Elephants bring good luck, especially when the trunks are up

I’m sitting in my home in Sydney, where the weather is 16.9 degrees, a drop of 15 degrees from what it is currently in Bangkok. It’s been almost 2 weeks since I arrived home, and the trip now feels like a dream. I flick through my photos and think about what I experienced… and it all seems like a million worlds away. The most trippy part for me is wrapping my head around the fact that I finally made it overseas for the first time!

When I think back to arriving in Bangkok and venturing out for the first time I can’t help but laugh. I had these horrible ideas in my head of being followed or pick-pocketed, yet I felt so safe and accepted. I remember worrying about what I’d be eating and feared getting sick, yet I ate fresh fruit, drank iced drinks and brushed my teeth with tap water! But most importantly, I kept my mind open to what lay ahead of me and what I would be experiencing as part of the Experiential Nursing Program. I knew before the trip that barriers in verbal and non-verbal communication would exist, and these barriers required me to be flexible and adaptable when interacting with people. Learning a few words in Thai definitely helped and it is evident that a smile can mean a lot. Also, being immersed in an unfamiliar culture compelled me to be aware of my own beliefs and customs and I remained open-minded to new and differing scenarios, always conducting myself in a culturally safe and appropriate manner.

I can say that without a doubt, I returned home with a greater appreciation of the health care available in Australia and a greater understanding of socioeconomic issues and their impact on health in developing countries. Where do I begin describing what I witnessed? Diseased and injured organs and limbs. Forensic photographs of horrific accidents. Babies born with lethal abnormalities. Women swaying around poles atop bars, expressionless. The sad result of sex tourism and children left in orphanages. Rubbish dumped in streets. A homeless man and his dog sleeping underneath the train station. Unprotected motorcycle and scooter riders transported 2, 3 or 4 passengers. Polluted waterways filled with rubbish and dead fish. Exquisite temples standing between rundown apartments and tall commercial towers. Markets selling medications that would require a prescription if sold in Australia. Women begging for money with children asleep in their laps. Private hospitals filled with international clients. People living with HIV socially isolated and forgotten about.

All of this just emphasises the fact that health care should be a right, not just something that exists to those who can afford it. The focus of health in Thailand needs to change from elective and cosmetic, to prevention of illness and promotion of health; through increasing education, eliminating stigma, and reducing social inequalities. Our visits during the program also highlighted the need for better equipped rural and remote facilities and recognition of their importance in the health care system for reaching disadvantaged populations.

Overall, this experience confirms my choice of career: Nursing, the art of care and healing that translates universally regardless of language, country, and culture. I know that I am destined to do more than work on a general ward; I want to be working to help the disadvantaged, I want to work in rural Australia, I want to travel overseas and see where nursing can take me, and I want to contribute to changing the culture of nursing in Australia.

Things I’ll miss about Thailand:

· Living in a completely unfamiliar environment and culture

· Walking through the city and exchanging smiles with strangers

· Meaningfully relating to people non-verbally

· Venturing out in to the city not knowing what to expect

· Seeing squirrels scurry along power lines

· Playing with gorgeous and happy children

· Sleeping less than 6 hours a night and dreaming about the buffet breakfast I’ll wake up to

· The buffet breakfast

· The street vendors and fresh produce

· Being able to afford to eat prawns in every meal

· Conversing in a new language (Sawaadee-ka!)

I will even miss:

· Waking up so early to allow copious amounts of time for traffic

· Eating too much food because it is too delicious not to consume

· The heat and the interesting smells

· Sitting on a bus for hours being able to absorb the views of changing landscapes

· Blowing my nose every 30 seconds while eating the spiciest meals

What I’ll remember for the rest of my life:

· Being so welcomed into an entirely different environment and culture

· Discovering an absolute love and passion for travel

· Participating in a rich learning experience and further discovering my interest in health care

· Pushing myself beyond my comfort zone and surviving

· Immersing myself in the experience and making the most of every moment!

Karina, Health for Wealth 2013, Thailand

This is an excerpt from Karina’s blog Prime the Line. Check it out to read more about her experience in Thailand on the Health for Wealth Program. 

Travel image - Karina

Baan Jing Jai Children’s Home

This was by far the most fun day of the program to date! Leaving after breakfast in our monstrous double-decker bus, we headed for the Baan Jing Jai Children’s House. All we had been told was that we had a few hours to spend there, and the onus was on us to organise and coordinate activities with the children. Again, I was unsure about what to expect, especially because I have never really been a kid person!

The Children’s Home originated as the Children and Youth Development Project under the supervision of the Church of Christ in Thailand. The object of this Project is to provide assistance, shelter, and educational and developmental skills to children who are underprivileged, street children, abused children, violated children, children from impoverished families, orphaned and abandoned children.

The Home presently cares for 80 children from the ages of 9 months to 18 years. There are no formally qualified staff, but house parents provide counselling, encouragement, love and care. Within the home, children receive the necessary skills and training for their daily lives, communal living and confidence. The children are provided with numerous activities including cooking, household duties, crafts, music and swimming. The children receive formal education in the school system (some are sponsored by private bilingual schools but most go to public schools), and can go on to vocational training according to their interests. Baan Jing Jai strives to fulfill the dreams and future of children and hope children are one day able to return to their own society and make notable contributions.

The premises currently consists of 2 rented houses located on either side of a small street. The boys sleep in one house that is next to the play yard, and the girls and younger children sleep in the bigger house that contains a small living room and kitchen.

Purpose of Baan Jing Jai Children’s Home:

· Provide the basic needs of the child

· Ensure all children receive a good education, both inside and outside of the school system

· Development and support of the children’s confidence and self-esteem

· Development and support of the children’s talents and special needs

For a few hours, we were left to play with the kids. Games and activities included music chairs, tunnel ball, skipping, bubble blowing, hair braiding, colouring-in, and dancing! An elephant even wandered down the street! We were also lucky enough to share lunch with the children, and had the children hold our hands and lead us to our table. It was such a wonderful feeling again being so welcomed and accepted, and the children thrived off our energy.

On a deeper reflection, it could be seen that the capacity for holistic care was most certainly limited, especially with the Home not having any qualified staff and no stable accommodation. I am interested to know how health care is provided and followed-up as many children exhibited congestive illnesses, and the brochure outlined that the Home cares for children infected with HIV. Learning this opened up a bigger inquiry for investigation… Is sexual health education provided? How are there individualised needs met? Who ensures and grants access to appropriate medication (ARVs)? Is there any form of infection control or segregation, with well-children mingling with potentially immunocompromised children? Are children provided necessary vaccinations? At what stage of an illness is the doctor contacted? Also, a 16 year old orphan has a baby of her own, both living at the orphanage. From a nursing perspective, I can’t help but wonder what level of care, support and education she was provided.

Obviously the level of care is very different and not comparable to that of a hospital, where, especially in the private hospitals, well-children are separated from sick-children. Understandably, this segregation is probably not possible at the orphanage. However, each child still has individualised health priorities and needs, even more so when it comes to infectious diseases and their sequalae (such as tuberculosis). So who is promoting health care? And what are the regulations for facilities such as this?

Despite all the smiles, it is obvious that there is a lot that needs to be developed and regulated – education, qualifications, guidelines, health care, transport… At the end of the day, I still do not doubt the work that Khun Pingta does for the children, and I am glad that children from disadvantaged backgrounds are such happy and loving individuals.

Karina, Health for Wealth 2013, Thailand

This is an excerpt from Karina’s blog Prime the Line. Check it out to read more about her experience in Thailand on the Health for Wealth Program. 

Baan Jing Jai
Baan Jing Jai
Elephant at Baan Jing Jai
Elephant at Baan Jing Jai

UNAIDS – United Nations

Yet again, we arrived at our first destination, the United Nations, extremely early. The bus drove us to the Grand Palace area just down the road and we had time to have a look around and take a few photos. Since 1792, the palace has been the official residence of the Kings of Siam, the Royal court and the administrative seat of government.

Upon entry we were required to go through security, have our bags x-rayed and hand over our passports in exchange for a name and security pass. We made our way to a small board room within the UNAIDS department and had the pleasure of meeting Steve Kraus. Yes, Steve Kraus, the Director of the Regional Support Team for Asia and Pacific, a pretty big deal! We were all buzzing and in that moment I felt so privileged to have such an opportunity. He also gave praise to Australia’s financial and technical involvement and support of UNAIDS, outlining that many interventions have so far proven successful, e.g. safe injection sites and opiate substitution therapy.

*there is an abundance of information about HIV/AIDS in Asia and the Pacific and regarding strategies to decrease new infections, reduce stigma and increase education, but I will just outline some basic information that I learnt during my visit*

HIV and AIDS estimates in Thailand in 2011:

· Number of people living with HIV – 490,000

· Adults aged 15 to 49 prevalence rate – 1.20%

· Adults aged 15 and up living with HIV – 480,000

· Women aged 15 and up living with HIV – 200,000

· Deaths due to AIDS – 23,000

· Orphans due to AIDS aged 0 to 17 – 250,000

· 70% of new HIV infections happen in 27 provinces

I found this presentation extremely interesting and educational and I will take a lot of this knowledge with me. I believe that my role as a Registered Nurse when caring for patients infected allows me to be supportive and reduce stigma and discrimination, thus aiming to reduce barriers to accessing and adhering to treatment. Despite developing countries having a higher prevalence of HIV/AIDS, Australia has seen a notable rise in HIV infections in the last year, reiterating the worldwide need for increased awareness and education, access to holistic care and treatments, and well-equipped health professionals free from stigma.

“Don’t be afraid to be a change agent.”

Steve Kraus, at the meeting with 20 University of Technology Sydney students, 11th July 2013.

Karina, Health for Wealth 2013, Thailand

This is an excerpt from Karina’s blog Prime the Line. Check it out to read more about her experience in Thailand on the Health for Wealth Program. 

The United Nations - Bangkok
The United Nations – Bangkok
UNAIDS Visitor Pass
UNAIDS Visitor Pass

Mumbai All

Mumbai, a city of opportunities, excitement and relationships. From street vendors selling paan (betel leaf) and chatpata snacks, to fancy museums and temples exposing the strong history and mythology of the country, the city is constantly buzzing with people of differing tastes, religions and experiences. From the initial day, it was clear that, given a period of only one month, I must be able to work, socialise and explore the immensely rich culture of this city efficiently.

Touring various parts of the city within the first few days of arriving India – the Gateway of India, Dharavi, Chowpatty, Crawford Markets (to name just a few) – India has exposed its diversity.

On a more professional note however, Andrew and I have been placed at the Bombay Stock Exchange (BSE), a financial and educational training institute that prides itself on its long-lasting history. Reflecting on the previous three weeks, my experience lies in stark contrast to my initial expectations. A surprisingly patriarchal society, it was interesting (and awkward!) to perceive the differences between the working cultures prevalent in India and Australia. For example, whilst wearing corporate attire is the norm in Australia, doing so on my first day at the BSE invited stares from several (partially shocked) workers who were obviously not accustomed to women wearing outfits other than ethnic kurtis and churidaars.

Further, noting the initial unpreparedness of the BSE in inducting their newest interns made me appreciate the efficiencies of the Australian corporate system as I was accustomed to working in. Nevertheless, it wasn’t long before they had outlined a detailed task for us that would test our abilities to deliver a report (and accompanying presentation) by the unchangeable deadline of three weeks. The clock was ticking!

Meanwhile, working here, one thing clearly strikes me: journeys are made with the people you engage with. Observing the office culture, I am impressed by the cafeteria system that creates a level of informality amongst employees of differing seniority, with all members of the BSE engaging in a cordial manner that only strengthens their friendships.

Along with this, as opposed to their initial hesitancy to interact, by virtue of familiarity, people have become gradually welcoming and this has definitely created a more enjoyable experience. People that easily come to mind include the security man who salutes Andrew every morning, Ramesh, the cleaner who loves Jackie Chan and tries to practice his English with us, and Ganesh, who makes wonderful adrak ki chai and tells us the lunch menu for the day. However, what remains deeply embedded in the Indian society is that of class – represented by the beige shirts worn by the cleaners, and the checked red-and-black shirts donned by the cafeteria men.

Similarly, office members are also not as reluctant to approach us and, as the first Australians to be accommodated by the BSE, lengthy discussions at work have blurred the lines between professional and personal relationships as each party attempts to learn more and more about the other’s culture and mentality. In light of this, I think Andrew and I make an interesting pair – as a Western male, many are curious to learn the multicultural nature of Australia. Contrastingly, although an Indian, as a female, the patriarchal system is a constant reminder of the fact that Mumbai, despite being one of the most modern cities of India, is still struggling to reinforce Western trends. Nevertheless, in the process of interacting with all these workers on a daily basis, the Indians have displayed their selfless, helpful and hospitable nature – be it accommodating for us through the tight security checks, or regularly checking upon our work as we sit in the cafeteria and try to motivate ourselves to focus on our report with its looming deadline.

It is true, Mumbai really is a city of extremes. Catching a taxi to work amongst the heavy traffic, or daring to lose myself in the busy streets around Churchgate, lie in juxtaposition with the serene walks along Marine Drive (although, all too often I have been drenched in the monsoon weather too!). Similarly, amongst the chaos of the city, I still feel like there is so much time available to the self – to sleep in in the mornings (due to our 11am starts), explore new streets (each with its own little surprise – the cinema culture, the beggars, the station crowd), and socialise in the evenings (when everyone has a spare moment to wind down and reflect on their time in Mumbai).

Overall, the opportunity to work in India has been an amazing experience, satisfying on both a personal and professional level. In aiming to improve the relations between the Australian and Indian governments, I think this program has definitely been helpful in dissolving barriers to the extent of enabling easier communication.

Jaya, Marketing Bollywood 2013, India

Traffic_in_Mumbai - Wiki Commons