war

One of my favorite local health assistant coordinators has already left for war. He was one of the most happy go lucky, positive human beings I ever met. Such a hard worker. This is truly a sad day for me. I really do hope he keeps safe.

One word, two words

I attended an opening ceremony today for a maternal and child health program follow up training. It's traditional that one representative from each organization and/or district present make a speech. My favorite speech, of the few that were translated into English, was given by one of my favorite medic leaders.

He started out by saying, "When I talk, I may sound angry, but I'm not angry, just warning you...." and he subsequently broke into a very emotive and touching sermon-like oratory.

"One word brings us all here together: HOPE" And I nodded in agreement, and looked around the room to study the facial expressions of all the women medics at the ceremony, wondering, "Are they driven by this as well?"

And then he continued..."We are here to make change and to develop our communities, but we will face many challenges, difficulties, and barriers". An immediate roster of examples started forming in my brain like a Top 20 hottest celebrity couples of 2008.

He ended by saying, "But the one word that will help us overcome all these: LOVE." Period.

His words made me very very happy and inspired. It was one of those moments that made me love what I do and appreciate so much the people who I get to work with.

Rambo the movie

I'll be going inside to a camp of internally displaced persons in eastern b---- to conduct a malaria workshop. It's pretty close to the border, but it's also only 10 minutes away from three b---- army camps. And we have to cross the river accompanied by either the thai border police after greasing their palms (i think that's the term) or the ethnic armed group. Thousands of people fleeing their villages now live in this camp. There have been major military campaigns in northern k---- state, which has resulted in 6 of our program sites to cease operations. There is speculation that many more clinics and villages will become inoperable this coming year as the b---- army plans to push force a ceasefire with the k----. It's bizarre that my life parallels this ridiculous movie coming out, the same weekend I'm heading in. I will be incomunicado for about 9 days. Will write when back! Then i'm going up to chiang mai to see this movie for myself.


link to rottentomatoes RAMBO

LYCM!

back in t/b border

i was asking the secretary of the --- dept of health and welfare about the new large clinic that was just built in one of his villages, thanks to a private funder. we were just catching up, shooting the shit, we'd both been out of the town.

me: so there was an opening celebration for the clinic?
secretary: yes. lots of food. people like to eat food at celebrations.
me: how many beds does the clinic have?
secretary: twenty
me: wow, that's big.
secretary: yes it is big...but i don't think this clinic will get burned down....
me: wha?!
secretary: even though it is large, i don't think it's that much of a priority right now for the SPDC to want to attack this village. they are setting up army posts close by to do some mining, but i think they found very little valuable minerals so far. so this clinic will not be important to them...
me: oh.

BURMA'S INDEX
Percentage of ruling military junta budget allocated to arms: 40

Per capita expenditures on healthcare by Burmese ruling military junta: $1

Total earnings in millions per year for selling natural gas to foreign companies: 40

Rank of Eastern Burma in terms of worst mortality rates for children under 5 in world: 2

Number of years current military junta has ruled Burma: 19

Number of years Aung San Suu Kyi has been under house arrest: 13

Percentage of deaths that malaria accounts for in Eastern Burma: 40

Cost of one insecticide-impregnated bed net to prevent malaria: $5

Average percentage change of malaria prevalence once village implements Karen Malaria Control Program: -68

Cost of one rapid diagnostic test for malaria: $0.80

Number of megawatts of electricity that will be generated by 5 dams that will be built along the Salween River: 10,000

Number of Karen civilians the dam project has displaced so far: 210,000

Percentage of the new energy proposed for displaced villagers: 0

Number of persons needed to test positive in order to consider a village endemic with filariasis: 1

Number of health workers working in Eastern Burma that tested positive for filariasis out of a sample of six: 2

Official estimates of filariasis infections in Burma: 2,000,000

Percentage of villagers in Eastern Burma that were forced to move from village in 2004: 9

Odds of child being malnourished if household was forced to flee from their village in the past 12 months: 3 in 1

S.A.W.

Today we visited an organization (Social Action for Women) that runs a handful of services (children's crisis center, safe house for women, hospice care for HIV+, and education ) for mostly abandoned Burmese children in the border town. we played down by the banks with the kids, who all had a serious case of scabies (need to do cost comparison to dump all existing mattresses/towels/clothes vs continue buying meds for bugs and symptoms. i say dump all the stuff and buy new, treat the kids once and for all rather than continuous symptomatic treatment. at least it would improve their daily quality of life to eliminate the scabies once and for all. how much would this cost? if anyone is interested in pitching in a $100 bucks, that will buy new mattresses for 40 kids). i'm pitching in to buy a new washing machine for the center...

also, there was a woman who is HIV+ who had a enormous tumor on her eye the size of a grapefruit. she had a dressing over it so i couldn't see it, but it was very maladorous from the dead tissue spreading throughout her face. i felt so bad. i went with my doctor friend, and while they were explaining her situation to us, you could see the pain and humiliation that she was experiencing. the tumor was described as being a big open sore, like a volcano. and because of the dead tissue, flies got in there recently and laid their eggs, which resulted in maggots crawling out of the poor woman's eye. the local clinic that serves burmese migrants could not help nor the local thai hospital.

The data (obtained from biannual household screenings) show a decrease in proportion of villagers tested positive for Malaria where interventions were implemented.

back on the T/B border

Oh soo wah my peoples? (that means how are you)...I'm back in Thailand, it's great, as usual. Am here to facilitate a couple workshops and help with some data (1. malaria control - implementing a new artesunate based combination therapy and 2. program planning/mortality/human rights data collection training). It should be interesting given the recent flurry of military aggressions against the ethnic minorities, particularly the karen, since the junta moved their capital away from Rangoon to a city farther north (and closer to karen state). I've been pretty swamped and haven't had much of a chance to write. I actually just got back from a village that I can't disclose the name of b/c the village is 'inside"... plus, Judy C was out here and we totally got to bond during our 4 hr truck ride that went from "what fun sitting back here with the wind blowin in our hair" to "what the fuck. it's raining and we have to keep each other warm with body heat." Because of all the rain, we rode a tractor into the hills as far deep as we could go thru corn fields and then walked the rest of the way. There we did some survey pretesting with the villagers and reviewed their malaria control program, in addition to teaching yoga to the entire village, after which we had a big longan fruit ceremony where they clinic staff sang their village theme song. I'm excited for this new survey b/c we'll be getting some new information - like the total goiter rate, and whether or not an area is endemic with filariasis. (that's the parasite that causes elephantitis of the balls, legs, arms. apparently, you only need to find 1 positive to consider an entire area endemic. we tested out the diagnostic tool on a couple folks here in mae sot and found 2 out of 6 were positive. scary.). I will definitely have to take a treatment course to rid my body of any filariasis worms. A little DEC+the good ole albendy. Did I mention the trauma workshop where the medics used pigs that were injected w/etomidate and then suffocated as subjects to train tracheotomies and other things that these backpact medics have to do due to landmine explosions and other jungle-related injuries? other than that, life is pretty quiet here - no dog attacks, no streets flooding. i've been eating great a ton of green papaya salad. i'll be heading back to LA soon where i'll have to continue my job search, probably go back to my old research place and kiss some butt. speaking of which, i made out witha couple boys in LA before i left. hot. omigod, i gotta continue some translation work...sawadeeKAAAA!!!

life on the T/B border

Yo my peeps! The other day at the Mae Tao Clinic here, this K---- (ethnic group from B----) dude came in b/c his penis hurt. When the doctor and my med school friend probed the patient (no pun intended) about it, they found out that he had injected coconut oil into his schlonger to enlarge it. I guess they're late adopters of the penis pump here. so, I'm finally starting to adjust to all the bugs over here, they can't seem to get enough of me and I'm slowly accepting the fact that these bugs are here to stay. Fortunately, I don't think any of them have the potential to lay larvae in my body like Amazon bugs, thank god, but I have other things to worry about - malaria, dengue, Japanese encephalitis, cockroaches the size of mice that hopefully don't fly. And mangy dogs. dogs here suck, and they like to bite people, like me. I got attacked by a dog last week, possibly rabid, so I'm on now a month-long, 5-injection course of rabies vaccine. Really, it wasn't too bad, my leg got a little gashed up, no stitches though. As for my work, I had the chance of attending a BP District Field meeting held by my org and their collaborating agencies at a location i can't disclose. Let's just say I had to dress like an ethnic K---- and live in a refugee camp near the border to attend this 4-day meeting. So there I sat, shootin' the shit with the ------------- etc. I mostly sat and listened, but got to chime in once in a while when they mentioned human rights survey, advocacy, or they needed an explanation on some public health terminology. Got to chew some betelnut with them. Was constipated for 7 days. My work has been picking up, as I'm about to start up training sessions. I'll have to travel north for a week, then south a week later. this is because we have a bajillion logistical hurdles to go through. like having to sneak medics into thailand from b----, how to rent a truck to carry to transport illegals, how to ..one of our budget line items is bribing thai officials to permit road access...we were even trying to figure out a way to carry our printers on a boat to take to our trainings...besides all that excitement, the food is just as exciting, especially since there's always an element of surprise and I get to eat so many things out of plastic bags, even my lemonade. If I'm lucky, I actually end up getting what I ordered. And that happens when I can point to what I want. Otherwise, I just accept the fact that I might be eating fishball soup, again. ok, miss you all dearly, i gotta meeting to run to, SAWADEEKAAAA!!!

ps. i really liked to wash down fried amphibians with a cold iced nescafe in a bag on a hot summer afternoon...if you look close, the mommy frog is holding on to her baby frog when they fried the crap out of the two.