Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Wednesday, May 15, 2013

Water Collection And Storage, Thai Style

Rainwater is collected in a large urn by a family's open kitchen in Isaan

You're bound to see them most anywhere in the kingdom of Thailand, in settings as varied as the styles of the containers themselves. From the simplest 55 gallon/190 liter plastic drums to bulbous cement or pottery urns to 250 gallon/1,000+ liter plastic drums and huge commercial stainless steel cylindrical containers like you'd see on the rooftops of stores or hotels in more urban areas.

In the countryside you're likely to see pottery-style urns such as the one above, with a trough slanted down from the roof that collects rainwater during the wet months. These are some of the most common for folks who don't want to use the plastic containers (or the stainless steel ones, which can develop tiny leaks within a few years).

Most of you know that rainwater is "soft" water, free from the calcium, lead and magnesium that can come from treated water. You can, however, still get contaminates from whatever washes off of your rooftop into the containers, but given the choice I'd still go with rainwater, even if only for bathing. Cooking with it and drinking it are another story. Legionella (remember Legionaire's disease in the news some years back?) and other risks are always there, I suppose, but there are filters and means of avoiding that which we don't need to go into here today.

Nevertheless, you'll see them almost everywhere... and why not? It's free water and fits hand-in-glove with the Thai way of conserving resources and costs. Waste not, want not.



Over the years I've seen more types of collection/storage containment devices than I'd have fingers - even if I resembled a the multi-handed Hindu-style statue. It was an idea I happily borrowed; after my first visit I set up a few 55 gallon drums and had my rain gutters empty into them, saving the water for watering the yard after the rains had stopped.

Naturally, standing water is a prime breeding ground for mosquitoes - something else you're sure to see (and perhaps suffer from) in Thailand, but a few mosquito fish (Gambusia affinis) will keep them under control. Many county health departments will provide them for free, if you contact them and ask. Just a few in your garden containers will do the trick.



One trip I took a few pictures of tanks on the roof of a school building. There were some tanks with the lids askew (like the one below), and I wondered if it was intentional (unlikely) or merely what I like to call "the curse of the lowest bidder" when the service company was hired (much more likely).

Friends who've grown up on farms have told me that when they had a true, down-into-the-ground well that they had to draw or pump from there were often unfortunate snakes, frogs, rodents and the likes down in them. I suspect that gave the water it's own "zing" that didn't fall under the heading of piquant, but I suppose they got used to it. I also suppose there are similar visitors to these water-gathering containers, via one opening or another.

Naturally, rain barrels aren't in use in different forms in many other countries, but I enjoy details like these wherever I go... and now you know a bit about the "barrels" in Thailand.



Monday, January 28, 2013

Trip Report, Part 31: The Report Concluded (Finally)

Carved detail at the Sanctuary of Truth in Pattaya

When I realize how drawn out this trip report has been I almost feel an apology is due. Part 1 appeared back on May 7th of last year (Bangkok Bound), and finally ends today, just a bit shy of nine months since that first installment.

As mentioned back then I tend to glean something out of most other's trip reports, so hopefully mine will serve a purpose and you'll find some helpful tips/ideas/suggestions that you can refer to, too, even if not all of it applies to you, your travel plans or your own tastes.

The trip report covered my Thailand trip nearly a year ago, and we'd just gotten through a weekend trip into new territory for me, but I figure I'm going to call it there. I'm not entirely done with things from that trip, but the series has gone on long enough, it's getting dark and the floodlights annoy the neighbors so I'm calling it with this wrap-up; a summary, if you will.

The last portions had to do with a long weekend away I'd taken under the wing of an always gracious Thai friend who delights in sharing the "off the beaten path" places with me, and for that I'm always grateful. He has another junket planned for me for my next trip there this year, and I've given up on trying to guess where we'll go and what we'll see.  Since this is Thailand it's comforting to know that the unexpected can - and often does - pop up along the way and sometimes he's surprised, too.

Along the way in the series we covered a lot of ground, figuratively and literally. To save anyone scrolling back that far I hope you'll allow me to refer to some points along the way. The stories you'll reach by many of the links below often contain updates or further information, as well. You are, of course, free to click on the "Trip Reports" link in the right hand column and just plow through them, although since I was still in the kingdom another couple of weeks there may be other posts with that label after today. You've been warned.

Here are some of the things we covered during the 30+ part report:


A friend said one time noted how I seem to return home more tired out than when I left on vacation, and they might be right.  This next time I'm hoping for more "down" time: more reading, more naps, more time in the shade beneath an umbrella.  We shall see.

Thursday, January 24, 2013

A Close Shave At A Thai Barber Shop

A young Thai man gets his sideburns trimmed in the shop I visited

There's a saying I've used over the years about will power (or the lack of it) that goes "if you go to the barber shop often enough, eventually you're going to get your hair cut." Although I'd walked past a lot of barber shops on my first visit to Thailand years ago I was hesitant to go in with my limited Thai skills. Nevertheless, I'd passed them plenty of times, and eventually I went in.


This local shop is still there, but the barber I saw for a few years isn't - he opened his own shop on the other side of the Chao Phraya river.

I don't mean a fancy shop in a tourist area with the signage and price list in English, I mean a neighborhood shop, where the only familiar words would be brand names and where the prices next to the Thai script mean nothing. Still, I was curious, and when I saw the familiar cylindrical glass jar of blue "sterilizing" liquid in it - the same I'd grown up with while visiting the barber - I figured "why not?" and sat down in a row of chairs to wait my turn. It felt much like a neighborhood shop from my childhood: conversation between anyone inside (who spoke Thai), photos of discreetly seductive ladies on the wall and a TV with a sporting event on.

My regular barber knew two
words of English: my name,
and "okay"
Of course, short of using an autoclave or some other such device there is really no true sterilizing barbering tools, but I saw myself that they opened and clicked a new set of razor blades into the handle for the guy inside getting a shave and weren't re-using the same straight razor over and over.

When I arrived, one of the barbers was bent over a man in the window-side chair who had his head turned left ear up, and the barber (!) was doing something deep inside it.  Puzzled, I watched for a couple of minutes. Soon enough the barber stood upright, smiled and triumphantly held up a pair of fine tweezers. Between the tips of them was a flat, rounded piece of dark golden brown something that I soon realized was ear wax.

My friend later that day told me it was a common thing for some barbers to do such a procedure, and it was as safe as they were skilled; no more and no less.  I haven't tried that one yet. The man who'd had it removed shook his head a couple of times and gave the impression that his hearing was better, and seeing what came out of it I'm sure it was.

As it turned out, when the man who'd just had the haircut, shave and ear job done paid and left I was next up to sit in that same chair. I could see a price list in Thai and some numbers, and some quick figuring let me know they were a pittance compared to prices back home. A cheap haircut in my neck of the woods is $12USD (about 360bt), but that's unusual... usually it's closer to $20. A haircut and a shave here was about $3USD.

I'd just started a walk from the Asia Hotel, which meant I had only showered a half hour before, so I didn't add the shampoo to the package, but I have since.  Not too many commercial places you can be fully pampered for less than $5USD.

Using all of the pantomiming skills I could muster I let the guy know how I wanted my hair cut and that I wanted a shave. He, in turn, mimed digging in my ear, but I smiled and politely let him know I wasn't interested in that today.  He shrugged his shoulders, draped a towel across my chest and fastened it behind my neck with a clip. He went about his work while humming quietly to himself, pausing a few times to look at the television in the "reception" area behind him when the other barber would hoot about the football game in progress.


The haircut was quick and just what I'd wanted. He handed me a mirror and turned the chair so I could see his handiwork.  I smiled and nodded as he leaned my chair back and tucked the towel up around my neck.  I confess I did look up to make sure he was putting a fresh blade into the shaver, but I don't think he noticed my distrust. I'll risk a few things while on holiday, but hepatitus C and HIV aren't among them.  I was needlessly worried, but I'm glad I looked.

The tiny brush you can see being used below on another man was filled with foam which he then spread on my cheeks and neck, as I'd expected. His touch was light, and he worked faster than some barbers do. What surprised me was that he also shaved the light fuzz from both my ear lobes and my forehead.  I've had lobes done before, but never my forehead.  When he was finished my entire face was as smooth as... well, as a baby's butt.


I'm sorry that I couldn't visit with the man, but just closing my eyes and relaxing for a while was really nice, too.  It wasn't as good as a nap, but it was nice. Did I mention he also did a five-minute neck and shoulder massage when he was finished? I should have.

Getting up I thanked him, swiped my face with my hand and smiled "smooth!" and he laughed behind his mask.  The girl behind the counter said "100 baht", and at that price I thanked her, too. I asked the barber for a picture, and he agreed. Now being spoiled I've visited the shop five or six more times each time I've been in the area, even if only to avoid shaving myself. I tipped him Bt20, but I didn't ever notice a Thai customer tipping them.

The shop is a couple of blocks behind the Asia Hotel at Ratchathewi, but the barber himself has opened his own place on the other side of the river. When I first noticed he was gone I ended up having a friend ask about him for me. The receptionist called him on his cell phone and he told my friend where he was. One of these days I'm going to find my way to his shop.

I've had good haircuts and decent shaves at other local spots in Thailand since then, but I've never found another "hole in the wall" place quite like it.  Still, I keep looking.

Tuesday, January 22, 2013

Trust Me: Adventurous Or Not, You Won't Starve.

Street meats in a market stall

Without throwing all caution to the wind it's easy enough to be somewhat adventurous about food while traveling in Thailand. You'd be foolish not to take into consideration that the Thai have systems that handle some things better than we do; perfectly natural, since they've grown up with them - bacteria and the likes - and developed a tolerance a lot of us don't have when stepping off the plane there. 

That said, there's absolutely NO reason why you have restrict your meals to the hotel buffet, familiar items at a grocery or 7-11 store or - ick - at McDonald's or another packaged food chain restaurant.  You just have to be willing to learn and adjust. Some pre-trip research is always a good idea. Might save you diving into something that might surprise you.

Take the innocent looking chili sauce, for a start. Some visitors can't tolerate the highly spiced food the locals usually can, so one of the first things they learn to say in a restaurant is "no pet," meaning "not hot".

Chili dipping sauce/condiment. Mind the seeds!

You'll likely get a small dish (a couple of tablespoons or so) of chili condiment with just about everything you order. There are lots of variations, but most have the four main Thai flavors in them: hot (chili), salty (salt and/or fish sauce), sour (pickled chili, lime vinegar) and sometimes sweet (sugar of one form or another). However you cut it a nice big spoonful will clear the sinuses   and tear ducts of most folks in short order. 

You shouldn't ignore the local foods wherever you go. That's what Pepto-Bismal, Immodium and electrolyte powders are made for. You live and learn, I figure, but use some common sense - such as asking a trusted expat or Thai friend when in doubt if you don't want to be very adventurous.

Most anything that's been cooked thoroughly and is kept hot enough isn't likely to bother you, and if it's something like raw produce you can read more in the post If You Can Peel It, You Can Eat It. 

Whether you feel more safe or prefer your Pad Thai in a restaurant, go for this:

Lunch at Chili Culture in Bangkok

If you're open to trying new things, you can go for the same dish as take away from any number of carts and stands...

At an open market

The point is: let common sense give you some direction, but don't let fear choose your path. 

Wednesday, November 7, 2012

Visiting Thailand: Travel Reference Links

Upstairs airline lounge area at Taoyuan International Airport, Taipei

In the post a couple of weeks ago about finding cheap flights to Thailand I mentioned following up with some links I've found helpful for travelling, so here they are today. I'll update and add to these again as I remember others, but this is a start.  Mainly gleaned from my own experience, but some also recommended by friends and other travelers I've met while on the road. Feel free to suggest others.

Travel Insurance
Purchasing trip insurance is a choice, naturally, but with life being the unexpected ride it is I think it's more than just prudent to have some; it really falls under the "common sense" heading. Insurance is all about "the transference of risk"  (in insurance lingo), and a comfort level with that is a personal choice. I urge you to explore and compare between at least two different companies.

I've used a few companies over the years, but the last couple have been Patriot Travel Medical Insurance , a part of IMG/International Medical Group and Travel Guard, a part of the Chartis Group. Both offer varying levels of coverage for both medical and other eventualities.

Your regular home insurance policy may cover you, but be sure. While there is reasonably priced and competent medical care in Thailand you don't want to be stuck with the bills. Some credit cards also provide coverage, also - worth checking out before you book your trip.

One rainy night in Bangkok

Worldwide Weather Sites
There are many weather sites. Many I know like the Weather Channel's site, but if you don't already have a favorite, I'd suggest Weather Underground - the cleanest I've found so far. Rather than just getting a report for, say, Bangkok, you can specify several different areas within the city, i.e. Suvarnabhumi International airport, Don Muang airport, etc. Naturally, no one site fits all, but I'd suggest starting with this one.

International Time / Clocks
A simple site with a convenient alphabetical table of the current time city by city is here: The World Clock. There are a variety of layouts available, and you can customize it to your needs, too.

Screen capture of the site

Flight and Airport Information
Naturally, you'd think the airline you booked with would have the best source of airline and airport information, and many times that's true. If you plan to hold someone responsible for the times, they're the logical sources. I still browse a couple of others, though, if for nothing else than the additional info available. One of the newer ones (to me, anyway) I've found handy is iFly.com.

We'll cover other reference links again soon. Feel free to alert us to any of your favorites.

Tuesday, July 10, 2012

A "Healthy Hotel" Reminder

Repeating an image from the Smiles series, as I don't have all that many photos of the housekeeping staff with their carts. Ah, well.


A study was done recently which claimed that the most unsanitary thing in a hotel room was... no, nothing in the bathroom, but the light switch on the bedside lamp; followed a close second by the remote control for the TV. Why the telephone keypad and handset didn't land high on that list I'll never understand. Apparently they just picked random items to test and stuck with those.


Two years ago in the Staying Healthy In Hotels post I'd shared the suggestion of taking a small baggie with maybe a dozen folded up santitizing wipes in it, such as the ones shown here. 

As I mentioned in the post, I wipe a few things down shortly after I've loaded into the room (and gotten rid of the bedspread - something often "soiled" but very rarely washed, if ever). One of the things I wipe off is the TV remote control, but I also do other commonly touched things and surfaces. Switches, drawer pulls and door handles, especially the bathroom ones. 


Despite how it may sound I'm truly not OCD about this, but it takes less than five minutes total for a little piece of mind. Who wants to get sick on vacation?


While the findings of some folks at the University of Houston haven't undergone "peer review" they made some unsettling observations concerning both bacteria in general and separately for coliform (fecal) bacteria. Levels they found were between 2 and 10 times higher than those considered safe in a hospital setting.


Not surprisingly, the dirtiest item of all was the cleaning mop that housekeeping drags from room to room, bathroom to bathroom.  The cleaning sponges and cloths would fit in with these, too, I'd suppose. Here's the list from the study I read first:

Dirtiest hotel items
1) Cleaning mops
2) Light switches
3) TV remote controls
4) Toilet seats 
5) Bathroom sinks
6) Bed headboards
7) Curtain rods
8) Bathroom door handles

Now, I don't wipe down the bathroom, but I don't lick the counter, either. Number 8 - bathroom handles - surprised me: last year when I posted about the Norovirus aboard a cruise ship it was pretty obvious that many people don't wash their hands after using the toilet. They had a young man stationed outside the open-door entrance/exit who could see the sinks. 



Most who spoke on the topic agreed that improvements in housekeeping could make significant cuts to the bacterial counts, but odds are against that happening. It's another case of "up to you" if you want to do anything about it yourself.


So often it seems stomach problems are blamed on the local food or water - and that can certainly be the case, sometimes - but I'd say there are plenty of cases where the victim has touched some contaminated item and gotten it into themselves that way.  Again - no point in being obsessive about it, but taking some steps to remain healthy while traveling is wise, I think.


Those who wish to read the CNN story I thought fairly complete can see it here.

Monday, June 25, 2012

Recreational Drugs And Other "Forbidden Fruit"

Items regularly found at night in Bangkok

[As a forward to today's post let me state as clearly as possible that I do not use, endorse nor encourage the usage of any of the items discussed today - except the durian, which can be delicious.]

Anyone who's considering a visit to Thailand ought to know that they punish those they catch with illegal drugs very severely. By these I primarily mean marijuana, heroin, opiates and any form of methamphetamine. If you don't know that you'd better learn about it before you end up sharing a 12 foot by 12 foot cell with 25 others for an open-ended visit, if you're lucky.

Trafficking is punishible by death in Thailand and other Asian countries, and your home country embassy can't really do much more than wave you farewell. Carrying your own prescription drugs into the country has been covered in a post about packing your bags you can check out to begin with.

We'll cover durian another time soon, but the spiky-skinned fruit coming into season in another couple of months is also unwelcome in a lot of places. While its smell can be highly obnoxious to some it isn't illegal.  Come to think of it, if merely being intensely malodorous were a crime in Thailand there would be a lot of irregularly-bathed tourists who'd be in serious violation of the law.

Being stopped with a durian is the least of your worries

Stupid toys like these pellet guns can (and do)
get people shot here in the US when mistaken
for the real deal.

The less worrisome of the illegal recreational items often pop up (if you'll forgive the erectile disfunction joke) in night markets throughout tourist areas, and can sometimes be purchased in small pharmacies if one is discreet, but more often than not anything that needs a prescription will involve seeing an actual doctor.

Once I was looking for a specific sinus medication and the pharmacist took pity on me when he saw and heard how miserable I was at the time, but that's not at all common.

The Viagra, Cialis and Kamagra you can see up top for sale on a street-side table in Silom aren't liable to land you in prison if you only have enough to qualify as "for personal use", but since a stop in at a clinic is so inexpensive it's still not worth the risk, in my opinion.

What tend to be grouped together under the label of "personal pleasure items" such as vibrators and a wide variety of latex novelties are also illegal in Thailand, although if you insist on making use of them while on holiday you can find them, which is probably less of an embarassment than having an inspector opening your suitcase at Suvarnabhumi International, holding up your Black Mambo and announcing for all to hear "Cannot!", as I actually witnessed a few trips ago. The face on the man standing by the suitcase turned a bright red. And no, it was not me.

Questionable smoking accessories


Some things like smoking paraphernalia are regularly put on display for sale here in the USA in what are euphemistically called "Smoke Shops"; places where the line between legal and illegal is smeared to nearly a meter wide, in some cases.  It's much the same in neatly arranged booths along Silom Road, beneath the Sala Daeng BTS station.



Not even a visit to a doctor's office is liable to get you a prescription for a glass pipe to smoke rock, but stranger things have happened in Thailand, I'm guessing.

My suggestion would be to merely be entertained by the colorful displays, and keep moving along.

Thursday, June 21, 2012

Thai Children On Smoking



A nasty headache kept me from writing today, but while checking email a few minutes ago I found a friend had sent me the link to the clip above, put out by the Thai Health Promotion Foundation, a group who have done several other amusing and informative public service announcements, so I guess there'll be a post today after all.

There are another half-dozen or so others on their site. The clips below could serve as messages to people in almost any country, but happen to be intended for Thai people.  Good on you, THPF!



Tuesday, May 15, 2012

Trip Report 5: A Detour Through BNH In Bangkok

Women buying food at a take-away cart on Naratiwat Road, by the Chong Nonsi BTS station

My second day in Bangkok was, thankfully, less hectic. Yesterday's arrival after 20+ hours of travel associated discomfort was enough, and I was ready to put foot to sidewalk and leisurely explore a different view of a familiar area. While I'd stayed a few times on the other side of Naratiwat Road at the Om Yim Lodge and the Sathorn Inn, this side of the road was virgin territory for me. I don't know why; it just was.

Clothes hung out to dry on the balcony - a very common sight.

Despite the jet lag and a roughly unsettled stomach my friend had been stubborn enough to be out on the town until the wee small hours of the morning, and paid the price for it our first morning in town. Sometimes a man's gotta do what a man's gotta do, I suppose, and I remember not wanting in the past to give in to anything I figured I could deal with, either.

He was truly in distress when I spoke with him around 11:00 in the morning, though, and since we were scheduled to go to Pattaya the following day I urged him to see a doctor here in Bangkok, get himself checked out and be back on track. He conceded defeat to whatever it was that was wrong and since he didn't have the strength to walk if we rode the BTS I took him by taxi to BNH  - Bangkok Nursing Hospital.

My friend in the ER of BNH

The main entrance was being remodeled, so we entered through the doors in the rear of the hospital, next to the Emergency area. Being off a bit ahead of me my friend simply went to the ER reception, related his complaint and was admitted there instead of into the hospital proper. After some quick but thorough care - including some intravenous fluid - he was ready to head back out in right about two hours, prescriptions in hand, to continue his trip.  To keep it as simple as possible, it was something he ate and a yelping case of dehydration. See "You’re A Couple Quarts Low There, Buddy". His bill was over $200USD - he had lab work and ER costs on it as well - but it paid off his wise investment in trip insurance - and then some.

After finding him a place to eat the bland food his doctor recommended he stay with for a couple of days we had lunch and then retired to our rooms to rest. By dinnertime that evening he was feeling well enough to again be bound and determined to not miss a night out, and this time I was feeling like tagging along, at least for a while.

Like the young man below, we began with a sensible dinner and then took on the night. More on that tomorrow.

Tasty take-away, and you may take that any way you want to.

Friday, April 27, 2012

Same Same, But Different! Part 11: Alcohol And Drugs

Still dead to the world from the previous night I managed to wake him. He was grateful for lunch I'd gotten from a nearby cart for him.


"We were somewhere around Barstow on the edge of the desert when the drugs began to take hold. I remember saying something like 'I feel a bit lightheaded; maybe you should drive . . .' " - Hunter S. Thompson, Fear and Loathing in Las Vegas.

That's how the late author's second book begins. When it first appeared as a serialized feature in Rolling Stone Magazine in November of 1971 some of my friends at the time felt as though they'd heard the word of God. "Oh, man... I'm gonna live like that!" they shouted, derailing their real lives to emulate the fiction and all too often ending up in the emergency room, some form of treatment center, jail, the morgue or some combination thereof.

What most of them didn't understand was that although Thompson could be a masterful and entertaining writer and spinner of tales he was also a troubled soul who spent his entire life wrestling with demons unknown and unfaced. He lost that match in February of 2005 when he took one of his beloved Smith and Wessons and shot himself in the head. Again, just my opinion, but the world needlessly lost a talented entertainer that day.

Being young, impulsive and bolstered by the invincibility that leads many of us into such foolishness in our youth I, too, jumped the tracks of rational living and paid the price for it. Not because of Thompson or Rimbaud or any other writer; mainly via peers, and there wasn't much pressure necessary to urge a young man with my psyche at the time to join in on what was passing as "fun" back then.

I'm most thankful that I was able to see past the sham of it all a couple of decades ago and stop putting poisons into myself on an hourly basis. Nowadays I shrug my shoulders and shake my head when I hear or read about people who are most certainly old enough to know better expounding on an addle-headed philosophy that falls somewhere to the left of whoopie.

Note, please, that I'm not judging anyone here; I'm just baffled by the behavior. People who can drink alcohol responsibly in a social setting have my profound respect. I can't, so I don't try any more. Some are in the habit of over-indulging on an occasional basis and without lasting damage to themselves, their lives or the lives of those around them, and I'd say that's fine if that pleases them.

In the lion's share of cases those whose prime raison d'être is to get as drunk as possible in an evening either have a problem or are one themselves, in my admittedly less than humble opinion. People who boast about their intake of recreational drugs earn the same respect from me as those who'd stand on a mailbox and shout that they beat their partner or steal from their families. I suspect that many of you agree.

The folks I feel sorry for are those lost souls who deal with a compulsion to drink or use some form of chemical; meaning to have "an irresistible urge to behave in a certain way, especially against one's conscious wishes."  That sort of compulsion.  People drink other than lightly/socially for a cornucopia of reasons, and there's no one label that fits them all.

It's a very real problem in Thailand, too. When it gets bad enough you'll sometimes see them sitting in doorways and along the curbsides of Bangkok "like punchlines between the cars", as Tom Waits put it. If you've spent any time in the country at all you've seen folks there like those in the pictures today.

There are an estimated 17.6 million designated alcoholics in the United States, but I couldn't find any figures for Thailand.  Part of it is cultural - weakness is shameful - and part of it is that there are precious few resources for recovery in the Kingdom.  As for the US figures I doubt that includes the people who don't/can't/won't acknowledge that they have a drinking problem, because their numbers are legion.

If you can drink responsibly, I say more power to you. Have one for me.  If you can't, consider reaching out for some help when you've had enough - and if you're nearing that point you understand what I'm saying.  If this sounds like you and you're in Thailand now, check out the link below.

If you know someone else in Thailand (Thai or not) who is having problems and you know them well enough to be willing to help them, let them know about Alcoholics Anonymous. It does good work in Thailand (and in well over 150 other countries), and by doing so you just might save a life, figuratively or literally.



I couldn't even rouse this couple to offer them food. I left some money under one of her pink slippers.

Wednesday, April 11, 2012

Health Tip: The A-B-Cs Of Hepatitis

This is the Hepatitis C virus, not Van Gogh's "Starry Night"

First of all, let me state (again) that I'm neither a doctor nor a medical expert on anything other than on a personal level, and I also believe strongly that we're all responsible for doing the research and legwork to protect ourselves when whenever possible. What I'm posting here is what I've learned from sources I feel are reliable for me, and I urge you yourselves to do some cursory investigating on the subject at the very least. In this case knowledge truly is power.

This is a portion of Van Gogh's "Starry Night"

When traveling to any third world country (and many would agree that on a good day most of Thailand qualifies as such) there's a possibility you may unwittingly be exposed to some unpleasant diseases. If you're one who ventures out into the less tamed parts of the city or country that possibility factor increases more.  If you're having unprotected intimate contact or sharing bodily fluids with someone (say, oh, I don't know... a Rented Admirer, maybe) the factor skyrockets.

Leave the usual STDs out of the mix today, and let's look at something you might not think of unless you've done some homework; something you can catch by eating or drinking regular things: Hepatitis.  There are five or more types, but we'll stick with the most common three - A, B & C - and while there's some protection available for A and B there's no prophylaxis for C, and not much care available for ANY of them, to my knowledge.  You'll more than likely fight off type A in a couple of months, but B and C wreak havoc and are deadly more often.

The less troublesome of the three types of hepatitis is "A", something many of us are exposed to as children (when it doesn't cause nearly as much of a problem), don't show severe symptoms from and naturally develop antibodies against, giving us protection later in life. A simple test to see if you've created the antibodies can indicate whether inoculation is called for. If it is, it's a simple matter of three shots over six months or so.  Easy. The Thai used to have far higher rates of infection of type A, but other than the border regions - say near the Myanmar border, where the rate of those exposed is in the high 90th percentile - education and better hygienic practices have helped throughout Thailand.

Tattoo art by... who knows?
Hepatitis-B is a little more difficult for your body to deal with, but since 1982 there has been a vaccine that's 90% effective in preventing infection. The Bangkok Post reported last July that 1 in 20 Thai are infected with "B", and that it's far easier to transmit than HIV, the virus that usually leads to AIDS. Type B can become chronic if untreated. It often leads to liver failure and increases your chance of liver cancer by 100 to 700%.  If you plan to venture into the countryside of any third world country it's wise to check into immunization for it.  They're not cheap, but it's your life you're protecting here.

Hepatitis-B can easily be transmitted through bodily fluids (think semen and vaginal secretions) and through blood.  My guess is that most of you aren't sharing needles with someone, but some of you do get tattoos while in the Land of Smiles.  Goodness knows there are any number of shops in tourist areas offering to do the work for you, and regardless of how clean any shop is reputed to be you're flying on faith.  Don't forget the "inked" person you're bedding down with there might not have been quite as careful who did their tattoo, carries it in their system and guess what?

Oh.  OK. You guessed.

One of the easiest ways BOTH Hepatitis- A and B are transmitted on a wider range is food and water contaminated in one way or another by fecal matter. Unwashed hands or unclean water are usually the culprit. You can wash your hands thoroughly after using the hong nam when you're out and about in Thailand, but you have to find soap first, and that's sometimes not easy.  It's the same for the locals - just harder to find the correct tools.

Those of you who will line the streets for the wild festivities of Songkran in another week might keep in mind that the water being thrown, sprayed and shot at you may have come from whatever nearby canal was handy.  It's a safe bet it wasn't bottled water, that's for sure.

By the way - this is NOT intended to be a panic report - just a reality check. Leave other travel out of it - I've spent at least eight months wandering around Thailand over the last decade or so, and while I'm more adventurous than most of you would be (I'm just guessing here) I haven't caught anything more exotic than a number of cases of diarrhea - knock on wood - but it's just common sense if you're thinking of really experiencing Thailand (or Mexico, or Vietnam, or Laos, or...) that you take the precautions and don't bring any biological souvenirs home with you.

See your doctor, call your county or government health department, make the appointment well in advance and let them tell you what's recommended for you... then follow through on it.  It's worth the time.

Wednesday, February 8, 2012

Health Tip: Yoong Means Mosquito

Internet image. I don't have that nice a camera.

A tip today for those of you who have somewhat dramatic reactions to the common mosquito bite. I tend to sport rather large welts about two hours after a bite, but it can take up to two days for it to show on some people.  What has happened is that while a  mosquito is getting a drink of your Type O or whatever it is you run through your system she leaves some saliva behind, and said spit contains a protein that causes the reaction in your system.  I said "she" because it's the female whose bite causes the problems.

The Thai name for mosquitoes is yoong, and while they can breed rapidly in standing water any time of year they're more prevalent there from May through September, the general window for the Thai rainy season.  Those are - naturally - also the months where more cases of mosquito-borne Malaria tend to occur.  Mosquitoes are also enthusiastic carriers of dengue fever.  Don't let either of these sicknesses scare you off, but educate yourself and become aware of how to prevent exposure to the best of your ability.

Most tourists aren't out in the rural areas where these diseases are much more common, but it's a good idea to check your home country's online disease control site for advisories, regardless.  A word to the wise and two to the not so wise.  In the USA call your county health department and ask them to look up where you plan to be going, or just go in and let them explain the recommended immunizations or prescribed medications.  Before my first trip to hike Cambodia's ruins I was advised to take Malarone, an anti-malaria drug.

Getting back to mosquitoes, though:  gan yoong (mosquito repellent) is easy to find at any pharmacy, Boots, or Watson's sundries shop, so don't bother to take it with you. The active ingredient for most of these is deet.  My personal favorite is Jaico (to the left above) although the packaging may be slightly different as this picture was from a while back.  It's a milky liquid in a roll-on formula with a 20% deet content.  You don't have to cover yourself with it; just a few stripes of it down your exposed neck, arms or lower legs will work.

I have three friends who swear by the Avon product Skin So Soft bath oil, and while I've had success with it in the US in the past I can't personally vouch for it's effectiveness there... although it probably works just fine.  You can find Avon products in Thailand malls, but you might want to bring a small bottle with you, just in case.

Your best chances of being bitten are in the first few hours after sunrise and in the early evening.  That means if you go for a morning walk in Lumphini Park or a stroll in the evening you'd be well advised to wear some protection, and this time I'm not referring to extremely thin latex.

For those planning to "rough it" in a simple countryside bungalow or local home you'll probably find that there's a phaa moong (mosquito net) in place to use over your bed when you sleep, and if there's one there I suggest you use it. They know their homes better than we do. If you've noticed more mosquito activity around your bungalow than you're comfortable with and there isn't a net, ask for one. If you're staying in a hotel and don't leave windows open on lower floors you probably don't need to give this another thought.

I mentioned in another post about the outdoor seating area of a nice little place in Bangkok called Just One. On my very first evening in Thailand years back (before I knew better than to wear shorts in the evening in Bangkok) I sat with my legs beneath the tablecloth there while having dinner and paid the price for it.

Don't scratch mosquito or other bug bites... it just invites infection. Cover broken skin with a plaster/bandage.

If you find yourself with bites, don't scratch.  Breaking the skin leaves you vulnerable to infection, and if you do scratch yourself open you'd be better off covering it up with a band-aid/plaster.

There are all sorts of home remedies for the itching that comes with a mosquito bite, and if you have one that works for you you might as well stick with it.  If you don't, you might have luck with the anti-itch potion below.  Its active ingredient is Witch Hazel, and it did help me some.  Others say over-the-counter antihistamines have helped, such as Benadryl, Zyrtec, Chlor-Trimeton, or Claratin.   Ice packs can help, too.

The best idea is to try to avoid being bitten in the first place.  In this case an ounce of prevention is worth a pound of cure.

Tuesday, January 31, 2012

The Rise And Fall Of A Go Go Boy: Conclusion

Although this story is about a go go BOY, HIV doesn't discriminate between males and females

[This the second of two parts about a friend of mine who was working the World's Oldest Profession in Bangkok.  If you found this via a search Part 1 was yesterday. There are places where those with HIV can get the treatment they need to prolong their lives if they choose to make the effort, but the best course of action is prevention.  If you play, be safe.  If you can educate someone else as well, all the better.]

Tiger By The Tail - Conclusion

Pee had no idea of how much time he was out, but told me later that when he first regained consciousness he saw an almost blinding white brightness through his slightly-spread eyelashes - so bright he wondered if he was still alive or in heaven. He drifted under again briefly and was greeted again by the same bright light, although now it was joined by a pain.

He opened his eyes more and realized the light was sun pouring through the window onto him, seemingly made even brighter by the white sheet his face was pressed against.  As he became more aware he could tell he was face down on the bed, and the pain was radiating from a point below his waist line in the area he usually called his "back door". He could tell something was very wrong, but the effects of whatever he'd been drugged with still had a blanket over his conscious thinking and he turned slowly to sit up, feeling the need to use the bathroom.

Then he saw the blood.  There was blood and another bodily fluid he was no stranger to smeared around on the sheet where he'd been lying, and when he managed to stand up with the help of the nightstand he saw more where he'd been sitting.  There was the sickly sweet smell of blood and the somewhat starch-like smell of semen.

He staggered off to the bathroom, leaned on the vanity counter and looked at himself in the mirror, his mind racing despite the after-effects of the drugs. Turning and looking over his shoulder he saw the mess was spread on his lower back, on his sides, on his buttocks and down his thighs.  Not a lot, but a mess, nevertheless.  He was still woozy so he sat on the toilet and realized for the first time since coming to that he was alone in the room.

He stepped into the shower and washed himself thoroughly, as though he could make it all go away by scrubbing himself well enough.  He examined himself after drying off, and other than some bite marks on his shoulders and some scratching on his sides he had no cuts or other injuries, and the bleeding had stopped.  There were no towels, and he walked out into the main room naked and wet, hands covering his genitals out of nothing other than habit.  Although towels were strewn about the room they were all used and dirty in a manner we don't need to go into here.  He finally pulled the top sheet off of the bed and wrapped it around himself before going over and closing the drapes.

The farang was completely gone.  His small bag, clothes and personal items were all missing.  Pee hadn't noticed when he'd first gotten up and gone into the bathroom, but he'd packed and taken off while Pee was still unconscious.  Pee's clothes and small bag were still in the room, although not where he'd put them the night before. Someone had gone through them, and while his wallet, ID and money were still there his "regular" phone was gone.  The spare was still zipped into the pocket inside the bag, though, and he called Dum, his co-worker from the club.  Although Dum had been sound asleep he hurried to the hotel, met Pee and helped him back to his room, where he cried on Dum's shoulder; partly from the humiliation and shame and partly from the pain that sharply reminded him he'd been violently violated somehow - he just couldn't remember how.

The short version of the "what the hell happened" story is this: the farang had checked in just hours before offing Pee, using a credit card that had yet to be registered as stolen by the rightful owner.  He'd paid the night clerk to look the other way, brought Pee back to his room, and then invited a number of others to join him for a party. The night clerk said there were at least six, and Pee was the party favor.

Pee - for a couple of reasons - couldn't make himself go back to work for a few weeks, but he called Tum back home, and after swearing him to secrecy he told him what had happened.  Tum, naturally, was worried that Pee had been exposed to HIV, but Pee refused to even speak with him about the possibility.  Pee had himself tested for STDs (he'd received a couple as parting gifts at the "party") and he stayed away from work as long as the doctor advised.

Subscribing to the "if it's my time to die, it's my time to die" line of thought Pee returned to work several weeks after he was raped. He had a photo he'd received from the farang over a year before and  had copies of it printed and circulated among friends in other clubs, hoping someone might spot him, but that never happened.  Anyone familiar with how things go in a club area know how lucky the guy was that he wasn't spotted.

Three months to the day of the rape Tum took the bus down to visit Pee, accompany him to get his HIV test and stay with him until his results came back.

Pee tested positive. Later it was determined to be a particularly difficult to treat sub-strain.

Even knowing it was a distinct possibility he'd be positive Pee was stunned numb, while Tum was inconsolable and cried on and off for the rest of that day.  Pee wept some also, naturally, but he'd been steeling himself with the aforementioned fatalistic attitude learned at his father's knee years before, and his tears were more for Nee and his daughter.  Tum also felt that this was an unalterable death sentence, even though I spoke at length with Pee about treatment.  He took medications for a while, but had trouble tolerating them and finally just said "if it my time, it my time".

Despite being intelligent on so many other levels Pee believed this was beyond his control.  He began going to the temple on a daily basis, meditating and praying for hours at a time.  He ate well and still exercised, but he dropped his gym membership and began to decline offs.  "I have enough money," he said one time on the phone "If I die my family will be good.  They have a house, they have the farm, they have the animals and a lot of money in the bank" - and he was probably right.

"Yes, but they won't have you, Pee," I tried to explain one time. "Think of Nee and your daughter."  He couldn't be swayed, and as I was feeling somewhat hypocritical for pushing him (I abhor how people all too often push their dogma on others) I backed off.

Pee's popularity declined with his looks and his health, and after he left his original club the places he worked became less and less desirable.  Eventually he was only getting offers he knew were risky or dangerous to his health and the siren song of home finally won out.  He packed up a few things from his rented room, gave away the rest to friends and called Dum.  "I'm finished.  See you in a few hours."  Dum met him at the bus station.  He told me later that he couldn't keep from crying at Pee's appearance when he climbed slowly down off of the bus.

From the bus station Pee returned to what he used to joke about as his "Farang Palace" - the house that multiple Jacks had built. Nee still wanted to marry him, and so a ceremony was arranged and they began what they both knew was to be a shorter than usual life together.  Pee loved his daughter and happily took over as many of the daily duties as he was able to, just to spend the time with her - while his health continued to decline.

I asked Tum to please promise to send updates on Pee, and I told him if I could I'd make time to go see him when I was there this Spring. Tum promised he would, but since Pee was no longer seeing a doctor, taking any medication or accepting any help whatsoever there usually wasn't much to report, other than he wasn't doing well - which I could guess myself.

Two weeks ago while I was preparing a family party to celebrate several January birthdays my phone chirped to announce the arrival of a text message, and it was from Pee's phone.  Being the eternal optimist I'd hoped it was some good news from him (sometimes he'd text a greeting for my birthday or other holidays), but it wasn't from him - it was from Tum.

Six words: "Pee die today. Email to me."

I stopped what I was doing and sent Tum a short email asking for a little more detail. He must have been right there to receive it because he replied within 15 minutes.

"Pee happy now," he began. "Now he in heaven and resting much. He sleeping three days before, no drink no eat. Nee and me stay him all. He stop breath today, now his spirit go to heaven. Pee want me send you something.  What address you?"  I sent back my mailing address, thanked Tum for letting me know and for being a good friend for Pee and went about my duties setting up the party, although my thoughts returned to Pee's death more than a few times throughout the day.

The next morning when I was doing my usual routine of candles, incense and trying to make peace with the universe I offered up a wish that his passing was peaceful and that his journey continued smoothly.  As usual I added the hope that perhaps someday our paths cross again somehow.

Three days ago an envelope arrived from Thailand, and I saw it was from Tum.  Inside was the photo from years back of Pee and I that my translator friend had taken.  Our arms were still over each other's shoulders, and we were both still smiling. There was a piece of note paper folded in thirds over the photo.  When I opened it up I could see writing too shaky to be Tum's, so I know Pee had written it.  It said:

"Remember happy times.
From friend Nong Pee."

I'll look at that picture and remember him often.