CIEE Khon Kaen Newsletter--2011--SP--No. 5

CIEE KHON KAEN SPRING 2011 NEWSLETTER II

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The Farang Times

Going abroad for a semester during college is fairly normal in the United States. Many do not view it as anything special; it is just something they do during college. For the rest of the world this is not the case as they tend to have a defined career path before entering college. Having such a specific major makes it hard to transfer credits from other universities or take time away from their major to study another subject in a new location. Due to this, we get to explain our circumstances to all kinds of people: locals, Vietnamese, tourists, and backpackers. Their reactions are all very similar— along with a little confusion, they say how lucky we are and ask why we chose Thailand (or why did we chose to leave our own university). We all give very similar responses to the question about Thailand: we wanted to experience a new culture and this is one of the only cost efficient public health study abroad programs. It took me a while to feel comfortable with the response about how lucky I am. I felt that they viewed me as solely a privileged American who has every opportunity at their finger trips. These perceived judgments came from backpackers who were using every last cent to travel and South-East As ians , many of whom had ne ver had the opportunity to leave their province. At first I felt guilty; how fair is it that I have this chance but they do not. Now, I realize that they are right; I am extremely lucky. A small percent of the population has the chance to travel aboard, let alone live in another

culture, and here I am living in Thailand. I am truly blessed. My rare opportunity has led me to make the most of my experience so far. I realize that I might never have this opportunity again. I am a math major with merely an interest in public health, so to spend four months traveling to hospitals and learning about both the Thai and Vietnamese health care systems is truly amazing. I now get the chance to talk to villagers about their health concerns and issues, and then try to implement a program that will help fix some of these problems. Not many people are able to say that they spent four months in a new country, doing something they enjoyed, and at the end hopefully make a difference. Everyone I explain my situation to is right, I am extremely lucky.

Kathryn Wolf, Bates Co!ege, Math major

Farang: a word meaning foreigner that we are lovingly referred to by the locals of Khon Kaen. This newsletter is co!aboration by the eight Community Public Health students as we! as our program facilitator, Lindy Bunch. Please read on to discover what we are experiencing here in Thailand.

In the first two semesters of offering the Community Public Health program at Khon Kaen University, the CPH students recorded their experience by pi%ybacking onto the Development and Globalization students’ newsletter. But, this semester’s newsletters are the first CPH production solely created by this semester’s eight CPH students.

We hope you enjoy it!CPH 2011

I WANT TO BE A FARANG

At a Pagoda in Hue, Vietnam


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TERROR AND TRAFFIC IN VIETNAM

Coming from the United States and seeing the traffic in Thailand was quite a shock. There are motorbikes everywhere, stop signs are a lot more like yield signs, and pedestrian crosswalks are not really understood. Quite surprisingly, I found Thailand’s traffic relatively mundane compared to that of Vietnam. Many motorbikes considered stoplights to be optional, and occasionally, the direction of traffic was optional as well. Larger vehicles like cars and trucks often drove through the middle of two lane roads, weaving back and forth to pass motorbikes as needed while motorbikes drove on either side. This was especially interesting to observe while taking the scenic route through twisty mountain roads from Danang to Hoi An. There were a multitude of road signs with only an exclamation point on them; my sentiments exactly.

Crossing the street was definitely an interesting experience. Imagine that you are trying to cross the street in the video game Frogger. Rather than starting at level one, your game starts at level fifteen. Rather than crossing four lanes of traffic, the lanes are indistinguishable, there are twenty vehicles coming towards you simultaneously, and they are all driving different speeds. I noticed that all the pedestrian signs look like the people in them are running instead of walking, which is definitely accurate. Take a deep breath and walk, walk, and do NOT stop. We all started getting the hang of it by the end. You get a bit less jumpy, but you’re still afraid for your life despite walking with more confidence.

As public health students, we all agreed that the traffic was a public health nightmare. Despite this, people tended to follow the speed limits quite well and always wore their helmets, unlike in Thailand. Once I got past the initial terror and novelty of it all, I began to think about what this shows about the complexities of Vietnamese society. I initially saw the frequent horn usage as an aggressive way to rule the road as it is often considered in the United States, but soon realized that it’s more complicated than that—as with most things we experienced. With the increase in cars, traffic is actually getting worse over time, and I am interested to see how Vietnam will address these issues and enforce the traffic rules that they supposedly already have. Coming from the United States and seeing the traffic in Thailand was quite a shock. There are motorbikes everywhere, stop signs are a lot more like yield signs, and pedestrian crosswalks are not really understood. Quite surprisingly, I found Thailand’s traffic relatively mundane compared to that of Vietnam.

Amanda Ga!aher, University of Michigan, Neuroscience major

Traffic in Vietnam


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SOMEWHERE OVER THE RAINBOW

I don’t consider myself political at all, but after being in Thailand for two months I can’t help but catch the political fever. Currently defined as a constitutional monarchy, whereby the Prime Minister is the head of the government and the hereditary monarch is the head of state, I am still unsure as to the roles of each. Based solely on my observations and conversations I have had with Thais and foreigners, I am going to attempt to give a brief overview of the current political structure of Thailand.

In the States, only during election season do I see faces of leaders on yard signs, billboards, and television. However, in Thailand, King Rama VIII is highly exalted by all and his framed picture can be seen everywhere from barber shops, road signs, and restaurants to Bangkok’s International Airport and 7 – Eleven. The Thai people are unified by the King. However, this point of unity seems to be one of the few present-- there are so many “colored shirts,” which to me all seem to be tie-dyed together.

In a nutshell, there are the red-shirts and the yellow-shirts. Many of the red-shirts, or the United Front for Democracy Against Dictatorship (UDD), campaigning fervor is Thaksin Shinawatra the prime minister exiled by the military coup in September 2006. During his rule he gained much popularity with a majority of the poverty-stricken and rural people because he was able to deliver what he promised: a three-year debt suspension for farmers, a million-baht credit for every village in the country, and universal health coverage costing just 30-baht per hospital visit.

The opposing team, the yellow-shirts or the Peoples’ Alliance for Democracy (PAD), center their campaign around Thaksin as well– however they downright detest him. The majority of yellow-shirts are royalists, businessmen and the urban middle class who wear yellow because it’s the King’s color. Their main argument is that Thaksin is corrupt because he abused power and showed disloyalty to the monarchy.

The obvious partisan split is easier seen on paper and not so much in person. Walking down the street it’s impossible to tell who is red or yellow. I can only see the admiration the Thai people have for the King and their country as a whole. The rainbow of colors that Thai politics appears to be is a much larger and a more complicated issue impossible for me to fully understand. It seems to be a blur way up high over my head.

Rebecca Lee, University of Minnesota, Health and We!ness major

Becky and Rachel at the Red Shirt Rally with some new friends


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When most people think of Vietnam, the two things that come to mind are the Vietnam War and the traditional noodle soup, pho. While I can say the pho was very delicious in Hanoi, there were much deeper issues for me to think about, especially being a Chinese-Vietnamese-American. I can say without hesitation that this study trip has changed my perspective drastically and I do not take for granted the opportunities and privileges I have in America.

One of the most memorable visits we made was to the War Remnants Museum in Ho Chi Minh City. It primarily contained exhibits related to the American phase of the Vietnam War. Most of the exhibits included graphic war photographs showcasing mangled bodies, the effects of Agent Orange, and the My Lai Massacre. There was also artillery, planes, and gear on display. The Agent Orange exhibits were especially heartbreaking and hard to bear. Agent Orange was a herbicide used by the U.S military to defoliate forests and bushes so enemies could no longer remain in hiding. However, it has had lasting side effects leading to the deformed bodies (missing body parts, extra body parts, etc…) of an estimated 2-4 million Vietnamese.

While the museum was definitely biased, it is still something that I was glad to have seen. In school, the Vietnam War was not something that was heavily emphasized, so it was eye-opening to get a different perspective of the war. I also believe that the Vietnam War is still relevant to keep in mind, especially when thinking about the current conflict in the Middle East.

Coming away from the trip, I have a newfound respect for my Vietnamese heritage.

While I was there, I thought about what my life would have been like had I been born in Vietnam. My mind started racing from thoughts about how my daily life would be to how different my parent’s jobs would be. Reality sets in, however, that I was born in the United States. The best I can do is to recognize the privilege I have and to never take it for granted. I also want to keep my cultural traditions alive and pass it on to the next generation. Sadly, I have never been able to speak Vietnamese fluently, but when I come back to the United States, I will be working on changing that.

This trip was unforgettable and I cannot wait until the day I get to visit again, hopefully with my parents next time as they have yet to come back to Vietnam.

Je'ey Tran, University of Colorado at Boulder, Integrative Physiology

“GOOD MORNING, VIETNAM!”

CPH at Cuchi Tunnels sitting on top of a tank used in the Vietnam War


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The dreaded “Day 45” that we were all to look out for hit last week while we were in Vietnam. We were to fall from our euphoric high of initially being in a new setting with new people and start craving friends from home, family, and cheeseburgers.

I’ve had random jolts of homesickness, sometimes after Skyping with my sister or my friends from home, but had not felt anything too drastic just yet. Before going to Vietnam, I still felt very motivated to explore temples around Khon Kaen, read up about Thailand, and constantly hang out with my fellow study abroad members. I kind of wondered what it would feel like to be homesick.

Quite honestly, I was a bit excited for day 45. I even circled it on my journal calendar: March 4th, 2011. But this day that was to hit me like a brick barely even felt like a feather. I spent most of March 4th sleeping in the Danang airport, eating numerous Vietnamese egg sandwiches, and watching a water puppet show with the CPH crew. Not a single ounce of homesickness or loathing towards my study abroad experience. I was even slightly disappointed when I looked at my journal a few days later and realized that day 45 went over my head without me noticing.

But now that we’re back in Khon Kaen, I’m starting to crave Papa John’s pizza. I spent hours looking through pictures of my friends and family yesterday and I discussed my new found emotions with others on my program. It helped talking about these feelings, getting support, and realizing that everyone is going through the same thing to some extent.

After flipping through my schedule today, I felt a pang of sadness when reading that on May 14th, we have to part ways with the life we’ve lived for the past few months and the people that have become so engrained in it. I have realized then that we’re at the half way point and though home sickness hasn’t hit me full force yet, I plan on doing everything to stop it. For me, this means more time exploring Khon Kaen and soaking up each moment and less time in my dorm room on Facebook or Skype chatting with friends from home. And to start off my action plan on the right foot, I’m in a café downtown typing this. Although, I may get a pizza later!

Manaswi Sangraula, George Washington University, Public Health

IT’S DAY FORTY-FIVE ALREADY??

Water Puppet Show in Hanoi, Vietnam


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IT’S A HARD-KNOCK LIFE.... Last week, our group went on an academic field trip to Vietnam with some of the CIEE staff for a little over a week. For me, this was an extremely invaluable experience. I feel as if while there, I gained an understanding of just how much I have learned in Thailand thus far during my study abroad experience and how much my perspective on life has changed for the better. While in Thailand I have gained a great deal of knowledge of the Thai health care system, health issues that Thailand and other tropical countries face, some Thai politics, and an idea of the apparent Thai lifestyle in the Northeast region. However, in Vietnam, I became aware of something I have learned that cannot be taught in the classroom. It is difficult for me to put my feelings into words, but I feel as though because I have lived in Khon Kaen for two months, I have more of an understanding of the actualities of life than I did before. I believe that by witnessing the tourism culture in Vietnam, observing the interactions between tourists and vendors and by speaking with Vietnamese who work for the tourist industry led me to realize how differently I view things since the trip.

After being in Thailand for two months, I have realized that life is not easy for many Thais, and this is similar in Vietnam. In Khon Kaen, I have observed people working extremely hard every day to provide for their family. I see this and have an incredible amount of respect for the people here. I realized that living in Khon Kaen rather than being a tourist has allowed me to see how the people live. When in Vietnam, I found myself wanting to learn what life is like for the Vietnamese and the new perspective I had gotten from Khon Kaen definitely fueled this. I was frustrated that the tourists in Vietnam did not seem to fully appreciate how the Vietnamese live and how hard they work like I have been able to observe in Khon Kaen.

I watched as countless people toured each city taking in the scenery. Vietnam is beautiful, and I too enjoyed the scenery, but at the same time I couldn’t help but think about the people trying to make an honest living there. I often became irritated by how some of the tourists treated store keepers or venders, and how it seemed as if they did not know anything about their lives nor did they care to know.

I found as I passed vendors or store owners in Vietnam, I wondered what their lives are like and about their families, as well as what they do when they go home. One person I spoke with was a Vietnamese boy who is 22 years old and works on a cruise boat for 26 straight days out of the month and returns home to his parent’s house for his few days off. He told me it’s hard to maintain relationships with friends on land because he is always away and most of his friends are the few people that work on the boat. He also told me that he gets very sad sometimes being away from his friends and family for so long, but working on the boat helps his parents out so this makes him feel better.

As I realized how much I was thinking about the hard working people in Vietnam, I recognized how often I do this in Khon Kaen as well. Upon this realization is when I identified that I had unknowingly learned something being so far from home in a completely different environment and culture. I am so excited to have this new outlook and I can’t wait for the next few months to grow and understand even more things as I experience them. Since being back from Vietnam, I want to make it a point to speak with those acquaintances I see in my daily routine. I hope to no longer say “Sawa Dee Ka!” and smile, but to speak with and befriend them.

Rachel Stahl, University of Rochester, Health, Behavior and Society Major

A local vendor se!ing (uits to a tourist in Hoi An, Vietnam


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THE VIETNAMESE HEALTH CARE SYSTEM - IN BRIEF

The Community Public Health program received a chance to explore public health management in Vietnam. Surprisingly, the Socialist Republic of Vietnam currently does not have universal health coverage. An alarming 50% of Vietnam’s population is uninsured. Those who are uninsured range from poor communities who have few resources, to those within the middle and high class who even without insurance have more monetary access to public and private provider systems. But now, Vietnam is moving towards universal health coverage.

Similar to Thailand, Vietnam is working to decentralize the current model. This new strategy will allow the four administration levels of health to better focus, plan, budget, and be effective. The four levels of administration include: Ministry of Health, Provincial Health Services, District Health Bureau, and Community Health Centers. Vietnam’s initiative towards universal health care has been modeled closely to Thailand’s current system. Vietnam has also emphasized health promoting community health centers where professional staff is accessible to most communes (the most local level of Vietnamese government). Staff volunteers are assigned certain neighborhoods and families to help promote and encourage healthy lifestyles. Vietnam’s medical system is based mainly on a modern model, however, traditional medicine such as herbal medicines, massage, and acupuncture are practices still prevalent but declining.

There are many obstacles that still stand in Vietnam’s path to universal health coverage. Vietnam’s expenditure on health is already the highest out of all Southeast Asian countries, but will still need to increase to expand public health management. The ratio of professionals to the patients is low and is even worst in remote and disadvantaged areas. Unlike the former 30-baht scheme in Thailand, Vietnam’s public insurance scheme comprises a 20% copayment resulting in more out of pocket costs. Regardless, Vietnam’s goal towards a universal health care system is an inspiration for more equality and access for all Vietnamese.

Pharmacists at the Traditional Medicine Hospital in Danang, Vietnam measuring medical herbs.

Operating room in Hoi An Hospital.

Measured herbs ready to be distributed to in-patients at the Danang Traditional Hospital.

Marcie Lee, University of Colorado at Boulder, Biology and Ethnic Studies major


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Council on International Educational Exchange

David Streckfuss - Resident [email protected]

Arunee Sriruksa - Assistant Resident [email protected]

Jintana Rattanakhemakorn - Language Director [email protected]

John Mark Belardo - Field Studies [email protected]

The complexities of the Vietnamese Health Care system are most clearly observed through the fusion of both traditional and modern medicine present throughout the various hospitals in Vietnam. While most central and district hospitals follow internationally accepted healing practices, community clinics incorporate large amounts of traditional medicine into their practice. Through observation and comparison of University, Central, and district style hospitals vs. preventive and solely traditional facilities, our group was able to juxtapose each approach to medicine and evaluate the effect that such a health care system had on the country of Vietnam. The qualities of the facilities and general opinion of traditional vs. modern medicine gave us an insight into the core principles surrounding Vietnamese health and helped to serve as a tool of comparison to the Thai health care system.

Upon arrival in Hue, our group was taken to Hue University Hospital and greeted by various welcoming staff and directors. We were given a tour of both the areas of study and University Hospital. Specialized staff were proud to show off machines such as the Gamma Ray machine used to treat brain tumors. Overcrowding of this medical facility, what we would soon realize to be a common theme in all hospitals providing modern medicine, was incredibly apparent. The visit to Hue central hospital opened our eyes to the rather poor conditions that patients in the central hospital were forced to endure. Cancer patients slept two to a bed after chemotherapy and mothers holding small crying children lined the pediatric unit. Aside from the prized machines used on only minimal patients, most people waiting for care in these hospitals faced long lines, and possibly below standard ser vice. The Center of Preventative medicine in Hoi An followed this same pattern although some facilities seemed a bit cleaner partly due to the high influx of tourists that were in need of medical attention daily. Given the low level of confidentiality, we were able to

observe individual patients and their conditions quite easily. In comparison to Thai medical facilities, Vietnamese hospitals seemed far grimmer. Perhaps what astonished all of us the most however, was the strong emphasis on traditional medicine as an alternative to modern medical care.

During our visit to Vietnam, we were introduced to two facilities sponsoring traditional medicine or acupuncture. Originally stemming from the Chinese, acupuncture and herbal medicine has played a large role in various Asian countries’ medical systems for hundreds of years. In Vietnam, both acupuncture and herbal remedies to pain and disease play a large role in the public health field. As observed in our traditional medicine hospital visits, acupuncture and herbs serve as a legitimate second option to modern medicine and are frequently used by people of all ages. These facilities are much cleaner, less crowded and equipped with equally as well-trained officials as hospitals providing modern medicine. Traditional medicine is also a cheaper option for those unable to afford hospitals providing modern medicine. In order to fully understand how the Vietnamese health care system works, one must first observe the conditions of the hospitals themselves and then look at secondary factors such as the prevalence of traditional medicine. Overall, our visit to Vietnam gave us a better outlook on health care systems in South East Asia and formed a backdrop to what medical differences may surround a socialist vs. monarchic nation.

Julie Maeuser, University of Colorado at Boulder, International Affairs

TRADITIONAL VS MODERN MEDICINE IN VIETNAM

mailto:[email protected]









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Follow the Farangs: CPH Calendar

March 12 CPH starts working with Ban Nong Kung Yai, Moo 4

March 15 Meditation with Ajaan Decha

March 21 CPH will ace the second Thai Quiz!!

April 9 - 18Songkran Festival Break! CPH will head to Phuket, Sukhothai, and Chiang Mai for a week of fun!

SPOTTED: CPH exploring Southeast Asia

((om Le+) Program Facilitator Lindy, Amanda, Ajaan Dave, and Becky in (ont of “The Forbidden City” in Hue, Vietnam

((om le+) Rachel, Jeff, and Kathryn at My Son, Vietnam in (ont of an old sculpture

Contributors

Manaswi Sangraula and

Rachel Stahl (Editors)

Lindy Bunch and

Josh Gohlike (Copy Editors)

Julie and Manaswi in (ont of Perfume River. Hue, Vietnam

Marcie takes on the streets of Hanoi, Vietnam

CIEE Khon Kaen Newsletter--2011--SP--No. 5

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