Who are the Hill People?

That's a great question.  Sure you can look them up on Wikipedia, but wouldn't you rather hear it from me?

The Hill Tribes are an ethnically diverse group living in the northern hills of Thailand.  Go figure, right?  The tribes themselves are knows as the Akha, Karen, Lahu, Lisu, Mien and Mon.  Though you may have never heard of most of those groups, chances are you do know about at least a subset of the Karen tribe - the Karen Padaung - they're the ones that wear rings on their necks, which result in their clavicles getting jammed downwards, and their necks becoming enlongated.  

 

Man, I hope we meet these folks.

 Sure they look happy, but the Hill Tribes of Thailand don't have it easy.  Many of the people living in the hills are actually Burmese immigrants who, after crossing the border to escape from the aggressive military dictatorship in Burma, find their plight to be ongoing. For one, their original economy was dedicated to smuggling opium from Burma to Laos, and using slash-and-burn farming methods, both of which were quickly stomped out by the Thai government.  

The Golden Triangle -Where opium goes to get smoked

On top of that, the Thai people are understandably not big fans of Burma, and by proxy don't have much love for Burmese immigrants.  They don't see them as new members of their country, so much as they see them as "squatters."  Combining a fear of increased drug trading and anti-Burmese sentiment, the Thai government refuses to issue National IDs to the Hill People, which in turn means they are unable to access most medical care facilities. Compounding this issue, without the money generated by farming and opium trade, the Hill People are poor, and lack adequate sanitation facilities.  This in turn leads to them becoming ill from all sorts of waterborne illnesses.  

It's amazing how important these things are

So, that's their story.  Of course, I've left a lot out.  I would suggest going and reading more about them on Wikipedia....or waiting until we get to the villages and interview the people ourselves!  It's happening.

I Love Shots

If you want to go on a trip to Thailand, you're going to need to learn how to handle a couple of shots.

Ohh yea

No, I'm talking about the kind that keeps you out of the emergency department.  That's right! Vaccinations!

 

This guy knows what's up

But wait! Before you get started you'll need a list.  This is what my partners and I have been working on for the past few months, and man, are we feeling super vaccinated.

SHOT 1: HEPATITIS A

SHOT 2: JAPANESE ENCEPHALITIS

SHOT 3: RABIES

Just Need a Little Help from my Friends

The trip we're about to go on could not have been put together without the combined support of a number of different groups and people.  After all, it costs money to send 4 poor medical students halfway across the world and pay for medications, supplies, equipment and other goodies.

First off, thanks to Dean Sackey for her initial guidance.  First, she helped us find fundraising opportunities, and she helped put what we should be doing with our trip in context, what appropriate boundaries were to the care we were providing.  In fact, Dean Sackey was instrumental in helping get us in contact with Dr. Wanke, who in turn became our mentor as part of the Tisch Fellowship we ultimately ended up receiving.  Really, without Dean Sackey's help, I don't know if our project ever would have gotten off the ground.

On a side note, Dean Sackey does public health work in Ghana

Of course, it would be remiss of me to not, in the same breath, thank Dr. Wanke.  Dr. Wanke was our mentor for the Tisch Fellowship.  She communicated with us, wrote letters of support, and acted as an editor for our application.  She made sure that what we wrote was acceptable and professional, and as a group with little experience in matters of global health, her assistance was indispensable.

Dr. Wanke is an expert in HIV infection and nutrition, and currently directs clinical studies at Tufts the Infectious disease department

And then what happened?

So, it was around the time that I had joined the group and we had decided to go with WTIND that some rumblings of concern began.  This is the the first, older website for the group, and the one we found first:

http://www.wtinad.org/

Notice the not so good English.  Always a warning flag that you might be getting taken advantage of.  Consider the mastery of the language displayed by email scammers from Africa: http://www.mikeindustries.com/blog/archive/2005/01/playing-along-with-email-scams.

Yea, we were concerned.  However, the group had been listed on Idealist.org, so we proceeded to consider it innocent until proven guilty.  Tim Pasek had a friend who coincidentally lives in Thailand, and he got in touch with her to verify whether or not this thing was the real deal.  I took a more indirect approach, first searching Facebook for WTIND organizations, looking up people in them that I could send a message to, and asking them about the organization.  I also got in touch with Dr. Mar Naw and asked him about his background.

I found out a few things.  First off, one should really look at Dr. Mar Naw's new site, which is way, way better than the old one, including the English:

http://www.wtind.org/

Second, here are some of the responses I got about the organization.  I've omitted their first names because privacy is sort of at a premium on the internet.  If you want to get stalk-y and find them, do it on your own time. The first person to get in touch with me was a Ms. Zambrano.  What she said really helped relieve some of the trepidation the group was feeling:

Hi Mitchell,

I was volunteering with the Global Youth Network. I really enjoyed working with Dr. David. We spent to 2 weeks with volunteering with him, and on the first week we worked with one tribe, building washrooms for the different families, and the second week we spent it at another tribe, mostly playing with the kids and doing random things like moving bricks, etc. 

It was a great experience overall, I enjoyed those two weeks. In terms of safety I felt safe at all time. To get to the different tribes we had to walk around 2 hrs, it was hard! But it was awesome, two kids that work for him walked with us just for safety.

That sounded great: it was real, safe, and we were even going to get 2 child bodyguards!

The next person to get in touch with us was a Mr. Hodge:

Hi Mitchell,

I'm glad you've taken an interest in WTINAD and am very happy to answer any questions you have.

The experience was certainly legitimate - my wife and I had the same concerns before we went out three years ago - but it was all quite smooth really. You spend the bulk of your time out in the hilltribes staying with the families in different villages you visit - it's certainly a very 'real' experience. We helped out at clinics and also worked on some sanitation projects (e.g. constructing toilets) which was really good with everyone in the village working together.

The medicine is also pretty different to what you'll have experienced in the US with much of the emphasis on malnutrition - the whole experience can be quite humbling. It was a lot of fun because the children in the village are always very keen to interact and you end up playing lots of games and stuff.

Dr. David speaks very good English but in the hill tribes only a few people do - often some of the older children as they are taught at school. But half the fun is realising how those language barriers overcome.

Lastly, a Mr. Granger got in touch with us:

Hey Mitch,

That's awesome that you're thinking about volunteering with WTIND! I think Dr. David would be able to offer you an incredible experience, especially as a med student.

WTIND is definitely legitimate and safe. Dr. David takes very good care of his volunteers and offers great learning experiences. And I definitely had a fun time. The kids in the villages are awesome. When we weren't doing some sort of work, we were playing games with kids. There was a language barrier, as most people in the villages speak different Burmese dialects, but Dr. David speaks the languages of all the villages and Thai and English, so he is able to translate when needed. Also, I think you'll find that although you don't speak the same language, it's easy to build unique and meaningful relationships.

Tim's friend got back to us too, and she had good things to say as well.

Overall, it sounded great, and everyone on the team was psyched about starting the project.  Of course, as we learned in Addiction Medicine, once you get past the contemplative and planning stages, you've got to take action, and, as it always is with things like this, our work had just begun.

On that note, I just want to thank, on behalf of the WTIND Tufts Crew, everyone that got in touch with us about this project. Past volunteers, friends, and Dr. Mar Naw himself, without your feedback, we may never have started down this road.  Thank you, thank you, thank you.

-Mitch

Ok, so where are we now?

So, maybe a step back is in order. For instance, how did the four of us find ourselves planning a project to deliver medical care and build sanitation infrastructure in the hills of Thailand?

Like most things, it started in a moment of brilliance conceived during a soul crushing period of studying.  We were still in biochemistry at the time, and you know how much your mind begins to wander trying to escape from the nightmare that is the Kreb's cycle.  I actually wasn't there at the time, but as I understand it, Tim broached the subject, stating that "We need to do something this summer."  Naturally, whatever we did needed to provide a service to the world somehow.  But where to go?  What to do?

We wanted to go somewhere that neither Tufts nor the world at large gave much attention to.  Searching on Idealist.org, Chris found Where There is No Doctor.  A small, grassroots organization run by one man: Dr. David Mar Naw.

It's around this time that I came in.  Like a mercenary, I didn't find the team of Greg, Chris, or Tim, they found me.  After minutes, and minutes of harsh questioning, I decided to join them.

There were some questions about WTIND.  Who was this Dr. Mar Naw?  Was he legit?  Were we going to fly to Thailand, head into the hills, and be set upon by some weird ethnic version of the hillbillies in Deliverance?  All excellent questions, and all ones that I am going to answer another time.

-Mitch

Entry #1

Everything needs a beginning, and for this blog, this is it.  My name is Mitchell Izower, together with Chris Ilacqua, Tim Pasek, and Greg Goldstein, we are the WTIND Crew.

This blog is dedicated to our upcoming public health work in Northern Thailand with the organization "Where There is No Doctor."  This group focuses on improving the health, sanitation, and education for the Hill Tribes of Northern Thailand, namely the Chiang Rai region. 

The Northern Hill Tribes are a grouping of peoples of various ethnicities, mainly Burmese immigrants, who live in the remote hills of Northern Thailand.  Having escaped from Burma, they've found their situation little improved in Thailand.  Anti-Burmese sentiment amongst the populace and bars to achieving citizenship has left them with severely limited access to clean water and medicine.

Our project is to assist the founder of this organization, Dr. Mar Naw, with providing clinical care for these people.  We will be charged with collecting vital signs, examining patients and assisting with making diagnoses, providing medication, giving injections, dressing wounds, and teaching first aid to villagers.   In our spare time, we will be participating in public works projects, like building toilets and clean water reservoirs.

In addition, we intend to document our time with the Hill Tribes, and use the internet to raise awareness of the plight of these people.  In doing so, we hope we can set up a charity online to collect money for WTIND.

We will arrive in Thailand in mid-June.  Until then, look for more updates about preparing for our trip!

-Mitch