips to hospitals/clinics; Noi is Thai, and one of their sons [Jurian, age 23 or 24 maybe?] is here and is a wonderful help because he has no accent at all when he speaks English [he attends U. Utah]. Anyway, Monday morning, Doug introduced us to a nurse who spoke to us about the history of Thailand and outlined Thailand's health care system. it was very interesting, and made me feel bad about being so ignorant.
we had lunch in the lecture room. it was fantastic. Zack, forgive me if I come back 100lb. overweight...they were right: the exercise thing isn't very doable, considering the impossibility of running down the sidewalk, and the absence of a treadmill or [usable] hotel pool...

After the guest speaker, Doug spoke more in depth about his experiences on (in?) the international scene. I won't bore you with every detail, but basically, I loved his talk. The information itself was valuable, but mostly, it taught me about myself, and how I still have SO much to learn, much of which can only truly be learned through experience.
After the lectures, we took a water taxi into downtown Bangkok to explore. It took quite a while, but the ride was pretty neat-- it is so strange to see little tin shacks on stilts, over the river, right next to these breathtaking temples. Talk about contrasting landscapes. Downtown was cool, too, I guess. Just really crowded mostly, but it was fun to get to know the rest of the program members. everyone is very nice, but I tell you what, I guarantee the experience would be different if I didn't have the same roommate-- she is fantastic. In the picture, she's the one next to me in the black pants. Everyone else is older than 30 [except one who's 27], which isn't a problem at all, it's just that there's an age gap.

Then today we toured a Health Promotion Center, which I THINK is under the Minstry of Public Health (MoPH). I really enjoyed being there, seeing the facilities, and meeting the doctors, nurses, and patients. Two speakers also presented-- one was an OB and the other was the advisor on nutrition for the MoPH--and gave a lot of interesting info on Thai health care practices. Again, I won't bore you with the nitty gritties here (ha, like I'm not already giving way too much detail). A funny note: the nutrition advisor has a daughter who watches Gossip Girl everyday to improve her English. That made me chuckle. But on the tour, one thing I really found interesting was that although the facility itself wasn't some multimillion dollar modern marvel (in fact, it was only air conditioned in a few rooms), the patients still received good care, and quite possibly better, more personal overall care. We also had lunch provided to us here, and I'm just going to stop making you jealous by leaving out the meal details (except for dinner, I'll tell you that we went to Pizza Hut. yum?)
We also visited the old capital city of Ayuthaya today, which had ruins that were quite superb, as far as ruins go, I guess. you can decide:



Okay, well morning is right around the corner, and many long days lie in wait. I'm sorry if I have made your eyes tired from reading, but you know me...
Hope you're keeping everything in line for me in the States. till next time...