tag:blogger.com,1999:blog-11100141499955951552024-02-19T15:25:33.270+09:00RyoesqueEvery day is full of new things to feel, learn, and think about. Some are really stimulating... it is truly exciting and encouraging when you meet energetic and enthusiastic people who share similar views with you... and as exciting when you come up with something together and get in the mud with everyone, believing it could really bring positive changes, big or small, to our communities.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.comBlogger47125tag:blogger.com,1999:blog-1110014149995595155.post-50130240515293074782011-02-26T18:33:00.007+09:002011-05-22T23:08:09.943+09:00A visit to Roi Et.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjabj5ZgUaWyVMyTEYITcM_hXZgddbXWcdspk_l2lAHjdzTbU2TQU_YwytXqJRIKhySpYrg1BdwV7pyuxtw9xePTjPgLcSx7de9yWUbtNBA9owmQJCSc6P4bE_yYpqV8tNP7oPhJ7UlFP6j/s1600/P3220415blog.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjabj5ZgUaWyVMyTEYITcM_hXZgddbXWcdspk_l2lAHjdzTbU2TQU_YwytXqJRIKhySpYrg1BdwV7pyuxtw9xePTjPgLcSx7de9yWUbtNBA9owmQJCSc6P4bE_yYpqV8tNP7oPhJ7UlFP6j/s320/P3220415blog.jpg" alt="" id="BLOGGER_PHOTO_ID_5609537487344094066" border="0" /></a>Bordered by Cambodia to the southeast and by Laos (and the Mekong River) to the north and east, 'Isaan' is what the Thais call the large tableland on the Khorat Plateau in the northeast where nearly a third of the nation's population lives. The name comes from Ishana, the Hindu god of death, possibly referring to the infertile soil and a climate characterized by long periods of drought punctuated by downpours and flooding. However, agriculture is the largest economy, generating 22% of the Gross Regional Product (GRP). Rice is most prominent, however, an increasing number of farmers are converting to cash-crops such as sugar cane and cassava (manioc). And, in the middle of Isaan lies the sleepy countryside city of Roi Et. Home to 40,000, it is also the capital of Roi Et province. The term Roi Et translates to 101, which derives from the 11 satellite colonies around the city and the 11 gates of the roads that lead to the towns, and it is thought that the number was exaggerated.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhbFVAtX-I1GTpHR2yYWrTJp4oScvPkrM1bDiqoJaGRNE_PBr5BslRbeQb2jg2aYuU58kZQRqVJ795PciTugLFSUojBmCAAkSMLPEalPZc_YEO8w9DTNQm4MzzBb_n28uk-yD2t95ecdfo/s1600/P3220462blog.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjhbFVAtX-I1GTpHR2yYWrTJp4oScvPkrM1bDiqoJaGRNE_PBr5BslRbeQb2jg2aYuU58kZQRqVJ795PciTugLFSUojBmCAAkSMLPEalPZc_YEO8w9DTNQm4MzzBb_n28uk-yD2t95ecdfo/s320/P3220462blog.jpg" alt="" id="BLOGGER_PHOTO_ID_5609537369571118370" border="0" /></a>Roi Et city and province are known for crafting 'khaen', an Isaan musical panpipe made from reed and wood. At the center of the city lies Beung Phlan Chai, a symbolic 200,000 square-meter artificial lake with an island in the middle that houses the city pillar shrine. Locals can been seen lighting candles, sitting on their knees, and giving prayers. Adjacent to the shrine is a park with a large playground and lawn with some sculptures of art, exercise area with equipment, as well as a running track. On any sunny day afternoon, after the day has cooled a bit, locals can be seen picnicking and playing around with their families, while some can be seen jogging with their portable music players. To the southwest of the lake is a small public aquarium, the only one in Isaan.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCrJlIgTNXV4-OKWT7-p3v-gd6OOlbYmDgc-v0rsYx-groyycQnHTPHRPveRz7gY8CiukSNU_vXWUgr7qEku6f2FkVbxJuOEXoqMHiBhyphenhyphenZwMF1I5qXIbRyreTrWirrS1ZeWYoyWi-QEpj1/s1600/P3220438blog.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjCrJlIgTNXV4-OKWT7-p3v-gd6OOlbYmDgc-v0rsYx-groyycQnHTPHRPveRz7gY8CiukSNU_vXWUgr7qEku6f2FkVbxJuOEXoqMHiBhyphenhyphenZwMF1I5qXIbRyreTrWirrS1ZeWYoyWi-QEpj1/s320/P3220438blog.jpg" alt="" id="BLOGGER_PHOTO_ID_5609537211402995570" border="0" /></a>Walking north on Thanon Haisok and turning left on Thanon Phadung Phanit, walking about half a kilometer before turning right on a small dead-end alley will lead you to Wat Neua, which means 'the north temple'. Appropriately situated in the northern quarter of the town, Phra Satup Jedi, a 1,200-year-old chedi from the Dvaravati period, is what makes the temple special, though its tranquil atmosphere with its quiet garden and occasional humming of birds that helps you relax is what I enjoyed the most. Nobody was seen, not even a monk. Buddha's representing the days of the week are housed in the corridor surround the chedi, but no traces hinting they have been cleaned regularly could be seen. The chedi here boasts an unusual four-corned bell-shaped form that is rare in Thailand. Around the 'bot' are a few old Dvaravati semaa, or ordination-precinct marker stones, and to one side of the wat is an inscribed pillar that was erected by the Khmers when they controlled the area during the 11th and 12th centuries.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9-5lMjiDzT0-ohWvo6-AWW1hjRmLQzEvJ5FhpuNHU6L9d0qhBmvrcAaganlUoA3EDr5PU2gAusGukL7TaZnN8Wt0e_oC7LGrGHb5rOSoVHoadLJDGLEwUYSuFb2B7zYB58J2tR-hjQJ1d/s1600/P3220427blog.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9-5lMjiDzT0-ohWvo6-AWW1hjRmLQzEvJ5FhpuNHU6L9d0qhBmvrcAaganlUoA3EDr5PU2gAusGukL7TaZnN8Wt0e_oC7LGrGHb5rOSoVHoadLJDGLEwUYSuFb2B7zYB58J2tR-hjQJ1d/s320/P3220427blog.jpg" alt="" id="BLOGGER_PHOTO_ID_5609537032232552098" border="0" /></a>Strolling in the opposite direction on Thanon Phadung Phanit will take you through a couple of local shops and banks, before a tall standing Buddha easily towering above the minimal skyline of the city jumps into your view. Located near the eastern edge of the town, Wat Burapha Phiram, a third-class royal temple which was formerly known as Wat Hua Ro, houses the tallest standing Buddha image in the country known as Phra Phuttha Rattanamongkhon Mahamuni, or Luangpho Yai or Phra Sung Yai in short. The Buddha is 59.2 meters tall and if the base made from concrete is included, it would be 67.8 meters. Near the base of the Buddha is an outdoor museum that displays figures telling the story of the Buddha. Unlike the almost-forgotten temple of Wat Neua, Luangpho Yai seems to be highly revered by the people of Roi Et.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcwcpc-IFrnYPAEukHwkUvmoQvqWgYPVFG9Vqtk802Q9rnE3E0LtKWClpNk-y7WW2h7uCbvCn3UGn35w2uhUS_Ce_oMxEIyOtDD-pdXHHw5DD8-4EBqIIJWMSwDxcEclOuUJYbY4wgt4yo/s1600/P3220450blog.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcwcpc-IFrnYPAEukHwkUvmoQvqWgYPVFG9Vqtk802Q9rnE3E0LtKWClpNk-y7WW2h7uCbvCn3UGn35w2uhUS_Ce_oMxEIyOtDD-pdXHHw5DD8-4EBqIIJWMSwDxcEclOuUJYbY4wgt4yo/s320/P3220450blog.jpg" alt="" id="BLOGGER_PHOTO_ID_5609536815788551842" border="0" /></a>Walking south on Thanon Phloenchit will lead you to the busiest part of town, with some high-class hotels and a shopping center, though the large and lively market is definitely what draws the most attention. No, there isn't anything special about it, and it resembles any other ordinary market found in most Thai cities. However, you won't be bored watching locals selling their fresh goods or cooking meals the smells of which will make you drool, and other locals come and go, probably collecting the ingredients to make their supper. And for me, this is the first place I had 'khaw-niaw ma-muang', now my favorite Thai dessert, which is coconut-milk-steamed sticky rice topped with thick slices of fresh mangoes and additional sweet coconut milk poured on.<br /><br />Is Roi Et a must-go place on a tourist's list? Probably not. But to relax and savor the atmosphere unique to Isaan, it might be worth spending a couple of days. :)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com1tag:blogger.com,1999:blog-1110014149995595155.post-60594418085098154312010-09-12T22:24:00.023+09:002010-11-21T13:58:07.794+09:00A visit to Inazusa.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmuSUhsEnBz36PacDdCWSYZyxDvkHM_o072dxt5aSM0WQi-E0F0s-qeakV4hK1P4kUFgk60jbTpUvH_K5NEW08iUPa-v9pC6PJvX4OX2otK28MPD4oYp_WUqOXQ_s1AGSpUzrmzqKOyPp0/s1600/201004242321.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmuSUhsEnBz36PacDdCWSYZyxDvkHM_o072dxt5aSM0WQi-E0F0s-qeakV4hK1P4kUFgk60jbTpUvH_K5NEW08iUPa-v9pC6PJvX4OX2otK28MPD4oYp_WUqOXQ_s1AGSpUzrmzqKOyPp0/s320/201004242321.jpg" alt="" id="BLOGGER_PHOTO_ID_5541860438914564946" border="0" /></a>Now part of the city of Shimoda, Inazusa is a peaceful countryside village on the Izu Peninsula, the easternmost part of Shizuoka prefecture. It actually occupies almost half of the city area, but its population is just over 10% of the city's, standing at 2,855 as of 2008. 35% of them are over 65 years old, which is a little above the average rate for a Japanese countryside village. Many of them are farmers, but nowadays they run other businesses alongside to make both ends meet. In April, I had the opportunity to visit Inazusa Clinic, a relatively new clinic that was set up just five years ago by JADECOM (acronym for Japan Association for the DEvelopment of COmunity Medicine), one of few health care organizations putting effort in bringing health care to rural, isolated areas in Japan.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVAGBoE8irU-udetmAMs-LK9D_TwS0bamSdFGzzzNq90AhbSPcqtKt-EkoBC3y6ZGWLXPaYSNhcRB0xdSG1UGUr0lAsJUPI-GnWhpNXN3YEYSn0B3gYy1hKDo2ZZjz71oMM1UppGQVrVUj/s1600/201004242314.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVAGBoE8irU-udetmAMs-LK9D_TwS0bamSdFGzzzNq90AhbSPcqtKt-EkoBC3y6ZGWLXPaYSNhcRB0xdSG1UGUr0lAsJUPI-GnWhpNXN3YEYSn0B3gYy1hKDo2ZZjz71oMM1UppGQVrVUj/s320/201004242314.jpg" alt="" id="BLOGGER_PHOTO_ID_5541860131311481058" border="0" /></a>Inazusa had a clinic that was funded by the city of Shimoda until 2002, when the sole physician of the clinic neared the age of 90, and without a doctor to take over the job, was forced to close down. So the village went without a doctor for three years. People who could drive traveled 20 minutes south to central Shimoda, where they could find some privately-run clinics. Accompanied by two nurses and two clerks, Dr. Hajime Kawasaki is the head of Inazusa Clinic, and he kindly accepted my one-week visit. Because I didn't have too much time, I wanted to spend the time to know the village and its people, and at the end of the week be able to 'draw a picture' of how the community looks like.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicVUyjOmptS_vTOBl0LddTlYkqcThDAsje6OPo03J6UP2goCqkLVLWAYYQFgmObO0DsageGi946nzXAvtcAHX88tmxrOKaApYHqHEUwOZG8hqFADm5yqvl_7Q41ynJXvVIdV9Rz2XXy9P_/s1600/201004202141.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicVUyjOmptS_vTOBl0LddTlYkqcThDAsje6OPo03J6UP2goCqkLVLWAYYQFgmObO0DsageGi946nzXAvtcAHX88tmxrOKaApYHqHEUwOZG8hqFADm5yqvl_7Q41ynJXvVIdV9Rz2XXy9P_/s320/201004202141.jpg" alt="" id="BLOGGER_PHOTO_ID_5541859529025432642" border="0" /></a>The first place I went to to meet the villagers was Ryusouin. This little local temple has been holding what it calls 'Temple Wellness Renko' (traditional exercise) sessions, where locals come to do exercise with the the monk, who interestingly has a bachelor's degree in physical education. In a rural area like Inazusa, during the 'obon' (Japanese Buddhist custom to honor the ancestor's spirits) season or whenever a funeral takes place, the family of the deceased along with the monk walk through the town visiting each and every home so the deceased can bid farewell. And the monk here found out that there were many who complained about back pain or joint pains, and together with the awareness that he himself was lacking exercise, came up with the idea. About 10 people come to each session, which takes place four times a week, and pay 500 yen per session that runs for about one hour followed by chit-chat time with tea and sweets. Asking the participants, not all of whom are locals, they say they come to talk with the charming monk, more than for the exercise. The monk says that he hasn't been able to attract the people who he really feels he needs to do exercise with, especially more locals, and that certainly is an issue to be solved. Also, citing the temple's proximity to the clinic, he says he has many ideas he might want to try together. Monks could play an important role in bringing a community together, like in Buddhist countries such as Thailand.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUVxX8jnuU8HQ4gT7mu5dAULtNhyphenhyphencJx1E6bN8z_hkjCbpXxVj6cNtrvcQ1F1rOwxUVHsR3Aq1d8BHq5HjoN96TR1UUy3FOCdqWLNBRtkcc2xvtMOFrvy7XtFWnP6S-NH2SY-iHVRf43HbW/s1600/201004222206.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUVxX8jnuU8HQ4gT7mu5dAULtNhyphenhyphencJx1E6bN8z_hkjCbpXxVj6cNtrvcQ1F1rOwxUVHsR3Aq1d8BHq5HjoN96TR1UUy3FOCdqWLNBRtkcc2xvtMOFrvy7XtFWnP6S-NH2SY-iHVRf43HbW/s320/201004222206.jpg" alt="" id="BLOGGER_PHOTO_ID_5541859095464912642" border="0" /></a>Another place I visited was the local nursing home called Azusa-No-Sato, which literally means 'the village of Azusa'. Like many other similar facilities in Japan, it also operates so-called 'day care' activities where the elderly who live with their families at home come to spend a day to play, take a bath, and socialize with the fellow elderly, not only to have them enjoy time, but to spare some break for the care-giving families. The national elder-care insurance is where the money for the service comes from, and the families would usually pay about 2,000 yen (JPY) per day, though funding for the insurance comes partly from the insured's past monthly payments. Because the nursing home's service includes picking up as well as dropping them off, I had a chance to get a glimpse of the actual homes and the areas the people live in. For the staff, it's not an easy job. It requires lots of energy, both physically and mentally, and considering their often below-average salaries, I had the impression that many workers in this field were not enjoying their work. However, it was different, at least here. Yes, the staff were always thinking and doing what they have to, but still, they were enjoying joking and playing around with the elderly as well, in a genuine sense. A staff said, "This is not the kind of job you can continue if you don't enjoy it. I really like my job."<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieFI_Nc7uqzsFQdB0AqynnGciA76TFH0ojhF1FO5R0KV06_7k9vQtzgK31QyKHEbbU9iTN0ehcJ5HQBFypTGaLlzOvU7WYS_BBQkW7we7Fp1P0z5hVVBimDGnzYyeI7usqY4wdV4CpIeMS/s1600/201004232213.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieFI_Nc7uqzsFQdB0AqynnGciA76TFH0ojhF1FO5R0KV06_7k9vQtzgK31QyKHEbbU9iTN0ehcJ5HQBFypTGaLlzOvU7WYS_BBQkW7we7Fp1P0z5hVVBimDGnzYyeI7usqY4wdV4CpIeMS/s320/201004232213.jpg" alt="" id="BLOGGER_PHOTO_ID_5541858744861093394" border="0" /></a>In Inazusa, or like in many other places, farmers have always naturally formed informal groups with fellow farmers nearby, like a neighbors' small gathering. Many of them would have lunch together, chit-chat, or even do some leisure traveling when they can spare the time. One of those groups, which calls itself Chalette, has interestingly founded a small 'manju' (Japanese traditional pastry with sweet red soy bean paste filling) shop. They say they wanted to do something different, something they enjoy doing, and something they can continue doing, and that's when they realized members in the group were good at making Japanese traditional pastries. So they collected 100,000 yen and started this shop. Conveniently located along a road that connects Shimoda and towns on the other side of the peninsula, the now well-known shop earns enough to fill the members' piggie banks. When they sell out, they sell out, but they don't increase their job because they want to enjoy it and don't want it to become a burden on them. "Family comes first. Job comes second."<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8t6Xs8eETfjE7zZozR83M3uN0ecdVuUqXp5w1dCxhp7rLaYloLGP4MIk-9vN7jBPi5tw7PbnWFNo4L35NSqAMXCHPdj3_KGVgEQnF-frTufUIT9a7uy3OTkZpJpMIyVa-ZcRdTjBKInLg/s1600/201004242281.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8t6Xs8eETfjE7zZozR83M3uN0ecdVuUqXp5w1dCxhp7rLaYloLGP4MIk-9vN7jBPi5tw7PbnWFNo4L35NSqAMXCHPdj3_KGVgEQnF-frTufUIT9a7uy3OTkZpJpMIyVa-ZcRdTjBKInLg/s320/201004242281.jpg" alt="" id="BLOGGER_PHOTO_ID_5541858324684802082" border="0" /></a>Another group of farmers founded a community farmers' market called 'Kimagure Shop', which literally means 'the range of products and price is up to the mood of the day'. When crops are harvested, it normally goes through a number of wholesale dealers before it reaches the consumer, and along the way the cost adds up and is represented in the price. So, what this community market does is farmers directly come from the fields to drop off their products, specify a price, and the market sells them off here, and 88% of the income goes back to the producer. This way, the farmers get bigger margins but the consumer gets them for less than what they would pay in an ordinary supermarket. Plus, the products are consumed relatively locally. So the products sold depend on the season, and now over 90 producers, not only farmers but local bakeries and flower shops, drop the market. It's becoming a place where not only the people of the community gather, but chit-chatting between the locals and travelers as well, being located alongside a main road.<br /><br />Inazusa is certainly a typical rural village, but does have many encouraging activities run by the locals that are helping to sustain happiness in the community. :)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-86889287979121712922010-07-24T10:55:00.001+09:002010-09-06T23:33:50.265+09:00A glimpse of the Philippines from Negros.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlsBA4vkWz-ppgDJxlbgOfZVs5DJjW4a6URnANV5qqe2eeL8WQJV6Rn-uR2XRHm3b0P9Et3MM-YtRwkgQTFLEgdyh0xUf6kBH4nHoL82GGoc9uc7U9pTucXN0R09DC9C7DeY4-6LvqENF5/s1600/20103110917.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjlsBA4vkWz-ppgDJxlbgOfZVs5DJjW4a6URnANV5qqe2eeL8WQJV6Rn-uR2XRHm3b0P9Et3MM-YtRwkgQTFLEgdyh0xUf6kBH4nHoL82GGoc9uc7U9pTucXN0R09DC9C7DeY4-6LvqENF5/s320/20103110917.jpg" alt="" id="BLOGGER_PHOTO_ID_5513659784570286850" border="0" /></a>In early March, I had the opportunity to visit Negros Occidental province in the Philippines, thanks to Dr. Yasuhiko Kamiya at Nagasaki University and the Japan Association for International Health's Student Division (JAIH-S). I was based at Bago Health Center in Bago City, about a 30-minute drive south of Bacolod City, the capital of the province. The kind staff at the health center allowed me to stay at one of their houses, and I stayed with Joseph Aunzo, who is a nurse at the office, and his family. Every morning, it's not the alarm clock that wakes you up but the chickens that start crying no later than 6AM. I headed off to the office with Joseph every morning by 8AM and had days full of observing the many activities not only of the health center, but of schools, local villages, non-profit organizations, etc.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgT2FPVV3iF923xHtTp2dAspNWag8vH1FUuUji07goySlxaHTE5fuTZFce-SHkzWZoGyaEGKeBzoIG0MFOJ9JGEpZHrK_vUiyCNCHCU5oSq9xDejMOPsz6WvO11jVE1Ek1H-Jj1jlH2Sf9q/s1600/20103080708.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgT2FPVV3iF923xHtTp2dAspNWag8vH1FUuUji07goySlxaHTE5fuTZFce-SHkzWZoGyaEGKeBzoIG0MFOJ9JGEpZHrK_vUiyCNCHCU5oSq9xDejMOPsz6WvO11jVE1Ek1H-Jj1jlH2Sf9q/s320/20103080708.jpg" alt="" id="BLOGGER_PHOTO_ID_5513659635048005234" border="0" /></a>Due to the fact that I only had a week in the region, my primary goal for the visit was know the daily lives of the people who live in the area, and get a glimpse of the social aspects, such as the cultural, economical, political background of the community that they belong to. And from there, with a health-oriented perspective, I wanted to see what the problems, or the weaknesses, of the communities are, how the people themselves are feeling, and what they are actually doing to tackle these issues. I also had the opportunity to meet some local politicians, and wanted to know how the government sees the communities and what they are doing.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCEaAFXcpTZR9sfy4E9rejQXrsFeMWbFdiyB6HH0LFCIGlQohXW2rmVnxfYN0B0dCrKuz4hZGQz8tUUtlq9OPVqBhNuVDmk7ahyQ8PBjjPhZiFo3rmyNtLRm8h1cKYqHiEpP3vD6Ifrx6z/s1600/20103100854.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCEaAFXcpTZR9sfy4E9rejQXrsFeMWbFdiyB6HH0LFCIGlQohXW2rmVnxfYN0B0dCrKuz4hZGQz8tUUtlq9OPVqBhNuVDmk7ahyQ8PBjjPhZiFo3rmyNtLRm8h1cKYqHiEpP3vD6Ifrx6z/s320/20103100854.jpg" alt="" id="BLOGGER_PHOTO_ID_5513659468207677506" border="0" /></a>One day, I was with Dr. Kamiya, and we made a home-visit to a nearby village. This house was the home of a child with cerebral palsy, one of many disabled children Dr. Kamiya had been personally supporting for many years. He not only donates older wheelchairs and fixes those that are broken and reuses them, but listens to the child, the family, and discusses with them what can be done. The house was an ordinary house that you find anywhere in the rural areas in this part of the country, and though not affluent, the family had been taking care of the child for well over 10 years, ever since he became handicapped. However, the family didn't have enough money to buy medicine. There are established non-profit organizations, such as Negros Occidental Rehabilitation Foundation Inc (NORFI) and Volunteers for the Rehabilitation of the Handicapped and the Disabled (VRHD), both based in Bacolod, but they obviously cannot be permanent solutions. On another day, when we visited another village, the people there had listed the five major issues in the community, and the lack of money to purchase medicine and the insufficient number of health-care professionals made up two of them.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggzvQ7ESWRWYM8LHyD2TQbNo9wLZXnDDW32n5kpspH3lzHG6r2jCq6etmdXWeovirfOpZGbfW8mfSxq1cISD1_JJXL1imP1gb0HYh1lYVDxP9MJBxaUVP4pVSXuUFLBNVDywWi_lwflY3e/s1600/20103090755.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEggzvQ7ESWRWYM8LHyD2TQbNo9wLZXnDDW32n5kpspH3lzHG6r2jCq6etmdXWeovirfOpZGbfW8mfSxq1cISD1_JJXL1imP1gb0HYh1lYVDxP9MJBxaUVP4pVSXuUFLBNVDywWi_lwflY3e/s320/20103090755.jpg" alt="" id="BLOGGER_PHOTO_ID_5513659174398978786" border="0" /></a>In the Philippines, the population is still growing at a fast rate. Families make many children so as to have them work and increase the household income. Catholic being the major religion, ever since the Spanish colonization days, may not be helping as they discourage contraception. Many people who worked in the health center also came from big families, some of them having seven siblings. When I visited a local elementary (primary) school, there were children full of smiles playing around, but some were saying to me "I don't have money to pay for lunch", "my house doesn't have a shower", "... because we're poor". Or were they seeing me as a donor? Comprised of six years, about 10 to 15% don't make it through the curriculum due to financial reasons, according to the teachers. The schools is trying to find scholarships, but obviously, there aren't enough. Yes, poverty, in terms of lack of cash, is an important issue and lies at the root of many problems, however, it was unfortunate that I wasn't able to feel the local people's will to do something creative to help the situation.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEW_Q8inYWVK1SO2UhZUqp5hUJSk5KaW09gbEsCy28Xsz_Flk_hXvvz5X1OXrOeuyXQeBvSqx1kwvR0TBWiah1ajDCNR-Z62xbr6lq5lZl0xQFom7IY1aa4HexvgY9URxqU4t7RGC88Rxf/s1600/20103090724.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgEW_Q8inYWVK1SO2UhZUqp5hUJSk5KaW09gbEsCy28Xsz_Flk_hXvvz5X1OXrOeuyXQeBvSqx1kwvR0TBWiah1ajDCNR-Z62xbr6lq5lZl0xQFom7IY1aa4HexvgY9URxqU4t7RGC88Rxf/s320/20103090724.jpg" alt="" id="BLOGGER_PHOTO_ID_5513658756851822498" border="0" /></a>I asked the staff at the health center and the hospital. Here, the local government needs to find budget to lure health-care professionals to this area. Because there isn't enough cash, there isn't a sufficient number of them, especially physicians. For example, Bago Municipal Hospital, the only public general hospital in the area, had 50 beds and an emergency room (ER), but there were only five physicians. There were, however, plenty of nurses. However, many of them are working without pay, and there's a background story to this. In the Philippines, about 40,000 new nurses pass the license exam (out of 100,000 total), but that is more than the demand. And even if you are in a relatively high position, such as a chief nurse, you still only earn about US$400 per month. So, what is happening is many are moving out to work in Europe, the U.S., and more recently the Middle East, especially Saudi Arabia and United Arab Emirates. From there, they send part of their income back to their families still living in the Philippines. The nurses who are working without pay are those trying to keep up with their nursing skills while preparing to work abroad. In Ma-ao, the village I visited, there was one physician, which is rather rare, because there are many public clinics that don't have a physician nor a nurse, and a midwife is carrying out all the diagnosis and treatment.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdmKHA64E-Wph4d3PEI6hYnbFWI9MouvJ3aeAsphSBaLPkipfUxruph-rW0VbPJzAG_6F9MK8CuJP8QFrWLcriNUtb2JokttO_Q8GeQzld5DS-PES7ApqN77twTTLFjbyr70PO-tbc0s9i/s1600/20103100837.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdmKHA64E-Wph4d3PEI6hYnbFWI9MouvJ3aeAsphSBaLPkipfUxruph-rW0VbPJzAG_6F9MK8CuJP8QFrWLcriNUtb2JokttO_Q8GeQzld5DS-PES7ApqN77twTTLFjbyr70PO-tbc0s9i/s320/20103100837.jpg" alt="" id="BLOGGER_PHOTO_ID_5513658346652081330" border="0" /></a>So, what's the government doing? Ever since the Philippines became independent from the U.S., politics have never been stable, effectively slowing down the issue of bringing affordable, if not universal, health care. Staff at the health center do say that "the government is putting at least some effort and its gradually starting to improve", but its certainly far from catching up. When I visited, it was near general elections so lawmakers had once again pretty much halted lawmaking and shifted to election projects. And every time an election happens, vote buyouts are very common, and the locals use the money to help pay for their daily expenses, including health care. The people say they don't have money. The government says they don't have money either. So who does? Of course, there are the huge multi-national corporations and related politicians, who have a hold of much of the country's wealth. Some Filipinos sarcastically put it this way: the Pareto principle (80% of wealth is in the hands of 20% of the population) is more like 95% to 5% for the Philippines.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj686kGxFae0zyPIL_DFvJOLmV2u6Fy92b2XMS2N-4gTxUXumkcy5fPnOp3-ktTRyr84QIRn-7nslMIaqIpl-wIBS2TF7Iwl10F-7DBPDDRHIHBvvSH_lOk0KUwLhIrANk2np9OgfG-eydr/s1600/20103090735.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj686kGxFae0zyPIL_DFvJOLmV2u6Fy92b2XMS2N-4gTxUXumkcy5fPnOp3-ktTRyr84QIRn-7nslMIaqIpl-wIBS2TF7Iwl10F-7DBPDDRHIHBvvSH_lOk0KUwLhIrANk2np9OgfG-eydr/s320/20103090735.jpg" alt="" id="BLOGGER_PHOTO_ID_5513658094576979826" border="0" /></a>It was a short stay for me, but I was able to meet a variety of people. However, as I mentioned earlier, the lack of money is at the root of many problems, but many people have stopped their thinking there. Yes, financial support is important, but that's an issue that will be around all of the time. What's important is how creative the people in the community together as a whole can become to overcome hurdles, including money, to make their daily lives happier. Yes, it's not easy, and it's not accomplished in just days or weeks. Some staff said that foreign visitors coming and praising the work the villagers do helps them gain confidence and move on. I guess that is important as well, but eventually, the people should be doing the things because they together feel the need to do so, not because somebody from another country is saying they're doing a 'good job'. When a people together become able to address its own issues, and creatively use their strengths and resources to tackle them, that is when a village starts to become truly independent, and it is what leads to empowerment and social development.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmA-4NMrAM1EjONuECsNppTXjXvgPaPsza4HWsp_obWSiJ6HZeoP3ngR7hdikcKxn0tCmGF5kl8ivZ25_H005ZWsuwJxyWXj1bytJ6fp4QujHP9Qyd30hecYdpRDnGkNaxtT64BZTtjeV8/s1600/20103100887.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmA-4NMrAM1EjONuECsNppTXjXvgPaPsza4HWsp_obWSiJ6HZeoP3ngR7hdikcKxn0tCmGF5kl8ivZ25_H005ZWsuwJxyWXj1bytJ6fp4QujHP9Qyd30hecYdpRDnGkNaxtT64BZTtjeV8/s320/20103100887.jpg" alt="" id="BLOGGER_PHOTO_ID_5513657692091699138" border="0" /></a>However, I want to make sure I am not saying the people have lost vitality. Yes, there are many who have fled overseas, but, there are many who have chosen to stay, even though their salaries are only a fraction of their counterparts in Europe or the U.S. They love their hometown, they don't want to be far from their families, or they have a strong passion for the work they do. Conversations with Nona Obando, the chief nurse at the health center, and Dr. Ramon were memorable, especially because I felt how much passion and pride they have not only for their responsibilities, but their home city. These altogether are invaluable assets to the local community and what helps it keep going. And then again, even for the people who have fled overseas, their feelings for their families and hometowns are the same. I have seen people in Japan and the U.S. who have lived for over 10 years without returning, but still continues to send money back to their families.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgw1Q_ietjTCVm4dPzDRlIF0EeNZ8s-HqZ62S26Wed0HgNk-cJUYeYNnp22g8tEmrQrwlZ71qyMYYAFQ3YojWXLUTNyDhX7Dl4BITwUn6qZOun253WiDiLddY99GbxPd1QW7d0aLpf5QTlc/s1600/20103110974.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgw1Q_ietjTCVm4dPzDRlIF0EeNZ8s-HqZ62S26Wed0HgNk-cJUYeYNnp22g8tEmrQrwlZ71qyMYYAFQ3YojWXLUTNyDhX7Dl4BITwUn6qZOun253WiDiLddY99GbxPd1QW7d0aLpf5QTlc/s320/20103110974.jpg" alt="" id="BLOGGER_PHOTO_ID_5513657442119615266" border="0" /></a>Immigrants are there all over the world, and ever more so with globalization. Whether documented or not, they all come because they want to make their daily lives better, because they want to support their families. And their longing to live in their hometown does not change. I would like to express my appreciation for Dr. Kamiya, JAIH-S, Nona, Joseph, Dr. Ramon, Dr. Pilar, and all the staff at the Bago City Health Center for their kindness and letting me have this opportunity.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-74181913375963221852010-06-27T14:11:00.008+09:002010-09-27T21:11:55.317+09:00What do airline alliances and consolidation lead to?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8eMnFtUVP7ThRBM14RqONXBlvQGr69iD0aVaua1PU8tykI7tMoxTmGdht7ua2Wl1NdaMzytSUaLIYTfAR7WuUZ5b-8UnMkTzIO55LYz50beb_OB5fDvHrgIGoEt77DkrRYT8-JdE9Iz8K/s1600/20102172578.jpg"><img id="BLOGGER_PHOTO_ID_5513441495030380066" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8eMnFtUVP7ThRBM14RqONXBlvQGr69iD0aVaua1PU8tykI7tMoxTmGdht7ua2Wl1NdaMzytSUaLIYTfAR7WuUZ5b-8UnMkTzIO55LYz50beb_OB5fDvHrgIGoEt77DkrRYT8-JdE9Iz8K/s320/20102172578.jpg" border="0" /></a>Having earned almost 80,000 miles on a SkyTeam member airline, the addition of Romanian national carrier TAROM and especially fast-growing Vietnam Airlines to the alliance in June is welcome news. At the same time, SkyTeam renewed its membership program, eliminating the 'associate member' status and thus upgrading Air Europa (Spain) and Kenya Airways to full members. Smaller airlines wishing to join no longer need to adopt a current member's frequent flyer program (FFP) if they already have their own. So June saw the number of member airlines grow to 13, serving 898 destinations in 169 countries and carrying 384 million passengers annually. Further, China Eastern is joining in 2011, and Air Algérie (Algeria), China Airlines (Taiwan), Garuda Indonesia, MEA Middle East Airlines (Lebanon), and Uzbekistan Airways have also shown official interest in joining, and are in various stages to apply for membership.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-DiQRhbSQ91ChfYUSu-RT1rxD6AKRx1q0upLferKV6YC-3lvLanPHP6vqSG1HPD7HQY30DEsYtLZAA1ZRuMk7UTpqktr56KQSIAFYwMobfni7IsZ6cTmFHq29X4LmDD_17XAJRTNyPIT2/s1600/20102213175.jpg"><img id="BLOGGER_PHOTO_ID_5513441048912679634" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-DiQRhbSQ91ChfYUSu-RT1rxD6AKRx1q0upLferKV6YC-3lvLanPHP6vqSG1HPD7HQY30DEsYtLZAA1ZRuMk7UTpqktr56KQSIAFYwMobfni7IsZ6cTmFHq29X4LmDD_17XAJRTNyPIT2/s320/20102213175.jpg" border="0" /></a>However, by size, the undisputed leader of the three major airline alliances is Star Alliance, which is also the oldest, having been founded in 1997 by Air Canada, Lufthansa, SAS Scandinavian Airlines, Thai Airways International, and United Airlines. Now boasting 28 members encompassing 1,077 destinations in 181 countries, they transport almost 624 million passengers annually. They recently added TAM Airlines of Brasil giving its presence a boost in South America, a continent without a partner ever since VARIG Brasil went bankrupt. On the other hand, the alliance with what some say is the most balanced network is Oneworld, with a member airline in every continent of the globe except for Africa (and Antarctica, of course). LAN of Chile (with subsidiaries in Argentina, Ecuador, Peru), Qantas of Australia, and Royal Jordanian in the Middle East help the group stand out. By size, they are third, with 11 members serving 819 destinations in 142 countries carrying 308 million passengers annually.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5-VgLUfXvbLrWKdlsrqY9Hf8IcI_9o8kol-imw4F6TPJ-FZNqbN7_sGAuasuriv8FfJ1OrYqkAV7-opSfCqT8U7qTjXsFBab5oIXBFY2aAhf43wJ1iZjpgSqHzHS6Km9thww4uIyVf66n/s1600/20102162572.jpg"><img id="BLOGGER_PHOTO_ID_5513441340643170290" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5-VgLUfXvbLrWKdlsrqY9Hf8IcI_9o8kol-imw4F6TPJ-FZNqbN7_sGAuasuriv8FfJ1OrYqkAV7-opSfCqT8U7qTjXsFBab5oIXBFY2aAhf43wJ1iZjpgSqHzHS6Km9thww4uIyVf66n/s320/20102162572.jpg" border="0" /></a>The battle to lure the leading carriers into their alliances is only getting fierce, especially in India, Latin America, and Africa. In China, the 'big three' have already decided on their future partners, with Air China in Star Alliance, China Southern in SkyTeam, and China Eastern also joining SkyTeam in 2011, which left Oneworld without a partner in the world's fastest growing market, though they do have Hong Kong-based Cathay Pacific. For the 'big three' in India, Kingfisher has already announced their intention to join Oneworld and Air India is preparing to enter Star Alliance, leaving SkyTeam to do whatever they can to persuade Jet Airways to join. The airline is reportedly most interested in Star. In Latin America, the recently-merged Avianca-TACA group is being fiercely fought for by Star and SkyTeam, though the airline says they are so far leaning towards the former.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqCNDjaDXR2gOR12iFox3NDA5qO_ti78g529PXdjorRE5vnT7DqQBxN0HCV4AgATX6W6EryQUbj5jeaPWBStDjz8HEvczyeO7MGYPVqiSWJVhcn3GDLgGHpeUP6DllIH7DOG0eu0BRkxvm/s1600/20107242409.jpg"><img id="BLOGGER_PHOTO_ID_5513440733737771938" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqCNDjaDXR2gOR12iFox3NDA5qO_ti78g529PXdjorRE5vnT7DqQBxN0HCV4AgATX6W6EryQUbj5jeaPWBStDjz8HEvczyeO7MGYPVqiSWJVhcn3GDLgGHpeUP6DllIH7DOG0eu0BRkxvm/s320/20107242409.jpg" border="0" /></a>The aviation industry is one that is fragile and constantly changing, yet often requiring airlines to make company-risking decisions. Consolidation is happening everywhere in the industry, where the strong are merging to get an even stronger hold of the market, the weaker are being gobbled up or wiped out, whether a legacy flag carrier or not, while a constant threat of low-fare low-cost carriers force the incumbents to make radical changes to keep up in the competition. Alliances are also a tool for consolidation, with airlines in the same alliances merging or taking over one another or forming joint ventures and making joint purchases of aircraft. Air France/Alitalia/Delta/KLM, Air Canada/Continental/Lufthansa/United, and the recent American/British Airways/Iberia are the most notable examples.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4UdLkqPGyFCBa3SJdmLyGZkg9Jzrge3CyiS-kejWE3LfybtN1UCHxI1m_dEb66c9HlwO2AyJtOxHvTi8l5cGE3XGx8rAoB7qU9cu8-s9dHmgxpsN4D5Hlo5oZsQjSxADEvwAC2djYPYIm/s1600/PICT3457small.jpg"><img id="BLOGGER_PHOTO_ID_5513440460699268498" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4UdLkqPGyFCBa3SJdmLyGZkg9Jzrge3CyiS-kejWE3LfybtN1UCHxI1m_dEb66c9HlwO2AyJtOxHvTi8l5cGE3XGx8rAoB7qU9cu8-s9dHmgxpsN4D5Hlo5oZsQjSxADEvwAC2djYPYIm/s320/PICT3457small.jpg" border="0" /></a>Recently, in the U.S., Northwest just completed merging with Delta, and now Continental is proceeding with a merger with United (retaining the latter's name), pending government antitrust approval. United belongs to Star Alliance, Delta belongs to SkyTeam, and American belongs to Oneworld. Then there are the now well-established low-fare airlines such as Southwest (the mother of them all), AirTran, and JetBlue, while not doing bad are Frontier, Spirit, and Virgin America. While across the pond in Europe, airlines are starting to get consolidated around three major airlines: Air France (SkyTeam), British Airways (Oneworld), and Lufthansa (Star). Then there are the well-known (or rather notorious) low-cost carriers such as Ryanair and EasyJet, among others like Air Berlin, Norwegian, and Wizz Air.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9B28BbPPs1X7xuG_2vQXKY4wYg08LCfBfQGuyu_I7nS-Efd4BCU_zuD6KvondG__e2nBLb8augQXICtz4KUqZhtZFryTDlIIaJGDAioXg0iFaSrFxGQL9uxm9zyNB1H5vJT-bhhiY6Erk/s1600/20103080683.jpg"><img id="BLOGGER_PHOTO_ID_5513440181653735906" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9B28BbPPs1X7xuG_2vQXKY4wYg08LCfBfQGuyu_I7nS-Efd4BCU_zuD6KvondG__e2nBLb8augQXICtz4KUqZhtZFryTDlIIaJGDAioXg0iFaSrFxGQL9uxm9zyNB1H5vJT-bhhiY6Erk/s320/20103080683.jpg" border="0" /></a>In Asia, consolidation has been rather slow, however, with the recent surge of successful low-cost carriers such as Air Asia (Malaysia, Thailand, Indonesia), JetStar (Australia, Singapore, Vietnam), Tiger Airways (Singapore, Thailand), and a handful of Indian start-ups, the legacy airlines are being forced to change. An airline like Air Asia X, which is the first low-cost low-fare model for long-haul operations, could change the entire picture, especially if they team up with the local low-cost low-fare carriers and connect their respective networks. It would have the potential to effectively create a low-cost low-fare network that spans worldwide. Plagued by mismanagement, political instability, economic turmoil, or other factors, once great airlines such as Japan Airlines, Philippine Airlines, and Garuda Indonesia (finally improving) need to act much faster. Malaysia Airlines, which is one of only five five-star rated airlines by Skytrax (others being Asiana, Cathay Pacific, Qatar Airways, Singapore Airlines), has been changing their 'long-term' plans too often and seem to have settled down on going solo, for the time being, after having had talks with SkyTeam for years.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpXbiBit4lR-jbkrX6AU3aFHLHpMnQ821sErHwzIgG8oW4sZgGun6GgW-reJ6ruCmVsy5W1zihGGS4VcIMAoSB8vs5yOKmdbTxJYTPgnTN9tGDTfrjAGiK6jlU3-S_S39JyrkrIZckzek5/s1600/PICT3456small.jpg"><img id="BLOGGER_PHOTO_ID_5513439968020644162" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpXbiBit4lR-jbkrX6AU3aFHLHpMnQ821sErHwzIgG8oW4sZgGun6GgW-reJ6ruCmVsy5W1zihGGS4VcIMAoSB8vs5yOKmdbTxJYTPgnTN9tGDTfrjAGiK6jlU3-S_S39JyrkrIZckzek5/s320/PICT3456small.jpg" border="0" /></a>In 2000, former TWA chief Bill Compton said that in 10 to 20 years, there would only be about 10 legacy carriers in the world plus a couple of successful low-cost low-fare carriers for each continent. Now, that doesn't seem to be an exaggeration. However, this brings us to another question. Deregulation of the airline industry was aimed at bringing the best value for the fare-paying customers, however, now it seems like they could have less choice in the not-too-distant future, if the industry does actually get dominated by just a couple of huge airline groups, thus raising the potential for higher fares. Hmm... but then maybe there will be the next surge of new airlines challenging the big ones. However, that is not as easy as said, and more so if the challenged are much bigger than they are today; countless start-ups have fallen to predatory pricing tactics of the incumbents.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-53981162090609424952010-05-04T14:44:00.003+09:002011-05-22T21:50:26.251+09:00A visit to Quneitra.Located at the southern end of the Anti-Lebanon Mountains lies the Golan Heights, an area surrounded by four countries: Syria, Lebanon, Jordan, and Israel. With its fertile soil and abundance of water, the rocky plateau has been a scene of battles between regional powers for several centuries over who controls the land.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_wK5rcx0AboK00bt5kL4hsHrCj5TxhVSN_KEfFdOx-xLwvVMZm6rJ1r8bb3VH5MGY6hk9ZlkMXsYF6B3SDiGuVrMBes8nPuMBaB-UXe_rtc74LU5QRO9K5p_YhOm9WEzsMjAyHVMBuDrh/s1600/20102253219.jpg"><img id="BLOGGER_PHOTO_ID_5508301756569762434" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_wK5rcx0AboK00bt5kL4hsHrCj5TxhVSN_KEfFdOx-xLwvVMZm6rJ1r8bb3VH5MGY6hk9ZlkMXsYF6B3SDiGuVrMBes8nPuMBaB-UXe_rtc74LU5QRO9K5p_YhOm9WEzsMjAyHVMBuDrh/s320/20102253219.jpg" border="0" /></a>Originally part of Syria, the land was lost to Israel on June 10th, 1967, the last day of the June War (for Arabs) or the Six-Day War (for Israelis). It was briefly recaptured in 1973 during the Ramadan War/October War (for Arabs), or the Yom Kippur War (for Israelis), when Egypt and Syria launched simultaneous attacks on Israeli-controlled Sinai and Golan Heights, but Israel regained control in its subsequent counter-offensive. It was only in the negotiations following a ceasefire that Syria was able to regain some 450 square kilometers, a demilitarized United Nations Disengagement Observer Force (UNDOF) zone a couple of kilometers from the 'de facto' border between the two countries. At the eastern edge of the zone lies Quneitra, a city which was completely destroyed when Israeli troops withdrew in 1974. For many reasons, Syria has left the city almost exactly as the Israelis left it.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxShb2CeElljq-soXVuwBhRcCKCYQyd1Y_mf1FN_ynkjd6ICnri9_VZJT4LjWY8WAQWrcyGVjYU7mD9zOtZlQy8wZgELI41XEbVlUiJOmjW-TunskGqjY7lJk-QaE0M-yBv02VN3rGiP6/s1600/20102253216.jpg"><img id="BLOGGER_PHOTO_ID_5508301642394387794" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVxShb2CeElljq-soXVuwBhRcCKCYQyd1Y_mf1FN_ynkjd6ICnri9_VZJT4LjWY8WAQWrcyGVjYU7mD9zOtZlQy8wZgELI41XEbVlUiJOmjW-TunskGqjY7lJk-QaE0M-yBv02VN3rGiP6/s320/20102253216.jpg" border="0" /></a>When I visited Syria at the end of February, Quneitra was the first place I visited. Although situated only 60 kilometers southwest of Damascus, I hired a driver because public transportation to the area doesn't come with frequency and would have required changing microbuses at Garage Sumariyah in Damascus and then a change to a service taxi (shared taxi) from the town of Khan Arnabeh, plus I had also heard recent rumors that you couldn't enter the U.N.-supervised zone unless you have your own transport. The road that heads down to Quneitra is picturesque, going through fields and farms, many of them producing vegetables, especially the olive, which is a specialty of Syria. When the snow-covered Mount Hermon of the Anti-Lebanon Mountains started appearing on the right, it was a sign that we were getting near, and soon we could start seeing some vehicles with 'U.N.' stickers.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizZOrc9M2n9l5UPPsk3vo-uBhba_angd6JteE8kO7KVDsUnHZU0gVJVonOopL40Ay7D-DH-awmvGnhhowiDAlEBkI2t0VQnTN-45ubRdDKMSTq551VJJKDjm-ZblEGb8Ahu1KKVZDIQU70/s1600/20102253226.jpg"><img id="BLOGGER_PHOTO_ID_5508301304370020338" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizZOrc9M2n9l5UPPsk3vo-uBhba_angd6JteE8kO7KVDsUnHZU0gVJVonOopL40Ay7D-DH-awmvGnhhowiDAlEBkI2t0VQnTN-45ubRdDKMSTq551VJJKDjm-ZblEGb8Ahu1KKVZDIQU70/s320/20102253226.jpg" border="0" /></a>Since Quneitra is part of the UNDOF zone, there was a gate, where Syrian officials stopped our car to check my passport and permit, which I had arranged in advance at the Ministry of Interior in downtown Damascus. It was a mere five minutes until they gave me back my passport and a Syrian officer hopped on the car to guide us around the demolished city. As we went on, houses with roofs lying on the ground and walls completely knocked or torn down started to appear on both sides of the street. We went through sites where there used to be shops, a mosque, a church, a school, and also a hospital, but obviously, all were vacated. The government does not encourage former residents to come back, and the few who still remain in town cater for the U.N. troops and visitors.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYauQQ8dGQpPQGyqdbtWOc9LaTOasRRdkfOQE1a1QP04bPuDJ6Wqnh54nl4STVunGYuhmfQvXEzKZFTOQxVAWJxYV5rGBpH47-D1bc1Lg2ZmE8dbnjyHCgx5dRLn4KafScvnFXUMEkgwOe/s1600/20102253235.jpg"><img id="BLOGGER_PHOTO_ID_5508301145471236018" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgYauQQ8dGQpPQGyqdbtWOc9LaTOasRRdkfOQE1a1QP04bPuDJ6Wqnh54nl4STVunGYuhmfQvXEzKZFTOQxVAWJxYV5rGBpH47-D1bc1Lg2ZmE8dbnjyHCgx5dRLn4KafScvnFXUMEkgwOe/s320/20102253235.jpg" border="0" /></a>At the western edge of the battered city were barbed wires, which mark the 'de facto' border, beyond which is effectively Israeli-occupied land. There is an unofficial border crossing that primarily allows Syrian Druze from the Golan Heights to cross one way through the passage to study, work and live in the rest of Syria. Only those who receive special permission are allowed to cross the border and come back for the Habil pilgrimage. More recently, apples produced in the Golan have been shipped across the border into Syria. However, no way is the crossing open to anybody else, obviously, as the two nations are officially still at war.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpZ-D-QNHw1aphoUYIFubMXLnARg2MYH3EImA0XiT2TmXS2HqmTUXbU7JlnWkSyyJbME2MLEZyC31CpyCC5VNztbIa9S_BVCKXNzmNxp1ClpwBW-SWDN2bmXqSe0Xxt_1jZiS952VXAGkm/s1600/20102253228.jpg"><img id="BLOGGER_PHOTO_ID_5508300969946654114" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpZ-D-QNHw1aphoUYIFubMXLnARg2MYH3EImA0XiT2TmXS2HqmTUXbU7JlnWkSyyJbME2MLEZyC31CpyCC5VNztbIa9S_BVCKXNzmNxp1ClpwBW-SWDN2bmXqSe0Xxt_1jZiS952VXAGkm/s320/20102253228.jpg" border="0" /></a>It truly was a ghost town with an eerie atmosphere, but it's not as simple as that. We were able to get off the car and walk around in some places, but could hear nothing. Just voices of us and the sound of our footsteps, plus the occasional wind. On the walls of some buildings, we could see Arabic inscriptions as well as those written in Hebrew, probably left by the Israeli soldiers. The Arab-Israeli conflict is one that is extremely delicate and has been complicated by the powers influencing the nations in a tangled web of relations. Israel was heavily criticized by the United Nations for the city's destruction, while Israel has criticized Syria for leaving the city as it is and claimed the Syrians added further damage to exaggerate. However, we have to remember that it's the locals who are the most affected. Their houses were burnt down by the Israelis, and now Syria is telling them they can't go home. The entire population is now scattered around the country.<br /><br />On the way out of the area, we saw two groups, probably families, picnicking on grassland near the crushed buildings. Syrians like picnicking, and perhaps those were just some people longing for their peaceful return to their motherland.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-4880722083620246472010-04-03T12:16:00.004+09:002010-08-22T14:35:23.178+09:00Returning to good old Philly.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2xUcPa4MymoPZ9WUPJ-pxctT2YhHU-bbMcq2fRx-8cj0U4Ga9i3L7Bq_v7ZOic67hiF3L52LHPQw_vVCovI40CiywJFktzsltCr-qsmBeLGB9G985l9XgSLot0i1zdt0_whXp_OQM4Pk8/s1600/20103161193.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2xUcPa4MymoPZ9WUPJ-pxctT2YhHU-bbMcq2fRx-8cj0U4Ga9i3L7Bq_v7ZOic67hiF3L52LHPQw_vVCovI40CiywJFktzsltCr-qsmBeLGB9G985l9XgSLot0i1zdt0_whXp_OQM4Pk8/s320/20103161193.jpg" alt="" id="BLOGGER_PHOTO_ID_5508099099758963586" border="0" /></a>Philadelphia. It's like my second home, or the first. It's where I spent my young days, my middle school years, and where I made many friends. I don't remember too much of the days when my family lived down near Washington D.C. before we moved up to the Keystone State, and though I spent no more than four years up there out of a total of ten I spent in the U.S., Philly means more to me than any other place in the country.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpN83OaRT5d5aMutVVAWTiu1LX3EI3rspMhkIjzG_EjSooQoQo6K0JmZRGnS9KntaFHloIFPW7SwvGHonWHhwbE0tOtVuuPOP9vG1RxSzM8IlIDi0S0kogiDExvXVTq_XUWAZAuVdahOs7/s1600/20103161180.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpN83OaRT5d5aMutVVAWTiu1LX3EI3rspMhkIjzG_EjSooQoQo6K0JmZRGnS9KntaFHloIFPW7SwvGHonWHhwbE0tOtVuuPOP9vG1RxSzM8IlIDi0S0kogiDExvXVTq_XUWAZAuVdahOs7/s320/20103161180.jpg" alt="" id="BLOGGER_PHOTO_ID_5508099314435970514" border="0" /></a>Looking back at the days, it's where I grew up most while living overseas. It is where environmental studies caught on me, while simultaneously being drawn into participating in activities that do social good for the communities, locally or globally. I still clearly remember the days when I did volunteer work every other week with the Whosoever Gospel Mission, a homeless shelter in Germantown, helping the homeless to empower themselves and become independent, or helping fundraisers for the UNICEF and the Kobe earthquake. Come to think of it, how many middle schools in other parts of the country or in Japan have volunteering with the homeless as part of the curriculum? Maybe some in the U.S., but I've never seen nor heard of in Japan. Looking back now, it helps to make you feel that they're not too different from us, but maybe just born in socially handicapped families, and together with unfortunate circumstances and some mistakes, have become 'homeless'. Well, this leads to a different topic so I'll stop here...<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLzPFVieu6JGFrO6LAzxIUxaMrPPmAJSuaYl5mxZEB3h23n1f9iYkwqiHY4hVRiLbdA72UZSC3MAjWEfYrGVqrpkuErJmRzL8d1p2_z27j0wAJsgbZMhgPG_OGA_IwtUR7LvI4WIb9ZMF9/s1600/20103161187.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLzPFVieu6JGFrO6LAzxIUxaMrPPmAJSuaYl5mxZEB3h23n1f9iYkwqiHY4hVRiLbdA72UZSC3MAjWEfYrGVqrpkuErJmRzL8d1p2_z27j0wAJsgbZMhgPG_OGA_IwtUR7LvI4WIb9ZMF9/s320/20103161187.jpg" alt="" id="BLOGGER_PHOTO_ID_5508098845697292066" border="0" /></a>I revisited Philly in March, as part of our 'graduation trip' I went along with five other friends at my university. In my words, Philly is like a countryside city of charm sleeping or rather 'hidden' between the economic powerhouse of New York and the capital Washington D.C. However, it's not any other mega city nor just a countryside city. Having been the first capital of the nation, the historic Old City area or the many cobblestone streets accompanied by well-preserved homes, churches, and various other monuments help to keep the rich history alive, while Center City has blossomed into a world-class downtown with towering skyscrapers, five-star restaurants, theaters, and galleries.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU2Xx3-3S2xiGpsN9897b03xqanTbttV7ktRkKqdW66h2SU_qz04dxcyJWpZtc17_xi36RoTJ_rliS9rvo01O2fTXdEOLkT8nI8y3U0YK4Dew2YtI_Frc_f5UespEHvER6Xe9frfhyRr5L/s1600/20103161186.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU2Xx3-3S2xiGpsN9897b03xqanTbttV7ktRkKqdW66h2SU_qz04dxcyJWpZtc17_xi36RoTJ_rliS9rvo01O2fTXdEOLkT8nI8y3U0YK4Dew2YtI_Frc_f5UespEHvER6Xe9frfhyRr5L/s320/20103161186.jpg" alt="" id="BLOGGER_PHOTO_ID_5508098628483780482" border="0" /></a>Philly is a city that has also given birth to a handful of favorite local foods that are now known throughout the country: cheesesteak, soft pretzel, and water ice. So I definitely made sure we didn't miss out on having a taste of those, especially the cheesesteak. Some say that "a proper cheesesteak consists of provolone or Cheez Whiz slathered on an Amoroso roll (definitely a must!) and stuffed with thinly shaved grilled meat", however, it's pretty much up to personal preference. Some like the rolls toasted and crispy (that's me), while others like them soft and chewy. Some would dip it in grease, while others would complain that too much grease makes the roll soggy (me). Some prefer the meat to be diced as thinly as possible (yup, me), while others prefer larger chunks. Some love the artificial Cheez Whiz (me too), while others prefer American or provolone cheese. Where to get the best? Again, up to you, but my favorite is Jim's Steaks. Although Pat's and Geno's both claim to be the first cheesesteak, Jim's produces better. Jim's has four shops, with the original one still located in West Philly, but the one that attracts most is the one down on South Street. It was 15 years ago when I went there the first time.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZEtm6DrmTUcnits6G1mge4nqzHCJrHkZtweVBD-TbKJHjPKbEHNYMkXnixae-4ISf5r83MZjM8NAx2K1qGcVQdzAfuRdjoqFzhI0XOpwjZxig_hgLJ_fa8M35em21cX2syClHEHcsz6KH/s1600/20103161183.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZEtm6DrmTUcnits6G1mge4nqzHCJrHkZtweVBD-TbKJHjPKbEHNYMkXnixae-4ISf5r83MZjM8NAx2K1qGcVQdzAfuRdjoqFzhI0XOpwjZxig_hgLJ_fa8M35em21cX2syClHEHcsz6KH/s320/20103161183.jpg" alt="" id="BLOGGER_PHOTO_ID_5508098294095123954" border="0" /></a>South Street is one of many shopping districts in the city. Offering an eclectic mix of over 300 mostly independently-owned shops, including diners to ice cream parlors, head shops to tattoo parlors, hip-hop clothing stores to jewelry shops, records stores to home and gift shops, and add to that lingerie and sex goods shops, South Street offers a unique selection of shopping opportunities; no wonder Jim's at South Streets gets a waiting line every weekend. Another shopping district I like, despite with a totally different atmosphere, is Chestnut Hill in Northwest Philly. The only business district in a largely residential area (big homes too), Germantown Avenue, with cobblestone and trolley tracks, is like the Main Street in a small old town with quaint storefronts, Victorian lampposts, and shoppers who stop to chat with one another. It has a modest selection of antique shops, upscale home goods shops and clothing shops, and several independent art galleries. It's a nice place to stroll on a weekend afternoon.<br /><br />Oh boy, am I missing Philly. :)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-19296224357494803072010-03-12T22:15:00.003+09:002010-08-19T14:37:54.550+09:00Savoring Polish cuisine and Żywiec.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaXg4otu7TCTn6jZV-16tRqbhAdFvk8M85EYticiviWFcKPcuYjm-zil1fY4WqURNJfptQMbr0_ogKJ8udxknbubg3C5pzgGxt86ezSvnI-VAtR-9Sy_q-bmdHfbCiIwDHWvbNCo-lv9En/s1600/20102192880.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaXg4otu7TCTn6jZV-16tRqbhAdFvk8M85EYticiviWFcKPcuYjm-zil1fY4WqURNJfptQMbr0_ogKJ8udxknbubg3C5pzgGxt86ezSvnI-VAtR-9Sy_q-bmdHfbCiIwDHWvbNCo-lv9En/s320/20102192880.jpg" alt="" id="BLOGGER_PHOTO_ID_5506991008145672338" border="0" /></a>When my Polish friend's family took me around the country, I had the opportunity to savor a variety of Polish cuisine, both at their home in Żywiec and at restaurants around the country. Polish cuisine contains much that is distinctive, but little that is truly unique to the country, with most of it representing a blend of culinary styles that run across countries in east-central Europe, such as Belarus, Lithuania, and Ukraine. Meat and potatoes are the mainstay of the national diet, while north European vegetables including carrots, cabbage, and beetroot provide good accompaniment.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj49CH0o8XqYH9A_1QZ7l10fdTduyqf2asj010sHGWsQ_758vRpxukoyZ8eGn1WUFgyIH7WmLwLWP8ydu3ddGRXBGyp0AmS9v2hLMMAfFcVPoLnm92RaapUdnY44YtDE-N9FATIvnClJyrg/s1600/20102192854.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj49CH0o8XqYH9A_1QZ7l10fdTduyqf2asj010sHGWsQ_758vRpxukoyZ8eGn1WUFgyIH7WmLwLWP8ydu3ddGRXBGyp0AmS9v2hLMMAfFcVPoLnm92RaapUdnY44YtDE-N9FATIvnClJyrg/s320/20102192854.jpg" alt="" id="BLOGGER_PHOTO_ID_5506976332276766226" border="0" /></a>When I visited, it was in February, still the winter season, though at the end of it, so there was plenty of snow that had yet to melt. During this time of year, vegetables become harder to come by, excluding those imported, and together with the long cold season, the people consume more meat and cheese. Every morning, together with the family I had bread with many kinds of cheese and ham. It was simple, but the bread bought at a nearby bakery was certainly not something I find everywhere, and it was the first time I felt I could eat cheese without eating it with something else. Simple, but depending on the combination of bread, ham, and cheese, you could enjoy a variety of tastes. A good choice of sweet pastries goes along well too.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi849d9BSp-lDKazVvE-O3DkmnJLT1qdi6YHmchcHIrmKmrxRJKXPZ_OTKVLe9V0_P1yiH0tqEZEZ-FhJb1cT6UJVCzJ9v4tFEBVqy0pEFxFZ0SEyHFn_Fy9mvBh77ftsgRIkLHXarfcYO1/s1600/20102182657.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi849d9BSp-lDKazVvE-O3DkmnJLT1qdi6YHmchcHIrmKmrxRJKXPZ_OTKVLe9V0_P1yiH0tqEZEZ-FhJb1cT6UJVCzJ9v4tFEBVqy0pEFxFZ0SEyHFn_Fy9mvBh77ftsgRIkLHXarfcYO1/s320/20102182657.jpg" alt="" id="BLOGGER_PHOTO_ID_5506976099720947970" border="0" /></a>What I also enjoyed much was the soup. It plays an important role in any Polish menu, serving as an introduction to a multi-course meal or just a mid-day stomach-filler. The most famous of them, and what I found to be my favorite as well, is barszcz (borscht), a reddish beetroot-flavored broth with a mild yet perfect balance of sweet and sour tastes. If you visit in the summer, you would find a refreshing variation on these theme called chłodnik, which is cold borscht served with lashings of sour cream and a side order of boiled potatoes. Another soup I remember is the fasolka, a solid, almost stew-like combination of beans and smoked sausage.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqB44evvRW-mDqxrrHmgbzcqICXq-810pZC0bw2yheooHlLqpIkwqfnbdaJgS3qoc9w1hJQsrtPabBOL9476Pz1ISnY9XPTKjAIKRmBjKilHopwQbQF46K1gA20j49uI4WPhyphenhyphenpIpKdZdm0/s1600/20102192891.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqB44evvRW-mDqxrrHmgbzcqICXq-810pZC0bw2yheooHlLqpIkwqfnbdaJgS3qoc9w1hJQsrtPabBOL9476Pz1ISnY9XPTKjAIKRmBjKilHopwQbQF46K1gA20j49uI4WPhyphenhyphenpIpKdZdm0/s320/20102192891.jpg" alt="" id="BLOGGER_PHOTO_ID_5506990629918122930" border="0" /></a>As I previously mentioned, meat is often the main part of Polish cooking, but it is pork that takes up top billing. You can reveal for yourself how important the pig is to the Polish society if you look over the delicatessen counter and see the sheer size of the repertoire of sausages and smoked cuts of pork. Although the generic name for sausage is kiełbasa, there are plenty of varieties to choose from: the thin, smoked kabanos, the garlic-rich wiejska, and the pink, mildly-spicy krakowska. A pork dish that I remember well is golonka, a deliciously tender roasted pork knuckle, traditionally served with chrzan, which is horseradish sauce. Dairy products, especially the cheese, is also central to the Polish diet. The oscypek, which is a bun-shaped sheep milk cheese sold everywhere in the town of Zakopane (though available in other places as well), was delicious, especially the smoked ones.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheM_uYSR955DgWiPWaj3uZuU3kKpXFzvkkOL4TgJWmMDPOKY7XlyLqdRUo2U46EeWKrT6Lao0aJyBqD6CLnU-ZORIzUYK7PPfn5wxCd9U835A-twZlFg3KtgKMNOLNh9eaB1WKEEHCG-s9/s1600/20102172587.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheM_uYSR955DgWiPWaj3uZuU3kKpXFzvkkOL4TgJWmMDPOKY7XlyLqdRUo2U46EeWKrT6Lao0aJyBqD6CLnU-ZORIzUYK7PPfn5wxCd9U835A-twZlFg3KtgKMNOLNh9eaB1WKEEHCG-s9/s320/20102172587.jpg" alt="" id="BLOGGER_PHOTO_ID_5506975712956167650" border="0" /></a>Something not to miss, and what has become more or less an icon of Polish cuisine is the pierogi. They are boiled dumplings of scallop shell shape and size, and are stuffed with a variety of savory or sweet ingredients, from minced meat, cabbage, potatoes, mushrooms, and cheese, to strawberries, cherries, or other fruit. The food is consumed well in this part of Europe, where the people speak language of the Slav origin. Belarus, Russia, Ukraine, Slovakia, Estonia, Latvia, Lithuania, Germany, Czech are all among them, although sometimes they are under different names such as kalduny in Belarus, and koldūnai in Lithuania. There is a similarity to the Italian ravioli and tortellini, or the manti, khinkali, or chuchvara in the trans-Caucasus region, including Turkey, while not too similar but still sharing some aspects are the Afghani mantu, Mongolian buuz, Nepalese-Tibetan momo, Chinese wonton, Japanese gyoza, and the Korean mandu.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdbMP4Q3fTSyCuligBnFj7ST8LLyWvp-ZcvpkE7ZOFZ7W0PmGhj7trltneQ-8SF5J-6miWHjQGzSMszuQa3tfuD2wrsP_wG0CMYxV7I7-uaW8H4_h656mX5nWWyqXer07ZMfu8NCERMPFt/s1600/20102182670.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdbMP4Q3fTSyCuligBnFj7ST8LLyWvp-ZcvpkE7ZOFZ7W0PmGhj7trltneQ-8SF5J-6miWHjQGzSMszuQa3tfuD2wrsP_wG0CMYxV7I7-uaW8H4_h656mX5nWWyqXer07ZMfu8NCERMPFt/s320/20102182670.jpg" alt="" id="BLOGGER_PHOTO_ID_5506975353727096690" border="0" /></a>Oh, yes, and I didn't leave out beer! Situated in the southeastern corner of Silesia province in Poland, Żywiec is a peaceful countryside town with a population of just over 30,000, and it is known for the beer that is named after the town. Although now under the Dutch Heineken empire, the Żywiec Brewery was originally founded by the Habsburg family in 1852 and has been producing ever since. Competing brewers include Tyskie and Lech, and though I could not recognize too much of a difference between the three, it was certainly nice to visit the history-rich bar located adjacent to the brewery and sip on a glass of Żywiec, naturally the most popular of the three in this part of Poland, enjoying the atmosphere of a Polish countryside bar.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-50999110665393374522010-03-05T23:29:00.007+09:002010-09-06T14:06:29.288+09:00A visit to Auschwitz, Oświęcim.70 kilometers west of Kraków lies the town of Oświęcim. Although a quiet, countryside town with a population of just over 40,000, this place is recognized widely as, and is still indissolubly linked with the name the Nazis gave it when they occupied Poland: Auschwitz.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwrE6MR9nfET_bm96Rx_uk6cz-3cMaS8cWuBeO1NrKPtD93ZxJltcp5QRSmGKT3avlf7slQzWDRvPsUlMLcwmFd3h8EAatjzA5ltFNmRGB49ZRZv46lZWWKrSmqcvPadxYi7QIo2RMkdbE/s1600/20102182649.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwrE6MR9nfET_bm96Rx_uk6cz-3cMaS8cWuBeO1NrKPtD93ZxJltcp5QRSmGKT3avlf7slQzWDRvPsUlMLcwmFd3h8EAatjzA5ltFNmRGB49ZRZv46lZWWKrSmqcvPadxYi7QIo2RMkdbE/s320/20102182649.jpg" alt="" id="BLOGGER_PHOTO_ID_5506412781982348514" border="0" /></a>I had the opportunity to visit this notorious camp in February, right after I had my license examination. I actually hopped over to Europe the very next day. My trip to Poland, and the first one to a country in eastern Europe, was made possible by Krzysztof Sanetra, a Polish friend I got to know well through a program at the University of Edinburgh, and his family. Although it was not his best time, as he was busy writing reports and preparing for exams, we were finally able to meet up once again, and he and his family were kind enough to plan out a sightseeing trip for me. I truly don't know how to thank them for driving me around the southern half of the country, sometimes on five-hour legs, arranging English-speaking guides for me everywhere, letting me stay at theirs, and taking care of me.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE-06QZoC1Nf27Oo82cmmCKOCnW7q0sEojS_nhV9bSGp19Xz1jGWrTyw5FzB924VAH6eetQwX6EWBLU8OaaCjDmJvx_5uc_D4axD_tcvrVrXG_JYA7e1vs1uVKyaBfp_m4-vp7mp3yv5WD/s1600/20102172616.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjE-06QZoC1Nf27Oo82cmmCKOCnW7q0sEojS_nhV9bSGp19Xz1jGWrTyw5FzB924VAH6eetQwX6EWBLU8OaaCjDmJvx_5uc_D4axD_tcvrVrXG_JYA7e1vs1uVKyaBfp_m4-vp7mp3yv5WD/s320/20102172616.jpg" alt="" id="BLOGGER_PHOTO_ID_5506412652067646642" border="0" /></a>Following the Nazi invasion of Poland in September 1939, Oświęcim and its surrounding region were incorporated into the domains of the Third Reich, and the town's name was changed to Auschwitz. Establishing new concentration camps in this newly conquered territory was a German priority from the beginning, as camps in their homeland were already getting overcrowded, and the occupation of Poland dramatically increased the number of potential 'undesirables' who would need to be interned. The site of Oświęcim was perfect for many reasons. It already had a Polish-built camp for migrant workers (which could easily be converted to prisons), it was remotely located between the Soła and Vistula rivers, and it was strategically situated at the 'center of Europe'.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhff_9OS_ALqI9dUE0Ei4T4awkBxTeeQwyGMFHlINpgLAOFGxNnpHEUWCh3oltqB1kkOwWR4PFQxPQ9bC8dTCpmBB8UbV1zUsrrfq6y9ycHAF1jvBPGp6C5Jljem8wuQc1YRPlhDTBCFGmp/s1600/20102172600.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhff_9OS_ALqI9dUE0Ei4T4awkBxTeeQwyGMFHlINpgLAOFGxNnpHEUWCh3oltqB1kkOwWR4PFQxPQ9bC8dTCpmBB8UbV1zUsrrfq6y9ycHAF1jvBPGp6C5Jljem8wuQc1YRPlhDTBCFGmp/s320/20102172600.jpg" alt="" id="BLOGGER_PHOTO_ID_5506412488010866898" border="0" /></a>Designed by Rudolf Höss, the camp was opened on June 14, 1940, initially with 728 Polish prisoners. The camp originally comprised 20 buildings, of which six had a second floor. However as the number of inmates grew, an extra story was added to all one-floor buildings and another eight buildings were built by 1942, using the prisoners as workforce. As time passed, the Nazis started to deport to the camp people from all over Europe, including Soviet prisoners-of-war (POWs), Gypsies, Czechs, Yugoslavs, French, Austrians, and Germans as well, though many of them were Jews. The number of prisoners kept on increasing, and a second camp, which is much larger than the original, was opened in 1941 three kilometers away in Brzezinka. It became known as Auschwitz II - Birkenau. A third site was constructed in Monowice near Oświęcim and became Auschwitz III. At peak, the camps accommodated no less than 20,000 people<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGBief_QM6zmlgK3LAxzDXDnSLrHsCS9GioENNnsBvDTLwVFS1kZSRmj5gfcnqFceAZpzlzF4wLzo9BCgiUegPFqqKN2DXe5AgPvw2qjOMfj54Bvw6DkQElJdp7uKfTEaGcvWu9xG2TXs3/s1600/20102172627.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGBief_QM6zmlgK3LAxzDXDnSLrHsCS9GioENNnsBvDTLwVFS1kZSRmj5gfcnqFceAZpzlzF4wLzo9BCgiUegPFqqKN2DXe5AgPvw2qjOMfj54Bvw6DkQElJdp7uKfTEaGcvWu9xG2TXs3/s320/20102172627.jpg" alt="" id="BLOGGER_PHOTO_ID_5506412175102879730" border="0" /></a>When you enter the Auschwitz Museum, which is located at the original Auschwitz I site, you will see above what the prisoners passed under each day: a gate with the cynical inscription 'ARBEIT MACHT FREI', which translates to 'work brings freedom'. It was a bitter cold day when I visited, with temperatures only reaching a high of five degrees below zero Celsius and snow still frozen, but back when the monstrous facility was still in operation, prisoners being forced to hard labor (sometimes exceeding 12 hours) in this harsh environment was the norm. Prison cellars now display various objects, including numerous photos, empty cans of Zyklon B (the substance thrown into the 'shower room' and could kill 2,000 in 30 minutes), the actual belongings of the people such as shoes and suitcases with the name of the deportees, and cloth and carpets made from human hair.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5qfOIN4bJS6Vt0QtFQj3vwbxt88doQ_v7odgJXzXoe5kEAH_UwG7TK-s3pj2TOdJsN-30doYpzb_znybTLgvyc3k_hcok0dumw9FoiXbYiQY7JJYUt80i25xcqRm8rrImvrggMjB8wCwB/s1600/20102172610.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5qfOIN4bJS6Vt0QtFQj3vwbxt88doQ_v7odgJXzXoe5kEAH_UwG7TK-s3pj2TOdJsN-30doYpzb_znybTLgvyc3k_hcok0dumw9FoiXbYiQY7JJYUt80i25xcqRm8rrImvrggMjB8wCwB/s320/20102172610.jpg" alt="" id="BLOGGER_PHOTO_ID_5506411750260864274" border="0" /></a>We also walked to the 'Death Block', which was a prison within a prison, completely isolated from the rest of the camp. The ground floor and the basement 'torture' cellars are still preserved in their original form. The courtyard between Blocks 10 and 11 is enclosed on two sides by a high wall. The wooden blinds on the windows of Block 10 were installed to prevent the inmates from observing the executions taking place here, though they could still hear the bullets being fired. At this 'wall of death', the Nazis shot thousands of prisoners, mostly Poles. In the yard in front of Block 11, the Nazis carried out punishments in the form of hanging prisoners to a special stake by their arms, which were bent behind their backs. An endless number of visitors leave behind flowers and candles at this place.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVvymafUTYhrBJfJwvtSY-JglodWpdlsAnGRG3QFxpUvXrcteQYtSSrORqE_v8l_2hX95CkKUU_Om2BbuBwdtR8PbDakm8XxNNv3f9n5HU-z5DA1579uZ4O_aWs5PXKgkshoz5Rvk181ST/s1600/20102172630.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgVvymafUTYhrBJfJwvtSY-JglodWpdlsAnGRG3QFxpUvXrcteQYtSSrORqE_v8l_2hX95CkKUU_Om2BbuBwdtR8PbDakm8XxNNv3f9n5HU-z5DA1579uZ4O_aWs5PXKgkshoz5Rvk181ST/s320/20102172630.jpg" alt="" id="BLOGGER_PHOTO_ID_5506411518226291410" border="0" /></a>The more I walked though the Auschwitz facilities, the more it gave me an eerie feel. It is so-to-speak a 'factory of death'. When prisoners arrived, children, the elderly, the handicapped, the pregnant, were immediately sent to the 'shower rooms' and mass-executed in a mere 30 minutes with Zyklon B (Cyclon B). Their belongings would be collected and reused or sold, their hair would be 'reused' to weave cloth, and there were experiments to collect fat from the corpses and produce soap. And, not surprisingly, all of this was carried out by the prisoners as well. Those who were young and of the working generation were kept alive longer, though forced to hard labor in temperatures of sometimes -20 degrees Celsius, given only one meal per day, allowed to visit the toilet only twice, and lived in bunks with poor hygiene. Cleaning the toilets was said to be the 'best tasks' among the prisoners, as they were always working inside, and could visit the toilet anytime they wanted to. There were tortures all the time, however, the harsh environment was often enough to take the toll. Whenever someone died, it was the norm for the inmates to keep it a secret, so that they can receive one more meal.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgE0ACvCCasDFJRrucZpIg9CzfcKMLU3MzIWwPIl_ycmn5oUcDbAz5KglFVm_HGC87KbL_3gOfQ-fonzu27Az4qJsZRpnJtcfQ1AABf8Y825PvBTSHxdVNC0bOCBNDX4qxjdgXpUOLZAhoC/s1600/20102172635.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgE0ACvCCasDFJRrucZpIg9CzfcKMLU3MzIWwPIl_ycmn5oUcDbAz5KglFVm_HGC87KbL_3gOfQ-fonzu27Az4qJsZRpnJtcfQ1AABf8Y825PvBTSHxdVNC0bOCBNDX4qxjdgXpUOLZAhoC/s320/20102172635.jpg" alt="" id="BLOGGER_PHOTO_ID_5506411129347356258" border="0" /></a>I found myself at a loss of words. With the even more massive Auschwitz II facility, the complex gives you the impression that it is truly a 'human-processing' factory, and one that is carefully planned and cleverly laid out. Yes, it was politics. But, how can humans become so inhumane? Was it not possible to direct all that intelligence and effort towards something else? We learn history so that we do not make the same mistakes and we can build on top of the past. However, though in different situations, genocides have been repeated, and more than once. Oświęcim will remain a place everyone should visit at least once in their lives...Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-92228121641476491032010-01-16T15:37:00.002+09:002010-08-21T01:37:02.319+09:00Taking a break in Cairns.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhn-dYcW-thFHQnY42bJkwfXfy2qEWN385xoKawlCpnws1wQqgT1yQ3Ow8DsSkCV_rqJzEHAhU99yT4zK7rbgjMpwIaHaJrBnNVrOt6A3ZRBifkpiO5BKPdHbAnbMhWGW0cDlu1bix-QoRs/s1600/200912282406.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhn-dYcW-thFHQnY42bJkwfXfy2qEWN385xoKawlCpnws1wQqgT1yQ3Ow8DsSkCV_rqJzEHAhU99yT4zK7rbgjMpwIaHaJrBnNVrOt6A3ZRBifkpiO5BKPdHbAnbMhWGW0cDlu1bix-QoRs/s320/200912282406.jpg" alt="" id="BLOGGER_PHOTO_ID_5505552873499894290" border="0" /></a>In December, I traveled to Cairns, in the northeastern corner of Australia, with my family. It was certainly a nice and long-needed break from the daily rigorous studying. My October was full of exams, and the beginning of December saw the last, yet the biggest exam of the six years: the graduation exam. Not until we pass that do we become eligible to take the national license board. In Japan, graduation from a faculty of medicine requires you to pass this graduation exam, instead of submitting a thesis. So, we do go through a period of 'torturous studying', however, we are never required to learn how to write a paper.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwvOIDhpn2ed0IEQrrSjn3LzW7x_WVtAQjgX6yceaUYa6rtIKDssPLWQSpqeJ46kBMS8R2mzQCDmP1BAr5fGZOh9Ck05FNgzrKvicAHG1v8AZrcR3qHXaQANbJ3nR8ik9U77c1gspbl-hE/s1600/200912282413.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwvOIDhpn2ed0IEQrrSjn3LzW7x_WVtAQjgX6yceaUYa6rtIKDssPLWQSpqeJ46kBMS8R2mzQCDmP1BAr5fGZOh9Ck05FNgzrKvicAHG1v8AZrcR3qHXaQANbJ3nR8ik9U77c1gspbl-hE/s320/200912282413.jpg" alt="" id="BLOGGER_PHOTO_ID_5505552781094511010" border="0" /></a>Named after William Wellington Cairns, then Governor of Queensland, this city was originally founded in 1876 to serve miners heading for the Hodgkinson River goldfield. However, the region has been inhabited by the aboriginal Walubarra Yidinji people, who called and still calls the area Gimuy, since long before the Europeans came. Later on, the city developed into a railroad hub and a major port for exporting sugar cane, which still remains the biggest local industry after tourism, and metals, minerals, and other agricultural products from the surrounding coastal areas.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyJBxYxACIv_X2TdzhREfypNGqaQXt0VZT8M3V7P9aQJe5e8NGU8r0nIerYwWreiHSNn0Rh35ud-JvHLJgW2bIh6cupp2QhR2aPqMemJf-d7nedKxOGdN8q_NQduscaC2g0uyg6K5m64SE/s1600/200912292453.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyJBxYxACIv_X2TdzhREfypNGqaQXt0VZT8M3V7P9aQJe5e8NGU8r0nIerYwWreiHSNn0Rh35ud-JvHLJgW2bIh6cupp2QhR2aPqMemJf-d7nedKxOGdN8q_NQduscaC2g0uyg6K5m64SE/s320/200912292453.jpg" alt="" id="BLOGGER_PHOTO_ID_5505552665375071554" border="0" /></a>Cairns gives you the impression of a peaceful countryside city. It doesn't have skyscrapers, nor does it have multi-story shopping complexes. It's not about the hustling and bustling one has to endure in Sydney or Melbourne. The seaside boardwalk gives you a pleasant view of the port and the peninsula across the cove, which is sacred aboriginal territory, and especially picturesque at sunset. However, the nearby beaches are not a place for swimming, as it is infested with crocodiles and some stinging jellyfish, a reminder that the seashore is predominantly mangrove swamp, and that the port was built after clearing part of it.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEga1Jt6legRmy8GzsKWgcpF_GRiHLB99xF-daH7ZaKym2WFU4k7jRBs2BBETtRCmo-cnbMZod2ekhWX92yOa0cDoSFIInwf7YcBAGzEmy3UjACxVhZP8luFJ8f7NtAgkQhi9Inl5FvhbPdc/s1600/200912282410.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEga1Jt6legRmy8GzsKWgcpF_GRiHLB99xF-daH7ZaKym2WFU4k7jRBs2BBETtRCmo-cnbMZod2ekhWX92yOa0cDoSFIInwf7YcBAGzEmy3UjACxVhZP8luFJ8f7NtAgkQhi9Inl5FvhbPdc/s320/200912282410.jpg" alt="" id="BLOGGER_PHOTO_ID_5505552522220222786" border="0" /></a>The best and most beautiful waters for swimming nearby is certainly out at the Great Barrier Reef, which is a UNESCO-registered world heritage site, and stretches over a distance of 2,600 kilometers. It is composed of over 900 islands and 2,900 individual reefs. Cairns is naturally the hub for those who come to see what is the largest single structure made by living organisms. However, we must keep in mind that the booming tourism (generates AU$1 billion every year) together with climate change are the biggest 'enemies' for this great natural wonder.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-38219421223133140732009-12-19T22:37:00.007+09:002010-08-21T01:38:10.114+09:00A visit to Lao-China Friendship Hospital.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEKXTOB3uXfq-q3ybmWwsakMzbKExI30wSLhQCsqqk4oFopo9lt91OHnWbNvp3O3klH1cIFnDGrZH0UiSg1xxXfaGT1yqJ8Ev4SKWheaUVtXFRnEvQHceYp6g3CwY7zvCXp4BHYDiuHn1H/s1600/20098242036.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEKXTOB3uXfq-q3ybmWwsakMzbKExI30wSLhQCsqqk4oFopo9lt91OHnWbNvp3O3klH1cIFnDGrZH0UiSg1xxXfaGT1yqJ8Ev4SKWheaUVtXFRnEvQHceYp6g3CwY7zvCXp4BHYDiuHn1H/s320/20098242036.jpg" alt="" id="BLOGGER_PHOTO_ID_5505474159217101634" border="0" /></a>When we visited Laos in August, I went without any prior contact, since I knew nobody in the country, but still, I wanted to get a glimpse of what health care looks like, and listen to the actual health care workers in the country. So, one afternoon, we negotiated with a 'songthaew' driver to take us to Luang Prabang Provincial Hospital, more commonly known by locals as the 'Lao-China Friendship Hospital', or simply the 'Chinese' hospital.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5P0RqSLwX9YtYj4AcdaOId-rshsT7sFoZ-HFy6uouhs8c6E-e8kJfNzclq8jhRgjtIoPOUw8X4q3tSfZTFKMjf4HQf6dZ3tAH25P8CyHdkQ-uLPFDruJEI0MQt8rPoE3E8OmCknKLMQ3k/s1600/20098242074.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5P0RqSLwX9YtYj4AcdaOId-rshsT7sFoZ-HFy6uouhs8c6E-e8kJfNzclq8jhRgjtIoPOUw8X4q3tSfZTFKMjf4HQf6dZ3tAH25P8CyHdkQ-uLPFDruJEI0MQt8rPoE3E8OmCknKLMQ3k/s320/20098242074.jpg" alt="" id="BLOGGER_PHOTO_ID_5505474061479138226" border="0" /></a>Located off the main road four kilometers south of the city on a seven-hectare land, the hospital was completed in 2004 with assistance from China, as its name implies. It was already during the late hours of the afternoon, so the outpatient department had already closed and many staff gone home. Although without any contact beforehand, the staff at the counter in the deserted main hall kindly allowed us to walk around the hospital. Upon starting our 'tour', we noticed that all of the emergency exit signs and fire hydrant labels were written in Chinese and English only, and without Lao, no wonder the locals call it the 'Chinese' hospital.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoxIVgdD7jAd6p6yuoKKQX1nv-2ap2x3IvQt49J0MUEGlsmHDB3K1EmATXY1Zg9yWjLmA1zCWL_tzL4THdv3PdXg8fzm4FIyWOaXAhpPzwoKOBEeOG8m4NzIDrTAlOA6x_RAQtwb-JgDlK/s1600/20098242060.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhoxIVgdD7jAd6p6yuoKKQX1nv-2ap2x3IvQt49J0MUEGlsmHDB3K1EmATXY1Zg9yWjLmA1zCWL_tzL4THdv3PdXg8fzm4FIyWOaXAhpPzwoKOBEeOG8m4NzIDrTAlOA6x_RAQtwb-JgDlK/s320/20098242060.jpg" alt="" id="BLOGGER_PHOTO_ID_5505473903333396258" border="0" /></a>While we were walking, we came into a nurse, who was apparently about to go home, and she was kind enough to let us hear about the hospital and her job. The hospital is divided into four major departments: inpatient, outpatient, labor room, and pediatrics. The outpatient clinic includes internal medicine, surgery, pediatrics, obstetrics and gynecology, family planning, otorhinolaryngology (ear-nose-throat), dentistry, and emergency. Depending on the day, the hospital sees about 25 to 100 patients per day, with Monday getting the highest number. Its medical staff comprises 97 nurses, 27 physicians, plus 10 volunteering nurses from South Korea. Some common medical problems include common cold, respiratory infections, cardiovascular disorders, gastroenteritis, and accidents. She said that an increasing number of people do not take enough exercise, something I am used to hearing in other parts of the globe as well.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU6lN1FzkC9trQ2yctImqOi7h7awNn4BgtsvP_BBclM2uQCAlf1Q06ciuIvfky5tYT3KX4KGxHRjkkWhS1JexbgF2qFyCu4XqpGRuvnfUUWXwiUyCAKhpAYJ0YXfOOL-_xHOqQ7abCjfIC/s1600/20098242075.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU6lN1FzkC9trQ2yctImqOi7h7awNn4BgtsvP_BBclM2uQCAlf1Q06ciuIvfky5tYT3KX4KGxHRjkkWhS1JexbgF2qFyCu4XqpGRuvnfUUWXwiUyCAKhpAYJ0YXfOOL-_xHOqQ7abCjfIC/s320/20098242075.jpg" alt="" id="BLOGGER_PHOTO_ID_5505473702794437986" border="0" /></a>After going through the examination rooms, we visited the ANC, or the antenatal care department, which they say is the busiest part of the facility. At least three staff must constantly be present here, so they are currently working on a 24-hour-work-and-24-hour-rest rotation. For vacation, they get 10 days off per year. According to them, the busiest months are February, March, May, and June, before the rainy season starts. Here we met some nursing students, who told us that they have a 2.5-year program. There were no medical students, but we found out that is because the sole faculty of medicine in Laos is in Vientiane, the capital.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5Vw8mhTxMA_6NAG0tpBYI8_JRC-2krpu2VsTg4PL58ghCUXS7iqrgf_cCjzE9K4193cJ1jy5w7weHp4Jwmt8AV1fjgt2Q_hf3bmGctS9czI1RDe18VD0gelqpgMVWjHU_pkwi_Of0aWxF/s1600/20098242057.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5Vw8mhTxMA_6NAG0tpBYI8_JRC-2krpu2VsTg4PL58ghCUXS7iqrgf_cCjzE9K4193cJ1jy5w7weHp4Jwmt8AV1fjgt2Q_hf3bmGctS9czI1RDe18VD0gelqpgMVWjHU_pkwi_Of0aWxF/s320/20098242057.jpg" alt="" id="BLOGGER_PHOTO_ID_5505473509104744754" border="0" /></a>For the patient, there are two often-encountered problems in the medical scene, although they do represent larger underlying issues. One is the lack of medicine matching that of international standards. In recent years, foreign aid, especially from China and Japan, has helped hospitals to update their out-dated facilities and equipment, and bring up more health care professionals, however, there still are often cases where the patient is asked to travel down to the capital of Vientiane, almost 500 kilometers away on a recently-paved mountainous road. And even at there too, the patient is often asked to cross the 'Friendship Bridge' to receive further treatment at a Thai hospital. In emergency cases, such as major traffic accidents, this clearly does not work. And, obviously the patient would have to pay for all of the transportation costs, and the fees skyrocket if you need to be transported across the border.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoYCgJOWIqugpjNnPfUD45ZDPKxk8IcbA9FcUwlBoxwo0TShUw1Tn13Yxa5A0EEZV79TnDXBFvoiA7Cli4WcSPHLbsGCcZOM-oIUAr4_32HUwX0SI9-4AktdC2RN2G9Ai0vcA-ZnXwiodc/s1600/20098242061.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoYCgJOWIqugpjNnPfUD45ZDPKxk8IcbA9FcUwlBoxwo0TShUw1Tn13Yxa5A0EEZV79TnDXBFvoiA7Cli4WcSPHLbsGCcZOM-oIUAr4_32HUwX0SI9-4AktdC2RN2G9Ai0vcA-ZnXwiodc/s320/20098242061.jpg" alt="" id="BLOGGER_PHOTO_ID_5505473239486343042" border="0" /></a>This leads to the second issue: money. Universal health care is still non-existent, so even in public hospitals the patient needs to pay. The same goes with ambulance, where patients pay by the kilometer, like a taxi. If she or he gets admitted, the average fee per night for a normal room is 40,000 kip (about US$4.80), but that is not easy for a country where people live on an average 10,000 kip (about US$1.20) per day, though the economic disparities are great. People who live in Vientiane, the nation's capital, are the richest, where over 50% of households have cars and 40% have air-conditioners, while next comes those living in the capitals of the provinces, like Luang Prabang, and the poorest are the farmers who live in the mountains and the countryside. According to the staff, patients who have financial difficulties paying fees may submit a request to receive aid from the government, but again, one needs to travel down to the capital to do so. It is not surprising that the 150 beds at Luang Prabang hospital are never near full.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3frxq4N8a_xJX9AcIyshrxoJknYuRQp46Vb5pJuVkEl65ORKZCkJ27n4rJZedPXX6nkm0SZfslY8tiA-3uz9uodsvK83xK1yBPczWUBnJJshXx7bC6tFprdsi2dS3-v0hi_em7fJnmM_s/s1600/20098242063.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3frxq4N8a_xJX9AcIyshrxoJknYuRQp46Vb5pJuVkEl65ORKZCkJ27n4rJZedPXX6nkm0SZfslY8tiA-3uz9uodsvK83xK1yBPczWUBnJJshXx7bC6tFprdsi2dS3-v0hi_em7fJnmM_s/s320/20098242063.jpg" alt="" id="BLOGGER_PHOTO_ID_5505473006320621650" border="0" /></a>The government seems to have started working on these issues over these few years, and is in the process of not only setting up a clinic in every village, but a primary school, and encouraging more villagers to have their children enrolled. Of course, the families would have to give up on earnings that would be made through having the child work instead and understand the long-term significance of education, so it's not easy, but at least they wouldn't have to walk hours to go to school anymore. They are also working to put more emphasis on preventive medicine, and moreover, health-building through community participation. Things have only started to change, and it will certainly take a long time, however, the interesting point about Laos is that they are going through the process at the same time their economy is developing, something other economically-developed nations went through at separate times, with economic development coming first.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-64001291692719433422009-09-20T17:27:00.004+09:002010-08-15T17:44:12.260+09:00Strolling in Luang Prabang.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgyVRmZmEHp0H91uj93E4A3FSXOFbz9pUgjog_un6yGqCc7viGnRvWavGhisJsRIZmQl8RnL9MZdikSsAWtfZQjgExdettVSWLoy82SCJ4Vp_BTfR3dFpg3W0zvmW8fnoKxFCxnkfOednF/s1600/20098221670.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhgyVRmZmEHp0H91uj93E4A3FSXOFbz9pUgjog_un6yGqCc7viGnRvWavGhisJsRIZmQl8RnL9MZdikSsAWtfZQjgExdettVSWLoy82SCJ4Vp_BTfR3dFpg3W0zvmW8fnoKxFCxnkfOednF/s320/20098221670.jpg" alt="" id="BLOGGER_PHOTO_ID_5505208581188406786" border="0" /></a>Between the mountains covered with jungles in north-central Laos lies the city of Luang Prabang. It is situated where the Nam Khan River flows into the Mekong River, well over 400 kilometers north of Vientiane. Every dawn, lines of monks dressed in orange robes walk through the streets to collect alms, and along with the Buddhist temples and the simple concrete buildings, the atmosphere seems to resemble that of its neighbor Thailand at one glance. Even the language is very similar to that spoken in 'Isan', the northeastern part of Thailand. The cuisine is similar too; Tam Mak-Hung (papaya salad) is basically the same as Som Tam, and they eat that with Khao Niaw (sticky rice), and it even goes along with Kai Yang (roasted chicken).<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-hA8BkyJaMGuD2WKM6i1nmGR67yWBnOIxqTu-XzZLVxmsnZpQNI12NwutsT1Ub1Odpyms9bgp80TuFpIsBvYPkpPg98ysFPUg9zrmUx_xwrpQsk1zotYXCG3SPoUiQlIBgE1IaAMGm1Gf/s1600/20098231851.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-hA8BkyJaMGuD2WKM6i1nmGR67yWBnOIxqTu-XzZLVxmsnZpQNI12NwutsT1Ub1Odpyms9bgp80TuFpIsBvYPkpPg98ysFPUg9zrmUx_xwrpQsk1zotYXCG3SPoUiQlIBgE1IaAMGm1Gf/s320/20098231851.jpg" alt="" id="BLOGGER_PHOTO_ID_5505208353098235154" border="0" /></a>However, if you look carefully, the decorations of the temples are different, architecture reflecting the days of French colonization still remains in many houses, and most of all, its social systems, including education, health care, and welfare is like those of its neighbor decades ago. Education is essentially free for public primary school (five years), junior high (three), and senior high (three), but the percentages of children enrolled are 84.2%, 54.4%, and 34.2%, respectively. And, since the country does not keep track of personal identification records, the actual age a child gets enrolled varies. The number of years for university education varies from two to seven depending on the majoring subject, however, none are free. Free health care is not available, but government aid may be issued if you travel all the way down to Vientiane and ask for it.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxTa4btmN34QmijX6NLkSBtA-VMtEY1Z6huBzU_9MBEvudpZh9JSuPX8a4VXNurt_7Izu0ZlV7OsbCNGol8w9sgtRWngEWFeOXZLX_YRXxLLu192PqfCvqP-GlO2xXsYsS6nneT1NhPc3g/s1600/20098241890.jpg"><img style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxTa4btmN34QmijX6NLkSBtA-VMtEY1Z6huBzU_9MBEvudpZh9JSuPX8a4VXNurt_7Izu0ZlV7OsbCNGol8w9sgtRWngEWFeOXZLX_YRXxLLu192PqfCvqP-GlO2xXsYsS6nneT1NhPc3g/s320/20098241890.jpg" alt="" id="BLOGGER_PHOTO_ID_5505208071710331586" border="0" /></a>I paid a visit to this landlocked country in the Indochina Peninsula in August. Registered a World Heritage Site by the UNESCO in 1995, the compact city of Luang Prabang is a nice and calm place to spend a couple of days. Besides the symbolic temple of Wat Xiengthong and the hill of Phousi, where you can get a picturesque view of the entire city, there are many so-called 'speed boats' that take you up and down the Mekong to various nearby villages and the buddha-adorned caves of Pak Ou, while 'songthaews' or 'tuk-tuks' (same nomenclature as Thailand!) can take you to the beautiful waterfalls of Tat Kuangsi. At night, nearby villagers, including the Hmong, come out to sell various goods, creating a bustling street market scene.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuFbsXLpb987wgMfrm70tEZBZjOqPUdCauh473E5zbeepv0dr4XEi3q163FhpXfo0DT-SADmIcNoACuUgG-DMyBzxnuPiM3XVjayYGOpwDP_4gB7NVudIosiT1oa8PP29jmTaQkwy7Hfh4/s1600/20098231814.jpg"><img style="float: left; margin: 0pt 10px 10px 0pt; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuFbsXLpb987wgMfrm70tEZBZjOqPUdCauh473E5zbeepv0dr4XEi3q163FhpXfo0DT-SADmIcNoACuUgG-DMyBzxnuPiM3XVjayYGOpwDP_4gB7NVudIosiT1oa8PP29jmTaQkwy7Hfh4/s320/20098231814.jpg" alt="" id="BLOGGER_PHOTO_ID_5505207853240783282" border="0" /></a>The recent influx of tourists to this economically underdeveloped nation has given birth to a plethora of bed-and-breakfast's and restaurants that satisfy a westerner's taste buds, however, this happened after restaurants catering for the locals came in, ironically. Families were and are still not too used to eating outside the home. So, it wasn't easy for me to find local food with a local taste at a local cost. Even the packaged foods, most, if not all of them, are imported from Thailand. People say that the more north you go, the more products from China and Vietnam you will find. But basically, there are only a few mass-produced goods (not to miss the famous Beer Lao!) packaged on Lao soil. What I personally liked the most was the Khao Soi (different from the Thai cuisine with the same name) I found being served at a 'street picnic table' right beside the Mekong. I even went for a second on the following day.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-9373569100587019132009-07-17T23:14:00.012+09:002011-02-16T19:19:50.050+09:00Mae Sot and Route 105.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsK07hkc27D_-69QGkrnhRc9W4tAoFWUTkejPikoiBqZF8dauH-GeRPXHUFlzXhn5giHLycHz9OZmELvXUImNNBFUhabyh2fULyQuuHQ22VPpqyvPO0RpyXhubsZ5ArzJ0SiHiicI_tAbR/s1600/20094281197.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsK07hkc27D_-69QGkrnhRc9W4tAoFWUTkejPikoiBqZF8dauH-GeRPXHUFlzXhn5giHLycHz9OZmELvXUImNNBFUhabyh2fULyQuuHQ22VPpqyvPO0RpyXhubsZ5ArzJ0SiHiicI_tAbR/s320/20094281197.jpg" alt="" id="BLOGGER_PHOTO_ID_5500802447545437586" border="0" /></a>In the northwest of Thailand on the Moei River border with Burma lies the small town of Mae Sot, the westernmost town of Tak province. The town is not only interesting for being a trade post between Burma and Thailand, but also for its diverse ethnicity: Thai, Burmese, Karen, Rohingya, Karreni, Mon, Kachin, and many other minority groups from across the river. Take a stroll in the market and you will notice that Thai is not necessary the major language spoken here. Due to the ongoing conflict between the Burmese military junta and the many ethnic minorities that inhabit the land along the border with Thailand, thousands have crossed the river and settled in villages and refugee camps along the border near Mae Sot.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_MJX6DbsBcbmW1pCVz3rsdGSZ9cXQR7WgLSeJJsvPLHnwuGDzbYH-yH_mVAFzffXkRvAkchSMMqDWE4D0BwgGMxquTttutvNh1E5hSsdGwCeGzf8fcjvVdmzvQEDXMKRurXIxrp89AU9t/s1600/20094281120.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_MJX6DbsBcbmW1pCVz3rsdGSZ9cXQR7WgLSeJJsvPLHnwuGDzbYH-yH_mVAFzffXkRvAkchSMMqDWE4D0BwgGMxquTttutvNh1E5hSsdGwCeGzf8fcjvVdmzvQEDXMKRurXIxrp89AU9t/s320/20094281120.jpg" alt="" id="BLOGGER_PHOTO_ID_5458764954725576770" border="0" /></a>A Muslim community is also present in Mae Sot, together with a mosque. One of my good old Thai friends lives in Mae Sot and she and her husband took me to a small cafe on a corner near the mosque. They make rot-tii-oo and tea at this place which seems to have become a pleasant get-together place for the locals to chit-chat during the early hours. Rarely will people be able to find any rot-tii-oo left after 10AM.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNnl3z6CK2PzFd4zTJDS-b6e3wYqYeoHy5P1xuFTYW1wM31ja-5mUm3jNNTnNH0WpzPkQro1wXUv_Gwh5cDrs5iIKaiHqV5hC8vpcjw6vE4zo8eci2afBey9sa3tdG_GMQcp_WnhvWQSaJ/s1600/20094291362.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNnl3z6CK2PzFd4zTJDS-b6e3wYqYeoHy5P1xuFTYW1wM31ja-5mUm3jNNTnNH0WpzPkQro1wXUv_Gwh5cDrs5iIKaiHqV5hC8vpcjw6vE4zo8eci2afBey9sa3tdG_GMQcp_WnhvWQSaJ/s320/20094291362.jpg" alt="" id="BLOGGER_PHOTO_ID_5500825232521870130" border="0" /></a>As of 2006, Tak province is home to 480,000, of which 150,000 are originally from outside the nation. And of that, approximately 80,000 are refugees that have either been registered or in the process of being so. Those who have managed to cross the border, most of whom are undocumented, have found shelter in border villages and refugee camps set up by the UN or other NGOs. And many of those who are not registered as a refugee work in the many factories near Mae Sot on a very low pay scale, though much better than in the land they came from. Meanwhile, Burma's population stands at around 47 million, of which Karens account for 7 million, the largest 'minority' group. Well over 600,000 have been displaced in camps within their country.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvvacpXzbBiFFN362bVhxh7MmhKE7iiifQx8KaF5fpMk-TkV1nhDPXXP3V9yzRMjAAKfDEbrTKIN55FwoZZb0kGya1mjW5ewAaknpjcInkdq56PdOlbIp-ggXzGXyimj-EiBvMIq5DORYC/s1600/20094281158.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvvacpXzbBiFFN362bVhxh7MmhKE7iiifQx8KaF5fpMk-TkV1nhDPXXP3V9yzRMjAAKfDEbrTKIN55FwoZZb0kGya1mjW5ewAaknpjcInkdq56PdOlbIp-ggXzGXyimj-EiBvMIq5DORYC/s320/20094281158.jpg" alt="" id="BLOGGER_PHOTO_ID_5500824937051663378" border="0" /></a>Naturally, Mae Sot is also the 'hub' for the many NGOs that work along the border to assist the endless number of refugees. Among them is a health care post called Mae Tao Clinic (MTC). Set up in 1989 by Dr. Cynthia Maung, herself a Karen who fled from Burma after the crushing of the '8888 Uprising' by the military regime, the clinic caters for those who travel across the border in seek of medical assistance, since there is none, if any, accessible, affordable health care available in Karen state (around 0.5% of the GDP is spent on health care), and for those who have already settled on the Thai side, but could not access health care because they are undocumented immigrants or simply for the lack of money. I met a lady who had walked for over a month from near Yangon, where she lost all of her family members in the deadly cyclone Nargis. She was suffering from PTSD (post-traumatic stress disorder).<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxhGb_FcIccsjMFJPqUg-oLaYxVhpeV-QhMYX8fWVwxj8Vvg5kocRmAT9hV42C8eYIecayuJpks7val40tZ6eDxGVPwn5Fy12ERJQNcw0QBgX6Ivzcv0YBmTzxDpGv7Wgxzrn65qA4C2tX/s1600/20094291337.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxhGb_FcIccsjMFJPqUg-oLaYxVhpeV-QhMYX8fWVwxj8Vvg5kocRmAT9hV42C8eYIecayuJpks7val40tZ6eDxGVPwn5Fy12ERJQNcw0QBgX6Ivzcv0YBmTzxDpGv7Wgxzrn65qA4C2tX/s320/20094291337.jpg" alt="" id="BLOGGER_PHOTO_ID_5500826097436218082" border="0" /></a>Staffed with 530, of which 260 are health care professionals, and many of whom themselves are originally from across the border, the clinic is visited by approximately 400 every day, totaling over 120,000 patients per year. Although now well-known and attracting donations from all over the globe, the budget still remains extremely tight with an ever-increasing number of patients and a lot of issues have yet to be solved. Its in-patient facilities are still infection-prone, especially to the likes of tuberculosis, and more and more refugees give birth here, meaning more and more stateless children.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNgSfiMnVuWrhPCjcbqJdp23BdIIcROBwMX0q09kpkR_A3pZGmBwsA3zjY-GaW8_yLKBPEKSFFTmcZk-qpnpWTP1H4zncyqlG1M40VPiZakCwfYrCsnkJmGJcCfzOThNt3ESDiBa6yjepB/s1600/20094291309.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiNgSfiMnVuWrhPCjcbqJdp23BdIIcROBwMX0q09kpkR_A3pZGmBwsA3zjY-GaW8_yLKBPEKSFFTmcZk-qpnpWTP1H4zncyqlG1M40VPiZakCwfYrCsnkJmGJcCfzOThNt3ESDiBa6yjepB/s320/20094291309.jpg" alt="" id="BLOGGER_PHOTO_ID_5500826361743745314" border="0" /></a>About 90 kilometers north of Mae Sot on Route 105 lies the refugee camp of Mae La, the largest of them all, housing 37,000 registered refugees and no less than another 30,000 unregistered ones. Because Thailand is not a member of UN's Convention Relating to the Status of Refugees, a person who wishes to be registered needs to be approved by both the UNHCR (UN Refugee Agency) and the Thai Ministry of Interior. With temples, churches, mosques, graveyards, schools, libraries, markets, and even a university, Mae La is like a huge refugee 'city', and so surprisingly, life here is not the worst for those who are registered, since they are eligible to receive food aid as well as space for housing, at no cost. Bored with nothing to do but unable to leave the camp nor return to their mother land, many couples fill the time to make babies, and family planning has become a seriously important topic. Others apply to live in a third country, while a handful work for the NGOs within the camp.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjskQF_jI9OcWV8bpRSJF-j8tJ2SAJ3cgXXCrxnL1f6BFl_bPccdL7hbiLbt1puoAJGexwJPb2_dHb1QpsyhMMOSzjYwnjeAlLzGcwOHFJTatZTP8HZ5KDRV46relokY4Cd1gUcjIeAwvH-/s1600/20094291321.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjskQF_jI9OcWV8bpRSJF-j8tJ2SAJ3cgXXCrxnL1f6BFl_bPccdL7hbiLbt1puoAJGexwJPb2_dHb1QpsyhMMOSzjYwnjeAlLzGcwOHFJTatZTP8HZ5KDRV46relokY4Cd1gUcjIeAwvH-/s320/20094291321.jpg" alt="" id="BLOGGER_PHOTO_ID_5500827441174147010" border="0" /></a>I visited one of Shanti Volunteer Association's (SVA) libraries, where children were forgetting their darker days and enjoying the time for learning. However, a boy who seemed unable to join the flock caught my attention. According to the staff, he had only arrived a couple of weeks ago, but just received the news that his father, who was also on the way, was killed in a fighting between Burmese government troops, the Democratic Karen Buddhist Army (DKBA), and the Karen National Liberation Army (KNLA), the military arm of the Karen National Union (KNU), which has been fighting for independence of the Karen state (in their words Kawthoolei). Whether or not that news was true is unsure, however, the extensive 'underground' information network of the people cannot be underestimated. And, the Thai cellphone can be used near the border even if it's on the Burmese side, as well.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0eRJ3v73J9VrqpypemM6U5U6Ihf9E32SvJl7gIOKlDWq5kYpvuapfLLcPPoPbvZvzFJ3S4TuxeYGQRqrhQjtIPF_JjG829YA4kir2HER22rlsSQTvpuC_hMSMJxJBlILb0IVrM2GfrmxE/s1600/20094291326.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0eRJ3v73J9VrqpypemM6U5U6Ihf9E32SvJl7gIOKlDWq5kYpvuapfLLcPPoPbvZvzFJ3S4TuxeYGQRqrhQjtIPF_JjG829YA4kir2HER22rlsSQTvpuC_hMSMJxJBlILb0IVrM2GfrmxE/s320/20094291326.jpg" alt="" id="BLOGGER_PHOTO_ID_5500827657724387618" border="0" /></a>Those who have been caught by the Burmese military or the DKBA have reportedly been forced to hard labor or simply 'used' as human walls in the event of fighting. In June, DKBA troops raided a Karen school, forcing students to flee to the jungle. 89 of them managed to reach Thai soil, however, nine of them caught malaria on the way in this naturally high-risk area for this fatal mosquito-borne disease. In the same month, near the Thai village of Mae Salit Luang landed four mortar shells launched from the Burmese side, prompting the Thais to increase border security. On June 15, the KNLA headquarters in Manerplaw fell to the Burmese army, and in May-June alone, no less than another 4,000 crossed the border.<br /><br />'Chronic emergency' is the term many use to describe this region's volatile situation, which has not improved, or only deteriorated, since the conflict broke out in 1949.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-1171503131357779032009-04-23T09:51:00.014+09:002010-08-21T01:39:38.318+09:00A visit to Sanyukai.Poverty. What does it mean?<br /><br />Many say it's about not having enough money to make a living, while some others put it in a different way: they are people who have not only lost their money, but also their families and all their trustworthy social relationships, as well as self-esteem and pride. While a good portion of the general public in other countries still see Japan as the darling of economic prosperity, and even the typical Japanese are not too aware, the poor population has been slowly increasing over the years, and at a quicker pace more recently. Poverty does exist in Japan, and it does in Tokyo.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3CCeP7cTy3RAtIRSGumhPoWCxHiMG6hn38pr4xxhOIMqKuPxY81s3CLWFk8ThSoBV2puXk5S_Fqo1HGhRPOQ9vAygN7J7wAHiXgo_54ClUR5wVuJETF1KQXMJkpVg8bdKoNqvMQ4XHdXe/s1600-h/Sanyukai200904.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3CCeP7cTy3RAtIRSGumhPoWCxHiMG6hn38pr4xxhOIMqKuPxY81s3CLWFk8ThSoBV2puXk5S_Fqo1HGhRPOQ9vAygN7J7wAHiXgo_54ClUR5wVuJETF1KQXMJkpVg8bdKoNqvMQ4XHdXe/s320/Sanyukai200904.jpg" alt="" id="BLOGGER_PHOTO_ID_5344856004261902914" border="0" /></a>In April, I paid a visit to Sanyukai again, a non-profit organization (NPO) that runs a free clinic, provides temporary housing, clothes, and food for the homeless. Located in the heart of Sanya district, an area that has become synonymous with poverty and homelessness, the group has been carrying out outreaches to hand out clothes and food, and so-called 'clinic tickets' for those who seek medical consultation for over a decade. The clinic is totally free (one of only two free clinics in Japan for the homeless), but naturally, it's sometimes not easy for a person to come and drop by, but reaching out to them and giving them these 'invitations' not only encourages them to come but also "makes them feel easier" to do so, says one staff. Situated in the northeastern part of the huge bustling city, Sanya has been a home for many who work on a daily wage basis, taking advantage of its proximity with factories in the area and the abundance of rediculously-cheap hostels.<br /><br />So what did I do? I participated in one of the outreaches they carry out on Wednesdays and Thursdays. Why? Because I like it. And this phrase means much more than it's said. I go to Shinjuku every day, and it's not too difficult to find a homeless there since nearby Shinjuku Central Park is home to a good number of them, so I have always felt that they are part of the picture I am in in some way. But what is there that I could do by myself? If I do have some leftover food I am not going to eat it, could I give it to them? But what would that do to their self-esteem? Do they really want that? After all, unlike in the U.S., begging is not common here. We belong to the same world, the same society, but there is something that is separating us. But through the outreach, I can be of some help and talk to the homeless without hesitating, and it really gives you the feeling that as if it not only opened the door for them but for yourself too. It's like this: they are near you but not as near as it seems, but you've finally found a way to step closer to them. Surprisingly, many seem to be happy even when we just say "hello, how's it going?". They've got lots of things they want to talk with you. That smile on their faces I don't forget.<br /><span style="text-decoration: underline;"><br /></span><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoprsrwnygNfIhA_UAj2VzYAAn3EIiv8BA78I8gwP0Wk8ABIAeWdcWQ6Hg60UBN5szJWv6WNs4WpE57e825AJVXGjjrdFxrJlmbVBybBFR0Kpw_CYliNT_C2XmPwYiuV_TPOtIsM7OO3m4/s1600-h/Sanyukai200706.JPG"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoprsrwnygNfIhA_UAj2VzYAAn3EIiv8BA78I8gwP0Wk8ABIAeWdcWQ6Hg60UBN5szJWv6WNs4WpE57e825AJVXGjjrdFxrJlmbVBybBFR0Kpw_CYliNT_C2XmPwYiuV_TPOtIsM7OO3m4/s320/Sanyukai200706.JPG" alt="" id="BLOGGER_PHOTO_ID_5344856206488750578" border="0" /></a>What is poverty? What is homelessness? I've been thinking about this for a while, and ironically, Mr. Hiroshi Goto, one of the staff there, pointed out something that I had heard before two years ago from a staff working in a homeless shelter in San Francisco: we shouldn't really 'categorize' them as homeless, but as people who have had various difficulties in the past that led them to how they are now. And that's true. They have come different ways. The 'issue' for each of them is different from person to person. And in the U.S., add to that those who have willingly chosen to become homeless. But there are things they have in common too. They have no money, no shelter, nobody to rely on, and have been deprived of dignity and self-respect.<br /><br />The number of people living under government aid, called the Temporary Assistance for Needy Families, has been increasing, and at a faster pace now with the slowing global economy. Back in 1992, that number was 585,972, but it reached 998,887 in 2004 and surpassed 1,000,000 in 2005, and as of March 2009, it stood at 1,168,306. Now, especially in these unsure times, it is not so difficult for a person to take a moment or two to think about poverty and take that as an issue that is not unrelated. With just a combination of some accidents, wrong-doings, or unfortunate consequences, anyone could find him/herself without a home. However, we must also keep in mind that the real homeless, the 'true' poor, have been deprived of all they could be, including friendships, families, and even their self-esteem. Whether that is the responsibility of the individual, or another, or the society, or more than one of those, varies from person to person. But we have to understand. And I think there is something we can do.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6WyfjB1FLc9PQMqm-9z_1bMnpOgaJkcr2alp1BCNpL6cW0hsCZPvyGZAB7sgCR-BxdJpRzdTLIh3l4cYf_f3ugkocaWUHtKloc_7hSANBziIzjnuiQFNT5ty6WwH2HGeupXQMvB-kBiyn/s1600-h/Sanyukai2009042.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer; width: 240px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg6WyfjB1FLc9PQMqm-9z_1bMnpOgaJkcr2alp1BCNpL6cW0hsCZPvyGZAB7sgCR-BxdJpRzdTLIh3l4cYf_f3ugkocaWUHtKloc_7hSANBziIzjnuiQFNT5ty6WwH2HGeupXQMvB-kBiyn/s320/Sanyukai2009042.jpg" alt="" id="BLOGGER_PHOTO_ID_5344856361304517922" border="0" /></a>Sanyukai is not merely a group that gives out a hand to the homeless, but one that is helping the absolute poor and using several creative ways at different levels to help the homeless empower themselves and become self-dependent. The true poor are deprived of their family and friends, and it starts from re-building relationships or making new ones. Every day, Sanyukai puts seats and some tables in front of their compact three-story building, and it acts as a place of gathering for the homeless. Sipping a cup of green tea that Sanyukai serves, they come and tell about the meal they had the evening before or joke about the noisy neighbor cat that wouldn't let him go to sleep. It's a place for socializing and relaxing, and up to around 15 people can be seen on some days. Some stay for lunch and eat with the staff. Whether it's a staff or a visiting homeless, everyone eats the same food here. And many of them visit on a routine basis, some even every day, so it is also an effective way for the staff to see who didn't appear on a day and try to find out what happened.<br /><br />Last month, Sanyukai was ordered by the metropolitan government to stop handing out its weekly free meals in one of the areas, after local residents filed a number of complaints saying the outreaches attracted more homeless and that "children are afraid" of them. One of the continuing challenges is how to have the local community understand their activities. There is a quote from a book by French writer and aviator Antoine de Saint-Exupér<em></em>y. "Men travel side by side for years, each locked in his own silence or exchanging words which carry little or no fright, until danger comes. Then they stand shoulder to shoulder. They discover that they belong to the same family."Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com3tag:blogger.com,1999:blog-1110014149995595155.post-77342581505365382202009-02-28T22:10:00.007+09:002010-08-15T12:50:27.831+09:00A glimpse of a university hospital.Time flies.<br /><br />Hmm... I think I've been using this word too much lately. But it's true, times really does fly. So here I am, finished with all the clinical rotations, something which I had so much expectations of just a year ago. Did it meet my original expectations? Well, that's another question. But nonetheless, I did learn quite a few things, was able to see and talk with many patients, and was able to get a glimpse of what a physician's everyday life here is like, working in a 1,000-bed university hospital located in the heart of one of the most important business districts in Tokyo: Shinjuku.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGBhBzpT9aW5g4_csy7Ip2L6UdOFvacuQemS7q_W2pSWjgaH_h8a6ov7bU_hKZtqaL1Xm_ZL_AWBGbuZjIpRb11MsvFOBahA71SzGzP8RYRgbjtk9_BDmRYyITfnMrRrBTZpZYCato6oK6/s1600-h/Clinical20090228.jpg"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjGBhBzpT9aW5g4_csy7Ip2L6UdOFvacuQemS7q_W2pSWjgaH_h8a6ov7bU_hKZtqaL1Xm_ZL_AWBGbuZjIpRb11MsvFOBahA71SzGzP8RYRgbjtk9_BDmRYyITfnMrRrBTZpZYCato6oK6/s320/Clinical20090228.jpg" alt="" id="BLOGGER_PHOTO_ID_5339950991847443298" border="0" /></a>I have believed and still do, that working in a university hospital means you have to take part in educating and nurturing the next generation of physicians, and that is not an option but a responsibility. And until I started my clinical rotations, I had believed that those who don't do too much or refuse to carry out that part don't have enough passion and enthusiasm, and therefore are working in the wrong place. But... that view has changed. Most physicians here, especially those in the upper 20s to 40s, whether an internist or a surgeon, or a pediatrician or a obstetrician/gynecologist, are super busy.<br /><br />Arriving at work before 8AM, their day often starts with a conference in the morning, followed by a visit to the in-patient ward, and then on to run the morning portion of the out-patient department (OPD), or head to the operation rooms instead if that's a surgeon. The lines of patients in the waiting room are seemingly endless, while some operations can easily take five or six hours, naturally. When do they have lunch? Well, they're lucky if they can get a meal at noon. The schedule for the afternoon doesn't look too much different, except for some more case conferences and lectures by older doctors or advertisement sessions by pharmaceutical companies. When do they finish all that? Maybe 6PM. Okay, can the doctor go home? Not so fast... because all the paperwork and some medical records are waiting to be processed by nobody but the physician. After that is 'free time' for the doctor, where he/she can work on research papers or make a PowerPoint for the next day's lecture for students, etc. It's not rare to see a doctor working well over 12 hours. Or, is he/she on-call for the night? Well, that adds another 10 hours or so, and on to another day. You don't get rests here after on-calls.<br /><br />And yes, to add to that, the pyramid of hierarchy in Japanese university hospitals is still present. You have to do as your boss (professor) says, and that is often a must. Some would even be too concerned about writing research papers or simply trying to make their daily work appeal to the chief professor of your department, since he/she would be the only person who can help you get promoted to a higher academic status. If the professor doesn't like you, tough luck. Yes, it's all about faculty politics. And then, on the other hand, you also have to help young doctors who have this long list of questions for you to answer. A physician in the upper 20s to 40s are kind of stuck in between the old and the young.<br /><br />Hmm... yes, a physician working in a university hospital has three major responsibilities; providing medical care, research (often for academic status), and education. But does the doctor really have enough time for all of that? And especially when considering the fact that doctors working in university hospitals in urbanized areas get one of the lowest salaries among doctors in the country, how much would that do to the enthusiasm of the physician? What's the incentive? Now that I have seen some of the reality in a university hospital, I even feel sympathy for some of them.<br /><br />When doctors start quiting, that is probably a tipping point, a beginning of a vicious cycle; quitting means more tasks for those who are left.Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-63069104134422705752009-01-18T18:29:00.002+09:002009-05-04T18:41:04.511+09:00Go to the people.Go to the people,<br />Live among them,<br />Learn from them,<br />Love them.<br />Start with what they know,<br />Build on what they have;<br /><br />But of the best leaders,<br />When their task is accomplished,<br />Their work done,<br />The people all remark:<br />WE HAVE DONE IT OURSELVES.<br /><br />- Yen Yang Chu (1893-1990)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-20555126955944549742008-12-31T18:02:00.015+09:002009-06-02T12:37:54.260+09:00A visit to Nagi Family Clinic.During the final week of August 2008, I had an opportunity to stay with Dr. Akira Matsushita, the family medicine physician at Nagi Family Clinic, one of Nagi town's only two medical facilities. A larger hospital in nearby Tsuyama, which is a 40-minute drive, is the only in the region offering tertiary medical care.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidbgJzDKbarp2xhr17vu_2HKmkUf44NmUXU2PiQw1ygS4Ys-o0wtB3dBKUk38e1cb0QIRLHUVHXhpEAt3eqCldClCgFjAvkDIMw5hLO8YmbJwF_n46on6NZkJZM2_mWmxpsKl0g2utxI1t/s1600-h/Nagi20080801.JPG"><img id="BLOGGER_PHOTO_ID_5288514168475512962" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidbgJzDKbarp2xhr17vu_2HKmkUf44NmUXU2PiQw1ygS4Ys-o0wtB3dBKUk38e1cb0QIRLHUVHXhpEAt3eqCldClCgFjAvkDIMw5hLO8YmbJwF_n46on6NZkJZM2_mWmxpsKl0g2utxI1t/s320/Nagi20080801.JPG" border="0" /></a>Nagi is a small town in Okayama, situated in the partly mountainous region of this rural prefecture in the southwestern part of Honshu, Japan. A 15-minute drive will take you to the border with Tottori prefecture. Sarcastically nicknamed 'the Ginza of Nagi' by some, the central part of the town is not bustling at all, with only two supermarkets (closing at 7PM), one convenient store, a tiny locally-owned bookshop, an elementary school, one pharmacy, the town office, and the clinic. Home to 6,690, Nagi's population has been decreasing year after year, just like many other rural towns and villages where younger generations have decided to move to not-too-distant urbanized areas such as Okayama city, Kobe, or Osaka, in search for better jobs, a wider choice in academics for their children, or simply a more convenient lifestyle.<br /><br />So, why did I visit the clinic? Well, after seeing various types of community-based health care in the U.S., Thailand, Scotland, and Tokyo, I wanted to have a glimpse of what rural health care is like in a place far from the country's capital or any other big city. The closest to Nagi is Okayama city, which is more than a two-hour drive. Dr. Matsushita, well-known among general practitioners in Japan for family-oriented primary medical care and medical education in family medicine, happened to be the former attending of a doctor at my university's general medicine department who I am very fond of, Dr. Hiroyuki Saito.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikZpam3PYYVZcpZgsf9KoyqGpHUrVEAXT20iFsBwH0Y0L_08KCzoiRpoiid7UsKS7b9EbQVhlUWSlHw8Wu24NZJ-GRikbFhUjSHwRGODgMDBtRdjKfMlc4-CktuPUrbij5gnpr2TspcCfY/s1600-h/Nagi20080802.JPG"><img id="BLOGGER_PHOTO_ID_5288514679064391042" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikZpam3PYYVZcpZgsf9KoyqGpHUrVEAXT20iFsBwH0Y0L_08KCzoiRpoiid7UsKS7b9EbQVhlUWSlHw8Wu24NZJ-GRikbFhUjSHwRGODgMDBtRdjKfMlc4-CktuPUrbij5gnpr2TspcCfY/s320/Nagi20080802.JPG" border="0" /></a>Now what's so special about this clinic? Well, to put it in a single sentence, Nagi Family Clinic knows its patients very well, and that is very, very well. The doctors take a considerable amount of time in listening to the patients, some of whom make visiting the clinic part of their weekly schedule just to have someone to talk with. You may think that is wasting time, but if that is helping the patient stay happy and actually healthy by means of making the patient think and recall what happened in the past week, that is not necessarily correct. All the medical records have been digitalized and are online on the clinic's server, and that has enabled them to create the 'electronic family tree', where when you look at a patient's medical records, you can also see the family members and their medical records at the same time, which is a handy tool that helps to make medical care more family-oriented. The doctor can interact with the patient with all that background of the patient in mind. Another special feature I noticed is that, every single staff, including the paramedical workers, know so much about the patients. Their medical issues, their character, their habits, and so forth.<br /><br />So, my week at the clinic and town enabled me to get a glimpse of who and what kind of people live here, the social issues that underlie, and how health care is done in this small rural town, from different perspectives, as Dr. Matsushita kindly made it possible for me to spend time not only with the clinic staff but also with the social worker at the nearby town office and staff at the local non-profit organization (NPO) called Kazamakura, which offers services for the elderly including home-visiting nursing care and driving them to health care facilities. A low-fare local town loop bus was introduced recently, but for the elderly, bus-stops are often still too far from the home to walk to, and you don't have the option of a taxi in this rural part of the prefecture. Like in many other rural areas of the country, the over-65-years-old population is growing there too, now exceeding 25%.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj33up9l0dtqFZWxCUbgZOliWeicvm9fvrWGhMw6eNzRHzao_Fu_ePktNsY8Zw2vHZsrr4rPTR1c9ETOL6AFrIQYyVkb0sGl0TU32Sy6BOy0sNfqiDMhDwXO6xejtxVL2X0uClY5nIOuWGf/s1600-h/Nagi20080803.JPG"><img id="BLOGGER_PHOTO_ID_5288514483968952130" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj33up9l0dtqFZWxCUbgZOliWeicvm9fvrWGhMw6eNzRHzao_Fu_ePktNsY8Zw2vHZsrr4rPTR1c9ETOL6AFrIQYyVkb0sGl0TU32Sy6BOy0sNfqiDMhDwXO6xejtxVL2X0uClY5nIOuWGf/s320/Nagi20080803.JPG" border="0" /></a>The Japanese Self Defense Force (JSDF) base and training grounds play a large role in supporting the local economy (the JSDF even pays a certain amount to the town for each and every single bullet fired) in a town where apart from one construction company's factory are only small local businesses and agriculture. And that factory is currently amid a dispute with the people living nearby, who are complaining of the exhaust that comes from the factory chimneys causing respiratory problems, though company officials claim they are meeting all environmental standards. It is a bittersweet situation for the local government, which finally succeeded in inviting this first company to make a factory in town but that is now having conflicts with the locals.<br /><br />Every week, a 'community care meeting' is organized at the family clinic, which is a gathering attended by staff from the homes for the aged in the town, the local town office, Kazamakura, the local pharmacy, and the clinic, to discuss the latest health matters and try to solve them through cooperation and close coordination. For example, they would talk about s 90-year-old lady living in the southern part of town who's dementia has recently deteriorated and needs more frequent home-helper visits, or how to make efficient and sustainable safety nets for the elderly living alone and far from the center of the town. This town, being small, means human resources are limited, but on the other hand it could also be an advantage, as it makes it easier for them to communicate with each other, coordinate closely, and make decisions fast. And including the aforementioned clinic staff, everyone knows the town people very well. Truly a form of community-based holistic care.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgquh7XjKI3mo8hjLAPES_j9ELC3cLPjVcIbK6Ih0SOrlHVlTGoSVyCHHrVYDQvYyZVW51WxlCw1qGoW6rYZwWu_yDVBvNNqYOxlZCXEvMh8eTh_6mc15wFE_zhb9I0HUvFv8A8kjOxZfSC/s1600-h/Nagi20080804.JPG"><img id="BLOGGER_PHOTO_ID_5288514278993949234" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgquh7XjKI3mo8hjLAPES_j9ELC3cLPjVcIbK6Ih0SOrlHVlTGoSVyCHHrVYDQvYyZVW51WxlCw1qGoW6rYZwWu_yDVBvNNqYOxlZCXEvMh8eTh_6mc15wFE_zhb9I0HUvFv8A8kjOxZfSC/s320/Nagi20080804.JPG" border="0" /></a>People of Nagi are bright. I don't know, but every time I visit countrysides, I can't help myself from getting the impression that people in rural areas generally seem to be happier than those living in the busy mega cities. And the elderly in Nagi, yes, some are surely vulnerable to illnesses, but there are still many 80-year-olds and even 90-year-olds working in the fields from sunrise to sunset. One old man told me, "yes, I'm way past 65 (retirement age), but working in the fields is what I enjoy and that is my living".<br /><br />Good communication and cooperation is there with the health care staff and happiness and livelihood are not yet lost with the people. Yes, many small villages and towns have chosen to merge with their neighbors due to financial uncertainties, and no doubt there will be challenges ahead for Nagi as well, but with all the strengths plus a touch of creative thinking, I believe they could well be poised to become a good example of rural community holistic care. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-17965826769372746722008-11-30T23:41:00.010+09:002009-06-02T12:38:27.342+09:00Flying into the sunset.On October 29, 2008, Northwest Airlines became a wholly-owned subsidiary of Delta Air Lines, after the U.S. Department of Justice (DOJ) approved their merger on that date. The name of the Atlanta, Georgia-based mega carrier, which takes its name from the Mississippi River delta, will be the surviving brand. Although it will still take some time for them to merge completely, including combining operations, frequent flyer programs, seniority lists, Northwest's aircraft have already started to be repainted into Delta's livery, signaling the beginning of the end of a long history that has continued since its founding on September 1, 1926.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_t4kMtP6bSaw703iKVrtZVcG51lWu7MwyE7yUSnlVfXCHpBCDW6iNWth3X8DaL1r7wB20BoMBpojl8dSSmVFxLcgkSEiIfnvfjf6gxgevgjrSJ7b2tqguk2AJ8fl-6UqGb4uAoiweBnfa/s1600-h/744nwa081226.JPG"><img id="BLOGGER_PHOTO_ID_5287839375726186770" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_t4kMtP6bSaw703iKVrtZVcG51lWu7MwyE7yUSnlVfXCHpBCDW6iNWth3X8DaL1r7wB20BoMBpojl8dSSmVFxLcgkSEiIfnvfjf6gxgevgjrSJ7b2tqguk2AJ8fl-6UqGb4uAoiweBnfa/s320/744nwa081226.JPG" border="0" /></a>The year 2008, along with many other recent years, saw a number of carriers going into the history books, with some going out of business while others being bought out by others. From record high fuel prices to extreme competition and now a global recession, the aviation environment is becoming more harsh and unforeseeable than ever before. For the mighty incumbent flag carriers too, there is no safe haven. In Europe, former major airlines, some of which are now but a shadow of its glorious past, are being amalgamated into the big three: Air France, British Airways, and Lufthansa (Germany). KLM is now part of Air France; Austrian Airlines, bmi (British Midland), Swiss International Air Lines are now owned by Lufthansa; Iberia (Spain) is discussing a merger with British Airways; others that are so far 'left out' such as SAS (Scandinavian Airlines) face an uncertain future and Alitalia (Italy) ran out of cash. Established low-fare carriers easyJet and Ryanair continue to thrive with their rigorous cost-saving measures, but have felt pinches with strong competitors and other low-cost newcomers.<br /><br />The same is happening in the U.S., despite at a slower pace. Once a trademark for air travel, Trans World Airlines (TWA) is now part of American Airlines, Phoenix-based America West Airlines acquired troubled U.S. Airways (retaining the latter carrier's name) in 2005, and after the announcement of the Delta/Northwest merger, Continental Airlines decided to switch loyalty from Air France/Delta-led Skyteam Alliance to Star Alliance, agreeing to cooperate comprehensively with United Airlines. The low-fare market is dominated by AirTran Airways, jetBlue Airways, and the mother of all low-cost carriers Southwest Airlines, and many new entrants who have dared to challenge have failed, though tiny Allegiant Air seems to have found its own niche, for the time being. And Alaska Airlines? Where are they heading for?<br /><br />From March 30, 2009, Northwest's crew will start wearing Delta's uniforms, and rumors have it that they will start standardizing the interiors of the aircraft then, including replacing Northwest's WorldTraveler in-flight magazine with Delta's Sky. Frequent flyer programs WorldPerks and SkyMiles are planned to be combined by the end of next year. On the last day of TWA's operations at San Diego on December 1, 2001, a Northwest crew joined them on the radio frequency saying "we sure are going to miss hearing your call-sign"... probably little or never had they imagined that the same day would come for them just a couple of years later. I find Northwest's product on international routes superior among U.S. airlines that I have flown on before, including their acceptable meal service, warm and charming flight attendants, enjoyable in-flight entertainment (IFE), affordable fares, and a good mileage program. I will surely miss those red tails lined up at Narita Airport.<br /><br />So long, NWA. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-71054115911079985892008-10-31T19:19:00.012+09:002011-02-16T19:20:11.054+09:00A visit to Ban Rong Ta Tee.During August 10-12, 2007, which is already over a year ago, the "Intergration of Health and Social Development: Thailand's Experience" program run by Mahidol University's ASEAN Institute for Health Development (AIHD) took us to Ban Rong Ta Tee, a village located in the northern part of Lan Sank District, Uthai Thani Province, in central Thailand. We would be home-staying in that village with the respective families for three days and two nights, carry out a small research by interviewing the villagers about what we wanted to know about, and come up with some kind of conclusion to present. Never did I think that that experience would have a tremendous impact on the way I see things...<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoZea1dpWTtXKjwO6j0jMYmbizHD5oHS-H2bYb-0AayM5R4cniu5hUi45mL8PuPc6xJFwbDo-WjIyYW9P6fG1PsHpnzX26AoPGWAbXL4y26cKoLFcUHtC3YapzP3uxNP78q10TuxxWr5TO/s1600-h/RongTaTee2550n1.JPG"><img id="BLOGGER_PHOTO_ID_5287791043433076002" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjoZea1dpWTtXKjwO6j0jMYmbizHD5oHS-H2bYb-0AayM5R4cniu5hUi45mL8PuPc6xJFwbDo-WjIyYW9P6fG1PsHpnzX26AoPGWAbXL4y26cKoLFcUHtC3YapzP3uxNP78q10TuxxWr5TO/s320/RongTaTee2550n1.JPG" border="0" /></a>Dr. Chokrachan Chairoeksuksan, a family medicine physician at Lan Sak Hospital, gave us an overview of how health care is provided in this rural area, in its most effective and efficient way possible. Lan Sak District is divided into six sub-districts (tambol), which in turn are made up of 84 villages. Primary medical care is taken care of at the 'primary care level', which is the local public health center, 10 of which are spread throughout the district. If the medical issue could not be solved there, the patient would be referred to the 'secondary care level', which is in this case Lan Sak Hospital. If further specialized care is necessary, that is the responsibility of the 'tertiary care level', which is in this case Uthai Thani Hospital, the largest public health care facility in the province.<br /><br />The public health center in Ban Rong Ta Tee community is one of 10 in the district and serves 5,263 people and 1,122 households. There are 104 health volunteers working in the villages and they play a key role in promoting health. Those who tend to act as leaders in their neighborhood, are more conscious about health, and are willing to receive some essential medical care training, would be a good candidate for a health volunteer. They would be responsible for connecting the villagers and the health center, including taking patients there when they need the help or gathering villagers to the health center for health promotion activities. There are no physicians at the health center and just five people (manager, community health worker, nurse, nurse's aid, janitor) run the center. The mobile physician team comes here once a month. I became good friends with the nurse, Wanrob Klomlit, who everyone calls Rob, maybe partly because he's the same age as I am.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTuPdCySYWj3ts5mxr5Alleheyamk9U0jhL2dZv4JGrZ0uIlKr0398-T-MHb-kTw5DY9Sid8gbo7XTUBUR_ZWQ5-55JWxM4UeeizYIoikIJzWNz7FusSIPKXNxh0I4X_F4jO9y4L70MWON/s1600-h/RongTaTee2550n2.JPG"><img id="BLOGGER_PHOTO_ID_5287790867223848162" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTuPdCySYWj3ts5mxr5Alleheyamk9U0jhL2dZv4JGrZ0uIlKr0398-T-MHb-kTw5DY9Sid8gbo7XTUBUR_ZWQ5-55JWxM4UeeizYIoikIJzWNz7FusSIPKXNxh0I4X_F4jO9y4L70MWON/s320/RongTaTee2550n2.JPG" border="0" /></a>Now, when we carried out our interviews in the village, our group decided to ask questions about the number of members in the household, their jobs, income, food habits and change over years (if any), their favorite foods, past medical history, smoking and drinking habits, education received, and what they would do in case of an illness. It was really interesting. Truly. Although each household was different, household after household, we started to get the bigger picture of the village. What kind of people live here? What are the strengths of the people? What are the weaknesses or the issues that underlie? What can be done by themselves to overcome those issues?<br /><br />So our group's research theme was this: the effect of lifestyle change on the community. We focused on the villagers' lifestyles, especially food habits and health care habits. And as we carried out are interviews of the villagers household by household, we realized that between generations, there lay some differences. So, to have a better glimpse and understanding, we decided to categorize the villagers into three generations; the first of which we defined as 50 years old and over, no-longer-working-in-Bangkok generation, the second would be 30-49 years old and the working-in-Bangkok generation, and the third is defined as up to 29 years old, the young workers and the children. Here, when I mention "working in Bangkok or not", I mean by the phenomenon where the working age group are increasingly getting jobs in the huge bustling capital of this kingdom, instead of working in their local hometown villages. So when visiting a household, it was not uncommon for us to see a family of grandparents living with their grandsons. Their parents? Down in Bangkok, or Krung-tehp, as the Thais call the capital.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSS_tvPOAfI2WV1pny1jXOnZzyIxidagePALQU8ozRinq-6QdeJHiPuzB0PyG8uxX3jed-vdieOnymGSg0-l5mQzHMIHzyVRdHHeVXe9AoridVcYuUzzloy5X8fwTacwJJbimWbchz8ZE6/s1600-h/RongTaTee2550n3.JPG"><img id="BLOGGER_PHOTO_ID_5287790654179799218" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSS_tvPOAfI2WV1pny1jXOnZzyIxidagePALQU8ozRinq-6QdeJHiPuzB0PyG8uxX3jed-vdieOnymGSg0-l5mQzHMIHzyVRdHHeVXe9AoridVcYuUzzloy5X8fwTacwJJbimWbchz8ZE6/s320/RongTaTee2550n3.JPG" border="0" /></a>Generally comparing the generations, we found out that basically everyone eats and likes the traditional Thai food, such as the som-tum (papaya salad), kao-man-gai (boiled chicken on rice), seafood, etc, but we found out that the third generation likes western fast food as well or even more, such as pizza, french fries (chips), or candy bars. Younger people like to drink beverages such as coke too and consume more fried food. In terms of health care, there were almost none who did not believe in contemporary medicine. Everyone had good relations with the health center and would generally accept any kind of general treatment, whether western or oriental/traditional medicine. In Thailand, herbal medicine is officially recognized by the public and the government. Some elderly still relied on things such as ointment made by themselves from resin or herbal fruits that are not seen in health care facilities, but after all, if they have been living with it for decades and they're happy with them, and don't have health issues, why tell them to stop.<br /><br />All in all, we saw two major issues in the community. A risk of lifestyle-related diseases akin to those now a problem in western countries, among the second and third generations is the first. Many in the second group already had past histories of hypertension, high cholesterol, diabetes, cancer, etc. The second is, with more and more younger generations going to Bangkok and deciding to live their for a long term, the village population is aging, which could lead to decreased livelihood or even the collapse of the community in the end.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLiAufHM_EBB3jFMdK0WhwhCJSWZD2tLYtW3qSfMarouvtBwP-L2Jj6tZWKXYNoAkdjrjWNNX1vO5nuME1bSDP8rfxjC6B0pWRenUAnDG2oCFDesx7FVEkRawLCnwYTQvGz5nc57VMTbGa/s1600-h/RongTaTee2550n4.JPG"><img id="BLOGGER_PHOTO_ID_5287790491555761762" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; WIDTH: 240px; CURSOR: pointer; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLiAufHM_EBB3jFMdK0WhwhCJSWZD2tLYtW3qSfMarouvtBwP-L2Jj6tZWKXYNoAkdjrjWNNX1vO5nuME1bSDP8rfxjC6B0pWRenUAnDG2oCFDesx7FVEkRawLCnwYTQvGz5nc57VMTbGa/s320/RongTaTee2550n4.JPG" border="0" /></a>However, there were certain strengths as well. The smoking and drinking population is not so large (Buddhism and monks have a big effect), they have a good environment with lots of nature, clean air, no traffic jams, and a relatively stress-free life, especially when compared to Bangkok. And even if many of the second generation move down there, there are still some that choose to remain in the village, and with the Thai tendency to regard their parents and families highly, those in Bangkok are unlikely to stay there forever, at least for now. Many village homes are centered around the health center and the adjacently-located primary school (elementary school), and the relationship between the health center staff and the villagers is good. They know each other well and the villagers feel easy about visiting, thanks partly or largely to the health volunteers.<br /><br />Rong Ta Tee Health Center has a variety of health promotion activities such as the mosquito project (over 92% of homes now use measures to keep mosquitoes out of their water), aerobic exercise on weekends, elderly persons' education for self-help, breast and cervical cancer prevention, diabetes and hypertension project, HIV/AIDS project, increasing well-being project, developing exercise leaders project, and promoting good health among the elderly project. Now, we felt that they should now put more effort in aiming some projects at the first generation, the young. They should take advantage of the proximal location. Also, they should start thinking of ways to re-develop the community by means of creating new values, such as community-oriented small businesses. Doing this with existing resources both material-wise and manpower-wise would be a key.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0AZ15TUiIix8Kw3Y5TANj1c3hnqWoD_gwsFVO0JMMqx7-aACEP3884ek49yWVO55GSrWe0BRWvGCXBPipIlFTrXDrcgST1LOEFpcHzM8RWtS7w7yNup7qmjRGs4GAUOqlO6clJw86dArq/s1600-h/RongTaTee2550n5.JPG"><img id="BLOGGER_PHOTO_ID_5287790278141893858" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; WIDTH: 320px; CURSOR: pointer; HEIGHT: 240px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj0AZ15TUiIix8Kw3Y5TANj1c3hnqWoD_gwsFVO0JMMqx7-aACEP3884ek49yWVO55GSrWe0BRWvGCXBPipIlFTrXDrcgST1LOEFpcHzM8RWtS7w7yNup7qmjRGs4GAUOqlO6clJw86dArq/s320/RongTaTee2550n5.JPG" border="0" /></a>But so, how did all this have a 'tremendous' impact on the way I see things? Well, I guess I learned two big things. One is that, the economical power of a community does not necessarily reflect the quality of life (QOL) of its people. In other words, it doesn't mean that if a family is not financially rich, they are not happy, and vice versa. Whether it's those living in Bangkok, Tokyo, or London living a daily life in the bustling streets full of stress, do all of them look like they are living a happy life? Through the interviews, I truly felt that many families in the community are living a happy life, in spite of some of their economic status being not so high at all compared to the average Thai. Happiness and economic development: they're not unrelated, but they don't necessarily come together. The other thing I learned is how much a people can get things done together themselves with minimal top-down type professional aid. With the health volunteers playing an important role, many villagers knew how to take care of themselves, and knew what needs to be done and who to go to in the event of a health problem. There were lots of on-going community involvement activities that are facilitated by the people.<br /><br />Community-oriented, people-centered health care through community organizing and building, unlike those hospital-oriented, physician-centered medical care seen in economically developed regions. That is a critical part of primary health care (PHC), as the WHO said together with UNICEF at the Alma-Ata conference back in 1978. Health care for the people by the people... there are lots Japan and the western communities should learn. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-23967133384895831832008-09-20T23:17:00.005+09:002008-10-16T23:00:32.559+09:00How should we save more lives from cardiac arrests?During the second week of September, I was in the Department of Emergency Medicine as part of my clinical rotations. Our university hospital focuses primarily on tertiary emergency medicine, therefore, only the most severe patients are carried into the ER here, such as cardio-pulmonary arrests (CPAs). However, there are exceptions, including cases where the ambulance had been refused by other hospitals, which is unfortunately, not rare at all. Through my four days here, there were some things I felt and thought I would like to share.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC1LuCtnzSo41F4RI-bogrJ8xf7S1WtOGa6C1KNNCzBX3iDpI5GQUZoEwdeCOgFoLBI4PejbytjgA97ieEmuLDocStnnwhfmSyGhIEiVht5aqr5xw93-8ayJPjLagsbpp2-nd3ACgNgJFk/s1600-h/AEDTokyuShibuya.JPG"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC1LuCtnzSo41F4RI-bogrJ8xf7S1WtOGa6C1KNNCzBX3iDpI5GQUZoEwdeCOgFoLBI4PejbytjgA97ieEmuLDocStnnwhfmSyGhIEiVht5aqr5xw93-8ayJPjLagsbpp2-nd3ACgNgJFk/s320/AEDTokyuShibuya.JPG" alt="" id="BLOGGER_PHOTO_ID_5255921012029373426" border="0" /></a>In emergency medicine, a CPA patient is defined as one who is unconscious, whose breathing cannot be seen, heard, nor felt, and pulse cannot be felt at the common carotid artery. When this patient is carried in, we basically follow either the Immediate Cardiac Life Support (ICLS) or Advanced Cardiac Life Support (ACLS) guidelines and attempt cardio-pulmonary resuscitation (CPR). However, through the days I was there, out of a total of seven CPA patients carried in, none recovered from coma and one reached recirculation but did not regain consciousness. The hospital admits 350 to 400 CPA cases per year, and circulation returns in approximately 50 of them, and total recovery is 10% of that, and that means a single digit number.<br /><br />When one falls into CPA, which part of the human is most quickly damaged? The brain. Not only is it a damage, but an irreversible one. It is said that if recirculation could not be achieved within five minutes of CPA, chances of full recovery declines to 50%, and after 10 minutes, that plummets to somewhere extremely close to zero. With this considered, in the U.S., some local authorities have begun to adopt the termination of resuscitation (ToR) guideline. <span class="fieldtext">It supports termination in the out-of-hospital setting subsequent to failed basic life support (BLS) resuscitation by emergency medical services (EMS) personnel if all of the following are true: (1) no return of spontaneous circulation prior to transport; (2) no shock given prior to transport; and (3) arrest not witnessed by EMS personnel.<br /><br />Our university hospital concentrates on tertiary emergency medical care, so in other words, patients carried in are those whose chances of full recovery are close to none. But no matter how the situation is, ER personnel will do whatever they can do to resuscitate. In Japan, the average time it takes for an ambulance to reach the site after the 119 call is seven minutes, and it takes 30 minutes from the time of arrival at the site to reach a hospital. It doesn't take a rocket scientist to see that that is well beyond the 5 minute 50-50 tipping point.<br /><br /></span><span class="fieldtext">Without doubt</span>, <span class="fieldtext">knowing the ICLS or ACLS procedure is a must for all health care providers</span><span class="fieldtext">. However, chances of a CPA patient being saved is extremely low, unless someone at the site knows BLS and carries it out. What I would like to clarify here is that yes, knowing the ICLS or ACLS guidelines and being able to perform it is important, however, teaching people the basics of emergency medicine and making sure they can perform BLS promptly and appropriately is the way to significantly cut the number of lives lost from CPA. The good news is, BLS seminars are becoming more common, and organizations from corporations to governments are placing automated external defibrillators (AEDs) here and there. Now, we also need to focus on how to help people keep up with their BLS skills. :-)<br /></span>Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-16415184234274761952008-08-31T20:49:00.009+09:002009-06-02T12:39:00.325+09:00A visit to The Royal Infirmary of Edinburgh.My first visit to Scotland, and Great Britain. It was months ago when I decided to participate in the three-week 'English for Medicine' course offered at the University of Edinburgh's (pronounced 'yeh-dinbra') Institute for Applied Language Studies (IALS), and what made me do so was that I wanted to see the Division of Community Health Sciences and meet a professor named Dr. Raj Bhopal there to seek some advice about how I should pursue my area(s) of interest. Having interest in family medicine and public health with a clinical taste, I also wanted to take a look at how general practitioners (GPs) work and get a general idea of the health care system there.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaL1bEnl1d_NRMjCinxgG76CvmsLTI3KMayJbA0_qm7varar7RU6K30SFLPZdqQQCfn_27a0yXRpzTfDrm9HJom6L3iQB4ZBsLjfIMocAW28QbJ4Jk1_vWddUtEkChNPbE_VpYAF90l1hp/s1600-h/RIE20080812_2.JPG"><img id="BLOGGER_PHOTO_ID_5249223239016358162" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaL1bEnl1d_NRMjCinxgG76CvmsLTI3KMayJbA0_qm7varar7RU6K30SFLPZdqQQCfn_27a0yXRpzTfDrm9HJom6L3iQB4ZBsLjfIMocAW28QbJ4Jk1_vWddUtEkChNPbE_VpYAF90l1hp/s320/RIE20080812_2.JPG" border="0" /></a>As in other countries as well, the U.K. has both public and private hospitals, the former of which is run by the National Health Service (NHS), a non-profit organization funded by the government but independent from, paper-wise. Now, in Japan, patients have the freedom to choose the hospital or clinic they wish to visit. Whether it's your local clinic or a university hospital or the cancer center, it is basically up to you to decide where to go, however, this is not the case in Great Britain. If you become ill and wish to see a physician, unless you have a contract with a private health insurance company, which will allow you to have access to a private hospital, there are only two ways you can see a physician: see your GP or end up in the accident and emergency department (A&E). GPs are allotted a certain population in an area, meaning from the patient's point of view, you are automatically determined who your local health care provider is depending on where you live. Only when your health problem cannot be solved at the GP or A&E clinic that you first have the chance to see a specialist, in the form of referrals written by your GP.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV-wuMTAZ-nR5iPN8ZFilFcVzqRWnUP6EjcevvDbP2vwg5yRvHAoWscwiMeUXxw9zyJzSoOPZcd2H2kMWmPn3I9oPLxfgP_6T4YEEy3Rf9VaplxY9XAgOnOboOezHIC_eAniSwNZouhc_8/s1600-h/IALS2008class.JPG"><img id="BLOGGER_PHOTO_ID_5249223682680381282" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV-wuMTAZ-nR5iPN8ZFilFcVzqRWnUP6EjcevvDbP2vwg5yRvHAoWscwiMeUXxw9zyJzSoOPZcd2H2kMWmPn3I9oPLxfgP_6T4YEEy3Rf9VaplxY9XAgOnOboOezHIC_eAniSwNZouhc_8/s320/IALS2008class.JPG" border="0" /></a>A GP has two major roles: an expert in general medicine providing primary medical care, and a gatekeeper of resources. The former role includes not only the clinical part (inside the clinic and also visiting homes), which includes pediatrics, maternal health, referring patients to specialist hospitals, and follow-up of patients with chronic illnesses, but also a variety of other tasks for community health, such as prevention and health promotion, and sex education and family planning. But in reality, most of the GPs in populated areas only have time to do the clinical part, which can be understood from the fact that patients are made to wait an average one week from when you make your phone call to the point of your appointment. No wonder an increasing number of patients, who can afford, are choosing private hospitals. If you're referred to a specialist, it will likely add more weeks or even months to that.<br /><br />The GPs' latter task, as a gatekeeper of resources, is in two perspectives. A GP has to prevent inappropriate use of treatments and 'control' the patients' demands, thereby saving financial resources, and also guide the patient to the right care they need, as in referring to the appropriate specialist, thereby saving human resources. However, because of this, there are many GPs who face a dilemma, as they are also the closest health care personnel for the patients, and speaking out for them is the basis of a GP's job.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIWbeJxWlhwd_HFMDKwNA8-ehlgK8Bhq484dYG8YBsMltv9gJGZm8h1ZCotLzSIMSYhAYLxGQHXa1ndTOYUpNnomtv7r3oJZ9GtNaLN3ZFGRyPAg4p3KAsbr4q-ujLNO0gf1_Yg9VYhT1T/s1600-h/RIE20080812_3.JPG"><img id="BLOGGER_PHOTO_ID_5249223507207897218" style="FLOAT: right; MARGIN: 0pt 0pt 10px 10px; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIWbeJxWlhwd_HFMDKwNA8-ehlgK8Bhq484dYG8YBsMltv9gJGZm8h1ZCotLzSIMSYhAYLxGQHXa1ndTOYUpNnomtv7r3oJZ9GtNaLN3ZFGRyPAg4p3KAsbr4q-ujLNO0gf1_Yg9VYhT1T/s320/RIE20080812_3.JPG" border="0" /></a>So, when I had an opportunity to follow Dr. William MacNee, a consultant physician and professor of respiratory and environmental medicine at the Royal Infirmary of Edinburgh (RIE), I wanted to focus on not only how he interacts with the patients but also how he communicates, or exchanges information with the patients' GP, system-wise, as good communication is vital between the specialist and the GP as well in a health care system like the U.K. Oh, how do I know him? Well, Dr. Patrick Barron, the passionate professor in charge of the International Medical Communications Center (IMCC) at my university, kindly introduced me to him.<br /><br />In a typical medical consultation here, the physician only jots down notes, instead of scribbling on the official medical records, which makes reading them a decipherment for others. After the patient leaves the room, the physician will read aloud and record on a tape what he wants written in the official records. The tape will then be duplicated, with one copy going to the patient's GP and the other to the physician's (or the department's) secretary for transcription on to the electronic medical records. The one going to the GP is labeled urgent (red) or not (blue). This system saves a considerable amount of time for the physician, though that means more work and some medical knowledge needed for the secretary.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-5AAXgoLbWBjdd81WADCG4_RDKtrZOk10HqZzuO2jNDiC57TolI3NgvZVgTb9Dy_MYuxugVXY47zvbTAiq0GEwdj7QE4rZAJ2aAbOkACBfRkwhEeNxXITP4vNaZnsO13aXHTSYJonx8XY/s1600-h/RIE20080812.JPG"><img id="BLOGGER_PHOTO_ID_5249223351929301234" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-5AAXgoLbWBjdd81WADCG4_RDKtrZOk10HqZzuO2jNDiC57TolI3NgvZVgTb9Dy_MYuxugVXY47zvbTAiq0GEwdj7QE4rZAJ2aAbOkACBfRkwhEeNxXITP4vNaZnsO13aXHTSYJonx8XY/s320/RIE20080812.JPG" border="0" /></a>The RIE is a specialist hospital, so there are no GPs, except for those in the A&E. Tracing its roots back to 1729 as the oldest voluntary hospital in Scotland, it was incorporated into the NHS scheme in 1948, and the current facility, located south-east of the city, was completed in 2003 for 190 million British pounds and boasts 900 beds. Due to its location, it also serves Midlothian and East Lothian. Adjacent to the hospital is the medical school of the University of Edinburgh, which the hospital has maintained close ties with for years. Some noteworthy features of the facility include a 24-hour A&E unit, the Simpson Centre for Reproductive Health, giving birth to 6,000 babies each year (largest in Scotland), and the Scottish Liver Transplant Unit. In the hospital's main hall are banks, eateries, a general store, a bookshop, a barber, and the patients' information center. Brochures and pamphlets covering a variety of topics, from information of diseases to informed consent, or self-help guides, such as how to deal with stress, can be found here and the good thing is all are free for the patient to take home. Very useful and interesting.<br /><br />Finally, I would like to share some phrases and expressions I heard in the patient-physician interactions, especially from Dr. Gourab Choudhury, who is Dr. MacNee's registrar. I spent the morning following him on the day I was at the RIE. When a patient kept on complaining over and over about how her dyspnea was so severe, he used the phrase "Oh dear." several times. It's sometimes not easy to think about how to react when your patient keeps on complaining, and I thought this was a nice and simple way to express sympathy. Another phrase is "Let's take it on from there.", which he often used when he was finishing up the medical consultation. I often find it difficult to find an appropriate phrase to end the conversation with a patient, but here it is, a simple, convenient expression with a positive-thinking meaning and a touch of sympathy. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com1tag:blogger.com,1999:blog-1110014149995595155.post-82237012032964907972008-08-10T19:18:00.010+09:002010-08-19T13:58:56.441+09:00Oban and the Isle of Iona.On a weekend in August this summer during my stay in Edinburgh, I had a chance to see the Scottish outskirts of the Highlands and Islands. That is when I visited the town of Oban and the Isle of Iona.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZgyZ_tYyqt0WH0K0Pg5QlyodbHBBSM-b0zrzD3qTipOCoycLVtfRt4Cdm-2aKXBcigG_ZtrZ9X1h-_bSgbBnSeYB6_fqZwcm26lCB3Hu-IM5TJ1oQPnTtLEPGTaV6un8WXXtbYn8JBneN/s1600-h/Oban20080802.JPG"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZgyZ_tYyqt0WH0K0Pg5QlyodbHBBSM-b0zrzD3qTipOCoycLVtfRt4Cdm-2aKXBcigG_ZtrZ9X1h-_bSgbBnSeYB6_fqZwcm26lCB3Hu-IM5TJ1oQPnTtLEPGTaV6un8WXXtbYn8JBneN/s320/Oban20080802.JPG" alt="" id="BLOGGER_PHOTO_ID_5246207641049673842" border="0" /></a>Built on a crescent-shaped bay on the Firth of Lorne, Oban is an important base for those who wish to explore the West Highlands and the islands of the Inner Hebridges in the western part of Scotland. It is a typical Victorian holiday town and has a lively nightlife scene throughout the summer, with good pubs and ceilidhs (pronounced 'kay-lees'), which is traditional Scottish dancing. A picturesque small town, and I mean small that you can virtually become familiar with all the nice cafes and restaurants in one day. And providing the weather is favorable, the view of the bay from the waterfront at sunset is simply beautiful.<br /><br />On a morning, together with my friends, we walked down from our modest accommodation in Oban to the port, where we caught a ferry to haul us to the Isle of Mull. Our bus came with us too. Upon arriving on the relatively large piece of land, we hopped on the bus for a bumpy ride to Duart Castle, situated on the east side of the island. Home of Clan MacLean, it was built in the 14th century and went through several military conflicts like many other Scottish castles before being abandoned in 1751. It was restored in 1911.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiyJYg-YwjN8Cnf4FA4gtveCFpRHg1dhaP7OG9CNH7IOROAuLiGeuStPuVDClvJhCsbt8OAPmfEVBMYXtTNFXQcNSGHRDR9LWWKmtDc_pIHra6STgzpHvzYnncfzr2K6kB1OrY0hlrzEZ5/s1600-h/Iona20080802.JPG"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiyJYg-YwjN8Cnf4FA4gtveCFpRHg1dhaP7OG9CNH7IOROAuLiGeuStPuVDClvJhCsbt8OAPmfEVBMYXtTNFXQcNSGHRDR9LWWKmtDc_pIHra6STgzpHvzYnncfzr2K6kB1OrY0hlrzEZ5/s320/Iona20080802.JPG" alt="" id="BLOGGER_PHOTO_ID_5246207777180767026" border="0" /></a>After touring through the castle, we traveled down to the southwest tip of the island where another ferry was waiting for us, though this time the ship was small and the trip was short. Leaving the bus behind, we crossed the body of water over to Iona, an island regarded by many as a very special and sacred place because of the arrival here of St. Columba in 563 AD. Columba came from Ireland and was a descendant of the country's kings and queens. He established a Christian church here and soon began to convert the heathen Picts of Scotland to the Christian religion. Soon, Christianity spread throughout the land and its strong position was confirmed when Columba was granted the power to crown Aidan as King of Dalriada, establishing a royal line of kings and queens of Scotland. Simply said, Iona is the birthplace of Christianity in Scotland.<br /><br />But even without considering that, Iona feels like an island that has a special something. I personally do not follow any particular religion, however, the island is so beautiful and peaceful that it truly calms you down and refreshes your mind, though of course, only if you have the weather with you. Sea water is so transparent here that you can see the ocean bottom from the deck of the ferry upon approaching the island's sole port. There is one village on the island which everyone calls 'The Village'. A few shops and cafeterias, the compact but sufficient port, and houses make up the village, though the island's Abbey is located five minutes from here by walking. The villagers say that until a couple of years ago, cars didn't even exist on the island. It is so small that you can walk to any corner. Roads wind between fenced but large pieces of hilly grassland, where sheep bask and graze in the sun. When you are walking, you feel as if time has stopped. Magnificent, beautiful, spectacular... it seems like any word fits to describe in some sense, but doesn't in another.<br /><br />Oban and Iona... truly places I would like to visit again sometime in my life. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-86645111937355182812008-07-31T15:54:00.008+09:002010-08-22T14:31:09.087+09:00Banning fast-food in low-income communities.On July 29th, the Los Angeles City Council voted unanimously to place a moratorium on new fast-food restaurants in South Los Angeles, an impoverished swath of the city with a proliferation of such eateries and above-average rates of obesity and diabetes. The action, which is yet to be signed by the mayor, is believed to be the first of its kind by a major city to protect the health of a people in a community, in this case, a low-income neighborhood.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLDLaX3RW-Gb7_iVPxEaSM1wjwUl2p3Oy5itO6LDcHKffr64n1QuCG1M5CTcqCGPDhXDKJKHP3TORgpEPf-h_Zrh0FI2T6vqKipMe-Acr7U78rfPVpkCEBMHa6IZcluc7hHl977DaYsV6o/s1600-h/EHCHamburger.JPG"><img id="BLOGGER_PHOTO_ID_5248386083260399522" style="float: right; margin: 0pt 0pt 10px 10px; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLDLaX3RW-Gb7_iVPxEaSM1wjwUl2p3Oy5itO6LDcHKffr64n1QuCG1M5CTcqCGPDhXDKJKHP3TORgpEPf-h_Zrh0FI2T6vqKipMe-Acr7U78rfPVpkCEBMHa6IZcluc7hHl977DaYsV6o/s320/EHCHamburger.JPG" border="0" /></a>An area with a population of 500,000 people, most of whom are African Americans and Hispanics, 28% of families here live on a budget of under 20,000 U.S. dollars a year. According to a report by the Community Health Councils, 73% of restaurants in this district are fast-food eateries, compared with 42% in West Los Angeles. These eateries alike are popular choices especially among the economically-handicapped. And not surprisingly, 30% of adults in this area are obese, compared with 19.1% for the metropolitan area and 14.1% for the affluent Westside, the Los Angeles County Department of Public Health found out.<br /><br />The year-long ban of new fast-food restaurants is intended to give the city time to attract restaurants that serve healthier food. Often referred to the 'Food Apartheid' by the health-conscious, the number of stores selling fresh foods is less than a quarter of that in other areas of the big Californian city. Research has shown people will change eating habits when different foods are offered but cost is a key factor in low-income communities. If you are running on a low income, or don't even have a job, and you don't have a car or other means of easy transportation, fast-food restaurants in the neighborhood serve as a cost-saving and convenient option. Although depending on what products you choose, it is not difficult to eat three meals a day for under five U.S. dollars total. Cheap, unhealthy food and lack of access to healthy food is a recipe for obesity.<br /><br />However, some people in the community believe this is not enough to solve the issue. Many people are aware that fast-food is unhealthy and it is not that they don't have any supermarkets selling fresh foods. Formerly called South Central Los Angeles, this is a part of town whose name was replaced by the current one in 2003, as 'South Central' had become almost synonymous with urban decay and street crime. One pointed out that local gangs dominate some areas near the supermarkets, and people wouldn't dare to take the risk of getting robbed, beaten, or shot. The same could be said for the supermarkets, as their numbers are actually dwindling, because they don't want to risk being attacked and robbed by the gangs. To add to that, even if the crime rate is lowered, many people in the area don't know how to cook, as they have never learned how to.<br /><br />The ordinance comes at a time when governments of all levels are increasingly viewing menus as a matter of public health. By the year 2030, it is estimated that 86.3% of Americans would be obese. L.A.'s ban, which can be extended by up to a year, only affects stand-alone restaurants, not eateries located in malls or shopping centers. It defines fast-food restaurants as those that do not offer table service and provide a limited menu of pre-prepared or quickly heated food in disposable wrapping. It exempts so-called 'fast-food casual' restaurants, which do not have drive-through windows or heat lamps and prepare fresh food to order, such as El Pollo Loco, Subway, and Pastagina.<br /><br />Meanwhile, representatives of fast-food chains said they support the goal of better diets but believe they are being unfairly targeted, claiming they already offer healthier food items on their menus. Not surprisingly, the California Restaurant Association and its members are considering taking a legal challenge to the action.<br /><br />A former gangster in the area has said the ordinance would bring minimal change, and for fundamental change, it has to be done by the people in the community... and this is an idea that lies at the roots of primary health care (PHC). :-)<br /><span style="font-weight: bold;"></span>Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-83777282129537407942008-06-29T17:03:00.009+09:002011-02-16T19:20:59.118+09:00A visit to Wat Phra Baht Nam Phu.Last summer, on August 8th, I had an opportunity to stop by the Wat Phra Baht Nam Phu, which translates to 'the temple of Buddha's footprints'.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOgTaS0Dgf6xM3v0lDOIJ6jjwzy6ebnogqJDfMbbsNOWMFwYXeGb3wV9iaTv5FayhsZs3rTWTeeAfp6BfuvV2-IQNDt9712TaiFTXHK5SyIhHSXJDSBdilPKqIy7iroHQW-geW0hizvI6b/s1600-h/PhraBahtNamPhu2.JPG"><img id="BLOGGER_PHOTO_ID_5246182844063069602" style="FLOAT: left; MARGIN: 0pt 10px 10px 0pt; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOgTaS0Dgf6xM3v0lDOIJ6jjwzy6ebnogqJDfMbbsNOWMFwYXeGb3wV9iaTv5FayhsZs3rTWTeeAfp6BfuvV2-IQNDt9712TaiFTXHK5SyIhHSXJDSBdilPKqIy7iroHQW-geW0hizvI6b/s320/PhraBahtNamPhu2.JPG" border="0" /></a>At least one million Thais have been infected with HIV/AIDS since the first reported case in 1984. The rate was increasing at an alarming rate in the 1990s, however, with the society at that time not well aware of what was becoming a major social issue, those affected were cast aside and left to die. Situated in Lop Buri province, 120 kilometers north of Bangkok in central Thailand, the temple was turned into what it is now, an AIDS hospice, by a Buddhist monk named Alongkot Dikkapanyo back in 1992. Since then, the facility has expanded to accommodate 400 beds from an initial number of eight, thanks to the temple's extensive public relations strategies bringing in donations amounting to the equivalent of millions of dollars. Photos of the temple’s sick and emaciated patients adorn posters and donation boxes across the nation and television stations from around the globe visit to film documentaries. Wat Phra Baht Nam Phu is currently home to over 200 HIV-infected adults, and has been for a number totalling 10,000 over the past, most of whom died from the illness.<br /><br />The temple's activities have always been controversial in recent years. Tourists from mostly western nations visit in thousands every week, taking tours that are guided by some of the relatively-healthy AIDS patients. They go through the wards where the relatively-weak AIDS patients are, without much explanation, and continue on to the 'Life Museum', a collection of dozens of mummified corpses of dead AIDS patients, who according to the staff, agreed to be put on exhibition prior to their death. That is followed by the crematorium, which is surrounded by what seem to look like sculptures or other pieces of art made from the bones and ashes of those who have been cremated here. Then they walk to a hall which houses a Buddha surrounded by piles of sandbags, or 'ash-bags', which contain the ashes of those who were cremated but have not yet found relatives to take it home. Visitors also have an opportunity to see a dance show done by AIDS patients too. And after all that, they leave behind tons of donations.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixGwmXL9FPnfP1BC8RXFl_DB_uI88gnXToPf5BACrkilDFko9ec6Tm76kh6K5WhdSgVD8_86waoCNy34FgDiCHPqPwbhEPMrlGvafdQFXt7cl06ywq4m8cvwcTSCxGwS6WPR_G_3rQj4f8/s1600-h/PhraBahtNamPhu1.JPG"><img id="BLOGGER_PHOTO_ID_5246182324905869234" style="FLOAT: right; MARGIN: 0pt 10px 10px 0pt; CURSOR: pointer" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixGwmXL9FPnfP1BC8RXFl_DB_uI88gnXToPf5BACrkilDFko9ec6Tm76kh6K5WhdSgVD8_86waoCNy34FgDiCHPqPwbhEPMrlGvafdQFXt7cl06ywq4m8cvwcTSCxGwS6WPR_G_3rQj4f8/s320/PhraBahtNamPhu1.JPG" border="0" /></a>Yes, the hospice provides care and 'protects' those suffering from AIDS, but what is it doing to how people see HIV/AIDS patients? Dead AIDS patients whose bodies are not taken back by their relatives become sandbags or pieces of art, or part of the exhibits in the museum that has little explanation of the bodies. Those who are weak, and in their twilight of their lives, simply lie on the bed as tourists pass by giving them that look in the eye. You can often see the visitors covering their mouth upon entering the ward, then swiftly moving through wordlessly. Many don't even say hello. Those who are still relatively healthy host the tours or performances for the visitors, helping to attract more donations. I can't help myself from feeling that all of these together only exacerbate prejudice.<br /><br />In Thailand, more than 400,000 have died from AIDS, however, it is also one of the few countries to have successfully curbed its epidemic with awareness campaigns, and later pioneered the widespread distribution of anti-retrovirus drugs (ARVs), which slow the progress of the incurable disease. In the 1990s, up to 100 patients died at the temple every month, but now, that number has been reduced to about 10. According to UNAIDS, fewer than 17,000 infections were reported in the country in 2006, compared with 143,000 in 1990, but officials are worried that the rate could climb again. HIV prevalence among intravenous drug users and sex workers remains high, while condom use among Thai teenagers is shockingly low. No time should be spared to come up with a new way to spread awareness.<br /><br />In Thailand, generally speaking, monks are highly respected. Much more than the government, to be sarcastic. I believe that when it comes to bringing social awareness, they have a vital role to play. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-5349177924831136072008-05-31T22:55:00.015+09:002009-06-07T22:09:08.243+09:00A visit to Magnet.<span style="font-size:100%;">So, I often talk about community health... but what is it that started everything?<br /><br />It all started on March 24th, 2007, when I paid a visit to Magnet, a clinic located in the heart of the Castro neighborhood in San Francisco. I was then on a program run by VIA (Volunteers in Asia), a </span><span style="font-size:100%;">non-profit organization (NPO) originally based at Stanford University. </span><span style="font-size:100%;">With men walking down the sidewalks holding hands, a movie theater showing dramas of love between men, and shops whose walls are covered with posters of naked men, it was not a scene that you are used to seeing.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsYTg_tBWI3HC_ShqfyWduiwaA6l5hlpr23M25YLzCUMgYLejnHU73l1qyLxIiD3zKKPnAcqbRxotJBAtxKLK5iInMxB4YYYza5R-RcD78MJ6eEOKpZtLKRbF42KjqeUy-aZ6veNZjRAO5/s1600-h/Magnet20070324.JPG"><img id="BLOGGER_PHOTO_ID_5219907314768063634" style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsYTg_tBWI3HC_ShqfyWduiwaA6l5hlpr23M25YLzCUMgYLejnHU73l1qyLxIiD3zKKPnAcqbRxotJBAtxKLK5iInMxB4YYYza5R-RcD78MJ6eEOKpZtLKRbF42KjqeUy-aZ6veNZjRAO5/s320/Magnet20070324.JPG" border="0" /></a>The Castro came of age as a gay village following a controversial 'Summer of Love' in the </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_0" style="font-size:100%;">next-door</span><span style="font-size:100%;"> </span><span class="blsp-spelling-error" id="SPELLING_ERROR_1" style="font-size:100%;">Haight</span> <span class="blsp-spelling-error" id="SPELLING_ERROR_2" style="font-size:100%;">Ashbury</span><span style="font-size:100%;"> district in 1967. The gathering brought tens of thousands of middle-class youth from all over the United States. The neighborhood, formerly known as Eureka Valley, became known as the Castro, after the landmark theater by that name near the corner of Castro and Market Streets. The community was hit hard by the HIV/AIDS crisis of the 1980s, and beginning at that time, city officials began a crackdown of bathhouses and launched initiatives that aimed to prevent the spread of AIDS. Today, kiosks lining the streets have posters promoting safe sex and testing alongside those advertising online dating services, and the city of San Francisco is home to around 100,000 to 200,000 homosexuals.<br /><br />Asking about the roots of the community, many bring up the name Harvey Milk, a gay rights activist and the first openly gay man elected to San Francisco's Board of Supervisors, or to any substantial political office. He was elected in 1977 representing District 5, which included the Castro. However, I felt that another, more recent activity was helping to bring the gay people together and empowering the community: Magnet.<br /><br />Although a clinic, it does not look like the conventional one in your neighborhood. The front side of the building facing the street is glass, instead of a wall with small windows, allowing everyone who walks by to have a view of the interior. As soon as you enter, a clean room with leather sofas and tables and a corner that resembles an </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_3" style="font-size:100%;">Internet</span><span style="font-size:100%;"> cafe greets you. A large bulletin free for anyone to post events in the community is near the corner and artwork of gay men adorn the walls with metallic coating. The examination rooms are located at the rear of the one-story building, however, for privacy these rooms are lined with walls and not glass, of course.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5HDccH0yFlfXJrCxMQ0D9QXubC_jnevDUgJTm0Le-fbuwLr3ndGdbQmL3cQCfRDMI3mjKi7lLMvx3EyeiK8GSmVdsn3d6aA4TyQhWd4ufdOu2bviMnNSVLCZtjKz7sq5pJBTGnvylup4a/s1600-h/Castro20070324.JPG"><img id="BLOGGER_PHOTO_ID_5219907476790797170" style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg5HDccH0yFlfXJrCxMQ0D9QXubC_jnevDUgJTm0Le-fbuwLr3ndGdbQmL3cQCfRDMI3mjKi7lLMvx3EyeiK8GSmVdsn3d6aA4TyQhWd4ufdOu2bviMnNSVLCZtjKz7sq5pJBTGnvylup4a/s320/Castro20070324.JPG" border="0" /></a>Founded by the 'Castro Guys', a group of health care professionals who were gay, Magnet's vision is to promote the physical, mental, and social well-being of gay men. Run by gay men (all staff are gay and half of them are HIV positive) for gay men, it offers free sexual health services such as confidential HIV antibody testing, testing and treatment for </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_4" style="font-size:100%;">syphilis</span><span style="font-size:100%;">, chlamydia, and gonorrhea, and hepatitis A and B vaccination. Other than for sexual health, it provides services such as ear acupuncture, chair massage, hypnotherapy, general mental health counseling, and a flu clinic. Although financial support was scarce in the beginning, now it is supported by a major pharmaceutical company which pays roughly 80% of the costs, and the rest is paid for by donations from the people in the community.<br /><br />However, in </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_5" style="font-size:100%;">addition</span><span style="font-size:100%;"> to providing sexual health services, Magnet holds a variety of on-going community activities. This ranges from book readings and art exhibits (as mentioned earlier) to town hall forums and health chats, or karaoke and dance nights to gay weddings. And even when there are no particular events, people drop by the clinic just to chat with others or share stories. In other words, Magnet acts as not a mere clinic, but more like a community center that brings a people together in an affirming environment that embraces the diversity of the culture that exists. This is a place where gay men can </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_6" style="font-size:100%;">access</span><span style="font-size:100%;"> resources and make connections and friendships between each other that not only helps to promote individual health but also community health.<br /><br />Magnet is an example of community health, but to be more exact, this is a form of primary health care (PHC), as defined by the World Health Organization (WHO). It is health for the people, by the people. Everyone walking on the streets of the Castro knows the Magnet. I was utterly amazed at the potential of how a small clinic can bring together a people who have been isolated and considered socially-handicapped by the rest and act as a catalyst in empowering the community as a whole. It serves as a place to meet people and bring everyone... the entire community together. Like a magnet, it truly lives up to its name, or much more than that.<br /><br />So this is how everything started for me. Community empowerment for the people by the people through community building and organizing, with a touch of creative thinking and facilitation, in this case, from a health care perspective. Simply exciting. :-)</span>Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0tag:blogger.com,1999:blog-1110014149995595155.post-69749891597572681022008-04-08T23:12:00.020+09:002011-02-16T19:18:37.480+09:00A visit to RTIC and Ta Nao Si Health Center.On March 27th, I was able to visit Rajanagarindra Tropical Disease International Centre (RTIC) and Ta Nao Si Health Center, in Suan Phueng district, Ratchaburi province, near Thailand's western border with Burma (Myanmar).<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMLfo0KaMJpcvl1MiHvGe-GRHeeh9fiAq06KTeSwF1vOqx6DKqkTboBooQHHLsQzls2N4jqN1LD1kKAZQ-OhW-1o1h_tmZi9gAYb1yZ8790BFXEqx1f7yP8z2Cgnodc6zUV5L5U2YLjyfF/s1600-h/SuanPhung.JPG"><img id="BLOGGER_PHOTO_ID_5193604392278011074" style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMLfo0KaMJpcvl1MiHvGe-GRHeeh9fiAq06KTeSwF1vOqx6DKqkTboBooQHHLsQzls2N4jqN1LD1kKAZQ-OhW-1o1h_tmZi9gAYb1yZ8790BFXEqx1f7yP8z2Cgnodc6zUV5L5U2YLjyfF/s320/SuanPhung.JPG" border="0" /></a>How did it happen? Well, a very good old friend of mine from my high school days in Maryland, U.S. took me there. He was one of my best friends there, but an year after I returned to Japan he also needed to go back to his home country, Thailand, and as our lives got busier, our emails became sporadic. However, as our lives progressed, so did information technology, and one day he invited me to Facebook, a social networking service (SNS) which is especially popular among university students in the U.S. with well over 85% of them being members. We've been in close touch ever since, and I had a chance to see him this spring for the first time in nine years.<br /><br />He majored in public health and epidemiology in university, and as that implies, shares a lot of common interests with me. We could go on talking for hours and hours, until our tongues became numb. And... he is also a humanitarian junkie. He's a highly-motivated, passionate, yet kind and thoughtful person who always used to talk about how he wanted to do good for his country and its people. So well, when I asked him if I could take a peek at some places he know that can be visited during my time frame there, he happily offered me to take me here.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzmsJZCSY2kig1DawQe_LWY1VLr5vaswaJc5BvoEQoQSKd9aqt_0pA11QCExhcDB2jS6aU0Cx477AOsm5dFCD9DjCj5Bhx27A4uEkyAUyLsLXOCOOrQ8P-9igv_leSvvN9XnPn3Vg25X-X/s1600-h/RTIC.JPG"><img id="BLOGGER_PHOTO_ID_5193604826069707986" style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzmsJZCSY2kig1DawQe_LWY1VLr5vaswaJc5BvoEQoQSKd9aqt_0pA11QCExhcDB2jS6aU0Cx477AOsm5dFCD9DjCj5Bhx27A4uEkyAUyLsLXOCOOrQ8P-9igv_leSvvN9XnPn3Vg25X-X/s320/RTIC.JPG" border="0" /></a>RTIC, or the Suan Phueng Research Unit, run by Mahidol University's Faculty of Tropical Medicine and supported by the Tropical Disease Trust Fund under the Princess Galyani Vadhana, is one of the faculty's research stations for conducting research on tropical diseases. The facility's primary activities are (1) provision of health services (especially against infectious diseases) for the local people, (2) field epidemiology training for students from not only the faculty but from other countries as well, including Cambodia, Vietnam, Laos, and Burma, and (3) research of infectious diseases (mainly malaria) in the area.<br /><br />Suan Phueng is a small district in Ratchaburi Province, located on the border with Burma, which is just a 15-minute drive from RTIC. It has an area of 2,545 square kilometers, consists of seven sub-districts with 8,254 households and a population of 66,972. Over 90% of the population are mainly Thai-Karen of low socio-economic status, some of who do not carry Thai identity cards. Along with 13 health centers, they also have a community hospital with 30 beds, about 30 minutes from RTIC. Common health issues of the people living in this area include malaria, dengue hemorrhagic fever (DHF), filariasis, tropical skin diseases, intestinal helminthiasis, and malnutrition.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuqQjn7_XBRzTSh_D6C1RQMHeoEI5TbyvDZbCfgLmZe5IDtqJUFUTA5i8ZlwS1Snw9Y0LrzHJ290PgWmC5cNDAO4GuVoyTUfx-f3xz9DYt1RYtwWgSESEU1vpSII41IFyLf_yZcluqloWl/s1600-h/ThanaoSiHealthCenter.JPG"><img id="BLOGGER_PHOTO_ID_5193605225501666530" style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuqQjn7_XBRzTSh_D6C1RQMHeoEI5TbyvDZbCfgLmZe5IDtqJUFUTA5i8ZlwS1Snw9Y0LrzHJ290PgWmC5cNDAO4GuVoyTUfx-f3xz9DYt1RYtwWgSESEU1vpSII41IFyLf_yZcluqloWl/s320/ThanaoSiHealthCenter.JPG" border="0" /></a>When we visited, Dr. Maneeboonyang of Mahidol University was on duty at RTIC and he happily welcomed us and gave a brief tour of the center. According to him, this area has the highest prevalence of malaria in Thailand at around 12-13%. The kingdom is one of only a handful of countries that have succeeded in eliminating and controlling this notorious mosquito-borne disease, however, it still remains a big issue along the border with Burma. But still, the situation has been improving, since prevalence was around 30% only a decade ago, with at least one person in every single household having malaria in one of the hamlets. According to Dr. Maneeboonyang, RTIC sees 10 patients per day in the dry season (January - April) and over 30 during the rainy season, and out of that, about two and six people are diagnosed with malaria, respectively.<br /><br />After the tour, he was kind enough to take us to Ta Nao Si Health Center, which is one of 13 health centers in Suan Phueng district. It provides primary medical care, immunization, and antenatal care for the local residents. We had a chance to have a short talk with the public health officer there, and according to him, the top three common diseases in the village are malaria, diarrhea, and flu, though hypertension (high blood pressure) and diabetes are becoming a problem especially among the elderly.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXHkrAcd3l1gUYP0HMSUg-QQHXMT7-9BRs3REqmgsub27BuOtmYCY9X4o04Wj-WrzElJzZKrBhVrgXSjOXe_NiN0jxgUNzUPBlr7NN0GBqn65i7XlwT-OXThyphenhyphenq-ta2OHU3Uu_2gq0fLgiB/s1600-h/ThanaoSiKaren.JPG"><img style="margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXHkrAcd3l1gUYP0HMSUg-QQHXMT7-9BRs3REqmgsub27BuOtmYCY9X4o04Wj-WrzElJzZKrBhVrgXSjOXe_NiN0jxgUNzUPBlr7NN0GBqn65i7XlwT-OXThyphenhyphenq-ta2OHU3Uu_2gq0fLgiB/s320/ThanaoSiKaren.JPG" alt="" id="BLOGGER_PHOTO_ID_5331896995348281266" border="0" /></a>At the end, we had an opportunity to drive around the village to see some homes of the Thai-Karen, which look different from the traditional Thai examples. It was not long before the sun was starting to set and so we had to leave the area (local roads are without pavement and lights), but the staff at RTIC were kind enough to offer me to visit again, next time staying for a few days. And there is also Tak province, sometimes called the "humanitarian aid mecca of Thailand", and the Thai-Burma border area there, about an eight-hour drive from Bangkok. I definitely have to and sure will come back again.<br /><br />Many thanks to my friend. :-)Ryosukehttp://www.blogger.com/profile/04213870752652946888noreply@blogger.com0