MY THAI MUSE:
90 days of noteworthy thoughts in the land of smiles Justin Siu
1
Table of contents A. THE BIG ASIAN APPLE The IC Life (4) Japan Town (5) Power of the U.S. Dollar (6) The Baby on the Street (6) Girls on Sale (7) The Lady Boy (8)
B. THE FREE HEALTHCARE SYSTEM The Railroad Community (11) HIV/AIDS Clinic (12) The City Psych and Criminal Ward (13) A Look into a Thai Hospital (14) The Twenty-Year Old Therapists (14) Electrotherapy Rehabilitation (14-15) Occupational Therapy: Hand Function/Swallowing/Child Development (16-17) neuro (17)
C. THE ‘REAL’ THAILAND Inside the Developing World (19) Suburb (21) Rural (23) Wild (24)
D. MONEY + SEX + POWER = CORRUPTION? MONEY (27) SEX (27) POWER (28-29)
the big asian apple
I like to call Bangkok the Asian New York with perks. It has all your high-end stores, highrise buildings, nightmarish traffic jams, fancy bars, sky-high restaurants, jamming nightclubs, foreigners, excitement, and everything in between. While drinks are, unfortunately, the same price even halfway around the world, everything else not imported isn’t. Bangkok is host to some of the world’s largest open air markets where I quite literally shopped till I dropped an ate till 1am late.
3
THE IC LIFE
At some point at the beginning of the quarter, the unspoken differences of being an “IC” or international college student was brought to my attention. It started out with the initial “culture shock” of having to wear a uniform. Thailand, Vietnam, and Laos are the only countries where the uniform-- typically black trousers or skirt with a white shirt-- is mandatory at higher levels of education. This policy of apparel is strictly enforced; some of my classmates had been docked points for not wearing the full proper uniform. There are bumper stickers taped everywhere reminding you “No Uniform, No Service”. (I experienced such firsthand when I was denied entrance to the library because of my faint blue shirt, which was supposed to be white.) And if you happen to miss those ubiquitous signs, there are another ubiquitous set of propaganda advertising university fashion. At first, we thought it was a cutethough annoying- idea of promoting unity. The uniforms aren’t the most comfortable wear for learning, but its nice to see my peers strutting out and about in cleanpressed shirts, polished shoes, chic skirts, and shiny university lapels. After the first week, however, I began rethinking this idea of “cute” on deeper levels. As mentioned during orientation, carrying a Mahidol University badge and wearing the proper uniform can do wonders by “getting you out of sticky situations”. What kind of situations? … That wasn’t specified and we weren’t told why. According to a native Thai MUIC student, though the reason is rooted in status. The uniform implies higher education. The ID badge printed with the Mahidol insignia further confirms an education
4
at Thailand’s top university. And if that were not enough status, an “international college” description distinguishes you as one of the top tiny percent of wealthiest kids in the country that can afford an international education. No wonder it’s common to see university kids at the mall in uniform? While the international college is under the Mahidol University umbrella, it is really a whole separate entity of its own. “IC students are totally separate and different,” my Thai friend told me. When this fact finally clicked, the clues all aligned with the people I met. Midst all the “uniformity”, its easy to spot Gucci bags, LV bags, Fendi purses, and other designer accessories that scream status. Yes, they may be fake-- but I wouldn’t for a second doubt if they were real. The native Thai IC students own shiny rides, speak multiple languages, study abroad internationally, and party hard in Bangkok like all the other international students from abroad. Basically, they come from Thai families with international businesses loaded with Baht and are privileged enough to pay for international teachers, many of whom come from the UK and US. I parallel the glamorous lifestyle of the Asian Big Apple seen on shiny magazines covers and tourist magazines-as many of them do actually come from Bangkok. Bangkok is modern, westernized, English-speaking for the most part, international, affordable, plentiful, exotic, and really quite the place to be for work and play. It is very likely the reason Thailand topped the HSBC Expat survey for best overall expat experience (U.S. took 23rd).
JAPAN TOWN Every Thursday, I venture out into Nakohn Pathom by train to my good friend’s Apsorn’s Elite English school to teach Mr. Yamauchi English. As a province quite a drive from Bangkok in the middle of Thailand, I was surprised to find that this busy Japanese electrical engineer was able to dedicate 2 hours a weeks (not including the drive) to learning English. He has a wife and two kids that live at his home in Bangkok. Every morning, he leaves the house before 6am to arrive at work in Ratchaburi at 7. Sometimes, he needs to stay overtime at the electric plant, so he’ll stay overnight at his second home in Ratchaburi. Class starts at 7pm, and he is chauffeured to the school after work in a slick white Mitsubishi to Nakohn Pathom about a half hour away … then, he’ll head home in Bangkok around an hour away. Now, that’s what I call dedication.
My friend told me she was in search for the Louis Wallet M60460, retailing 640$ on the LV website… I found it for her that same day at the market for 15$.
As out of the ordinary as I thought it was to find a non-Thai-speaking Japanese in Thailand. It is, in fact, not all that uncommon. Nestled in the bustle of BKK is what I equate to LA’s Tokyo town, but bigger. This micro-community boasts a row of pricey Japanese restaurants, a significant population of Japanese, and even a Japanese school that teaches in Japanese. Most of the familial residents have fathers that are longer-term business men or work for international companies, such as Mr. Yamauchi himself. Bangkok is really an international hub of all sorts, with people you can never really quite guess from where.
5
POWER OF THE US DOLLAR I felt like my money multiplied landing in Thailand. Even as a broke college kid working in a boba milk tea shop, I never imagined I’d get to casually sip on wine at classy skybar sofas atop high-end hotels on a metropolitan strip at 21 years old for 10$. If anything, that’s something I’d do in America at 55 as a retired rocket scientist. I ate lunch for a dollar everyday, ate at high-end restaurants for 15$ a plate, took half-hour taxi rides for 6$, and could afford LV, Gucci, Fendi, and Prada (granted they were fake). I splurged and never felt guilty about eating or shopping as much as I’d like. I never realized how far one American dollar could go. But as much as I love cheap prices and cheap food, I can’t help but call into question equality of
trade. Living in Bangkok is no doubt more expensive, but even there some prices are nothing like any Las Vegas deal can quite rival. Cheap prices equate to cheap labor and cheap services. The average Thai
makes 300 baht a day-- that’s 10$ a day-- the same amount I make in an hour working in the boba shop without any sort of degree. While this excludes most of the higher-educated employees and professionals in the Westernized capital, it accounts for most of the Bangkok shop vendors and laborers scattered throughout the city. A touristy souvenir shop vendor I once met a little outside the metropolitan area was delighted to find out I was from California. In broken English, she told me that that’s where her daughter wants to go for study. She asked for my e-mail and I gladly gave it to her, making note that she could e-mail me when she did … or if she ever did, I thought. I couldn’t help but wonder how she would ever make it across half the world making 10$ a day when my airline ticket itself was 900$. 10$ a day can make a decent living in Thailand where cost of living is low, but really doesn’t give you much autonomy to travel far.
THE BABY ON THE STREET While walking down one of Bangkok’s brothel-filled streets one night, I couldn’t help but notice a mother sitting criss-cross on the ground with her 3-year-old toddler sprawled out on the ground. In a moment of utter surprise and appall, I pleaded with my friend,“What the hell is that baby doing on the ground!?” As they sat in the middle of the street, they were being asked to be trampled on underneath a flow of hordes engrossed in lines of go-go girls fawning on both sides. Barely anyone gave a glance to them and simply walked on as if they hadn’t seen anything out of the ordinary… And to be honest, sights like these were nothing out of the ordinary in Bangkok. It was not uncommon to see a mother with her baby sitting on edge of the sidewalk with a plastic cup set out in plea for money. Even more common were individuals maimed in some way, either arms, legs, or eyes. 6
Whenever I come across one, I wonder what their lives must be like. I wonder what they eat, if they experience happiness, and how much they suffer watching everyone around them living life on the other side. I avoid making eye contact because I realize there’s not much more I can do for them at the moment but say a prayer and go on on my merry way. Sometimes, I’m tempted to drop some baht into the plastic cup-- which I did once-- but decided I wouldn’t for fear that I might actually be perpetuating a gang setup, like those in China or Bangladesh. It’s painful to watch. In a discussion on the taxi ride home, my friend brought up a likely explanation for human nature around these matters. It’s not that we’re heartless and blatantly deny suffering in this world, but, rather, must turn a blind eye to these issues in order to save ourselves the pain and to avoid debilitating our own emotions and spirit.
GIRLS ON SALE
By night, Pattaya beach, just a few hours south of Bangkok walk was lined with girls going for about a mile long. They stood about an arm span away from each other, not talking to one another but just waiting. At the end of the Pattaya beach was Walking Street— an avenue hub of bars, clubs, and exotic, explicit entertainment. Just that morning, the beach was filled with tourists, mainly older saggy white men. When my friend and I took a stroll down that same beach, empty at night, we knew exactly where they were. They had either all joined the party at Walking street, or were so-called “window” shopping along the beach for the girl of their choice. It was exactly as I had imagined from media. I saw a man stop to stare at one of the silent figures, approach her, and ask how much, how long, and where. Walking Street itself was bustling with more girls and boys of the night. Many of them I noticed were Russian, dancing in their elevated glass cages of well-established venues, and I couldn’t help but think that they were probably trafficked to Thailand from Eastern Europe. I noticed that many signs were in Russian, indicating a large Russian tourist crowd, which I guess explains the supply. Even in Bangkok itself, streets like Silom and Cowboy street, the very street featured in the Hangover II, are dedicated to selling sex in blaring neon lights and young girls in skimpy outfits. My
psychology professors claims that there are more brothels than he can count on his two hands from his view at home in Asok, Bangkok. As we walked down Cowboy street one night, young Asian girls would incessantly paw at my tall white roommate. Prostitution and sex trafficking has been a blatant issue in Thailand and is, to the surprise of many, actually illegal. What disturbs me the most is that law enforcement fails. Sex commercialism is no doubt obvious. Walking Street is stationed with tourist police at the head of the street. According to what I’ve read, however, the only real strict crackdowns happen in cases of underage sex slaves. As a result, sex sales is a norm. Rumor has it that most boys at the University have lost their virginity to a prostitute. It’s a common occurrence, and routine hangouts at a skimpy bar are often a hangout hotspot. Sex is accessible and affordable, and I don’t blame growing boys with raging hormones for taking advantage. In fact, girls that stand at the clock tower just across from Mahidol University, making sex available just a second away.
7
tHE lady boy My department coordinator was beautiful and had good fashion taste, great makeup, nice hair, nice nails, and a genuine LV leather bag. For some reason, however, I couldn’t help but second-guess her gender. As convincing as her get-up was, something about her voice and facial structure led me to think otherwise. And until I inquired and confirmed my suspicions, I had to give my sixth sense credit. Nonetheless I had to say, she was definitely one of the “more convincing” lady boys. Most looked like abnormally muscular women with obviously masculine features. My friends would joke that I would come back to America as a ladyboy, and their implications really weren’t that off when it came to Thailand being the home of the world’s largest population of transgendered women. I was surprised to find them casually everywhere-- in the market as a cashier, as waitresses, or just your everyday customer. What shocked me the most was how “conservative” Thai culture came to such a liberal stance on sexuality in society. Even in the so-called progressive America where gay marriage is making its first breakthroughs, transgenderism struggles to find tolerance and acceptance.
A guide on Thai sexual diversity distributed by an MUIC professor. 8
At the world famous Tiffany’s show, it was refreshing to see a class of talented transgendered performers celebrated in a colorful repertoire of cultural dance routines, diverse costumes, and international backdrops. The show was held in a beautiful mansion with a mediumsized frontyard parking lot that simultaneously accommodated 15+ large tour buses. The show boasted #4 on the World’ Top 10 shows in 2001 of TravelCom magazine and attracted tourists (predominantly European and Chinese) from all over the globe. And while the show primarily remains a unique form of entertainment on the international level, perhaps it is more of a challenge to the international perspective on conventional gender roles. At my international college for instance, there seemed to be a wide range of gender expression, with a refreshing sense of freedom of expression (ironically constrained by mandatory dichotomous uniforms). At the international college at least, where tradition is constantly faced with new ideas, culture, concepts, and thinking, there is an increasing breaking away from conventional ties, whether it be for better or for worse.
THE FREE HEALTHCARE SYSTEM The beautiful ladies of Rehab.
As an American, there are obstacles to health care I typically wouldn’t think about. For me, a visit to the doctor can be as quick as an hour and as simple as hopping in my car in between classes, driving to the local Kaiser Permanente 10 minutes away, getting my routine check-up, and driving right back to class. For the average Thai, however, a “simple trip to the doctor” isn’t always the case. As a pediatric physician and toxicologist at Siriraj Hospital, Ajan Chomchai is witness to some of the most tragic cases of health care access. In one of her many medical encounters, a mother and her newborn baby diagnosed with kernicterus were clearly told to return to the hospital the next day for treatment, or her baby would suffer lifelong severe brain damage. She didn’t return to the hospital until five days later with a baby, needless to say, in very severe conditions. Any physician or logical bystander may accuse her of negligence or even stupidity; a closer scrutiny of her situation, however, says otherwise. My anger, at least, turned to sympathy upon hearing that she was probably a new single mother, alone in her endeavors to bring her baby back to the hospital. This means she likely had to return to work without any sort of “maternity leave” in order make enough money for another taxi ride to the hospital and back.
For many Thais, seeing the doctor is nowhere near simple. Like the mother, it means giving up a day of work, saving enough money for the motor taxi or taxi (which is relatively expensive for the average Thai) to the “local” provincial hospital that can be quite far, finding someone to help watch the kids or run the business, etc. .Missing a day at work may mean not eating for the day, so concepts like regular check-ups are not even in the question... For those who don’t live in that reality, we can only imagine On the brighter end, all Thai citizens are covered by some kind of health care plan, granted some have more privileges than others. 76% of Thailand’s population is covered by the Universal Coverage System, which requires one to register within their local provincial hospital. 15% are covered by Social Security, a co-payment and retirement plan for employees of legitimate companies. 7% are covered by the Civil Service Medical Benefit Scheme, made available only to government workers and allows for a broader selection of hospitals. And lastly, there is private insurance and clinics for the better off. The remaining uncovered population do not possess citizenship.
9
The "recreational" lot. A disease-filled canal?
10
THE RAILROAD COMMUNITY Every week, I take the State Railway train from Salaya to Nakohn Pathom, a short 25 minute ride. I arrive at 4:40pm because the bulletin and the station lists route 169 departure time at 4:45pm. However, even if arrive at 4:50pm, I never sweat because I know its always going to be at least 25 minutes late. I don’t know what’s going on with the train, but I’ve waited up to 2 hours for the same train every week. Everyone casually boards as if they got all the time in the world to wait, but I get impatient, coming from a culture where Amtrak trains arrive on the dot and leave in 5 minutes sharp… no exceptions. The ride there isn’t too bad, save for the hard wooden seats. I know I shouldn’t complain, considering I ride it for 60 cents. The train really goes at whatever speed it likes. Sometimes I’ll arrive in 20 minutes, and other times I’ll arrive in 45 minutes, as if the train itself has different errands to run each week. Sometimes, though, and perhaps more than it really should, it stops for maintenance. This is not too big of surprise, considering the age of the vehicles and rickety noises it makes while it runs. In the middle of the quarter, my community health class visited the very community that ran the railway system, whereupon I wanted to confront the manager regarding such an inconsistent system. A microcommunity of administrators, office workers, train drivers, train mechanics, depot mechanics, and workers make up an urban middle class governed by a separate state enterprise. This community that has grown to 26423 employees since 1891, started operation of the Bangkok Noi railway station in
1903, which served as a strategic point during WWll. In 1999, the railway station was relocated to Thonburi and expanded its routes with a Western line reaching Kanchanaburi and a southern one reaching Choomporn. People like working for the state enterprise because they offer good benefits with tax and social security covered by the state organization. The downside? -a high stress job without provision of primary and preventative care. In 2013, the system experienced 150 de-railings- an incredibly scary statistics to know while boarding the train. Aside from that, mechanics especially must cope with loud noise, heavy vibrations, toxicants, pollutants, and poor ergonomics in work conditions such as the uncomfortable wooden caboose chair made by connecting two boards together at a 90 degree angle. The population yields a high prevalence of obesity, tobacco use, alcohol use, and health ignorance. To make matters worse, a stagnant dried canal runs through the center of the community, raising risks for diseases such as dengue, which, as one resident claimed, killed her husband last year. There isn’t much recreation, let alone a safe recreational space. All they have is a small parking lot space that is filled with cars by evening. The village takes on drug dealing by night. Ironically, the community is overlooked by the towering majestic white building of Siriraj hospital. Fortunately, efforts have been made beginning this past year to change this neighboring health disaster. The hospital has begun building a repertoire of trust and communication with these men and families by providing free health checkups and profiles, vaccinations, and home visits.
11
Adam’s love~ dedicated to fighting AIDS.
HIV/AIDS CLINIC GUYS ON DISPLAY
Guys On Display (or sacrilegiously known as the acronym G.O.D.) is one among the handful of gay venues situated in the heart of Bangkok. Like its name implies, it has guys on display, or go-go dancers just like any other typical gay venue. After a night of crazy dancing to concert music at Funky Villa, my friends and I headed over just to check it out. It doesn’t open till 1am and actually had quite a number of people for a non-thirsty Thursday weekday. The crowd was a mix of foreigners and Thais, with some hanging around in small cliques and others making out with random strangers. Within half an hour, I had been hit on by a young guy that began with the typical getting-toknow-you. When he tried to get into my pants, I told my friend it was time to leave. The guy didn’t let me go that easily though; on our way out, he had chased my friend down and got my number. I am all too familiar with the fact that the promiscuity runs rampant in the gay community so I wasn’t surprised when Dr. Nittaya told us that homosexuals have three times as many sexual partners as heterosexuals, indicated by the exorbitantly high prevalence of HIV (30%) in Bangkok. MSM (men who have sex with men) are a high risk group targeted by the Ministry of Public Health for promiscuity and lack 12
of adherence to HIV prevention measures. Even the large population of sex workers account for less than half this transmission rate. It’s not that MSM are ignorant of the fact that unprotected sex raises risk of HIV transmission, but that many are unafraid, given the type of free highly active antiretroviral treatment available to them as Thai citizens. With proper and prompt treatment nowadays, HIV-infected individuals can live just as long, healthy, and normal a life as any other individual. Any infected citizen with a CD4 count < 350mm qualifies for treatment. Dr. Nittaya MD PhD and her team at the Anonymous Clinic, strategically situated across from a gay bar in Bangkok, has worked tirelessly to bring these statistics down. Early detection and early treatment is the key. 49% of new infections occur via 20% of those infected unaware of their status. On the other hand, making 100 people aware would prevent 8 new transmission events. Hence, Thai public health is normalizing and de-stigmatizing HIV-testing and education through health media, visible mobile clinics, MSM-friendly hospitals, and quicker testing. Along with better detection, government officials are soon to lower the qualification standards for anti-retroviral treatment so infected patients can start treatment even earlier.
THE CITY PSYCH AND CRIMINAL WARD I had never been so close to so many criminals and murderers. Personally, I found it doubly scary that the paired the psychotic and the criminals, or both, into the same campus. As I watched them behind bars, I realized any of them could have easily made their way into the managing station through the unlocked door that separated all the criminals from the staff. And honestly, that wasn’t such an outrageous thought considering one of them had stabbed his inmate just the week before. As I stood in my clean pressed button-down and slacks, I felt highly uncomfortable being watched from behind bars as a tantalizing reminder of luxury, freedom, and privilege. I should have listened to my Thai buddy the day before and dressed down, rather than up as I do for the hospital. 3 of the thirty that day were deemed sane and safe enough to join the Saturday picnic that afternoon that was taking place on the campus green. The three men that were chosen were later joined by a few other women from the female unit in the neighboring building and we were all led out of the gated and guarded courtyard. As we awkwardly made our way out, I was pleasantly surprised to be approached by one of the more amiable women radiating smiles that spoke decent English. She began by welcoming me and telling me how she loved the mental ward. I stared at her like she was crazy (no pun intended). From what I saw, you were forced to wear a drabby hospital uniform and had not much else to do but lounge about in a confined space all day with limited privileges. In fact, she described it as her “paradise”!
There, she was provided for and didn’t have to work. She had nice, caring nurses, inmates, food and board provided for, and slept better at the ward than she did at home. Her sister visits her sometimes, as she had done that day, and she even goes to church every Sunday. She went on to tell me how Jesus had changed her life, how she prays every day and is filled with peace, joy, love. If she wasn’t a missionary, I asked my friend what the heck she was doing in a place like this… “bipolar disorder” she told me. I would never have guessed. Most of the inmates and family members of inmates that joined us that afternoon for the Saturday ward picnic were quite normal, except for one that exhibited obvious mental retardation. Some were schizophrenic, some were paranoid, and some had criminalistic tendencies but the identity of these patients weren’t really all that obvious. We enjoyed a whole afternoon making music, playing games, eating and singing karaoke together like any other social group. Yet again, we only got to meet the best of the group. A weekly music group therapy session was cancelled just the week before due to a stabbing. So the spectrum of behavior is wide and some are confined from the community for highly legitimate complaints. The staff that work with these patients, needless to say, maintain great patience and must have a heart to care for the more dangerous or less ordinary. Many of them, in fact, live in the staff quarters built right outside the gates of the inmates quarters yet still within the ward bounds. They work where they live, and are entwined with the lives of their criminal neighbors. Now that is commitment.
13
A LOOK INTO A THAI HOSPITAL I had the privilege of working at Golden Jubilee-- a University-associated hospital located directly across from the school. Upon my arrival, I was pleased to find that walking into the hospital was more like walking into another indoor world made up of a translucent sun roof and jungle-like interior with separated apartments for each department. You know you are in a Thai hospital when
there is a Thai traditional massage department and a large dental department neighboring one another. (Their medical equipment, on the other hand, is for the most part, Dutch.) Thankfully, most of the staff knew some extent of English, even if you couldn’t quite call it proficient. Because they were taught with English medical terminology, I was able to pick up the most important concepts.
THE TWENTY-YEAR OLD THERAPISTS I don’t know how I would feel if my therapist was twenty years old. Every few months, however, a new flood of them filtered into the rehab departments on their internship rounds. I was asked to address some of the interns (that looked the same age as my high school sister) as nong meaning younger brother/ sister. I was flabbergasted to find that some of them really were younger than me, if not the same age of 21. It blew my mind to see these young health profes-
sionals at work when I, even after 4 years of expensive undergraduate education, still have another 4 years until I can truly lay a useful finger on any patient. In Thailand, students typically enter their lifetime health professions upon graduating high school. Medical students, for instance, are freshly graduate high schoolers that dedicate the next five years of their lives studying medicine without the obstacle of an undergraduate degree and the dreaded MCAT.
electrotherapy rehabilitation Even before the doors to the department open at 8:30, folks middle aged and beyond are already waiting outside for their 20-30 minute session in rehab. Rehab is nothing too intense; to me, it’s more like a 20-30 minute spa session. Most procedures were focused on increasing blood flow and relieving muscle pain and tension with different heating, pulling, and massaging methods. I’ve worked in 3 different American rehabilitation departments, but most of the gadgets in the department were new to me. Thankfully, the 10 young beautiful ladies manning the department were incredibly nice. If they weren’t busy with one of the ten patient beds, they were sitting around the therapists’ station talking ninja-or gossip- and munching on all sorts of Thai goodies given to them by patients. “HOT WATER BATH”: The hot water bath, scientifically known as the Packheater, is probably the hottest (no pun intended) commodity in the department. The majority of the patients come in for a 15 minute session with a hot pad (aka Enmo moists-- cotton packs filled with volcanic grains) pulled from the water bath and towel wrapped around their area of pain for increased blood flow. A courtesy curtain enhances your 15 minutes of peace.
14
Continued on next page.
LASER EYE TREATMENT FOR THE HAND (NOT EYE): Laser treatment originally used for eyes, was apparently now being used in the department to increase circulation in deeper skin (vs. the hot pads). The Endolaser 422 is a laser therapy unit used for photobiomodulation. A laser pen with interchangeable probes is hooked up to a small 5X9 box and is also used for pain management, wound healing, soft tissue injury treatment, nerve regeneration, skin treatment, and cosmetic regeneration. Therapist and patient are required to wear goggles to protect their retinas from straying powerful rays. ION MACHINE: To continue the list of circulation-stimulating procedures and machines is electrotherapy facilitated by the Endomed 684. Two wires installed to an electronic box with pads at the end are attached to two sides of a patient. When activated, ions move from one pad to another creating an electric current that stimulates nerves and muscles. The plastic pads on the ends are protected with yellow spongelike gloves that are changed with each patient and washed at the end of the day. THE WAX MUSEUM: Perhaps my favorite toy in the department is the wax museum, otherwise scientifically known as the Paraffin Bath. Used for paraffin treatment, you dip your hands into a box of hot wax, and repeat 10 times until you engulf your hands in a thick-layered glove of hot wax. You then glove the glove with a real glove and wait 10 minutes. The heat, of course, increases circulation and is supposedly especially effective in relieving arthritic pain. SHORTWAVE THERAPY: Similar to electrotherapy, shortwave therapy (facilitated by the Curapuls 970) takes advantage of electrodes to create an ion current. The Curapuls 970, however, is much larger than the Endomed 684 and is used to cover and treat larger areas of the body. Different capacitive electrodes facilitate the many shapes of the body. The magnetic field created by the electrodes provide a form of electrotherapy as well as heat therapy. A continuous or pulsed mode session of fifteen minutes stimulates wound healing, oedema and haematoma absorption, pain reduction and stimulation of peripheral circulation. To avoid any risks, the patient bed should be wooden or should not contain any metal. During my own five minute trial, nothing dramatic happened, but my leg area that received treatment was definitely warm.
Shortwave therapy~Curapuls 970. TENS MED: This handheld device extends two wires padded at the ends that can be attached to whatever area of pain. As its acronym implies, it produces what it says-- Transcutaneous Electronic Nerve Stimulation that provides pain relief, especially for chronic pains. TENS treatment are particularly safe, user friendly, and do not have any side effects. It effectiveness varies from patient to patient. SPINAL STRETCH: Some patients also come into the rehab for a fifteen minute lumbar spinal stretch with the Eltrac 471. This traction unit utilizes skeletal traction to provide spinal decompression and instantaneous relief for herniated discs, degenerative disc disease, or pinched nerves. Decreasing pressure through traction on a long-term basis bestows a mechanical effect and biophysical effect on the nerves by guiding skeletal alignment and increasing circulation and oxygen supply to local structures. Hence, patients usually come in 2-3 times a week for treatment and are recommended to continue exercising at home in order to stabilize the muscles.
The cervical Eltrac
The machine itself can be set to pull continuously or intermittently. While the machine can sustain traction forces of up to 90kg it is programmed to pull 7% of the patients body weight. .
15
occupational therapy; hand function/ swallowing/child devlopment P’Kun was young, enthusiastic, ditzy, and the only one in the department that could speak decent English; needless to say, we became good friends :). At 23 years old, she was doing her first round (of two) occupational “residency” before graduating into certification. I followed her around all day and got a taste of the odd mix of departments a Thai occupational therapists mans everyday-- namely hand function, swallowing, and child development. OCCUPATIONAL: The first time my friends and I decided to take motor taxis home, I swear I almost peed in my pants. We were speeding down bustling freeways and through undeveloped grounds on the backs of our drivers holding on to their shoulders for dear life. It was definitely a major thrill, and trying to catch the moment with our one-handed camera work only made the experience that much edgier. That same day, I told my parents about my once-in-a-lifetime experience and they responded with, of course, “Were you wearing a helmet?” and “You should probably never do that again.” But even without them telling me, I knew riding a motorcycle wasn’t something I wanted to do for a routine thrill. The streets of Thailand- Bangkok specifically- are a horrific traffic nightmare. In Los Angeles, we complain about bumper-to-bumper traffic, road rage, and bad drivers that do not get off your ass. In Thailand, however, traffic is not only bumper-to-bumper, but drivers are quite literally on your ass. Impatient motorcycles, taxi cabs, and trucks pull right up to one another and leave no space in between. Furthermore, people fail to signal and motorcycles zip around without regard to their surroundings. Worse yet, there is no speed limit and there is no pedestrian right of way.
16
With these chaotic images in mind, it was no wonder “road traffic accidents” was listed as the major cause of death for Thai people under 45 years of age. Most of the population rides around in motorcycles. While it was an initial shock for me, it’s not surprising to see old grandmas rocking their own motorcycles, or young 13-year olds dropping off their mothers at work on a motorcycle, as I had seen on one typical day. Most do not wear helmets. For casual riding, most do not wear shoes either. There are frequently 2-3 riders on a bike, and everyso-often, a full-fledged family of a mother and 3 kids on one bike. School girls that wear skirts would sit precariously on one side of the motorcycle seat with both feet on one side. It’s a typical daunting site that would never fly in America. Working in the occupational department allowed me to see the results of these tangible statistics. Most patients came in with some kind of muscle weakness or partial paralysis either due to stroke or an auto accident that had caused cervical damage. Often times, only one half of the body would be partially maimed. Almost all patients were wheeled in on wheelchairs and most had one hand/ arm severely maimed. Hence, there were a variety of desktop toys designed to help patients improve hand function and coordination. They would come in a couple times a week and practice their routine hand toys. Some included transferring and stacking cones, putting balls in a basket, and moving hoops through a wire. Some needed to re-learn how to brush their teeth or dress themselves with a maimed hand, in which case they would make their way over to the mock bedroom for extra training lessons. Less severely maimed patients would come in to use the 400,000 Baht (13,000$) CPM machine. As its acronym implies, it imparts on its patient continuous passive motion to help improve range of motion. Continued on next page.
SWALLOWING: P’Kun has a way with working with swallowing patients in a way as if each were her own parent. While I love working with patients myself, I get a bit squeamish when it comes to the more unsightly. Patients that come into the swallowing department often have a salivary leak on the sides of their mouth due to a loss of nervous control around the oral area. This also results in trouble swallowing, chewing, mouthing, and speaking. Even though patients are reluctant, whiney, slow, and unresponsive, P’Kun persistently pushes for improvement. She takes them through a set of mouth-shape exercises, tongue exercises, and will then massage the maxillary and mandibular bone to stimulate nervous growth and control. CHILD DEVELOPMENT: T was a cute kid, but simply watching him drained my energy. The 1 hour that P’Kun spends with T is really not much more than a private one-on-one playtime session twice a
week. At 7 years old, T has exhibited signs of slow mental development, hyperactivity, and inappropriate behavior at times (i.e., hitting himself and others during tantrums). Two large, flat, Mc-Donald’s-like playrooms are set up in the department, complete with a swing set, ball pit, trampoline, foam castle, and puzzles. And just as there was a plethora of equipment for stimulation, there was just as many tools for calming overly active kids like T. Next to
the foam castle was a mosquito net bed, dimmers and colored lights to set the mood, lava lamps, light patterns, and a music player with a selection of tranquil noises for a state of the art naptime. Every time T comes, P’Kun makes the most of every minute socializing with T, making sure he gets the type of outside social interaction he may not get outside the hospital. When the hour is up, P’Kun returns T to the waiting dad in the waiting room and gives him a short assessment of T’s progress.
NEURO The “pediatric neuro department” is really a walled-off corner of the larger one-room neurological rehabilitation department. Children are walled off because their cries may be distracting to other patients. P’Di spends most of her time here working with children one-on-one. P was the 6-year-old girl I watched her help that day. She had to be carried in by her mother because, although she had arms and legs, she couldn’t walk or sit up, as if her head were too heavy. She was actually able-bodied at one point early on, but had lost most of her abilities to an unknown cause. She had not front teeth and could not speak. Obviously this was a case not easy to improve, let alone treat. P’D claimed that P’s parents didn’t take good care of her, as is the case with many other pediatric patients. (Personally, I think the problem is a lack of health education.) For the whole hour, P’D flipped P in all sorts of positions, helping her exercise and stretch multiple muscles, but trying in vain to get P to muster
any sort of movement herself. Her second pediatric patient, L, on the other hand, was much more active. The hour was an interactive toy session and his mother and I were able to play a part in his child’s play. L had a muscle weakness in his lower back and could not stand for long. Although he was 8, he had a tendency to play on the floor and move across the floor on his butt to avoid having to use his back. Of course, we would push him to walk in order to further develop lower back muscle strength. The outside neuro department is a whole other world. I help set up ropes and springs on rehab beds for knee movement and adduction exercises, and the patients do the rest. Some patients also relearn how to walk and climb stairs during their stay at the department. 17
THE ‘REAL’ THAILAND Basically, amazing Thailand in a nutshell.
18
inside the developing world Before arriving in Thailand, I had this image of Thailand that resembled Africa. But until I received pictures of my “dorm”, I wasn’t sure what to expect from a “third world country”. And just to give you an idea how clueless I was, I had literally had this status picture hashtagged with “#ha!and ithoughtiwaslivinginahut”. Excuse my ignorance international ignorance. My room looked more like a hotel room with luxury amenities I never would’ve expected from a developing-- swimming pool, gym, balcony, personal outdoor sink, and free van service. Surprisingly, it was nicer than my apartment back in La Jolla, CA. I’ve been abroad more than most, but
never to a so-called developing country. Media has portrayed the developing world with many confusing images, and I wanted to find out for myself what constitutes a developing country. Thailand is currently rated medium development on the human development index.. This means that while Thailand is definitely not bad in terms of development, it definitely still has a lot more room for improvement. The socioeconomic terrain across the nation actually varies from province to province, from obvious concentrated wealth at the capital ranging to extreme rural poverty in the south. Step outside the Bangkok bubble, and you’ll find yourself in a different world, much less fettered by Westernization and international traffic.
Doing it local.
Putthamonton Park- Thailand’s largest sacred Buddhist ground. When it rains in Thailand … A little more drainage needed!
19
Thai gods apparently love red Fanta and toy trucks.
The slums down my street.
Floating market.
Mahidol University Campus. 20
SUBURB
Even where I lived, only 30 minutes away from Bangkok in the neighboring province, life slowed down quite a bit compared to its bustling counterpart. It was much more “homey” (you knew you were no longer in Bangkok when vendors and menus no longer speak English). While it was quite well-established with Mahidol University, a nursing school, a new hospital, the largest sacred Buddhist ground in Thailand (Putthamonthon Park), a classy local department store, a good-sized bar, and monopolized by 7-11’s every other block,life was much more traditional. Street food vendors were out grilling chicken, squid, and fish balls by 6am, and Buddhist were out and about making food rounds by 7am. There was a local floating market where you could buy what I call the amazing legitimate native Thai food from food boats (likened to the trending California food trucks) that dock along the market and pass you your food from their boats on an extended sick. There were temples. And at just about every home and medium-sized business is a tribute to two things: 1. the current King Rama lX and 2. a spirit shrine. I could definitely see this suburb looking like Bangkok in another 20 years. I heard the BTS Skytrain was likely to extend a route to Salaya. It represents and embraces a quickly developing
province with sky scraping apartment complexes springing up on newly paved roads. Nonetheless, that’s not to say that Salaya doesn’t have its lower socioeconomic population. On my very own street, was a small low lying slum, a stark contrast to its luxury-living neighbors. A couple families next door opened up a local “restaurant” in their home-basically a space thatched with a tin sheets of metal and surrounded by cardboard and plastic liner for walls. And next to that was a neighborhood lane of slightly better construction with rent running at half the price of my apartment, but less than half the quality. They looked more like concrete rooms with the bare amenities of a single electric light and running water. Did they have a toilet? I’m not sure. DOGS, DOGS, DOGS: Unfortunately, I’m not a dog lover because dogs are everywhere in the city. At first it was a daunting site and, as an American, I instinctively wanted to call the pound. But of course, that would’ve been silly for any Thai to hear because they were as common as pigeons in Los Angeles. None of them are neutered, so they multiply uncontrollably and roam the streets like restless wanderers. Most are harmless and actually cute … so, I guess I can’t blame shop owners for putting out leftover food for the dogs. I guess it’s like feeding pigeons.
pleasing the exam god Midterms and finals week are an especially spiritual week. Outside the social sciences building on campus is a large tree wrapped with colorful string and surrounded by all sorts of little animal figurines ranging from roosters to zebras that students bring to please the spiritual gods in exchange for good grades.
21
My student Mr. Yamauchi and boss and good friend Apsorn.
THAI STARBUCKS English schools are like Starbucks-- they’re seen on every other block and students flock to them, knowing that the knowledge they have to gain does more for them than a cup of caffeine. While the average Thai does not speak English, one knows that an essential advantage to finding a lucrative career in the big city and expanding one’s vision beyond Thai borders is learning English. During my stay, I had the privilege of helping my good friend Apsorn teach English at her Elite English school in Nakohn Pathom. She’s a hardworking and talented woman, having earned scholarships to fly her way into America to complete a masters in English teaching at Azusa Pacific University, California (just down a few neighborhoods from my house!) and to work as a medical interpreter in Indiana. She then flew back to Thailand where she opened her own tutoring and teaching business. There are many students, but there are also many teachers, many of whom are foreigners with an English native tongue-business is competitive!
Arom’s flower-making site. 22
rural As CEO of a business that runs international exports and winner of the 100,000 Baht OTOP KBO entrepreneur contest for top product, it was especially surprising to discover that Arom’s manufacturing company is really but a team of 30 older women working at her home studio. In a time span anywhere from a week to months, they fulfill large designer flower orders that are shipped to London, Japan, Czhecloslevokia, and India. That day, they showed us how they make their fake designer flowers by hand-- a handicraft skill that takes enormous patience. From the large backyard where banana trees grow, they harvest banana leaves, strip them of juices, dry them, dye them, cut them into petal-shapes, and glue flowers together petal by petal, leaf by leaf. It took me about 45 minutes to make my first flower, which would ‘v went for 45 Baht/piece retail and 65/piece wholesale, leaving 20 baht per flower for profit (that’s less than a dollar each). Another half an hour away via van through sparse jungle and grassy plains, we arrived at another small rural company that also manufactured handicrafts from raw materials-- this time purses from bamboo husks. The marketing director, also the designer, is a young male in his 30’s that ventures out into product/handicraft conventions searching for new ideas and advertising his designer handbags. His worksite is more visitor-friendly and is set with a display gallery and even up-to-date projection screen and laptop for demonstrations. As a younger entrepreneur, he’s definitely more in touch with the technological world, but tied in between a traditional technique of crafting and modern style of designing. Every few months, he’ll bring back new designs for his handicraft team to assemble. Small teams of middle-aged women work together on different parts of a designated bag until all pieces can be put
Rural farming. together to form one sturdy bamboo straw bag sold anywhere from 400-1000 Baht (10$-30$) each. I got to try this basket weaving technique and failed halfway-- twas a technical task that required too much patience. Another half hour later, we were at a large rice plantation. Surprisingly, there were no large tractors, no large plowing machines, and no pesticide vehicles. This means everything was done by hand. The economics and marketing team I had come with, however, held up a sample rice bag for export. It was vaccummed sealed in plastic, properly labelled, and ready for export. Although I’m sure this rice plantation provided plenty income, its difficult to think how these families so far out from civilization survive. In fact, many communities don’t even really need tangible income-- they simply barter with their neighbors in self-sustainable micro communities. This is especially common in agricultural communities that make up a great portion of Thailand’s population. At just two hours out into rural Thailand, it was amazing to see how these small businesses worked from their humble rural locations without anything as much as a cell phone to produce products that reached destinations millions of miles away . It was a little disappointing to find labor so cheap for things that are hand made with such delicate care. As a metropolitan boy from around the world, I’ve always been the consumer of mass manufactured goods and never gave much thought to the origins of my products. It was strange to see where some of these products came from-- from its very raw beginnings as raw as the plants their materials are derived from. To think that things made from across the world come into my hands everyday baffles me and bestows a new perspective on the things I buy.
23
WILD
Through the veins of Thailand run wild picturesque plains, hills, and mountains-- well, I’ll let the pictures speak for themselves...
The Golden Triangle- known as the world’s largest opium trade center at some point in history
Fire limbo-ing at Koh-Samut Island.
Tiger penis and cobra whiskey~ that one’s definitely new.
2-D 3-D~ Art in Paradise, Pattaya.
24
Mountains of Chiang Mai.
25
SEX+MONEY+POWER= CORRUPTION? You know there is political unrest when images like these appear on the local news...
26
SEX
You’d be surprised to know that prostitution is actually illegal in Thailand. However, the fact that I can’t walk down the beach without encountering a prostitute every other step of the way or innocently walk to Patpong Night market for some innocent tourist shopping without being bombarded with pingpong show offers and erotic massages, blatantly says something about law enforcement. Basically, it’s not enforced. The Ministry of Internal Police and Tourism Authority of Thailand (TAT) are in
MONEY
Thank God I look Thai. My pinch of Hawaiian blood is just enough to give my skin a darker shade of olive, a defined jaw, and almond eyes that lead people to think I’m actually a native. And it’s not just because I’m Asian. Asians in the states almost always guess that I’m either Thai or Vietnamese. Anyways, I’ve found that looking Thai, knowing some basic language, and applying my pseudo-native accent are probably the most important things when it comes to shopping in Thailand. Basically, there is a Thai price and a “Falang” price for every item. The difference is like paying in-state and out-of-state tuition, and the differences are just as blatant. Everything from park entrances to club cover fees to a motor taxi fee can cost on average twice as much for a nonnative. Especially when vendor prices are never really standardized and sit around without a price tag, prices seem to be determined on the spot by the color of your skin and your ability to speak Thai. Bargaining skills are a must. I’m too docile for aggressive bargaining, but I’m Thai-enough to be able to obtain the Thai price. Until they ask me more complicated questions like, “What’s
charge of managing prostitution. And while tourist police are stationed at the streets of nightclub venues, it seems they are really there to protect tourists rather than to enforce the law. Unfortunately, prostitution is an unspoken issue in Thailand, and furthermore difficult to catch, as it hides itself behind euphamisms such as “massages” and “shows”. Nonetheless, the problem is known and obvious. Because of the revenue it generates, sex tourism gets a tacit approval from the Thai government. In their annual report, the TAT recognizes the revenue generated from sex tourism as “nightlife”.
my style” and discover that I’m not actually Thai, the Thai price has already been set and I can’t help but pat myself on the back for pulling off such a clever ethnic stunt. My black and Latina friends often went shopping together, and when I heard the prices they were offered-- God bless their souls. My Thai friend realized her Latina friend was charged 1 corn for 100 Baht, when the Thai sign clearly read 2 for 100 Baht. But even for Thais themselves, Apsorn tells me that the lack of standardized prices and written contracts at local small businesses opens the way for petty price exploitation. One day she might be charged 30 baht for a van ride to the market, but the next day 60 baht for the exact same ride. When fixing things like the air conditioner, the mechanic can verbally agree to one price in person, but can charge you an exorbitantly higher price when the job is actually done. One day when my friends and I took a taxi to Bangkok, the taxi driver agreed to a 300 Baht ride. When we arrived, he charged 400 Baht. It would be ignorant for me to generalize my situations, but money issues do not seem unseemly.
27
POWER
You can say I’m stretching the connections a little far, but smaller business dealings are perhaps a reflection of a greater financial issue in the government. I’m not one to speak about politics, but I know there’s an air of corruption in the Thai government when they get in the way of my finals! At first, I thought it was just a small political skirmish in Bangkok. They happen all the time. But until every Thai student’s Faceboook profile turned into a political campaign and my school decided to mandate excusable excuses for protests, I knew something in the nation was badly brewing. Students, including teachers were missing class to march in these so-called protests against the “Thaksinocracy”. On one of those mornings, one of my professors who
28
Huh, funny they’re still not caught yet.
had participated in one of the more peaceful protests explained to all the foreigners what the fuss was about. I had never seen professors, let alone massive scholarly public institutions publicly voice a political stance. My professor explained that she was not a very politicallyinvolved person at all, but that the politics of this issue was so powerful that it moved just about every citizen to take action. Popular anti-government protests against the government of Prime Minister Yingluck Shinawatra or Pheu Thai Party leaders were triggered by a proposed amnesty bill that would have pardoned civilian crimes against democrat leaders Abhisit Vejjajiva, Suthep Thaugsuban, other corrupt politicians, and would have most infamously facilitated the return of the self-exiled
Continued on next page.
former prime minister Thaksin Shinawatra. The former Thaksin government had faced allegations of corruption, authoritarianism, treason, conflicts of interest, acting non-diplomatically, and muzzling of the press. Thanksin himself was also accused of tax evasion, lèse majesté (insulting King Bhumibol), selling assets of Thai companies to international investors, and charged for concealing his wealth during his premiership and abnormal accretion of wealth while in office. In October 2008, the Thailand Supreme Court found Thaksin guilty of conflict of interest and sentenced him in absentia to two years of imprisonment. Since then, he has not returned to the country. The amnesty bill would pardon all his wrongdoings. Prime Minister Yingluck Shinawatra who succeeded her brother is known as his political puppet. Due to strong opposition, Pheu Thai Party leaders decided to reject the amnesty bill and any of the like if it were rejected by the Senate. On November 1st, the Senate unanimously rejected the bill. Nonetheless, the protests continued to escalate when Suthep and eight other Democrat members of Parliament resigned from their positions to lead an anti-government protest against the government, which they criticized as an elective dictatorship and proxy for Thaksin. The protests consisted of several groups, including Suthep’s Civil Movement for Democracy, the Green Politics group, the Network of Students and People for Reform of Thailand (NSPRT), PEFOT, the Dhamma Army, and the State Enterprises Workers’ Relations Confederation. On November 20th, the Constitutional Court ruled that a proposed amendment to the constitution was invalid. The Pheu Thai Party, however, rejected the ruling on the basis that it had no jurisdiction over the case. This sparked an inflammation of protesters over the following weekend, with over 100,000 protestors gathering at the Democracy Monument on Ratchadamnoen Avenue. The pro-government UDD-ledd “red shirts” led a counterprotest of approximately 40,000 supporters.
That same night, we received an e-mail from the school saying school was cancelled. Tensions between protesters and the police increased as Suthep and his followers continued to push for dissolution of the House of Representatives and call to replace elected officials with a “People’s COuncil” to choose leaders. On December 8, all 153 minority Democrat Parliament members jointly resigned, a move intended to further pressure government for change. In a “final battle” on December 9th, Suthep led protesters on a march to the Government House. That very morning, Prime Minister Yingluck declared the dissolution of the House of Representatives and scheduled a general re-election for February 2nd 2014. Our school was closed down for another two days and final exams were postponed for a month. Half my finals magically turned into take-home finals… but my finals are really besides the point. It was exhilarating to observe a nation at one of its most pivotal moments of history where democracy was being voiced and fought for. My rehab department chair made a drive to the Bangkok Chaeng Watthana Government Complex with her husband to protest every night from 8pmmidnight. A country with such amazing culture needs to be protected by a stable government. Citizens like my coordinator with patriotism and action like this move a developing country forward and I can only hope Thailand for the best.
By November 25th, protesters had begun forcing their way into government buildings, forcing evacuation of the Dept. of Special Investigation’s headquarters, and disrupting the electricity supply and internet services when breaking into offices of state-owned telecommunication companies CAT and TOT. Violence erupted between the Red shirts and anti-government protesters proceeding in four deaths and 57 wounded. When protesters attempted to force their way into the Government House and Metropolitan Police headquarters on Dec. 1, police barricaded protesters outs and used tear gas and water cannons to disperse protesters.
29