A breeze in Borneo lifts your spirits, brings sanity to the sultry heat and lets you look at things differently. It can waft right through your day.
Saturday, August 26, 2006
Comments of a Newcomer
Off and on I have been a member of Toastmasters. I found myself teaching at the university level and not a very good teacher. This was interesting because I spent a lot of my time teaching. When I looked around I didn’t find many of my colleagues very good at teaching either. This was around about the time Canadian universities adopted the University of Kentucky's Teaching Improvement Project System, (TIPS) which actually set about training medical faculty to teach better. So I wasn’t the only person who noticed the problem. Before the TIPS program, medical faculty had generally followed the See One, Do One, Teach One model of medical education.
As I have been moving around a lot, I found ToastMasters a useful way to get to know people in new communities while building skills. There are many good aspects of Toastmasters clubs. They provide a supportive group of people providing helpful suggestions, a chance to practice different approaches with a non-medical audience and some excellent training materials. There is also a sort of group think that varies depending on the club. This is recognized by ToastMasters as a common phenomenon relating probably to the forming of group norms. So one of the things ToastMasters encourages is for newcomers to give comments. They encourage members to listen carefully to newcomer comments. Such comments may not usually be couched in the best possible way but are honest reactions that are invariable useful. The listeners job is to extract the kernel of truth in the comment.
In this tradition, as a newcomer to the medical blogosphere, I have a couple of newcomer observations to share. I think it is a wonderful thing to have a medical blogosphere. I stumbled on it quite by chance. Somebody posted a short notice about Tundra Medicine Dreams blog on the Listserve of the Society of Rural Physicians of Canada. It was the first blog I visited, I loved it and still do. If you have ever lived and worked in aboriginal communities in the north, Tundra Medicine Dreams along with the TV shows, Northern Exposure and North of 50, are going to be on your list of life time favourites. In no time at all I wanted to do my own blog.
I haven’t been around the blogosphere much, hardly at all compared to most of you. I discover new spots regularly that amaze. Moof does something about domestic violence and mentions a previous site and the history of how sexual abuse is recognized and dealt with comes tumbling down. There is a wealth of material on here for case studies. Flea, a pediatrician, handles a quandary of a child who receives the wrong vaccine in the best possible way and loses a family from his practice.
Now I am no blog expert when it comes to either content or process, except in the sense that X is the unknown quantity and spirt is a drip under pressure. I can’t even add to my Blog Roll without major template problems that last for weeks. So I offer my comments as a raw and green newcomer, one who really doesn’t yet understand all the group norms.
I have noticed that medical bloggers who by their own admission say frank, critical or sarcastic things seem surprised, Mexican Medical Student here and Barbados Butterfly here, that some readers react negatively. Some even create a whole reactive blog about a negative comment. This may be followed by reassuring noises from their loyal readers saying what a wonderful person they are, etc. So one gets the impression, intended or not, that one is not supposed to make anything less than laudatory comments at all. These are two blogs that interest me, so maybe that makes me more sensitive. It’s true for all of us that we don’t hear negative feedback well, if at all, unless it is couched as a suggestion for change. But this approach to dissent is not conducive to the kind of creative civil society dialogue, as espoused by Jane Jacobs, that we need to encourage these days. I even caught myself trashing the look of a web site of an anti-evolutionist because of the black background which makes it unreadable.
As my father would say, "That, Borneo Breezes, is a lazy person's argument!"
For people to change, we need to cultivate a diversity of opinion. There are lots of different, strongly-held opinions about almost everything as the recent blogs at Parallel Universe and other places about male circumcision make glowingly apparent. Blogs provide a good place to have such discussion, hear dissenting opinions and respond to them. They are even a good place to rant and listen to other people rant, especially if they are humorous. I didn’t think about this when I started to blog, but I can see now that the discussion that blogs sometimes generate through their comments is perhaps as important as the piece. This in fact makes it better than newspapers, my current fetish.
Moof has done a great job on stimulating discussion about euthanasia. More is needed along this line. And we have all got to develop a thicker skin. We are not talking to just our friends who agree with us or even our friends who don’t agree with us, we are opening it up for everybody. Obviously there need to be some ground rules, indeed it looks to me like some have already started.
My second comment is about the need for a medical meta-blog. A meta-analysis is an analysis of epidemiology studies about a topic. A meta-conversation is a discussion about a conversation. A medical meta-blog would be a blog about the medical blogs. Grand Rounds may have been started with something like this in mind, but the recent ones I have seen, seem to be descriptions about a weekly array of what’s available. Now, it is a very useful service, a great boon to medical blogging and bloggers and a wonderful way to initiate non-bloggers into the medical blogophere. A medical metablog would do some critical analysis by topic or issue or category of blogs. If it was by one of the medical bloggers, it might have to be anonymous because of the problem noted above about critical comments. It could be anonymously rotated. I could see a pithy review being syndicated to newspapers. It might help break through the glass ceiling of the internet. There could be money in this idea for someone. What do you think?
The Sunday Morning Market in Satok is a wonderful experience. You can meet your friends there, make new friends, walk among the heady aroma of exotic spices, obtain the bounty of the rainforest, select the best crabs and locate entire string rays for sale. Many of the vendors arrive the day before and sleep overnight Saturday so they can start bright and early at 5 am Sunday. They say you can find wild boar, birds in cages and turtles, although I haven't tried. Even if you arrive at 8 am as we do, you will be late. Parking is at a premium as the whole area around the market is packed. Waiting for my friends to find a spot, I meet an older man who has already finished his weekly marketing. He had locked his bicycle close to the edge of the road near the entrance. We chat for a couple of minutes as he balances his weekly supplies in plastic bags on both sides of the handlebars and stores the dry products in the stuff bag at the back.
"I am come every week", he tells me. "Flesh, very flesh." Wheeling his bike out between the crowded vehicles, he waves jauntily and rides off home obviously pleased with his weekly shopping. I am so much enjoying talking to him, I am slow with my camera. You can find all the specialties of the rainforest and South China Sea in Satok. There are large packages of midin or fiddleheads, their slender, coiled fern heads peeping out of wrapped banana leaf packages, bamboo shoots smoked or plain and snake fruit, buah salak, with its leathery brown skin covering a luscious,whiteish-yellow fruit which is eaten plain or with a soy sauce dip. Dragon fruit with its white flesh studded with small soft black seeds and bundles of wild greens of all kinds are all on disply. Some vendors have a small variety of different produce, obviously from their own garden. Others have enormous quantities of one or two items. A number have the ingredients for the complete meal in one place, chili pepper, onions, jack fruit, lemon, tomatoes and ginger. You don't need to go to anyother place to collect your ingredients.
Ruffled beans also called square beans because they have four corners to them and long beans as well as many wild greens are in large piles and small mounds. The lovely flowers of the gingerplant are also eaten and are prettily displayed. We had one in our garden which was beautiful. I was horrified when the decision was made to eat it.
I watch several people who drop by the stalls offering sago worms or grubs. The fat white worms are still alive in plastic dishes that contain small pieces of sago bark. Care goes into selecting them. They are a real delicacy for some groups here such as the Melanau. They can be eaten fresh or fried and are said to be cure for asthma. I wonder if these tasty morsels are some of the items we watch people eat on shows like Survivor. The fish section is particularly large and active. It includes both dry and fresh fish. To one side, young guys cut and gut fish in clean rapid strokes. They show me the roe or eggs of the fish which are sold separately and practice their English.
Crabs are held in plastic tubs with grates over the top. Each crab has been tied up with a thin piece of string over the carapace which holds their front claws so they can not damage each other. One customer wants only females. Assisted by the vendor, she goes through two of the tubs checking until she finds females. There aren’t many. It looks to me like she is going for them all. People here have very distinct tastes for fish. Some only buy shrimp at certain times of the moon. We look on the internet to see if we can find anything about why that is so and find a webside which outlines research being done on tide tables (phases of the moon) and quality differences. Why not, we think? More Old Wives Tales with a solid basis in fact.
While the fish section is the most crowded, has the most variety and seems to attract the most attention, there are also lots of live and dead chickens. The live chickens are trussed up in packages with string loops for holding them, so you can check them out and haul them home easily. The man selling dead chickens is declawing all the feet which will also be sold. Vendors don't do much sitting around in this market.
Some stalls feature cooked food for consumption on site and for take out. Bamboo skewers are being slowly cooked over hot coals in metal drums that have been sectioned in half. You can select the meat or fish you want and then wait for it to be cooked. This grilling is one of the finest ways for bringing out the taste and is a high art in Malaysia. Often the meat is dusted with spices. There is a section of the market where Indian woman have spread out containers of various different spices and curry mixes. Maybe we should just try a small amount each week until we discover the best one, I think. I stroll down the fish section. Sting Ray is available. Today there is even a whole string ray which is rather unusual. There are red snapper in a range of sizes, which I can recognize from the Pacific coast. A variety of eels are offered smoked, dried and fresh. Periwinkles, snails, clams and shrimp of many sizes and colours are found. The dry fish section is huge. Even the smallest sardines have been sorted into sacks of different prices. While undertaking my tour of the fish market, one of the professors from the university hails me. Later I run into a couple from our compound. It seems everyone is here.
For a time I lose sight of my friends. I have been taking too many pictures. The young fellows gutting fish are concerned to see me scanning the area.
“Are you lost?” they inquire.
“No, I think my friends are lost, because they are so short I can't see them”, I say.
“I am tall, they can easily find me”.
Near the fish section of the market, right beside the entrance, there is a van packed with sacks of ice. Hygienic Ice, says the sign on the side of the white van. A young, well-built man pulls out huge sacks, loads them on the dolly and wheels them into the fish section. He brings back empty sacks. By the time he has his next dolly piled high with 2 sacks, it is time to move it to the fish stalls.
In Satok Market you appreciate the work that is behind the food we eat. You are aware of how many people are involved and how much the market and food is a part of life here. It's a whole world intimately linked with the land and sea. Photos: square beans, man leaving Satok with weekly shopping, sago grubs, midin, ginger flowers, sting ray, BBQ treats, cocks, guys gutting fishes
Especially for my students. This week The Examining Room of Dr. Charles is hosting Grand Rounds and has provided a wonderful collection of 57 medical blog selections from all across the blogosphere. If you click on the highlighted "Examining Room of Dr. Charles" you will go directly to Grand Rounds.
Once a week for the past 100 weeks there is a Medical Blog Grand Rounds. The host blog reviews submissions from medical bloggers and compiles a post on the host website. The post by the host has a short introduction to each featured blog and a hyperlink which allows you to click on it go directly to the featured blog. It is a good opportunity to check out a number of medical blogs which you might find interesting.
There is one blog called Aetiology that deals with epidemiology themes, especially infectious disease related. Several blogs with the intersection of life and medicine. My favourite is Tundra Medicine Dreams, a blog by a Physician Assistant in a tiny community in Alaska who writes about life and health in the Arctic. There is even one blog in the grand rounds which discusses a old childrens book about doctors. This week's Grand Rounds is a lovely collections of snapshots of different aspects of medicine. Borneo Breezes is pleased to have Hazy Daze featured somewhere in the middle. Enjoy.
I am celebrating that I have solved my problem with loading pictures. I actually counted down 404 lines manually located char 5 and then didn't know what to do. So I looked at other lines and thought maybe I should line it up with them. And presto, it worked. Either that or someone in the innards of my computer finally heard my cries and answered me.
I am under a haze this week, something more than the Lazy, Hazy, Crazy Days of Summer in the song of the same name. It is the annual Hazy Daze of South East Asia. The Air Pollution Index has reached hazardous levels not only in Sarawak but also in mainland Malaysia. There is talk of issuing masks to everyone in the University campus in Samarahan, just an hour from downtown Kuching. Concern about navigational safety is rife with visibility reported at 1 mile. Office workers in Kuala Lumpur report that it looks like a wall of solid grey cement outside the windows. Essential supplies in some remote areas are seriously depleted because aircraft have been unable to fly due to poor visibility.
Smoke haze has been a problem in Malaysia for more than ten years. The first thing to acknowledge is that health issues are almost always political. Take breast feeding. Most women in Malaysia breast feed for somewhere between a week and a month, only 29% continue for the recommended 6 months. The Malaysian Ministry of Health is right now considering action against 8 of the 12 powerful multinational companies selling infant formula who have transgressed ethical marketing guidelines at least three times. I don’t know about you, but I thought this had been sorted out years ago. Kudos to Malaysia for keeping tabs on the infant formula multinationals.
So if breast feeding, the original motherhood issue, is political, just imagine the action around air quality. For years, Malaysia has been experiencing smoke haze for several months between May and October. The haze is worse in Sarawak and the southern part of peninsular Malaysia. Malaysians seem to believe the haze arrives on southwesterly winds from Indonesian Borneo and Sumatra. Both legal and illegal logging has increased due to population pressures in Indonesia with much of the land clearing being done for agriculture using ‘slash and burn’ techniques. Satellite photography verifies there are more than 600 forest fires on the Indonesia side of Borneo this week compared to 40 on the Malaysian side, so there is some truth to the allegation.
But air pollution or haze, is also a result of increased burning of fossil fuels in vehicles, industries and power stations as well as emissions from millions of inefficient cookers burning wood and other biofuels. Malaysia has been one of the most rapidly industrialized and motorized countries on the planet. So it is pretty clear, that there are plenty of home grown contributions to air pollution. In fact, neither country is off the hook.
And just in case you were starting to think this has nothing to do with you and your world, UN scientists have documented that haze affects rainfall and farming putting hundreds of thousands of people in the region in jeopardy. And for those of you further afield, a pollution parcel such as the South East Asia haze which stretches three kilometers high, can travel half way around the globe in a week. It has become, in the words of the same UN scientists, a regional and global menace.
The government’s response at the top of the haze crisis in 1997 was to make the Air Pollution Index an official state secret. For the next eight years there was a ban on publishing the air pollution numbers. Politicians were worried the numbers would give a grim and distorted picture thus negatively affecting the tourism industry, the second largest foreign exchange earner in Malaysia.
The haze did not go away and the complaints did not go away, just the numbers. Last year, August 10, 2005, the government lifted the ban. This year we have the haze, the complaints and the numbers. I, for one, am glad that we now have the numbers. I believe we never really address difficult health problems until we have the numbers. Now I believe we have a fighting chance. I also think we need more numbers. We need to know about the relative contributions of vehicles, industry, logging and agricultural burning. We need to know how much of an improvement we can get from the various mitigations available to us.
The situation parallels the history of air pollution. For the longest time we knew that air pollutants, such as sulfur dioxide and particulate matter, caused ill health but what we lacked were the numbers. How many people get sick and how sick? It wasn’t known if there was a safe level or threshold for pollutants, or how much of which components caused the damage. It is only in the last twenty years that a body of well-documented studies have been able to substantiate scientifically, with numbers, the damage to health.
One of the most quoted reports about air pollution is that of the dense London Smog of 1952. The dramatic increase in airborne particulates that occurred during the Great Smog was tracked and it was noted that one day later there was an overall increase in daily deaths which didn’t return to pre-smog levels until the smog cleared. Somewhat later analysis showed that the 4000 'extra' deaths during the smog were chiefly cardiovascular and respiratory deaths and they were highest in the elderly.
The association was however somewhat less than complete evidence for a causal relationship. Polluters were still able to say that the London Smog is a worst case scenario and we are causing much less impact on air quality and may not even be causing ill health. Outside of the Clean Air Act which made a dramatic difference to Londoners, very little happened for more than 35 years.
There were a number of problems associated with making the causal link between air pollution and ill health. One problem was in determining which of the many pollutants are responsible for ill effects and at which level or concentration. Air pollution was and is a “soup” of many different pollutants. Another was the ethical concern about doing human studies which may expose people to potential dangers. What we were left with was observation of current situations, many of which were small company towns without the needed numbers of exposed people.
In the late 1980s, C. Arden Pope, a PhD in Agricultural Economics at Brigham Young University, who up until that time had only done agricultural studies, noticed that when a mill was on strike there were 2/3 less children with respiratory conditions in a Utah town. I am not sure how, but he teamed up with DW Dockery, an environmental epidemiologist at Harvard. I imagine him thinking, “Professor from Harvard, an environmental epidemiologist, just the ticket.” On the other hand, maybe it all started because they were old friends having a poolside drink in small town Utah, sputtering in the blue air and exclaimed, "Got to be possible to show this is bad for our health”. Or maybe, having all his data in hand, Pope went to Dockery for help in documenting a possible association lurking somewhere in the numbers. However it came about, it was an inspired partnerships, for there were many detractors ready to pounce on the first and subsequent studies.
More papers followed. The science improved. Better testing was devised. We learned that PM10 – particles the size of 10 microns, the ones everyone had been measuring, weren’t the problem. It was the smaller particles of 2.5 microns that did the respiratory damage. So we switched from monitoring PM10 to monitoring PM2.5. Guidelines were altered. Once we had the numbers, despite their limitations, we started to move ahead much more quickly with control and prevention activities.
I am hoping that now we have the numbers to talk about, to improve and to augment, that we can begin to move ahead with control and prevention of air pollution in South East Asia. If I had my druthers I would set up a number of medical research grants specifically to address air pollution, respiratory and cardiovascular health in Malaysia. This effort is going to need the mobilization of the whole population, individually and collectively. The more numbers there are to convince them, the easier it will be.
I also can’t help but notice that these breakthroughs in medical science, such as Pope made in air quality, seem to be done by people working outside their usual professional boundaries. In this case, even outside of medicine. Medical science is so much based on methodical, incremental improvements that that is all many medical researchers do. Careers are built on it. Physicians as a result, think along traditional lines and often seem hampered in taking the creative leaps needed when a brick wall looms. This feels like a topic for a further blog.
At fifteen I believed my values were immutable and formed my core, the essential part of me. When I first learned that values varied with circumstances and were changeable, I thought I was being dunned. It wasn’t long however, before I wholeheartedly embraced the idea.
So much so, that a good friend told me in a moment of pique, “You are the most opinionated person I know. Your only saving grace is that you are constantly changing your opinions.”
We were at the Montreal Expo. We doubted we would ever find each other again if we separated, so we were trying to agree on places we both wanted to see. I told her the crystal in the Czechoslovakian pavilion was rock bottom on my list. I lost and had to go with her. She was annoyed because I loved it, unreservedly. I took her comment, then and now, as a compliment. Since I do hold strong opinions, I figure it is best to be open to persuasion and flexible about them. In some ways, I may actually cultivate this approach. For example, my list of favourite things is very site specific and includes newspapers here while I no longer subscribe to any newspaper at home. Early Morning Walks In Borneo, I rise at the time of the morning called by the Iban, Dini Ai Dalam or Deep Down Dawn. It is that moment just before the sky releases it's hold on the night. The proximity to night and the early stirrings of Borneo breezes ensure that it seems cool, even if it isn't. For people of the rainforest, it is a time when many journeys begin. My journey takes me no further than a nearby park.
When I start my walk, it feels as if I am the only one afoot. Even the security guards at the gate are drowsing in their plastic chairs. Gradually as my eyes adjust, I can make out others. The time called, Empliau Bebungi or Calling of the Gibbons soon follows. Imagination is needed here because there are no gibbons in my part of Kuching. By the time Tampak Tanah or To See the Ground rolls around I am on my way home.
The naming of the parts of the day for the Iban appears to be similar in some respects to the naming of the caribou by the Dene and of snow by the Inuit. For people who are connected with their environment, what matters gets noticed, described and shapes their world. So I hug the phrases close to me.
Early morning walks have become one of my favourite things in Borneo. We visited Mulu National Park last weekend, walking miles to and through caves and still I missed my early morning walks. It’s not a matter of endorphins as I only walk, never run or jog and only for an hour. I prefer to believe it is the magic of that hour in the rainforest.
Borneo Post On my way back home, if it is there, I pick up a copy of The Borneo Post at the gate. My advice to people visiting another country is to read the newspaper. I follow my own advice. It gives a sense of what matters. My reasons for enjoying the paper parallel those of Somerset Maugham,who savoured The New Straight Times, a Singapore newspaper, when he was in Malaysia, for the quality of the writing and its local colour. Maybe too, like him, I will one day write more about it.
I read about the terrible vulnerability to fire of a longhouse with 135 doors and many open hearths. How a shouted warning from a neighbour, up in a nearby coconut tree, can save all the lives. A muted blessing since it leaves them to watch the conflagration of their home. Sarawak unfolds before me in the newspaper. “Running amok”, a expressive phrase we have borrowed from Bahasa Malaya to describe a person gone violently, uncontrollably mad, leaving havoc his wake, is uncommon but still happens. In Malaysia it is almost always associated with a parang or panga, a large, sharp blade readily available in most rural homes.
A riveting tale of maternal mortality averted is painstakingly laid out by a journalist. A Penan, one of the nomadic hunter and gatherers who still live deep in the rainforest, in a cashless economy, manages to bring his wife who is in prolonged labour, hundreds of miles downriver to the coast, where she is transferred to hospital. It is almost, but not quite, a fool’s journey. They start off when they are already in trouble. I imagine the father knowing, as he surely must know, either he gives it a try or he loses his wife.
There is no regular transport to or from his area. The labouring woman, the father and their 8 year old son hitchhike on logging rafts, Chinese traders and longboats. The agonizing trip and the assistance offered to the distressed woman are detailed. It is a convoluted water journey to a place he has never been, that delivers his small family to a far off sea. How, one wonders, have the mother and baby survived? We read about this heroic story because the father and son are now stranded without cash in the coastal town of Miri. Almost before the ink is dry however, money has been raised to transport them home. Even so, it may take them weeks to return home.
For someone who wants to motivate health workers about maternal mortality, this article is a gift. So too are the management articles that reflect Malaysian realities, the regular updates on the current Hand, Foot and Mouth epidemic and the useful critiques on local environmental impact assessments. The newspaper has become one of my favourite things.
Tropical Fruit Juices Everywhere is SE Asia you can find fresh tropical juice. Coconut juice can be drunk straight from the coconut and costs about 30 cents. Pink guava, fresh lime with a salted plum added, leechee, pineapple, orange, watermelon and mango juices are available even in smaller stalls. My favourite is Aloe Vera juice made by peeling the long cactus spikes, slicing the pulp into stripes and soaking it in water. The pulp is jellied so can be chewed. It is sold in small plastic bags tied with rubber bands. We collect ours from a local shop where it comes is groups of ten for 15 ringet or about $4.00. During Ramadan, a big time for fresh juices, watching men push sugar cane through what looks like a washing machine ringer to produce sugar cane juice is a sure draw for me. Fruit juices are another of my favourite things, even canned juices such as jellied water grass, soya milk and ginger drinks.
Food Displays The local food stands with fresh forest produce, dried and fresh fish and piles of fruit and veggies are favourites. I love to see the different arrangements, learn about local availability and taste new and unknown varieties of fish, fruit and vegetable. I like the sense of discovery when I see a new item, taste it, and then see where it grows. Among the fruits I continue to be astonished by dragon fruit from a cactus, snake fruit from the rainforest palms, mangosteens, star fruit, longons, leechies, rambutans, mango apples, and durian. It is as difficult to describe the different tastes. Imagine trying to explain the flavour of pineapple when you only know apples and oranges.
Durian requires a special section of its own. It takes a while to get used to it. We are just getting into durian season now. I know people who are planning trips to Sarawak who have waited for durian season. It is the only fruit I know that is actually forbidden in places such as airplanes and hotels because of the strong smell. The taste however is heavenly, something like vanilla cream cheese laced with marshmallows. People who love it are avid and the line ups at fruit stalls now are long. The fruit itself is large and covered with hard spikes Among vegetables, the square beans, ruffled beans, midin or fiddleheads, long beans and a small green pepper a bit like cucumber, are wonderful just to look at never mind to taste. I am still looking for names for some of them. Fish stalls are full of dry and fresh fish I have never seen. What I can do is try them all. Menus are not much help since most are simply called fish dishes. People may not have names for them all but they know what they like. Dried fish and even fresh fish purchased at the last minute and carefully packed, are frequently taken as gifts when going to another area. I have a theory that half the cardboard boxes in the plane luggage hold, and there are many, are full of fish.
Baskets Without a doubt, a lifetime passion for baskets has followed me. I began dissembling my vast collection before I came to Sarawak when it threatened to push me out of my own home. I found by giving baskets away to friends who appreciated them, I got to continue to enjoy them twice over, once for the memories of where and when I obtained them and once for the appreciation by others of their innate beauty. I most enjoy them when they are in regular use. I have resisted collecting baskets here. I take pictures of them instead of owning them.and appreciate them vicariously though my friends. It works, sort of. It is good to learn to appreciate things without possessing them.
Starter Kits Another of my favourite things is discovering something about which I know nothing. Usually some kind of starter kit is needed. My kind of starter kits cannot be bought, yet anyway.
When I entered medicine, my old Sea Ranger leader came round to wish me well. Things were financially rather bleak. She was a housewife, so her visit and the ten dollars she gave me represented a major show of solidarity. I knew ten dollars would feed me for a month on rice, wieners and frozen peas, but I wanted to acknowledge the extravagance of her gift. So after some consideration I decided to give myself a starter kit of Jazz, something I had heard about, thought I would like, but about which I knew nothing.
With the ten dollars I managed to buy a thin paperback about jazz and three vinyl records from the remainder bin, Sketches of Spain by Miles Davis, The Composer of Desafinado by Carlos Jobin with Ipanema on it and one by Thelonius Monk. Maybe I liked the cover art, or maybe, not knowing any of them, I based it on price. It took me a while to get into Monk, but the other two records and paperback were the best possible introduction to Jazz. It opened a small window on a whole world that continues to bring me enormous pleasure and serves as a constant reminder of the importance of support.
I am working on a starter kit about sago. Sago biscuits are one of the tourist items in Sarawak. While I have heard of sago pudding and tasted sago biscuits, now I am learning how it is harvested in logs from the forest, floated down the river to the mouth and then milled into powder flour and beads for making food. The effort seems enormous. At the cultural village a woman starts with the cut logs, goes through the whole process using a grinding stone and large frame sieve and then sells her tiny beads of sago. I have yet to find out why it is important in this area but I am still working on it. Some starter kits need to be developed.
Wild Flowers I enjoy discovering the wild flowers of a place, where they are found and when they bloom. It makes me feel more linked or connected to the place. On canoe trips I take pictures and press flowers. In new places, I walk and drive the rural roads on the outlook. I record the sites and dates and return when I can. I have identified “new-to-me” flowers from a car window at 100 kpm. This is not as difficult as it sounds. If you know the height and colour of the usual wild flowers found in an area, what sticks out is likely to be something rare and unusual. When you stop and verify it is so, your companions are simply amazed and you have established a certain reputation. Imagine such a one being in a place where the wild flowers, the common wild flowers, are orchids and pitcher plants.
I am not alone in this love of orchids and pitcher plants. Rare and beautiful orchids and exquisite varied pitcher plants are on sale for pennies in many places. But unless the buyer is very careful, such plants do not do well in urban gardens. Surprisingly, they like the shelter, humidity and fecundity of the rainforest more than city yards. So there are lots of dead or dying orchids and pitcher plants around. The people selling the plants are barely surviving on the margin. The issue is a difficult one, similar to the survival of gorillas in mountain forests in Rwanda or elephants in Kenyan game parks. The solution needs to be approached in ways that benefits local people and rewards them as the protectors of this bounty. Lots of innovative programming is being done in Africa at present, I sure hope it gets to Borneo in time. This is one of the aspects of sharing my favourite things. I know we can only really protect and care for the things we know well. I want others to enjoy them but I feel an overpowering need to protect them. It’s a battle I don’t win all the time, but I keep trying. Photos: Pitcher Plants, Dragon fruit, NO Durian sign; fish stall in market, sago logs, refining sago, baskets and common roadside bamboo orchid.
My elementary school had large roll down maps of the world. When the map wasn’t on display at the side of the room, it was rolled up on its two long poles and stored in the corner of the cloak room. The maps were old so the pink parts were still labelled as the British Empire although we had begun to refer to it as the Commonwealth. But whatever one calls it, the variety and number of nations involved is impressive. Names such as Burma and the Road to Mandalay exert an emotional tug on me still that is likely rooted in those early maps.
Some of the names are now changed. Myanmar, it turns out, has always been the local translation for Burma. Myanmar opened up to travel a couple of year ago. My friend, Aye, who has worked in Malaysia for 20 years is taking a group of us with her to visit her home. For me, it is finally a trip on the Road to Mandalay.
We stay in Yangoon in the family compound formed of the homes of her brothers and amazingly her own home waiting for us. We are a couple of streets from where Aun Sang Suu Kyi is held under house arrest. Depending on what is happening at Aun Sang’s place, traffic is rerouted and the street we are on becomes very busy. It makes the cruel and seemingly endless detention so much more awful to be here with her so close.
Along the roadways in town and especially in the rural areas, we notice that homeowners have placed water-filled pottery jars by the roadside for people passing by. Not all are as elaborate as the one in the picture, but all are appreciated and used by the many on foot.
Aye has brought gifts for everyone and there is much gaiety with unpacking and kids bouncing around. We are royally welcomed and fed traditional Burmese cooking. We stay only long enough to hire a van and load up supplies. The van has seen better days but the price is right and has a driver to boot. We are happy to leave the planning of the route and sights to Aye. There are a couple of old friends to see enroute and a sister to connect with in Mandalay for the visit to the Bagan plains. Then from Mandalay we will head for the Shan plateau and the famous Inle Lake with its floating villages. In Yangoon we practice reading Myanmarese script which, with its circular characters closely resembles Sanskrit and is sometimes referred to as “bubble script”. We are no linguists but in short order, with a little help, are reading the numbers on the license plates with ease. Heading for the post office, post cards in hand, it feels as if we have dropped back in time to when, surrounded by trees and benches, post offices where gathering places. We are advised not to expect to find post cards once we are outside of the city. But the same could be said about Sarawak and does not prepare us for the sharp contrast between Yangoon and rural Myanmar. Shortly after we leave Yangoon, vehicular traffic decreases dramatically. Cars and trucks are so rare, they seem out of place. Buses are non-existent. People are walking, riding bikes, driving cow-pulled racks, sitting three deep on motorbikes and coaxing donkeys, but there are few cars. That’s the first thing that hits you. That ordinary rural folk in Myanmar have limited access to motorized transport.
Up for an early breakfast we witness a buyer of chillis arrive in a small town. Sacks brought to town the night before on carts are lugged onto the plastic tarp the buyer has spread on the open ground. A scale is strung up under the tree. Each bag is carefully weighed and recorded before being tossed into the back of a decrepit panel truck. An hour later when the truck pulls out for the next town, it is as if it had never been there.
We set off early most days to avoid the penetrating heat of midday. After interminable tinkering by our driver, we conclude that the air conditioning works sporadically. Much time is spent working on a formula for sporadic. Everyone has their favourite theory, which like the air con, sometimes works and sometimes doesn’t. The breakfasts we find in small towns are wonderful, hot coffee and deep fried beignet-like treats. The others in the group are sticking to what they know but I am attracted to what others around us enjoying.
There are temples, stupas, majestic guardian lions, caves full of Buddhas and historical sites everywhere. They are well kept, clean, and visited often by the locals. On the doorstep of Mandalay we reach the Plains of Bagan, on the bank of the Ayeyarwady River. To see it for the first time is to be stunned. It is a huge area of more than 60 square miles of ornate, elaborate stupas, statues, shrines, temple painting, wall murals, monasteries and temples. Everywhere you look, there are different styles and archaeological periods on display. In the 13th century more than 4400 different structures were identified. By the early 20th century 2000 plus monuments were still standing, many of them more than 800 years old.
Bagan is one of the world’s treasures but has yet to be proclaimed so by UNESCO because that would put a stop to government plans to build fancy tourist hotels on site. Bagan was and is a deeply religious place for people in Myanmar. Legend has it that when Buddha visited as a young man he foretold there would be a golden land here where his beliefs would flourish. Burmese who can afford it still make regular pilgrimages to the area. By the time we reach Mandalay, my quixotic eating habits have done me in. But the show must go on, so I lay across several seats in a huddled heap in the back of the van and spend one day in bed in Mandalay. I am back on the road in time to see Mingun Paya, which had it been finished would have been the world’s largest zedi. A zedi is a solid Buddhist monument toped by an ornate spire. Close by, carrying out the large theme, is the largest uncracked bell in the world, the Mingun Bell.
We reach our night stop high on the Shan plateau at Kalaw. It is cool and refreshing in the cabin and for the first time blankets are needed. The place brings back memories for Aye who camped here with her Girl Guide troop including Suu Kyi. We are up at 4 am for the next leg of the journey so hardly even have time to appreciate the view. The flat beds loaded with massive teak logs that come careening around corners are much more frightening at this hour in the morning mist.
By the time we reach Inle Lake I have fully recovered. Inle Lake is surround by mountains and covered by floating islands and fishing craft. Hand poled sampans move gracefully among the islands. Some islands are floating fields where crops are tended by the farmers who ferry back and forth. Except for the lake-crossing taxis, water craft on the lake are motorless. Nets are thrown by hand in great looping swirls. Fishermen steer standing up with one leg wrapped around an oar better to steer around obstacles and watch for fish. Even small boys have mastered this fascinating technique. On the other side of the lake we tour silk factories humming with the clacking of shuttles and watch women making paper from reeds and grasses and men pasting small sheets of gold leaf on a Buddha statue in an island temple. Heading back to Yangoon, a young girl who can’t be more than 10 rides on the back of a huge water buffalo with her small brother attached on her back. I ask to stop to take pictures and an even smaller boy emerges from the bushes on another water buffalo. My friends chat with the kids and give them some oranges. It seems the kids are heading home. I am still shaking my head. We also pass tractor-pulled flats packed with children and parents on a school outing. In Yangoon, our backsides get a chance to recover. We tour the jewelry stores where pearls, jade, coral and almost every kind of cut gem in the world can be found. Aye is an aficionado with a good eye when it comes to gems, although she doesn’t wear much jewelry herself. The others have come with specific requests so we have fun filling them and learning in the process. At night we pour over gem books. For Burmese Buddhists the Shwedagon Paya is the most sacred site in the country, the one everyone hopes to visit at least once in their life. It is said to contain 8 hairs of the Buddha. 2500 years old and rebuilt many times, its glittering golden dome rises 98 meters into the air. Lighted up it dominates Yangoon’s night skyline. Despite its splendour, it is first and foremost a place of prayer and hums with activity all day long. I am the only tourist, all the rest in my group are Buddhists, as are most of the people in the temples we visit. Each temple visit is for them a pilgramage to be properly observed. To be there with someone making their slow round of honouring and obeisance is deeply moving.
I accompany SuuSuu, Aye’s sister-in-law. She prays at a number of spots, leaving behind jasmine, joss sticks and her prayers. After each stop she explains the site and significance to me. SuuSuu prays for her husband and a daughter at the Wednesday shrine. She tells me that is because they were born on Wednesday. She adds that there are eight such alters, one for each day but Wednesday has two, one for the morning and one for the afternoon. For some reason this arbitary, unfathomable fact cheers me. For her grandson who is going to Penang for congenital heart surgery she pauses at another site. I watch the ebb and flow of people as she makes her rounds and appreciate that this is a wonderful way to see the Shwedagon. But what I appreciate most in Yangoon, even more than the intricate marionette shows and fantastic sea food at the boat hotel, is the brief afternoon visit to the Htaukkynt War Cemetery, a quiet well kept spot just outside the city. More than 20,000 graves provide the name, rank and country of origin of those who lost their lives in Burma and Assam in WW11. In the center, surrounded by the graves, is a splendid open structure of colossal marble pillars that seem to speak directly to the sky above. What a monumental structure to put in a grave yard, I think. When I get up close I read that the pillars are chiseled with the names of those who aren't buried here, but who also gave their lives here in the War to End All Wars, whole regiments of Sikhs, Karens, Gurkas, Pathans and others from all the pink places on my classroom map.
Photos: Temple spires, water by roadside, biker with baskets, animal-drawn cart, fishers on Lake Inle, boy steers boat, paper making in Inle Lake; kids on water buffalo; Shan kids
A community medicine physician, I have worked for more than 30 years in Uganda, Kenya, Ethiopia, Malaysia, Laos and Pakistan. Currently I divide my time between Mbarara University of Science and Technology in Uganda and Frontier Primary Health Care, an NGO in KhyberPustoonKhwa region of Pakistan.