The first view of Ban Arya
Greetings from the Clinic in the Clouds!
I know blogs are supposed to be spontaneous, near stream of consciousness, daily diaries, but we’ve been on top of a mountain for the past week and the mountain featured neither internet cafes nor wired connectivity. Sorry about that!
Silence should not be construed evidence of Christmas break sloth. The Warm Heart team has been hard at work, and I do mean hard at work, since December 22nd. In a week we built a “clinic in the clouds” that swirl around the small Akha village of Ban Arya (population 207 without us).
P'Ann and P'Aoy add style to clapboarding
Nung Nu and Nung Fu lend a hand
The exhausted Warm Heart crew takes five at the end of the day
You can see lots of photos of the project - what Ban Arya looks like, kids, people, construction, the Warm Heart staff at work and at rest - if you go to: http://picasaweb.google.com/WarmHeartWorldwide.
Actually, it wasn’t just us. On any given day ten Akha women with their dangling beads and high silver headdresses (wrapped in colorful dish towels whether as a fashion statement or protection from the sun, I have no idea) hoed up a storm, five men cemented the foundation or a dozen kids just buzzed around.
The hoeing crew ogles themselves on Will's camera
The Ban Arya cement team skim coating the knee wall
Young carpenter watches P'J for tips
The project really started on the 19th when a couple dozen of our friends from a Chiang Mai 4-wheel off-road club showed up to help carry our supplies up to Ban Arya. These guys have to be seen to be believed. In Texas or Oklahoma, you wouldn’t bat an eye – big, diesel Ford 250s and Toyotas with huge tires, jacked suspensions, chrome roll-bars, macho grills and winches, and, yes, snorkels. All that’s missing is the gun racks. In Thailand, however, these dudes are totally over the top and we love them. They’re all in construction and didn’t think anything to throwing twenty-five bags of cement, twenty-five bags of sand, lumber, tools, food for a small army and beer for a bigger one into the back and heading off up the mountain. The tougher the better. Good thing, too, because it was 9:00 PM, bitter cold, and pitch dark by the time they had off-loaded!
On the 22nd half the Warm Heart team bounced up the dirt path that passes as a road, dumped tools and supplies at the site and then settled in at the Queen’s cabins. The entire top of one mountain in the range is a Royal Project devoted to organic farming and the preservation of endangered flora. At the highest point are a fantastic lookout and a clutch of A-frame bungalows. The area is exquisitely landscaped with local flowers, shrubs and trees, and the views are breathtaking. We made a big fire, grilled strips of beef and sang a lot (something that Warm Heart does whenever there’s food and fun). Looking up through the tall pines, every star was in focus and the moon was brilliant. The air was clear and cold. It was perfect – and it stayed perfect for a week!
Bags of sand for the concrete work
Grandfather and his granddaugher watching the show
A village child born with fetal alcohol effect
On the 23rd almost a third of the village met us at the to-be clinic – the women in full Akha dress (which they wear all day every day) and the men in a motley of shorts, tee shirts, army uniform parts, blue jeans and traditional Akha pants. Everyone fell upon the sorry old structure that was to become the clinic and in a matter of hours stripped the frame clean. Gone were the old vertical bamboo slat walls, the sagging paneling, the piles of junk, the filth in the privy. A dozen hoes attacked the rock hard red clay around the slab to carve out drainage ditches and repair erosion runnels. By noon “Grandpa” (as the merciless Warm Heart staff dubbed our 55 year old carpenter) was hard at work framing up new walls and by evening the first of the new clapboard was going on.
The pre-renovation building clad in our banner
Grandpa and P'J framing the end wall
P'Aoy, P'John and P'Pleu clapboarding the clinic
Mounting the new exterior door
This stage of the Clinic in the Clouds project – preparing the clinic building itself – involved a gut job renovation of an existing structure. By the time the gutting was finished, all that was left was slab, knee wall, ten tree log posts, a roof, and a separate out house. In five days, the combined Warm Heart and Ban Arya teams squared the posts, put in wall studs, clapboarded the entire building and added the interior dividing wall, put in four big double windows and three solid core door, added solar power and wired the building for three compact florescent ceiling lights, a hanging work light where the examination bed will be and wall plugs, plumbed the out house and the examination room adding a sink and wall faucet, built a new, bamboo fence and dug drainage ditches around the building, laid concrete aprons around the building to prevent future erosion under the slab, skim coated the cinder block knee wall with concrete inside and out, stained all of the wood with anti-termite stain, and painted the knee wall around the building inside and out. It was a huge amount of fun.
The renovation project was funded by Hannah Reynolds (who also came to Thailand to help with construction) and contributions from her friends at Bryn Athyn College. (http://www.brynathyn.edu) The GlobalMed Chapter of Northeastern University is also a prospective donor. (globemed.nu@gmail.com )
NaaLay swinging a hoe
Even renovated, the clinic is a simple building that will serve many purposes. It sits on a concrete slab some 20 ft by 35 ft and stands 15 ft to a single peak. The roof is supported by 10” square posts. A cinder block knee wall runs around the outside above which rise walls of 2×3 stud covered by clapboard. The interior is split into a large room and a small room. The large room will serve as a classroom for the health volunteers and for Impact, an NGO run by a son of the village and his wife. They will use the space to teach villagers to read Romanized Akha and preserve traditional culture. The small room will be the clinic itself with an examining table, metal medicine cabinet, stainless steel instruments table, sink, and so on. Lighting is supplied by translucent roof tiles and florescent bulbs powered by a solar panel, inverter and deep-cycle battery set.
Warm Heart daughter Nung Sudah's dad
NaaLay the real leader of Ban Arya
Our hosts are a collection of remarkable people. Leading the work team is our Warm Heart daughter Nung Sudah’s father, P’AhUe. He is short, stocky, deeply tanned and weathered with broad, calloused hands. Looking into his strong, craggy face, there is no question that Sudah is his daughter; the resemblance is uncanny. Leading the project – and it seems the village, too – is NaaLay, the senior health volunteer. NaaLay is tireless. She can out hoe, out lift and out carry any person in the village, to say nothing of Warm Heart. She is everywhere giving directions or giving a hand; everyone listens to her. It’s hard not to. NaaLay has a smile that gives off light, but eyes that never leave yours during a conversation. At thirty-four she may still be working for her sixth grade certificate through Thailand’s informal education program, but this is a woman to be reckoned with.
We have made lots of valuable contacts up on the mountain. We have become very friendly with the director of the Royal Project, who is delighted that Warm Heart is providing the first ever medical facility for the people in this area. He has promised to include us in his dispatches to the palace. We have also had the opportunity to talk at length with the director of the Phrao Hospital who was touring a water project with his staff and stopped to spend the night at the bungalows. He is excited about the prospect of hosting a first class emergency medicine training program at his hospital and about the possibility of partnering with an American hospital.
Houses stacked against the hillside
Court yard of the house next to the clinic
Ban Arya is a pretty normal mountain village in most ways. What sets it apart is the nearby Royal Project which provides year around employment at 100 baht (about $3) a day. Very few mountain villages have a local source of cash income and must depend on remittances from village members working in distant cities. In other ways, however, Ban Arya is typical. Houses are built up the sides of two connecting, steep sided small valleys so that most look out over the one below. Two packed clay tracks run through town and a web of foot paths connect the homes. There are three churches, but no school, no store, no clinic (yet), no extension service, no post office or other official building, nothing but bamboo homes. There is an herbal doctor, a basket weaver, a musician. Every woman in the village is a master cross-stitcher and every man can build a house without using nails.
Shy, shy, shy
Kids mob Chiang Mai University voluteer Will to check out his iPod
Wow! iPod wins another convert
Over the top model with the mostest
Like all mountain villages, Ban Arya is a village of kids. They are everywhere. Ban Arya is a village that sends all of its school age children to the valley at age six so that they can attend school – and still it is crawling with kids. The minute we roll in in the morning, there they are, big eyed, serious, shy. It takes a bit for them to approach, but the hair on my arms is totally irresistible and once they’ve dared touch that, there’s no stopping them. And no matter how many of them infest the work site, there are always more elsewhere in the village. Raise your eyes from work and you see them climbing up the posts of porches or running down steep paths, swinging in the big Akha swing or chasing dogs down the road. You can hear them, too, yelling, laughing, talking, but interestingly never crying and never being yelled at by adults. Kids manage their own lives here. The bigs take care of the littles, and fighting, crying and running to momma are just not part of the repertoire.
Speaking of kids, one Warm Heart project wouldn’t be complete without spawning at least one and preferably two more projects, and by this measure Clinic in the Clouds is now complete. We have been talking among ourselves for several months about what to do to help a ten year old autistic boy in Ban Arya. On the 21st his mother died leaving his father to cope with him and several other children. Almost the first thing I was asked when we arrived in the village on the 22nd was could Warm Heart find a Warm Heart for him as we had found Warm Heart for Sudah. If only it were so easy.
This little boy is just the tip of the iceberg; every village I know in Phrao has an autistic person in it. Helping this little guy has to be part of finding a sustainable solution to the much bigger problem of how to deal with the large number of children with developmental disabilities who are a huge burden on extremely poor families with no place to turn. The government provides a subsidy of 500 baht per child, but this is nothing and does nothing to improve the quality of life of the child either.
What to do? Stay tuned; there will be a lot on this subject in the next few months. Honest, we don’t go looking for problems; they find us. But when something needs doing, it needs doing.
On a more amusing note, the second project that the clinic has spawned is all about bacon. Really. You may take bacon for granted, but here in Thailand bacon as scarce as teats on a bull, to change species. All of those many, many falang (as we’re called) who want bacon with their eggs in the morning have to buy it imported at the most astronomical prices. So? you are asking.
Well, here in Ban Arya the market for fresh pork is just too far away and there’s no money in selling pigs to each other. Solution? Don’t sell fresh pork; sell a higher value-added product such as bacon or smoked ham. They’ve got lot’s to feed pigs and lots of different, interesting woods for smoking; smokers can be made out of simple, local materials; smoked meat is much lighter that fresh and so costs less to transport; and no question their product will fetch a much better price!
Question: Do you know a meat smoking aficionado? One who would like to volunteer to spend a couple of months here in heaven teaching the first Thais in history the ancient art of smoking?
Smoky cook fires being tended by the Warm Heart team
Christmas. Yes, we spent Christmas in heaven. That in itself was pretty special, but it gets better. Ban Arya speaks of itself as three villages. This puzzled us no end until we finally figured out that what they mean is that the village of Ban Arya is divided (in an amicable fashion) into three confessional villages, Catholic, Protestant and Evangelical. So what about Christmas? On the 25th everyone goes to their own church for a quiet service. Then on the 27th the whole village assembles for a day long Christmas celebration that includes no small Buddhist and animist representation, too. It is a do!
Kids playing next to the old building
But before enjoying the grand Christmas festivities cum thank you and farewell party, we still had to finish the clinic. We got an early start, which proved to be a mistake. The hitherto trusty diesel generator wouldn’t start. All the Warm Heart and village tough guys took turns trying to crank it over, but no go. Too cold. So we resorted to pouring tea pots of boiling water over it until after almost 45 minutes, lo, with a chuff and a puff or two of black and then white smoke, it roared to life. Action.
Pathetic puffs of smoke from cold generator
P'John screws in the last board
In a couple of hours the final two walls went up, the foundation got painted, the final wiring went in, the floor got washed and after five frantic days, the first ever Clinic in the Clouds was done!
OK, so it isn’t done. The building is ready to be a clinic and all of the equipment and medical supplies are promised. What remains, however, is the main course – the training, without which the building is just a building and the equipment is just stuff.
Luckily for Warm Heart and Phrao, my little sister Dr. Tenagne Haile Mariam, Professor of Emergency Medicine at the Ronald Regan School of Medicine at George Washington University, will be here in a couple of months. Tenagne will work with the local hospital to develop a training program appropriate for the requirements of the Hill Tribe villages – and for health volunteers with limited literacy and Thai language skills. Once perfected, the training will provided to health volunteers, ambulance drivers, and public health clinic staff throughout the district.
Stay tuned. This should be quite a story. Thailand has no residency program in emergency medicine and currently graduates 60 EMTs annually. In a country that suffers 530,000 serious automobile and motorbike accidents per year, we have big hopes for Tenagne’s training program!
Cooking a feast in the back of a pickup
And now for that Christmas party. The moment we arrived on the final morning the backs of both pickups were converted into impromptu kitchens. An entire 50 kg rice bag full of cabbages had to be chopped, huge bundles of cilantro minced, dozens of blocks of pig blood cubed, big bunches of morning glory picked over and cut up. Two ten gallon pots of broth were put to boil on big charcoal burners. Over at the village “community center” (a covered sitting area where everyone hangs out), chickens were being plucked and pigs butchered.
Serving the stew
Finally it was time to put it all together. A parade of women let by our own P’SiPan arrived at the work site bearing big metal bowls of meat – chickens to be cut up and all the parts of a pig. More chopping. Everything was assembled in two ten gallon pots set to boil on smoky charcoal burners (where they were stirred like MacBeth’s witches kettle with yard long ladles). While the pots bubbled, the chopping and mincing continued as bowls and bowls of condiments were prepared – chopped Chinese cabbage, bean sprouts, pickled cabbage, parsley, garlic, chilies, and I am honestly not sure what else.
Every kid should have it so good
At the stroke of noon – lunch is the only thing to which “Thai time” does not apply – the word went out by crier (yes, by crier). From every direction kids, mothers, fathers, grandmothers and grandfathers descended upon us. People lined up by the tailgate of P’Pleu’s big pickup. They got a bowl, spoon and fork, and served themselves noodles from our 60 kilogram store – that is more than 120 pounds! With heaping bowls they shuffled past P’Oy, Mae Joom and P’Pleu’s wife who ladled out pint servings of the hot, steaming broth and meat. As soon as they had a spare hand, people returned to the old Warm Heart truck for a drink – Coke, “orange water”, “green water”, “red water”, or beer.
Two ladies enjoy their Fanta
People trooped off to find comfortable places to eat anywhere they could. The kids climbed the hill and perched on rocks. Lots of the guys just stood around and shoveled it in. The women sat in big circles; others clustered with little ones and traded bites with their kids. Our girls set up their own mat for “girls’ lunch” in peace.
Cooks eat last - NaaLay and Sudah finally get lunch
We ran out of food. I kid you not. Twenty gallons of soup. Sixty kg of noodles. Cases of soda. All gone. Everything. “Sorry, Ms., there’s no more.”
No one seemed to mind. Everyone just sat around and talked and talked and talked – and repeated shook the hand of any and every Warm Heart staff member encountered.
Ban Arya headman blessing Warm Heart at end of project
I didn’t see an end to this and the sun was getting a bit low in the sky – it is, after all, an almost four hour drive back down off the mountain – when the village headman showed up in ceremonial garb. He was truly impressive in a truly wonderful way. Over his regular black trousers and yellow golf shirt he had donned an Akha man’s smoke – imagine a long vest – made of black cotton and cross-stitched with fantastic designs, symbols and figures. On his head, he wore a brown boater with a bright pink chiffon scarf tied around it with a big bow. Wow!
Evelind and SiPan watching the end of project speeches
We all gathered around the headman and the local Army boss – the true commander of the mountain – for farewell ceremonies. First, the presents. I got a beautiful Akha bag that Evelind is not going to get off me. Then presents for the kids – kanom (snacks). From the true toddlers to the six year olds they lined up and Evelind and I were firmly requested to do the duties. It was huge fun since none of the kids had any hope of hanging onto the amount of stuff they got. (They did manage to eat most of it, however.) Finally, the speeches. Mercifully, it was now getting cold, so things stayed brief. Long and short of it? Warm Heart is invited back anytime.
Final project photo - too many people for the picture
Stay posted. We will be going to Ban Arya a lot in the five months before the rains start.
