back in bangkok

after a year filled with ups and downs, i returned to bangkok & thailand. the last time i was here, i was leaving my fogarty site in chiang mai, feeling super nervous (but excited) about returning to clinical medicine as an M5, and looking forward to the match. it seems that things do indeed come full circle as i am in a similar position this time around, although i am only spending six weeks here instead of many months. when i return to the US in a month, i will be an M6, looking forward to my last (real) clinical elective, ER at Henry Ford, and getting ready for the match (again). i feel like this scenario may repeat itself again before i start my intern year, but we'll see.

since my fulbright year, thailand has been a bedrock for me. it was the place where i found a connection to my past, where i became proud of my cultural heritage instead of trying to hide it, and where i experienced a small sense of loss and disappointment that our generation was no longer made up of families with eight or nine siblings (as my parents' was). thailand was also the first place where chris and i really spent time together, where we traveled, where we ate a ton of food. thailand was also the first place where i really started to understand the human effects of poverty, of HIV/AIDS, of the tragedy when people died of preventable illness. thailand made me realize that difficult issues like drug use and commercial sex work and corruption were real and affected real people, people that i knew and respected and loved. thailand made me appreciate lots and lots of shades of gray. thailand made me wonder why it was so physically easy to move back and forth between the Global North and Global South all within a block or a city or from the capital to the provinces or especially to a neighboring country. bangkok reminds me of what it is to have so much and so little, exemplified by a series of thoughts i've had since being back:

1) Bus fare

bus fare has gone up a lot since i started coming to thailand, and another fare hike was recently approved, drawing outrage from the working poor who need to use the bus system to get around. to put it into perspective, the cheapest buses used to cost 3.5 baht for a trip, but now will cost 8.5 baht (up 1 baht from previous fare increases), and because most poor people need to transfer at least two or three times, this seemingly innocuous price increase can easily amount to over 100 baht a month.

the subway and skytrain, both of which i often use, are quite expensive compared to the bus system & don't reach a lot of areas of bangkok. although i often try to take the bus, it is definitely a choice for me and i can easily take a taxi to get where i need to go. for example, i usually take a taxi to work since it's most convenient and it costs me 80 baht for the fare and 50 baht for the tollway (necessary to save about an hr's time sitting in traffic). to put this into perspective, the minimum daily wage in Bangkok (which is the highest in Thailand) is 194 baht a day, or a little over $6.

2) women and children

the friend im staying with works in the field of child protection and we've known each other since our fulbright days. during her fulbright, she helped set up this income generation project in one of the biggest slums in bangkok, klongtoey, and it continues successfully to this day! it's basically a women's group that makes really cool (mostly silver) jewelry (amalee buys all the supplies from jatujak, one of the largest open air markets in Asia, and they work together to identify and make new designs). amalee meets with the group every weekend to collect the pieces that the women have made the previous week, distribute new materials for pieces to be made in the coming week, and pay the women for their work (they can also take out small loans). the women also work on finishing up jewelry pieces it's meant to be supplemental income, and it was cool to meet many of the girls and women who participate (ranging from age 12-13? to 40's). it's also a forum for the women to discuss issues in their lives, which mirror many women the world over must deal with - domestic violence, child care, raising children alone, patience, silence, love.... next week there is a thai craft show where they will go and sell their jewelry. i will post pics and other info later!

3) natural disaster

within days of my arrival both cyclone nargis and the earthquake in beichuan devastated burma and china. if the burmese haven't suffered enough under military junta rule, the (lack of) response to those affected by the cyclone only highlights their plight and the continuing human rights abuses that continue to happen under this regime. to help people that have been working in burma (and also support the free border clinic run in mae sot), please click here.


4) the english expectation

as a native english speaker, i often feel that i become immediately more credible just because of my ability to express myself in a langjuage that i'm comfortable with. in thailand (and much of asia) people often don't want to 'interrupt' or 'cause trouble' by asking questions or saying they don't understand. the first week i started at my internship i wasn't sure what was going on, but we had an epi talk about the roll-out of influenza vaccine to people ages 65 and older throughout thailand and nobody wanted to contribute (even though i'm sure they were far more qualified than me to do so). sometimes i think it's unfair that many meetings aren't conducted in thai...after all, we are in thailand.

there's also a divide in development work and agencies between local hires and those who come to work from elsewhere. my friend has noticed this in the UN and ive also noticed it in various agencies - all admin staff (secretaries, etc) are thai, but there are few professionals that are thai - or even speak it. this leads to a thai-non-thai divide, resentment, and difficulty trying to navigate being thai-american in a western vs thai environment. more thoughts on this later!

ok, im going to try and be better about blogging. next update: work and play in bangkok!