The program is complete. The health intervention has been implemented. We decided on an informative flyer about the importance if food separation, free compostable bags, and a report of our research findings to the municipality office. The health volunteers at the village expressed a need to encourage villagers to separate food waste which would reduce waste overflowing in the trash bins, reduce insects and animals scavenging in the bins, an help the environment by putting that waste toward use as feed and farm fertilizer. The municipal office requested we share our findings with them because they rarely receive feedback from villagers who are often wary of government workers. We hope sharing our research will improve communication between the municipality and the village and help with future measures to address waste management.
I am happy with my time spent in the community and am happy that the village health volunteers seemed satisfied with our project despite its minor impact. I am disappointed overall in how limited we were with only one intervention day. A semester leading up to a community project was met with an anticlimactic ending. The Thailand CIEE program has a lot o room for growth.
Ultimately I survived the semester, despite the frustrations, limitations, and manipulation a of a program that doesn't give its students the freedom to create an experience independent of the program. I met great people, made a lot of personal growth, and have planned a kickass post program travel plan. If I could go back I would not have chosen this program and I would not advise anyone to do this program, but if I could have the perfect experience it would still be in this country with these people.
CIEE SPRING 2014"Break my spirit not my team"
Its finally come for project time over here in Thailand. After months of extensive class time, less than minimal free/travel time, and only short homestays, the program is just starting to become enjoyable. Last week we submitted our research proposals. My groups project will be in Gai Na and will center on municipal solid waste management.
Last week we did our first round of primary research in Ban Samran Gai Na, a rural community just outside Khon Kaen. The community receives a municipal trash service, which is supposed to come 3 times a week to collect trash. The service costs just 20 baht a month (less than $1) and seems like an ideal waste system. However, the trash pick up is highly unreliable with interviewees stating it comes anywhere from every day to once every two weeks. The service also supposedly doesn't pick up foliage and yard waste so villagers are left to burn these forms of waste, which poses health concerns, especially when they include a plastic bag or two. Additionally, the waste bins are constantly overflowing, and some of it isn't bagged, which invites animals and vermin to the area.
Though we are still continuing our research with more homestays and data collection, we are starting to think about what interventions might be appropriate to help this community. Today we are meeting with the municipality to talk about problems the community is having and get their side on the collection time issue. Then we will be interviewing more villagers with a focus group to get some feedback on how they would like the situation improved. Hopefully we can come to some conclusion on an intervention that might address bin size and number or alternatives to burning waste that wont be excepted by the municipality.
Though I'm excited to finally do a project to help Ban Samran Gai Na, its also disappointing that it took this long in the program for us to take action. Most of the semester was spent studying Thailand's healthcare system with a lot of class time and no real time to explore Thailand and understand it from a different lens. The second course allowed us to spend more time in the communities getting to understand issues from a villager perspective and learn research tools. Now in just the last 3 weeks we are spending 2 weeks researching for a project and then have only 1 week to design and implement one. It feels like a rushed job. I am happy that now have some experience with semi-structured interviews, developing questionnaires, and facilitating focus groups. These are important skills for future projects to help future communities.
However, as far as this program and this experiences, maybe the intentions were there but the program design could use a lot of improvement.
Thus far we've been on 4 Thai government hospital tours, 1 private hospitals, 2 community home stays, 1 interview of a sex worker, and a tour of the Laos health care system. All these visits and tours have given a broad understanding of Thailand social issues and burden of disease. Thailand faces an interesting health burden with a triple threat of communicable disease, non communicable disease, and traffic accidents. Additionally, they have to balance being a middle income country with the pressures and stressors of increasing business and media presence. In the absence of a strong breast feeding campaign, Thailand and Laos had a major problem in which mothers were feeding their babies sweetened condensed milk and coffee creamer instead of baby formula. There were no regulations on the advertisements for these products, so mothers were mislead by logos and images that resembled baby formula ads. These kind of mix ups and mis-communications are common in developing countries and require strong health promotion.
The issue I'm most interested in right now is the lack of sex education in Thailand and the high rates of teen pregnancy. Despite most other health indicating statistics improving in thailand, teen pregnancy had increased in the last 10 years. There are a lot of social and cultural factors that compound the issue of teen pregnancy. In Thailand, if a teen in a public high school becomes pregnant she is expelled from school. She can pay to enroll in a special school for mothers but cannot continue her education at a normal high school. Many don't go to the alternative school and their education ends prematurely. This limits their job opportunities and chances of improving their socioeconomic status.
Part if the issue is that thailand only recently started implementing sex education in their public schools. Sex education starts around 5th grade but is limited by the ministry of education to just 8 hours a year. Also, the classes take a biological approach and ignore the emotional and relationship aspects of sex. While Thailand very liberal in some ways, such as their healthcare system, in other ways they can be very conservative. Sex education has typically only been for married couples and there still exists a cultural stigma against teaching teens about sex.
It has been hard to find out any information about sex education and teen pregnancy. Academic resources are limited and no health care provider seems to want to talk about it when we visit hospitals and clinics. It's going to require a lot if digging to write my research paper. However, if I can get a better understanding if the systems and stigmas that impact the issue, it will really help me if I choose to make my community project related to Thai teen pregnancy rates. I hope that in the next few weeks I can get some real answers on the situation and create a strong research background for potential projects and interventions in the communities.
So much has happened in the past month: a homestay in a slum community in Khon Kaen, an interview with a sex worker, an exclusive opportunity to enter a Burmese migrant worker village. My experiences so far have been incredible and unique, a direct result of the type of program I am on with CIEE.
I chose CIEE’s public health program in Thailand because I’m a major in public health, looking to get some department electives, but the program is truly compatible with all majors and interests. Lectures so far have spent a lot of time going over the basics of public health and the Thai/American health systems, but we are now starting to delve into community health issues such as HIV, dengue fever, and liver fluke. While lectures are interesting enough, it’s the time spent in the communities, interviewing villagers and health volunteers, that makes this abroad program.
Today I spent 4 hours in a closed off, Burmese village on the property of one of Khon Kaen’s largest fishnet factories. Outsiders are typically not let past security, due in part to the legal status of some of the workers, but also to prevent an outsider influence from inducing protests about worker living conditions. On an offhanded offer, we hopped in the back of a pick up truck of a woman who worked at a community hospital near the factory. She was going in to provide a sex and pregnancy education workshop to the women of the village.
After interviewing the village leaders and community members we learned a lot about the education, health, and social issues of the village. In the second half of the semester we need to pick one community and design a public health related project or intervention. Though it could be very difficult to sustain access to this community, I think implementing a project in this community would be an incredible experience and a huge help to such a disenfranchised group.
Side note: I ate crickets. And boiled blood chunks. I don’t have much to say about this. Also, chicken tendons are different from chicken tenders. Very. Very. Different.
After 24 hours of traveling I finally arrived at Bangkok, navigated the airport, and found the CIEE program directors. The protests in downtown Bangkok had caused the program to switch to a hotel outside the city and limited any late night exploration. Honestly this was fine with me as I was wiped and most of the other people on my program had already arrived and were sleeping off the jet lag.
The next morning we set out early for our trip to an ambiguous “orientation site”. On the way we stopped for a hike/nature walk at a Khao Yai national park on a mountain outside Bangkok. When the guide zipped off ahead half us got separated and lost in the Thai wilderness. With no phones or understanding of the scribbly looking Thai characters on the signs at forks in the trail it was pretty awesome. There were monkeys all over the place, it seems kind of like monkeys are to Thais as turkeys are to New Englanders. They are bothersome, and not intimidated by speeding/beeping cars, and only interesting to visitors.
The ride up to Khon Kaen was long, tiring, but interesting. Almost every strip of the highway was lined by shops and markets selling Buddha statues, or lined with rice patties. We finally arrived at the orientation site, a “resort”. The place has elaborate Thai architecture arranged with a hodgepodge of sculptures and shrubs around a manmade pond. Over and around the pond is a maze of walkways and floating buildings and docks.
Thus far orientation has been busy but enjoyable. We are here for 5 days and each morning starts with intensive Thai class from 8-12 followed by workshops specific to the two programs under CIEE, Public Health and Development & Globalization. Everyone in the program is incredibly nice and accepting, as are the administrators and the staff. The Thai staff are particularly enjoyable, full of smiles and so friendly.
Today we went over our syllabi and course descriptions. It looks like we will have 3 homestays this semester in varying communities such as the Burmese immigrant communities, urban slums, rural farming communities, etc. I’m excited to learn about the specific needs of the Khon Kaen communities and explore topics for my community health project!
As far as food I have made a huge effort to eat everything offered. I’ve been eating fruit regularly!!!! Huge. I’m trying all the dishes and enjoying them! Though I still tend to stay safe with the “mai pen” (not spicy) stuff. The staff bought us American snacks and candy last night. God. Bless. Them. And God bless Cheetos.
A junior from Franklin, Mass, I'm majoring in Public Health and enrolled in a 5 year joint program to get my masters. My program in Thailand focuses on learning about different Southeast Asian health systems and developing a community health project related to Thailand's key health issues. At GW I am a part of DC's oldest sketch/improv group, receSs, and I nanny after class for two of the coolest cats on capitol hill.
This semester I'm going to take every opportunity to explore my surroundings as I've explored DC and learn how Thailand pulls off an effective universal health care system. Riding elephants, jungle excursions, and visiting every wat and incredible site in the southeast region are all part of the plan. I am also going to explore the Thai diet and overcome my aversion for all food beyond pizza, mac and cheese, and waffles...