ciee khon kaen sp15 newsletters 2

Isaan Insider

C I E E K H O N K A E N

Volume XXI, Issue No. 2, Spring 2015

2 | ISAAN INSIDER | ISSUE 2 | SPRING 2015

We’ve officially hit the halfway mark! Students have delved

deep into their studies; Development & Globalization (DG)

students have so far studied food and agriculture, and politics

in Thailand. Public Health (PH) students just completed their

first course, Public Health Management in Thailand (PHMT) in

which they developed the capacity to identify culturally

specific social determinants related to health and illness, and

understand the practical application of these concepts in the

public health system during site visits and study trip. Public

Health students also travelled to Laos for a comparative study

trip where they discussed and compared Southeast Asian and

Thai trends of health and diseases. Read on to learn more

about what students have been learning the past couple

months!

Khon Kaen


CONTENTS

Development & Globalization 1 Unit 1: Food & Agriculture 1 Unit 2: Politics 3

Public Health 7 Opisthorchiasis and Liver Cancer in Thailand 7

Thailand’s Roadblock to Pedestrian and Driver Road Safety

8

Surgical Face Masks and Plastic Surgery 9 Stray Animals in Thailand! 9 What About the Elderly? 9


Development and Globalization

Unit 1: Food & Agriculture Development & Globalization students studied food and agriculture on their first unit. Their research was guided by the theme of food sovereignty. For their unit project output, students decided to create an interactive simulation stemming from the knowledge that they gained and synthesized during the unit exchanges and homestays in the community. In the simulation, 4 players all from different backgrounds participated in different simulations that took them through agricultural life events.

At the start of the simulation, each player was given his or her life history. Then, each player was guided to the first station where they experience an event associated with farming methods, life events, the environment, support groups like the government and AAN (Alternative Agriculture Network), the market, the economic situation, their health, or land leasing and contract

farming.

By the end of the simulation, players and observers should have an understanding of the factors that contribute to a farmer gaining food sovereignty and that students would be able to see how food sovereignty is impacted by health, sustainability, and capitalism. The different types of currencies in conjugation with various stations should help paint a picture of their unit.

Check out each player’s background and some of the different scenarios that occurred at each station for that particular player!

Player 1 is an organic farmer that

spends many hours a day tending his farm. Most of his produce is going towards sustaining him and his family. Player 1 sells some of his produce, but is not making a lot of money. He is involved in a rice scheme. Throughout the course of the simulation, Player 1 experiences:

~The rising cost of herbicides and pesticides, and because he has bad credit and doesn’t want to risk taking out another loan, he cannot afford to make the switch to chemical farming to grow more crops and work fewer hours and still support his family.

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The government has agreed to encourage chemical rice farmers to continue producing by subsidizing production.

~Player 2 has been selling his rice through the rice scheme, which has increased his income as the Government has been buying his rice at above market prices. All is well until the coup happens and the scheme is revoked. The government no longer subsidizes rice. There is an excess of rice (overproduction). Prices drop, and the money Player 2 took out for this year’s crop is not fully paid back.

~Player 2 is forced to enter into a land lease contract with agribusiness because his soil is so depleted. He signs a contract with a cattle company that will bring in the young pigs and provide the feed; Player 2 raises them on his land using his own labor, and then when the pigs are fully grown, the company will come visit again and cart the pigs away to butcher and sell. Though Player 2 has to pay the company for the inputs (the pigs and the feed), he knows he will make money in the end based on the yield.

Player 3 is making the switch from chemical agriculture to organic farming. She was born and raised on a local farm in Yasothon Province, Thailand. Her parents were chemical farmers and she has inherited the family farm. Although she’s been farming her whole life, she is now the head of the farm. Throughout the course of the simulation, Player 3 experiences:

~Player 1’s neighbor becomes a Sugar cane contract farmer and whose land is uphill from Player 1’s. As he shares the same water source as his neighbor, his water has become tainted with unknown chemicals and herbicides. A black layer has begun to accumulate on Player 1’s soil. IFOAM (International Federation of Organic Agriculture Movements) came in the next month and tested his land and his organic certification has been revoked for the time being.

Player 2 has inherited his chemical farm from his parents. The government has chosen to support rice farmers, which is why he has stuck to chemical farming. Additionally, he doesn’t have enough money to transition to organic farming because he must pay for his son’s schooling in Bangkok. He is also involved in a rice scheme, like Player 1. Throughout the course of the simulation, Player 2 experiences various situations such as:

~Unfortunately rice mills are only interested in paying a high price for organic and transition rice as there is growing demand for it, however, a transition to organic calls for a 5-year period where the harvest yields no crops and Player 2 loses money.

~Although she appreciates her child living and helping on the farm, Player 3 realizes her son would receive a better education in Bangkok. Because of this, she has decided to send him to Chulalongkorn University and will in turn cost Player 3 quite a bit of money.

~Player 3 has joined the AAN (Alternative Agriculture Network) and has found a lot of support in the community. While she is in transition to organic farming, the AAN will help maintain her transitions status by creating barriers to chemical runoff. The AAN is also connecting her to a Green Market where she can sell her surplus crops.

~Since switching to organic farming, Player 3 has noticed that her soil and water quality have improved and she can pass the farm on to future generations!

Player 4 is a chemical farmer. She grew up in the village that she lives in now. Her parents were conventional rice farmers and that is all that she has ever known. During the green revolution in 1977 she started using chemicals on her land so that she would have higher

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where she showers has died. No one in Player 4’s family history has ever experienced hair loss like she is experiencing. She asks her neighbor who is an organic farmer if they are experiencing the same, but they said that they had at one time, but that once they switched to organic, it stopped happening.

~An agri-business representative comes to Player 4’s village and asks if they can lease her land. That means that the company will clear her land, and then use it for three years growing sugar cane. She will get a monthly rent and because of her poor health, she decides to lease the land to the investors. But, then, after three years of leasing her land to a sugarcane agribusiness, the company is no longer interested in leasing your land because her soil is depleted, no bugs or worms enrich the growing environment and crops will not grow.

In summary, after unit 1, students

crop yields as well as deciding to grow only rice. Recently her soil has become void of many nutrients and her yield is decreasing. Throughout the course of the simulation, Player 4 experiences various situations such as:

~She travels to the mill five towns over with 500 tons of rice. There is a surplus of rice in the global market because of the rice scheme, and her rice has decreased in value, so she will only earn 14 baht/kilo. As they run the rice through the mini-mill that tests the quality of her crop, she discovers that 30% of her rice is broken grains. Therefore, Player 4 does not earn money for 150 tons of rice, and she has not fully returned on her investment.

~She has noticed that her hair is falling out and the grass around

found that “food sovereignty” was not a set definition -‐ what was sovereign for one did not fit the definition for another. Students looked at the balance between seasonally available food and culturally appropriate food. Then, students started exploring food sovereignty through 4 different lenses: capitalism, religion, sustainability, and health. They wanted to see how each lens affects a family's ability to reach food sovereignty. During their community stay, they quickly found that religion did not play a role in decision-‐making for this community, so that lens was removed from their research. They also saw it wasn't a simple choice of whether to achieve food sovereignty or not -‐ in the grand scheme of life, families are faced with health and financial issues that force individuals to make decisions that they might not want to. Unit 2: Politics Unit 2, politics, was focused around the theme of political legitimacy. Based on the definition of political legitimacy, a government is legitimate if the citizens think it right, lawful, and proper that the government should hold power. Students analyzed political legitimacy through 3 different lenses including traditional, charismatic, and rational/legal.

Traditional legitimacy derives from societal custom and habit that emphasizes the history of the authority of tradition. In Thailand,

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Students learn more about sugarcane farming as they exchange with villagers.


the monarchy is considered a legitimate source of government because it is traditional.

Charismatic legitimacy stems from the ideas and personal charisma of the leader, a person whose authoritative persona charms and dominates the people of the society to agreement with the government’s rule. A charismatic government usually features weak political and administrative institutions because they derive authority from the persona of the leader, and usually disappear without the leader in power.

General Prayuth (Thailand’s current prime minister) could be considered a charismatic leader.

Finally, students analyzed legitimacy from the rational/legal side, which would legitimize the government off the basis that there is a system of institutional procedure, wherein government institutions establish and enforce law and order in the public interest. Therefore, it is through public trust that the government will abide the law that confers rational-‐legal legitimacy; ultimately it was found that this type of legitimacy does not exist in Thailand.

For their unit 2 project output, students created a satirical TV skit montage that was done in privacy at the CIEE study center. Certain elements in these skits could be seen as controversial within Thailand if they were displayed in public.

Overall, the montage included 16 different segments, some of which

include:

1. “Cooking Show” 2. “12 Core Values” 3. “Thank You Notes” 4. “Street Survey”

The “Cooking Show,” explores Thai-style democracy, centralization, the constitution and false legitimacy. Students wanted the Cooking Show to highlight some of the absurdities of the history of Thai politics. In the show, the recipe itself got redrafted numerous times, symbolizing the constitution. Students also touch on themes of vote buying, the NCPO, Thai-style democracy, and centralization of power. For example, many issues surround the concentration of power in Bangkok, with the rural regions being disregarded. There is also the issue of the vagueness surrounding the term

"Thai-style democracy,” and there being no real definition. The legitimacy of corruption claims are a theme throughout history, and students question where that legitimacy is derived from. Some highlights from the actual show are:

Host: “I’ve heard this is a Northeastern cuisine… we just paid them off to give us the recipe.”

Host: “Remember folks, we’re making this green papaya salad “Thai-style”, which means whatever the heck you want it to mean! All we know is that you don’t have much of a say in it!”

Host: “Oh… this just in… I’ve been impeached for partaking in this cooking show…”

“12 Core Values” focuses on ideas of propaganda and fear of conflict. The segment aimed to display the voices of the outspoken students of the

Development & Globalization wrapped up their political unit with an exchange with Songkran Grachangnetara, an editorialist for the Bangkok post.

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arrested and forced into signing a gag order with the military. The Thai military appears to mainly use legal/ rational tactics to establish their legitimacy, and uphold their power with force. Some highlights from the actual show are:

Begins with the reciting of the 12 core values: “…Being grateful to the parents, guardians and teachers, seeking knowledge and education directly and indirectly, treasuring the precious Thai tradition…”

Host: “Today, we are lucky to have Phun, a Dao Din student, here to talk to us. This is not her real name, and she will remain hidden to protect the identity of her and her family. So Phun, how do you feel about these values?”

Phun: “The values are Prayuth’s cute little way of making his government seem more legitimate by tying his regime to positive values. Here in Thailand, were not under a dictatorship, were under the rule of the “good people”. What does that even mean?”

Host: “…thank you for opening our eyes to one of the tactics that the Thai government and military use to establish legitimacy.”

Northeast as many social movements attribute their effectiveness to student activism. When students spoke with student activists of the group “Dao Din,” they were open, loud and angry because they were unhappy about the injustices they saw in their country and felt no need to be politically correct about sharing it.

Throughout their week of studying politics, students often heard about the military’s attempts to win the minds of the Thai people through the 12 core values, the billboards and wall postings and their self-named rule of “good people.” However, students discovered there is no rule of good people; there are dictatorship systems or democratic systems. Additionally, the 12 core

values are backed by the King, which helps to tie traditional legitimacy into the junta. Students chose to have the person behind a curtain during the skit to show the danger of speaking out and lack of free expression. If an actual Thai citizen said what students said in this clip, they would surely be

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“Thank You Notes” explores themes of transparency, constitution, and vote-buying. Thank You Notes is an ironic take on events that occurred during the week that students studied politics in Thailand. Students chose to discuss the military and their governance through thank you notes to address the public appreciation of the military in contrast with the private opinions of individuals. The purpose of the notes, publicly, is to allow each citizen a voice in the new constitution, and yet it is understood that the military will disregard ideas that do not already align with their plans. Overall, through the thank you notes segment students aimed to address the image the military presents of themselves against how the public knows them to behave. Some highlights from the actual show are:

Show Host: “Dear military, thank you for teaching me what it really means to be Thai with the 12 core values. Reciting them in the morning is the highlight of my day!”

*Hmmm…Smiles*

Show Host: “Dear military, thank you for taking down the Facebook pages of people who disagree with you - they were all wrong anyways!”

*Ha! You’re welcome*

Show Host: “Dear military, thank you for the National Council for Peace and Order. Martial law really helps with the whole “peace and order” part of your council!”

Show Host: “Dear Committee on Anti Corruption, thank you for suggesting that the middle class


should be solely responsible for electing qualified leaders. We all know that the other 80% of society just really isn’t capable anyways.”

“Street Survey” looks at ideas of legitimacy and the monarchy. In this segment, students chose to focus on the monarchy, as well as the military, martial law, and fear of conflict, to try and convey the different reactions and thoughts they gathered during the unit. The segment aimed to convey how many Thais love the king, but some see him as a political tool used by the military. Furthermore, many people fear voicing their political thoughts, if they oppose the military junta, due to martial law. With this in mind, students tried to show Thai love for the king as well as the predicament of fear surrounding voicing differing opinions. The segment gets at the students’ greater theme of legitimacy by conveying the importance of the public’s reaction regarding those in positions of

power. Some see the King as helping to make the regime legitimate based off of whether or not he condemns it. However, when regarding Prime Minister General Prayuth, his legitimacy is put into question. This mirrors how the current division concerning feelings towards the interim government. Some highlights from the actual show are:

Correspondent: *walking down the street, stops at random person #1 and holds up a cartoon picture of the king* Hello, Ma’am do you know who this is?

Random Thai Person: *grins widely* It’s the King! I love him! (enthusiastically) *High-fives correspondent*

Correspondent: *Stops Random Thai Person, holds up picture of PM Prayuth Chan-o-cha* Hey there, can you identify the man in this picture?

Random Thai Person: That’s General Prayuth, the dictator, I mean coup

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leader…

Random Thai Person: That’s our Prime Minister, what a great guy… *starts singing coup song*

Correspondent: Hi Sir, can you identify the person in this photo?

“Random” Thai Person (Actually General Prayuth): Are you a supporter of Thaksin, the ex-prime minister of Thailand who was banished? Are you threatening me? You shall be arrested! Take him away boys.

*Military comes in and takes correspondent away*


Course 1: Public Health Management in Thailand Public Health students have just completed their first course, Public Health Management in Thailand (PHMT). To aid their learning, students created a blog where they can post on various topics they learned about during their first course. Check out some of their posts below: Opisthorchiasis and Liver Cancer in Thailand

By Avery Trim, University of Massachusetts Amherst

Within Thailand, especially the Northeastern region, fish is a popular food that is commonly consumed by a majority of the population. Found in a variety of well-‐known dishes and meals, such as ปลากะพงขาวนึ่งมะนาว (Pla Kapong Khao Neung Manao) and ปลาเผา (Pla Plo), fish is an essential component of the Thai diet. However despite its importance, fish poses a significant threat to the health and well-‐being of the Thai population. More specifically, Thailand faces the problem of liver cancer resulting from the consumption of raw fish. Liver cancer is linked to a parasite

known as opisthorchiasis, or a liver fluke, which is found in fresh water fish; when a person consumes a raw or under cooked fish containing opisthorchiasis, the parasite then makes its way into their liver and causes liver cancer (Fernquest 2012).

Liver cancer and the consumption of fish containing liver flukes has become an increasing concern over the past few years. Ranking 7th as a cause of death in Thailand, liver cancer has roughly 23,000 new cases annually “and 87% of them are in an advanced stage” (Fernquest 2012). Because of this, a number of

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initiatives and programs have been developed in order to educate the population about the health risks associated with consuming raw and undercooked fresh-‐water fish. One of these initiatives involves a campaign started by youth volunteers in two provinces within Northeastern Thailand. The campaign targets young elementary and kindergarten children, providing education on proper nutrition and stopping the consumption of under cooked and raw fish (Fernquest 2012).

Public Health


Khon Kaen, Thailand that the majority of people have motorcycles, there is a small amount of people who have cars or ride buses, and I as well as the other foreigners are the only people crazy enough to walk places. One of the major hazards I have noticed, especially at night, is the absence of sidewalks. There are random gaping holes where sidewalks should be. I have included pictures below of some of the things I come across on my regular walk to class. Not only does this discourage walking, which is a great way to incorporate daily exercise, it is also unsafe for those people who do walk. The limited number of sidewalks, crosswalks, crosswalk lights for the complex roads and multiple lanes greatly lower pedestrian safety as well as driver safety with pedestrians randomly running out in the road in front of them.

With the majority of the population having motorcycles there is virtually no protection if there is an accident except for wearing a helmet. The sad truth is only 45% of people in

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Additionally, from my personal experience learning about opisthorchiasis at Khon Kaen University, children and young adults seem to be the main target in providing education and awareness to raw fish consumption, because the alteration of their eating habits seem to have the greatest affect in reducing prevalence.

Another initiative is the Lawa Project, which was an intervention strategy implemented in the Lawa Lake area of Khon Kaen, in order to reduce infection rates. The initiative involved the use of “anthelminthic treatment, novel intensive health education methods both in the communities and in schools, ecosystem monitoring and active community participation,” and ultimately reduced infection rates by about one third (Sripa et al. 2015).

Ultimately, while liver cancer resulting from consuming raw or under cooked fish is a growing concern in Thailand, steps are being taken to bring awareness to the problem and reduce is prevalence. Targeting young children in terms of health education and promotion of healthy eating habits has also proven to be particularly beneficial.

Thailand’s Roadblock to Pedestrian and Driver Road Safety By Lena Barouxis, University of Massachusetts Amherst

It has become apparent to me that Thailand’s road safety and regulations are quite different from the States. I have seen first-‐hand in

Thailand wear helmets (World Health Organization 2011). The amount of fatalities related to 2-‐3 wheeled motorized vehicles makes up 70% of all accident-‐related fatalities (World Health Organization 2011). Also, 80-‐85% driving accident victims were motorcyclists and the rest car drivers (World Health Organization 2011). The Thai government has recognized the need to better road safety. They have implemented their own plan based off of “Global Plan for the Decade of Action for Road Safety 2011-‐2020” (World Health Organization 2013). The goals are to reduce speeding and drinking and driving, increase motorcycle helmet, seatbelt and child restraint use (World Health

Organization 2013). The government is aware they need to better road safety management by building safer roads with less potholes and distractions, and need


After doing a little research into why operations providing patients with sharper noses were so popular, I found another explanation for why this trait is desired; an alternative, historical explanation than to simply appear more farang (western). According to some anthropologists, Chinese face reading techniques and the messages behind its practice have ingrained themselves in Thai ideals of beauty. It is also believed that this is further aided by the large population of Sino-‐Thais currently residing in Thailand. Central to Chinese face reading is the belief that one’s nose is a predictor of one’s future life situation. Therefore, according to this belief, if the nose is changed, so is one’s future.2 So, a Thai not wholly satisfied with her life may therefore convince herself that a life of satisfaction can be achieved with a change of her nose.

Reference: 1Ishigooka J, Iwao M, Suzuki M, Fukuyama Y, Murasaki M, Miura S.

a system to better reprimand those who don’t abide by the rules. (World Health Organization 2013) By addressing these major issues Thailand will significantly reduce fatalities and injuries for pedestrians and drivers of all types.

Reference: World Health Organization. (2013). Global Status Report on Road Safety 2013.

World Health Organization. (2011). SEARO | WHO in the South-‐East Asia Region World Health Organization.

Surgical Face Masks and Plastic Surgery

By John Romero, Tulane University

It’s hard not to notice the wearing of surgical masks by some of the students here in Khon Kaen. I’d never seen non-‐medical personnel wearing them in the states, and certainly not as every day wear. After seeing so many people wearing these masks, I began wondering if they had motivations for doing so beyond the obvious (barrier against air pollution). A conversation with my roommate revealed a reason I would have never predicted. For some wearers, the masks serve as protection following plastic surgery involving the face, especially nose and lip modifications. Given that up to 47.7% of patients seeking cosmetic surgery meet the criteria for possessing a mental disorder1, the supposed prevalence of plastic surgery among KKU students is compelling.

Demographic features of patients seeking cosmetic surgery. Psychiatry Clin Neurosci. 1998 Jun;52(3):283–7. 2Aren Aizura, “Where Health and Beauty Meet: Femininity and Racialisation in Thai Cosmetic Surgery Clinics,” Asian Studies Review. 33:3 (2009), 303-‐317

Stray Animals in Thailand!

By Kimberly Chen, Ramapo College of New Jersey Since being in Thailand, one big difference between this country and the United States that I have observed is the number of stray animals running around. I am a huge animal lover, and I have the tendency to try and pet the ones that look cute and furry, especially dogs and cats. In the more rural parts of Thailand, I have seen dogs

Anyarat Thiptara from the School of Veterinary Medicine at the

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advice from their parents or grandparents only to later realize they were right the whole time. As of right about 13% of Thailand’s population is over 60 years old; it is predicted to increase to 25% in the next 20 years (Public Relations Department 2014).

I admire the initiatives that Thailand has taken to care for the aging population. For starters there is ‘The Act on Older Persons’ which was established in 2003 to assign responsibility for the protection and support of the elderly. In addition, there are residential and nursing homes throughout Thailand to support the care of the elderly. One example is the Ruth Center in Bangkok, which exists to “work with slum communities in Bangkok’s Prawet District to improve the quality of life for the elderly.” Finally, on several of our site visits to hospitals we learned that there are programs specifically for the elderly to promote physical exercise.

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lingering around almost every few hundred feet. In the night markets near Khon Kaen the stray dog population also seems to be fairly high, although these dogs seem to be taken care of better by people. After petting a few of these animals I wondered how sanitary or unsanitary these feral animals really were. I worried specifically about the risk of contracting rabies through animal bites because I have learned about the serious dangers of the disease.

Anyarat Thiptara from the School of Veterinary Medicine at the University of California researched the epidemiologic trends of rabies in Thailand. He explained that dogs were the main reservoir of rabies in the country, and that the dog population has increased over the past decade. Many of them are not domesticated and spend most of their time outside the home, which increases the dogs’ risk of contracting rabies. In the 1990s, over 200 human deaths per year from rabies were recorded but the number has decreased dramatically. In 2008, only 8 deaths were recorded. So I think it’s safe to say that I will continue petting the cute stray animals in Thailand, but I will be sure to approach them with caution. Reference: http://www.ajtmh.org/content/85/1/138.full What About the Elderly?

By: Rebeca Lopez, Occidental College

One thing I’ve learned as I have become older is that the elderly know so much more than we give them credit for. I am sure I am not the only one that has ignored

On our comparative study trip in Laos I had the opportunity to speak to several health officials. One of them mentioned that he admired Thailand’s elderly care initiatives and hoped Laos would adapt something similar in the next few years. When I asked how many nursing centers were in Laos I was told zero because the elderly normally move in with family. The cultural norms are that once you can no longer take care of yourself your children will. I do not disagree with this because it’s the same in my Hispanic culture but I do believe that there should be more of a focus on the elderly. It would be great to see health centers host programs in the afternoon such as walking club or nutrition education. Let us not neglect to care for those that cared for us first.


For more information, contact: Assistant Resident Director • Arunee Sriruksa • [email protected] Community Public Health Program Academic Director • Anootnara Kuster • [email protected] Field Study Coordinator • John Mark Belardo • [email protected] CIEE Portland Advisor: Susan Pollis • [email protected]

Visit us on the web, at: CIEE Khon Kaen Development and Globalization Program webpage CIEE Khon Kaen Community Public Health Program webpage

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