INPAENG's health perspective

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true <div id="LastMDatecns!93179AC2E769A54D!206">April 25</div><h4 id="subjcns!93179AC2E769A54D!206" style="margin-bottom: 0px" class="TextColor1"><a href="http://suteefieldwork.spaces.live.com/blog/cns!93179AC2E769A54D!206.entry">What is INPAENG's health perspective?</a></h4> <div id="msgcns!93179AC2E769A54D!206" class="bvMsg"><div>After two months living with INPAENG people, listening to their converstions and participating some social events.</div><div>I could partly conclude their ideas about health.</div><div>INPAENG people are living in the alternative paradigm of doing agriculture. For twenty years, INPAENG style of farming is based on self-sufficient concept. They changed their lifestyle from grow plants, rice for sell to the paradigm of grow for consume, for eat. </div><div>INPAENG's mottos are </div><div>'grow everything you eat/use, eat/use everything you seeded' </div><div>and </div><div>'move the forest into your backyard (by selecting kinds of seedlings that will grow to vegetable you would eat/use. Grow plants for herbal medicine, for shade, for your children new house etc. and ground them on your own land).</div><div>So, even they have small amount of money, but they have lots to eat;  their backyards supply almost everythings for their life.</div><div>They feel that this lifestyle is healthy. The persepective of good health reflect in 'Eat-well and Live-well' (Kin Dee, Yue Dee) has been observed. They believed that what they eat will certainly affect their health. And the living condition (includes family life, work environment and psychological status) is also crutial for health.</div><div>In their sense, eat-well doesn't mean eating protein, carbohydrate, vitamin, mineral, lipid or the 'more fibre, less meat' paradigm. </div><div>Their food are Rice+Vegetable+Fish (sometimes chicken, hardly pork or beef) (Kao, Pak, Pla). Not like city people concern about food (not enough veggie, too much meat), rural people have lots of veggie. What they concern about food is 'how much chemical substance contaminated in that food'. </div><div>Because of their experince as peasents, they know exactly how much chemical used in the rice field. Chemical fertilizer, pesticide, herbicide are main chemicals used in the rice field. They know exactly how much chemical used in veggie field. They themselves exposed to these chemicals. </div><div>This chemical remains in the ground, contaminate the underground water (main source of water used in the area). They know for sure that this chemical remains in their bodies. They consider the chemical is 'toxic'.</div><div>Eat-well is eating clean food, food without toxic. They can't trust market food, (to much chemical contamination; they used to sell those veggie to the market). They found that they can trust only themselves. So, 'eat-well' means eat veggie and friut that they grew themselves, use no chemical (use organic fertilizer insted). This leads to the the first motto 'grow everything you eat, eat everything you seeded'.</div><div>Live-well is living peacefully with family members, house with many generations living together would considered as a successful family. Successful family would introduce a sustained lifestyle to the young generation, keeping them from moving to work as 'unskilled labour' in Bangkok or in big cities. They reorient young people to know that they can live with less money and more happiness in this lifestyle. This remind me to a poster that I saw in Adelaide</div><div>eat money Only when the last tree has died and the last river been poisoned and the last fish been caught will we realise we cannot eat money. Cree Indian saying</div><div>INPAENG's second motto  'move the forest into your backyard'. </div><div>Forest brings the sustainable lifestyle. Forest supply most of life necessities such as food, medication, (raw material for) shelter, fuel. Forest collects water for the area. It also consider as a saving account for INPAENG people. Forest brings family members together.</div><div>Then, you will see that in their opinion, Health = Eat-well, Live-well. Health = clean food, aggrigated family members, forest, river, family economics while health care, health promotion program seem to be far from their concern.</div></div>

2007-08-28T06:40:24+07:00

in their opinion, Health = Eat-well, Live-well. This involve food, family members, how they live their life, family economics. false 122576

2008-10-06T14:53:26+07:00

false

2007-08-28T07:11:40+07:00

INPAENG's health perspective

20885

false <div id="LastMDatecns!93179AC2E769A54D!184">24 April 2007 </div><div id="msgcns!93179AC2E769A54D!184" class="bvMsg"><div>A team of villagers were sponsored by forest-protection project. They planed to set up a forest inspection survey to find the border of forest in their area. I asked for permission to go with them. They allowed me to go. So, thirteen strong men with lots of forest trekking experience and a know-nothing-about-forest dentist came together in to the wild. This is the experience that I will never forget. A nine hours walk up and down four-five mountains is not a forgettable event of one’s life. Moreover, I learnt many things while I’m in the forest. <img src="/file/sutee_gotoknow/the+rangers.jpg" border="0" alt="community rangers" title="community rangers" width="450" height="300" align="middle" />Community forest rangers I saw lots of burnt areas in the forest caused by bush fire. I know later that ninety percent of bush fire in this area is man made. People burn forest to hunt animals, they burn to wash out the day leaves, they burn to gain more land for cash crop, they burn to for new fresh grass for their cattle, they burn for mushroom to grow etc. I think burning forest is very common activity in their everyday life. I saw lots of trees that were cut illegally. Every ranger knows who cut the trees and who the authorities behind the curtain are. They said it’s OK (even it’s illegal) to cut trees to make new house for their children when they get married. By cutting only for own use would not affect the balance of the forest. But nowadays people from other villages came to cut trees to sell. So the situation of deforestation in their area is very urgent issue to solve. This is why the ranger teams need to be formed. This team is financially supported by INPAENG network. <img src="/file/sutee_gotoknow/deforest+for+money.jpg" border="0" alt="ssdf" title="ssdf" width="450" height="300" align="middle" />DeforestationI felt that all the men in this team are forest-professional. They knew the way to walk, know what leaf can be eaten. They knew where clean water is. They walked quickly on very tough tracks using only slippers while I felt very hard to walk or to keep balancing on the rocky, up-and-down and slippery ground even I used ‘new balance’ sport shoes. I would be died if they let me alone in the forest because I don’t know what are safe to eat and where the clean water is. But for them, being in the forest is like shopping in a big supermarket. Following them to the forest confirm my hypothesis that for them and lots of Isan (North-eastern) people health = family+forest. While family members give psychological support, forest gives physiological support. Forest gives Forest gives food, water, medicine, accommodation, cloth moreover the very green forest is the ‘training camp’ for forest monks to practice the meditation and finally to be enlighten. So keeping the forest sometimes means to assure that our country will not lack of the enlighten ones. <img src="/file/sutee_gotoknow/8%5B1%5D.30+am.jpg" border="0" alt="forest" title="forest" width="450" height="300" align="middle" />In the wild This confirmed me the INPAENG lifestyle ‘to move Bhu Pan forest to your backyard’ means grows verity of trees that family need to by yourself, in your land and use them. So INPAENG members go into the forest to find seeds or baby plants to grows, not to cut. Moreover they analyzed the usage of trees in sixteen categories eg trees for eat, for oil, for building house, for save the water, for herbal medicine, for bugs expelling etc. So, for me their health is not link only with health service or social determinants as be written on the book. I found health of people here link tightly with forest. For them, forest = clean food, clean air, clean water, shade, recreation, spiritual sanctuary etc. I think this is very interesting when we think about issue that WHO propose on their website <a href="http://www.who.int/globalchange/ecosystems/en/">http://www.who.int/globalchange/ecosystems/en/</a>. I think it’s impossible not to include this issue in the health promotion activities esp. for people in rural areas, people that have their own land for agriculture.</div></div>

2007-07-17T10:54:25+07:00

false 112188

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2007-08-28T07:43:32+07:00

My First forest Survey, totally different from Oral Health Survey

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true <div id="LastMDatecns!93179AC2E769A54D!147">30 March 2007</div><h4 id="subjcns!93179AC2E769A54D!147" style="margin-bottom: 0px" class="TextColor1">Health in many dimensions</h4><div id="msgcns!93179AC2E769A54D!147" class="bvMsg"><div>Last week, I had chances to participate four health-related events. First event was DSL patient and Sakonakorn general hospital (as mentioned in last web blog). The second event is a program called “For our friends”- a project that aims to educate and empower HIV-AIDS patients. This project is hosted by a monastery, the abbot worked with four community hospitals around that area. This three days and two nights program used the “modern training” paradigm of educating and motivating people. Ten working staffs and sixty patients were divided in small groups to participate many lecture, demonstrations and self-reflecting activities. The Abbot was the main facilitator for almost all the program. He worked as a social worker (rather than “old style preaching monk”) to advocate, mediate and enable the participants. By his reputation and faith, it was easier to motivate and to change people’s behaviour. He also motivated the public health workers to change their working style. For example, when educating infected patients about food and nutrition, he replaced the lecture style with the participating style. He asked people in each group to list 10 most favourite dishes that they always eat. Then he let the nutritionist to explain the good and bad nutritional affect of each food, and also how to modified the bad food to be better for HIV-AIDS patients to eat. <img src="/file/sutee_gotoknow/1.jpg" border="0" alt="ajan Chattakorn" title="ajan Chattakorn" width="600" height="450" align="middle" /> Phra Ajan Chatakorn and nurses from the community hospital working on the HIV/AIDS issue<img src="/file/sutee_gotoknow/3.jpg" border="0" alt="training program" title="training program" width="600" height="450" align="middle" />"for our friends" training program Thirdly, I interviewed the chair of Provincial traditional and herbal medicine group. He is also an abbot of Wat Srisaked, Sakonakorn. He believed in the ancient lifestyle. At that time life is peaceful, full of kindness, less selfish, respect the mother nature, and be mindful to consume the abundant of natural resources. He thinks that diseases and illness of people in present day were caused by the lifestyle that does not go accord with mother nature. He adopts the concept of “Dharma is nature” to his practice as a traditional medicine healer. Moreover, he also integrates the knowledge of herbal medicine, Isan’s traditional belief and astrology as the way to diagnose patient’s chief complaint. He thinks that this is ‘the holistic approach’. The abbot hosts a meeting for local and herbal medicine masters every month. (I will participate this meeting tomorrow). It’s very interesting event to see the movement of ‘alternative medicine’ to find their place in the community and to challenge the main stream modern medicine (the movement is stronger and stronger after MoPH (Ministry of Public Health) set up a Thai traditional medicine department since last decade, before that the local and traditional medicine master were labelled ‘illegal healer’ or ‘ghost doctor’. In INPAENG, there is also a herbal medicine master, Ms. K, she is a member of this group. She explained to me about this issue that nowadays it’s quite clear to the lay people that only some diseases or illness such as fatigue, muscle pain, constipation, food poisoning or any other non-fever disease are all right to seek care for local medicinal master. But the serious illness such as bone fracture or any kind of fever, they should consult the modern medical doctor. <img src="/file/sutee_gotoknow/14.jpg" border="0" alt="ajan " title="ajan " width="450" height="600" align="middle" />Phra Ajan Uide, the abbot and chair of Sakonnakorn Thai traditional Medicine society Lastly, it’s my honour to join the ancient healing ritual called ‘Yao’ or ‘Phi Fah’. They believed that some symptoms (such as the haunting feeling or some psychological illness) is caused by nature spirit, ghost or supernatural power. The aim of the ritual is to plead with ‘Phi’ (ghost or spirit) to leave this patient and ask the ghost to bless that patient before leaving. The ceremony took place at the patient’s house. Almost fifty people were in the house; this includes the healer master, the healer assistants, all of the patient’s family members, the neighbours, and the people that were healed by this healer master. Some of them help preparing talisman (made from banana leaves) to use in the ceremony. Some of them worked in the kitchen to prepare meals. Some are the ‘Kan masters’, who played the Isan traditional musical instrument called Kan. (Some are just observers, like me). This ritual took more than six hours to finish. The healer master prayed and chanted to the holy spirits and begged them to bless the patient. The patient is an old lady who has tons of children and grand children. She was blessed by the master. She was blessed by her family members. At the end, she leaded all members to cast the spell on buckets of water to transform them into holy water. Then, every participant was sprinkled with that holy water by the patient. Surprisingly, there was a big rain at the climax of the ceremony (We are now in the middle of dry season, it’s quite unusual to have rain at this time of the year). The rain encouraged the participants that the Holy Ghost agreed with the blessing. Lots of symbolic objects were used in the ceremony. The glutinous rice, banana leaves may refer to the abundance of planting. The spade, the fishing instrument may refer to the power to harvest. The most interesting aspect to me is, this ceremony supply all psychological needs that a peasant could need. The Psychological support from family members, care from neighbours, and hope for the abundance in harvesting season are the most common things that a peasant ever wants. These symbols are all expressed directly and indirectly in this six hours ceremony. Moreover, at the end of the ceremony the patient was dressed with the same articles as the master and leaded all participants to make the holy water. This is very important aspect of the ceremony, because it was showed that the power was transferred from the ghost and the healer to the patient. At the end, she had power to control herself; she was transformed to an active people not a passive patient. <img src="/file/sutee_gotoknow/5.jpg" border="0" alt="ll" title="ll" width="450" height="600" align="middle" />The Healer and Kan player <img src="/file/sutee_gotoknow/6.jpg" border="0" alt="ss" title="ss" width="450" height="600" align="middle" />The Dance: Healer and Patient interaction <img src="/file/sutee_gotoknow/8.jpg" border="0" alt="as" title="as" width="600" height="450" align="middle" /> Many symblics objects involved in the ceremony<img src="/file/sutee_gotoknow/10.jpg" border="0" alt="sa" title="sa" width="600" height="450" align="middle" />Healing an individual is healing the community<img src="/file/sutee_gotoknow/11.jpg" border="0" alt="ss" title="ss" width="600" height="450" align="middle" />The transformation at the nearly end of the ceremony, patient has a red band and lead the ceremony: power shift<img src="/file/sutee_gotoknow/13.jpg" border="0" alt="sd" title="sd" width="600" height="450" align="middle" />Now, the patient holds the sword (symbol of power) and leads all the people in the ceremony to make holy water All four events gave me the insight of ‘the meaning of health’ in this area. Lots of things are waiting for me to explore. </div></div>

2007-07-15T07:59:36+07:00

modern Med, traditional Med and spiritual healing false 111609

false

2007-07-17T13:10:38+07:00

Health in many dimensions

20885

true 25 March 2007The classic storyLast Tuesday, Mrs. Dang, my neighbour, asked me if I can accompany her to the provincial hospital. I said yes. Dang is Jan's aunt. This girl 'Jan (Psudonym)' is 15 years old, she was suffering by the rash on her limbs, face, knees and she also has pain on her sholders. Jan met a Gen. Med. doctor at a private hospital in the city last few months. Doctor told her that, she's got DLE (Discoid Lupus Erythematosus) and refered her to get the medicine at community hospital near her home. Jan kept having medicine from community hospital for two months. She feels that her symptom is not getting better. Moreover, she wants to move to Bangkok to stay with her mother and for her senior highschool study. Her aunt asked me if I could to drive them to the provincial public hospital to meet that Gen Med doctor (he works with two hospitals, office hours in public hospital and after hours in private hospital). We arrived the hospital at 9.00, hundreds of patients were there at that time. First we contacted the reception to check if Jan's health care card is OK to have a free treatment here. The reception requested a copy of her document, luckily her aunt knew and did it before we arrived (if not, maybe we needed an hour more just to walk to make a photocopy and back to the queue again!). Then we walked to the Gen Med department, know nothing, only the magic words 'just wait here' at that time more than a hundred of patients were waiting there. No doctors are there until 10.00. Dang told me that they spent their time working for private hospital in the early moning. We waited patiently until 12.00, a nurse told us that doctor would have a lunch break until 1.00 pm. However, our Gen Med doctor went back and started his work again at 1.30 pm. We finally met him at 2.30 pm. He could remembered Jan and had a brief talk to her, the clinical diagonsis took less than 10 minutes to finish. He confirmed that Jan should continue using the same medication and made an appoint for DSE antibody blood check on next month. He prescribed the same pills. In conclusion, we wait 5 hours in order to have the same medication. (at least we don't have to pay for the pills and doctor fee). I'm not surprised for what happened to Jan. This is the classic story that happen again and again in Thai public health service including in Dental health service.

2007-07-15T07:55:48+07:00

This can be the most common story for our public service false 111608

false

2007-07-24T13:34:04+07:00

The classic story

20885

true 19 Mar 2007 Living in INPAENG It has been two weeks since I came to INPAENG network. I live in the INPAENG centre, which is the training and meeting centre. Many groups and organizations come to this centre almost every day. Some of them spend only one day to study INPAENG lifestyle, some stay overnights. So, I 've got opportunity to participate the meeting and training to gain more understanding about the concept of INPAENG network (includes INPAENG lifstyle and the adminstration in the network). Moreover, I spend two days and nights with a host family. Mr. Kampan was my host.  He told me his story about how he could survived from debt and starvation by adopting the INPAENG lifestyle (Plant everything you will eat and use, eat and use everything you seeded). He also told me about the pride of being self-sufficient and showed me a good hope of his family. Mr.Kampai was my first informant and by listening to his story, I saw the interrelation of health, lifestyle, occupation, pride, family and mother nature. This urged me how important the INPAENG concept is.I revealed all my identities to them. They know that I am a PhD student from Australia who got a scholarship from my office, Thammasat University, and I am exploring the Buddhist concepts, Thai social capital and their health. I also told them that if they find anything that I can help for their training program, I am happy to do so. Mr.Thavatchai gave a job of English translator when a foreign group came to the centre (12-16 March, a group of NGO officers form Myanmar came to have a training at INPAENG centre), and computer database program, and also teach children (they are on their school holiday) for English and anything that I want to. <img src="/file/sutee_gotoknow/meeting.jpg" border="0" alt="ss" title="ss" width="600" height="450" align="middle" />English- Thai translating In the a workshop for Myanmar brothers and sisters. I stay in a wood house behind the main meeting hall in INPAENG centre. They were so kind to make a bamboo partition for me so I can have my privacy even when I have to share this house with other trainees.<img src="/file/sutee_gotoknow/my+house+in+INPAENG.JPG" border="0" alt="inpaeng" title="inpaeng" width="504" height="408" align="middle" /> I planned to participate the meeting as many as possible in first two weeks. Luckily, I’ve got what I wanted. From 4-19 March 2007 only fifteen days, I joined two short training course (one day course), one five-day training course, three network meetings, and one staffs meeting. Moreover, I’m very lucky to meet Mr.Yongyut. He is an NGO officer who worked with people in Thailand North-eastern area, including INPAENG. It can be claimed that he is one of the most influenced people in the network. It has bee twenty years since Mr.Yongyut and a group of villagers form the INPAENG concept. He is also a Thai traditional doctor. But he looks like a very ‘modern’ traditional doctor, because he knew the modern medicine very much (his wife is a tutor in faculty of Nursing, KKU). His knowledge is heavily based on scientific evidence, but his work focused on the self-dependent way of disease treatment (by using herbal medicine that can be found in the local areas, change living and eating lifestyle or using Thai traditional massage). I talked to him several times to learn the basis of Thai traditional medicine and Isan lifestyle. He can be considered as my very important informant. <img src="/file/sutee_gotoknow/Mr+Yut.JPG" border="0" alt="sd" title="sd" width="600" height="450" align="middle" /><div id="msgcns!93179AC2E769A54D!138" class="bvMsg">Mr.Yongyut and his students</div>

2007-07-15T06:47:55+07:00

the first two weeks false 111603

false

2007-07-24T13:07:56+07:00

Hello INPAENG

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true <div id="msgcns!93179AC2E769A54D!125" class="bvMsg"><div>Mr.Thawatchai; an NGO officer who would introduce me to the INPAENG network, called me and told me that he is on the meeting and will be back to INPAENG next Monday. He said it would be better for me to go to INPAENG at that time. It's time for preparing stuffs that will be used in next four months. I would leave my home and drove to INPAENG (800 kilometers) very soon.</div><div>Many things to do before leaving, I met the Dean of faculty of Dentistry, Thammasat University (my boss) and told him about my progress. I had my laptop tuned up. I went to 2 libraries and 4 books shops and got more than 20 books (mostly it's about Thai medical anthropology). I borrowed a car (a 7 year old TOYOTA 1.8L) from my in -law and spent a day to checked it up (lubricant, tyre, engine etc.) I went to an optic shop and have a new pair of eye glass lens. I also needed more T shirts and a mosquito net.</div><div>Today is Makha day, the Buddhist 'all saints' day, (please visit  <a href="http://www.dhammathai.org/e/day/maka_eng.php">http://www.dhammathai.org/e/day/maka_eng.php</a> for more information) it's good to go back home and felt the meaning of each public holiday again.  Many people will go to the Wats (monasteries) and celebrate this occession. However, the police officers warn the public of 'Bomb threat' in many places. The terrorists love to do their plan in a ceremony with big crowd. Wish me luck.</div></div>

2007-07-15T06:24:53+07:00

Preparing to go to INPAENG false 111600

false

2007-07-24T12:35:48+07:00

the second week: it's always wise to be prepared

20885

true <div id="msgcns!93179AC2E769A54D!119" class="bvMsg"><div>I went to Chiengmai on the third day of my trip. I met two scholars as planed, Dr.Uthaiwan on Monday and Prof. Anan on Tuesday. </div><div>Dr.Uthaiwan was a dentist who turned himself to be a community facilitator (He was the head of Chieng Mai University's department of community dentistry for many years before he retired to be a full-time NGO worker, his work focuses on community empowerment for health). His ideas of social strength are very interesting. The main idea that I got from him is that community's strength is closely related with the efficiency of communication. Local radio stations and 'the dialogue', the in-depth conversation, seem to work very well as tools for community development. Dr.Uthaiwan's point of view on oral health is also a ground-breaking. He showed the insider's viewpoint : from a full-time community development worker who has dentistry background. He adopted the paradigm of wellness to the community empowering work. He believed that looking at only disease will not lead to the growth and the development of the community in the long run.</div><div> <img src="/file/sutee_gotoknow/prof_Anan.jpg" border="0" alt="chiengmai" title="chiengmai" width="512" height="384" align="middle" /></div><div>Prof. Anan and Sutee </div><div><img src="/file/sutee_gotoknow/aj+utaiwan.jpg" border="0" alt="chiengmai" title="chiengmai" width="600" height="450" /></div><div>Ajan Uthaiwan and Sutee </div><div>Professor Anan Kanjanapan is a Professor in the department of Anthropology, Chiengmai Univerysity. It was very good to prepare by reading his recent articles before I met him. I can ask some questions that I can't understand from to his book. Like Dr.Uthaiwan, Prof.Anan doesen't agree the approaceh that start with problems of the community, there are only issues to learn. This means one should approach a community as a 'learner' role, not a 'problem solver'.  He also suggested some shortcut to help me finish data collection within four months (however, he does'nt think that it will work to collect data from two communities within four months.) </div><div>I also had a chance to meet some of the Chiengmai University's oral public health staff : Dr.Atisak and Dr.Sasithon whose backgrouds are dentists whose postgraduate study and work focused on social science. They gave me many useful suggestions. One of the most impressive is 'The social events are always complex and not straigthforward. When your evidence lead you to the easy simple cause and effect, you should question your finding, cause it may wrong.</div><div>In conclusion, my Chiengmai trip was very informative. I the opportunity to meet many people who gave me lots of valuable suggestions. It was a wonderful start of my  'qualitative quest'.</div></div>

2007-07-15T06:00:19+07:00

problems in the community OR issues to learn about false 111599

false

2007-07-25T10:35:48+07:00

first week in the field: Chiengmai and scholars