Playing Doctor...

Today was my best day in the clinic. I was in the adult outpatient department with a medic who speaks amazing English and really understands the Mae Tao system. It's an interesting set-up. Lacking trained physicians, they train their medics in much the same way EMT's and Paramedics at home are trained. You learn to recognize certain symptoms and you treat them according to guidelines.

The result is that it's a system that I can function in a little bit. I'm starting to get a feel for what their broad categories are, and how to treat each category. It's not a perfect system. People do fall through the cracks if their symptoms don't fit neatly into the clinic guidelines, but many people are helped. It also simplifies examining patients because once you don't need to find everything -- there's not much point in diagnosing an illness that it would be impossible to treat. Many patients had some kind of musculo-skeletal pain. I would do a bit of an exam and form an idea of what might be going on, but it didn't really matter since they were getting sent home with lots of ibuprofen and some info on workplace ergonomics, PT etc.

So, I guess the above sounds rather sad, but on the positive side a lot of people receive care that they wouldn't normally get, period. If that's 80-90%, then that's great. The limited number of diagnosis makes it a situation that I'm not lost in.

The medic I worked with is one of the few people who is being relocated. She's probably coming to the US. It's great for her, but only the most talented people are picked for relocation. The result is that all the people who have skills get shipped out. Not great for the Burmese population left behind. She asked about New England weather, and I asked if she had ever wanted to see snow. I think she's going to hold out for California. I think that the lowest-low here might be in the 50's.

Also, a few friends and I had our first lesson in Burmese tonight. We are going to be doing it twice a week. Our teacher is great. He is very proud of being Burmese and really takes pride in teaching us not only about his language but also his culture. It's a good opportunity, even if I won't have time to get much past greetings and introductions.

Trying to find a balance...

One of the challenges here is finding a balance between doing top quality research and empowering the local organizations to take ownership of the work (capacity building). I like that the organization I'm with leans heavily towards local involvement, although bridging the gap towards western rigor is accomplished by lots of work.

Every time I'm in a situation like this I'm further struck by how much knowledge I take for granted. Concepts like objectivity, random sampling, bias, are all things thoroughly ingrained in anyone who has been educated in a developed country. Here where people haven't had the benefit of much education those concepts are foreign and difficult to explain. I like to think that someone who has no education outside of watching US television would know more about science, healthcare, surveying and statistics than the average person here. Not that I advocate such exposure to television, but it highlights the level of knowledge that the average westerner is assumed to have.

Having said that, there are some amazing people here, like the guy who said he'd never seen electric lights until leaving Burma, who in a matter of years have learned English, public health methodology, healthcare, budgeting, and many other skills. The sad part is that they are trapped in the clinic or refugee camps.

I have recently been made aware of the difficulties of not having a nationality. Gaining Thai acknowledgment (a visa or whatever) is extremely difficult if not impossible. The citizenship requirements in Burma are such that most people born there will never been citizens. In that situation you have orphans in the camps who can never be adopted because there is simply no structure in place for the adoption of children with no nationality. I spoke with an English teacher in the camps who has a very bright student that he thinks would do well at a university. With the international interest and resources coming into the area, sending him to a foreign university would be an option, except that his lack of nationality would make the paperwork impossible. At least that's my understanding of the situation.

Our Biking Adventure...

[so I have figured out how to get pictures on the page. However, putting them where I want appears impossible] I had often thought about trying to ride to some of the local scenic spots, but hadn't really collected the motivation until my friend from Montreal pushed the idea. There is a waterfall about 25km from here that we decided on as our destination. With a good set of directions and some bikes (mountain) with gears rented from a local shop, three of us set off at around 7:30 yesterday morning.

It was great to get out of Mae Sot. The Rural area around us is beautiful. Lots of rice paddies and little bamboo huts. We rode across the valley for about 17 km (10 miles?) until we came to the one "hill" that was on our route. The highway split, with presumably the new road going straight up it at a ridiculous grade and the old road going, as we were told, around it. I had hoped that by 'around it' they meant that the highway went up the mountain and came back down while our smaller road took a longer route while maintaining the same elevation. Sadly, our choice ended up being a 3km climb up the super-steep grade or 6 km on a lesser but still very steep grade. This is where the real challenge of the day, the mid-90s temps with similarly high humidity really took it's toll.

But we arrived, barely, at the top of the climb. Thankfully, the climb took us to a sort of plateau where we found a few more miles of flat road until we reached out destination. I was afraid that we were going to have to descend the other side, meaning that another similar climb would wait for us on the return.

The waterfall wasn't too spectacular, but I was just happy to get out, see the countryside, and ride a bike for a bit. I'll try to upload some pictures. We stayed for about an hour, lounging in the shade. The higher altitude definitely provided some relief from the heat. There was a "pool" that Caroline got in, but I opted to stay out of, worried not so much about infectious disease but about the looming 15 mile ride home in wet shorts.

The ride home though was uneventful. The descent was a lot of fun. Mountain bikes will only go so fast on downhills, but by laying on the top-tube I could probably get up into the mid 30's. It was fun to listen to the whine of the knobby tires as they spun probably faster than they were meant to on the hot concrete. The roads here are really great. Smooth pavement with a nice wide shoulder. There were thunderstorms building up all around us, but we managed to avoid the rain, until about 30 minutes after arrival at our final destination, the pool at the fancy Mae Sot hotel. That was okay though -- we just sat in the pool while it rained for a little while and then cleared up.

At the end of the day I really wanted a cheeseburger and to experience the over-indulgent sense of fullness that is so common in the US. At the last moment I switched to a ham/bacon sandwich. As I should have expected, following the trend here, it was one piece of ham, two strips of bacon, and lots of veggies. Thankfully the onion rings I had ordered with it saw me to my goal. I came home and went almost directly to bed. Today I don't feel too bad. My legs are fine, I just feel a bit dehydrated and sunburned. It was a good way to spend the day though.

Comparing medical systems...

As a side note, today, for the first time in around 5 years, I paid for a haircut. However, it was only about $1.50. I gestured that I just wanted him to shave my head, and he held out a variety of guards for the clippers. I chose my usual 1/4" and he went to work. Now I just have to try not to sunburn my head/neck. And even further aside, I think I have fleas, but that seems to be my usual summer condition lately. Unlike last summer, at least now I have the option of bathing nearly as much as I want. That helps keep the infestation to a minimum.

One of the cool things about being here is that I'm hanging out with people from lots of places. Mostly Australia, England, Canada, and the US. Since many are in some aspect of healthcare, we often talk about what things are like in different systems. I must say that the US shows very poorly in almost all comparisons. And while I knew it had problems, while trying to explain it to people who are unfamiliar, I can't help but feel like a complete idiot. I know I didn't create it, but I'm part of the people who authorize it, even if in a vague, disenfranchised sort of way.

Instead of ranting on about the problems we have, I'll just recommend Micheal Moore's newest movie.

The most interesting difference (though I can't quite explain why) is that in England and Canada, primary care specialties (pediatrics, family practice) are the most competitive for students to get into. In the US they are the least competitive and the but of many jokes. It all comes down to the dismal levels of medicare reimbursement. The competitive specialties in the US are the ones where you can work 4 days a week and make a decent amount of money. To make half as much as a dermatologist, a family care doctor has to work 50+ hours a week and can only spend 15 minutes with each patient. It's unfortunate for our healthcare system that it is that way, but really, who would want to do that if you can do something else? Elsewhere it seems that primary care reimbursement is comparable to other specialties and so students get to choose based on what they want to do, not what has the best lifestyle. And it seems most of them are led to primary care.

A few more things -- in Chiang Mai and in the market here

There were a couple interesting anecdotes I forgot to mention. Massages are very popular (and cheap) offering for tourists here. Despite the associations I have from home relating to "Oriental Massage and Spa" places, things here seem legit. A friend and I decided to try to out foot massages before leaving Chiang Mai. It seems that for just about everything, half an hour is around $3 and an hour is $5. We apparently failed to choose the sort of place with dim lights, incense, and whale-song playing in the background. Rather, the place we ended up offered masseurs who made fun of us for much of the 30 minutes. My favorite was their poking and prodding of my callouses and asking "you walk many mile?" "You live in mountain?"

On returning to Mae Sot, we were dropped off at the bus station just outside of town. It is near the clinic, and in front of the clinic there is typically a variety of forms of transportation for hire. We thought we would get some sort of ride home from there. Sadly, we found four police officers sitting on the benches and the normally busy area otherwise deserted. As we walked by, they asked us "where you from? Where you going?" and laughed. While I did appreciate the absurd humor being interrogated as if I was an illegal burmese immigrant, but the reality is that they were looking for the people we work with. On the walk back, there was another checkpoint about a mile down the road. They were less concerned with us. I may try to find someone to explain the hunt for illegals to me. At any moment they could easily catch a hundred, but they only make half-hearted attempts occasionally, and sometimes actually go after people. I don't understand the reasons behind it though.

Also in Chiang Mai the sex industry that Thailand is known for was quite apparent. Not as bad as Bangkok, but definitely not hidden. I think we all had a weird fascination with it. The girls who were working would be hanging out at the restaurant or bar talking with the staff, having a good time, and then head off with someone. It seems very accepted, which is foreign to me. In general, it seems more like a package deal. The people at our hotel were with the same girls the whole time we were there -- in addition to the expected things you have a guide and company for the length of your stay or "contract" or whatever. We saw a lot of 50ish year old American men walking around who we first thought to be looking for prostitutes but later (and probably more correctly) identified them as guys from Vietnam who just never made it home, for whatever reason. So far, if I had to pick a place to live in SE Asia, it would be Chiang Mai. It has all the comforts of a US city and is in a beautiful location.

I just returned from the market here in Mae Sot. Of note were the many buckets of live eels, frogs, turtles, and maybe snakes (or were they a different kind of eel?). I try not to cringe, but it's tough. My lunch was a bit of an adventure. I went to a place full of Thai folks but with no white people or English menu. I just pointed at something that turned out to be much like everything else here -- chicken, basil, vegetables over rice. It was pretty spicy, but I managed. I'm starting to get used to it. The feeling of a belly full of spicy food is very comparable to the warm queasiness that follows drinking straight liquor.


I spent today in the lab at the MTC. I saw a lot of malaria in blood smears. I probably could have made better use of my time by studying up on the different types, but I think all the slides I saw had P. falciparum, so even if I'd pre-studied I wouldn't have learned much about differentiating them. The latter part of the day was filled with trying to get Microsoft word to display a document in Burmese. So far, no luck. Probably at the office tomorrow they can fix it easily.

Chiang Mai

We just got back from a three day trip to Chiang Mai. It was a great break. Chiang Mai is maybe the second or third largest city in Thailand, in the North. We learned a lot about the history, but briefly the city was built there in around 1200 AD. It was walled with a moat around it. The wall is still partly there, and the moat is a very evident square in the middle of the city. We stayed by the moat on the outside of the old city. It was a very friendly area for tourists.

We spent much of time outside of the city seeing temples, including some from the first days of the city that were just unearthed a few years ago after a flood hundreds of years ago. The oldest thing we saw was a carving of the buddha from around 2500 years ago. They think it came from India and was brought to the first wat (buddhist temple) in the city.

I had left here expecting it to be something like Gatlinburg, but was thankfully mistaken. We stayed at the Lai-Thai Guesthouse and I recommend it. Their staff was great, their tours were reasonable, and the food was very good. Some of the best Italian food I think I've ever had was at Stefano's just up the street. I keep feeling compelled to speak to "people with accents" in French or Spanish, but was finally able to follow that impulse (approximately) when Stefano met us at the door to leave. I also highly recommend The Roof-Top Bar. It was great, with floor seating on thick, cushy bamboo mats. There was a retractable awning -- we arrived while it was raining outside and when it stopped, to our surprise the roof slid back exposing us to the night sky. I guess it was on the 5th floor of a building, and getting to it required a lot of ducking under things and going up sketchy, steep staircases. Not a good idea for a bar I guess, but it worked.

I feel like I worked on my Thai a bit. I can say a couple phrases in ways that are understood. That's a big accomplishment. The city was very modern. I had some business to see to, and we met at a mall that surpassed many I've seen in the US. We went to a movie at another mall Sunday night -- Ocean's 13, which was entertaining. We struggled to buy our tickets because we had to select our seats on a computer screen before going in. It was confusing. Between the movie and previews was a short tribute to the royal family during which everyone stood. It was strange. On the whole, the three day trip seemed like a week. I think there will be plenty to do if/when I go back. Getting there was difficult, taking fully half a day on cramped buses. Returning we spent 6 hours on a VIP bus that went much faster.

My job there was to deliver a 100 page document in Burmese to a translator to have it reproduced in English. I had the only copy and there is no known electronic copy, so I had to find a place to photocopy it first. When I walked in to the small shack with a copier in the middle, the owner asked for my passport in broken English. I think that is the only reason people of no color usually come in. Eventually I explained to him that I needed to copy the book. I am not sure if he'd ever seen Burmese before. It was all very entertaining, and enabled me to spend about an hour (handing him pages) hanging out in "real" Thailand (as opposed to tourist Thailand). It was a different feel catching a tuk-tuk (maybe the motorized version of a rickshaw?) to go to my meeting. I didn't have the guilt associated with being a clueless, illiterate tourist since I felt I had a goal or some other reason for being there. That feeling lasted for an hour or two and then I was back to being a tourist. Also of note, one of our tour-guides was Karen. We still weren't completely forthcoming about what we are doing in Mae Sot, but he seemed excited that we knew something about his people.

In general, Chiang Mai is the sort of place I think I could spend some time. It's extremely friendly to tourists but at the same time still a functioning Thai city. There is a lot of mountain biking around, although it would take a while to find it without paying $50/day for guided trips.

There's some more going on, but I'm tired and this is probably long enough as-is.

New projec t, weekend travels etc

The week has come to an uneventful close. My work is moving ahead slowly, but at a pace that I think will see it finished before I leave. Since I'm working with community groups, there is a lot of back and forth. I do some stuff, then I wait for them to do some things, then I have some more to do. I try to hurry up with my end of it so that I'm not the one holding things up. Some things though I try to do inefficiently -- like going around to talk to people in person instead of email or phone. I like it that way, and I get to know more people and see more of life here. Also it's keeping me on my bike for about an hour a day, which is good. I am thinking about riding in the MS 150 just a couple weeks after I get home. When I get home I'll probably be pretty strong over short distances, but riding two 75 mile days might be a mistake.

I've entered into a side-project. They are working to improve the sanitation in some camps several hours north of here. Part of it involves building new latrines. It is in the mountains, and they build their villages on the tops of the ridges for defensive reasons. The cost is that the water source is guaranteed to be below the latrine/septic system. Given my interest in sewage and plumbing in general, I'm getting involved.

The environmental office at the clinic is run by a Burmese man who studied environmental engineering in the US and returned here two years ago. Since then he has been working to improve the MTC water systems that have been cobbled together over the last 17(?) years. There is some interesting stuff. Once the clinic expanded beyond their first holding tank, they built another one...five feet higher than the first. So, for the last few years they have been pumping sewage from the old to the new tank. A big project now is finishing a new tank, lower than the first, before the rain really gets started. It's about the size of a small 2-story house.

He is going to have a class on latrine construction here next week and I want to sit in on it. It will be in Burmese, but hopefully there will be pictures. I don't really have anything to contribute to the discussion, but I have a lot to learn about how they do things here. I never really know when I'll be busy and when I won't, but I should have time to attend. He's also given me some info from various NGOs on how to go about making septic systems in these situations.

I'm going to spend the weekend in Chiang Mai, which should be interesting. They say that Mae Sot isn't really a Thai city, that it's a Burmese city that happens to be in Thailand. Chiang Mai has more the Northern Thailand city, or at least the one all tourists go to. It should be fun, and a nice break. It kind of works out also since the first draft of the survey is ready for translation and the translator they normally use is in Chiang Mai. I will meet with her Sunday to talk through things. We will probably be back to Mae Sot on Monday afternoon.

I'm going to hopefully get some pictures of Mae Sot taken next week and post them here.

Maybe beginning to understand things here?

Not so much the language, but the broader situation. Trying to describe it is even more difficult. There's a lot I don't want to talk about -- many of the people I work with are risking a lot by doing what they do, and there are people poking around looking for them. The Lonely Planet section on politics in Burma says that 1 in 10 people is an informant for the SPDC. I would imagine that in a town like Mae Sot, there is a fair representation as well. I'm not sure quite how it works out. Thankfully, as a westerner in Thailand legally, I have nothing to worry about. The status quo seems to be that illegal people involved with health and education projects are tacitly ignored. Those working to a political end in Burma are much more likely to be investigated.

The violence against the different ethnic groups is not overt. It's as simple as coming into a village and putting holes in all their cooking pots and burning their rice stores. Over time, it places pressure on the people. There are also several major dam projects that will force people from their land. These villages are 'remote.' One person said he had never seen or heard of a car or an electric light until he came to the refugee camp. They spend most of the dry season moving around to avoid the SPDC, and settle for a while in the rainy season. Many of the young people come to the refugee camps because that is there only access to education, but then it is very risky to re-enter burma. While there was a strong resistance several year ago, there is currently not a very cohesive force against the SPDC. The people living in the jungle are so cut off that they may not be aware of the big picture and the need to organize. It is hard to see much hope without foreign involvement, but I don't see that looming ahead unless the rekindled friendship with N. Korea will draw more attention to burma.


Closer to home, I went to a market under the bridge to Burma and bought a very playable guitar for around $25. Now I have something to do besides reading and roaming around town. It was interesting to see the bridge to Burma. With all the stories we hear, it seems that looking across it should be like looking into the gates of hell, but it's actually quite anti-climactic. There is a military presence on both sides and some fencing, but across the river is a fairly nice looking town.

CSI Miami in Mae Sot??

Interestingly, some guy from CSI Miami has been hanging around Mae Sot lately. We think he is narrating a documentary about the situation in Burma. Not sure. I've seen him a time or two, or at least have been told that I have, but I am not sure if I've ever seen the show.

It's good to know that people are working to spread the word. I haven't said much about the politics here. In the late 50's there was a military coup that has controlled the country ever since. In 1988 there was a huge pro-democracy movement that led another coup I think from within the old leadership, the State Law and Order Restoration Council. For some reason, they decided to have elections in 1990. The National Liberal Democratic party got 82% of the vote and chose Aung San Suu Kyi as the new national leader. This election was rejected by the SLORC and Suu Kyi was placed under house arrest. She has occasionally been released, but once attacked and nearly killed. In the meantime she has been awarded various things including a Nobel Peace Prize. She is currently still under house arrest.

The regime's economic strategies seem to be based on forced labor of ethnic minorities (like the Karen and others I work with) and leasing of all the countries resources to foreign corporations. Burma also supplies this part of the world with opium and amphetamines. Today, the NLD has broken up and is engaged in fairly disorganized guerrilla warfare. There are currently plans to damn several rivers destroying large areas of Karen and Shan land, making life even harder on them. My impression is that it is not an all out war on the minority groups, but a slow, deliberate campaign to squeeze them out by removing food supplies, land, access to healthcare, forcing relocation etc. It seems to be working very well.

The military government, in 2005, decided to move the capitol from Rangoon to an area of remote jungle in the middle of the country. It is a few miles outside a small town, but has been built ex nihilo over the last two years. It can be found on Google Earth. It is the only city in the nation that has electricity 24 hrs/day. It is basically a large military compound with villas for the generals and probably a large impressed work force to maintain it and continue construction. Some say the move was due to fear of invasion, others say that an astrologer suggested they make the move. Most of the world thinks it is crazy. China is on the fence about whether to move their embassy or not.

More on what I'm doing...

It is difficult not to be vague in a title because not much has been going on. I am basically doing the clerical work behind a community group's survey of gender issues and reproductive health in various Burmese communities, specifically migrant, refugee and internally displaced persons (ie still in Burma). While my position isn't terribly glamorous, I like that I am a resource to the local people. They know the communities and what they need. In general the foreigners here seem to provide a support layer for local efforts. It was frustrating when some people came to the clinic a few days ago and implied that the clinic staff must be excited to have westerners here to help them. The clinic staff really does quite well on its own.

Without digressing further, I tend to go to the office every day around nine, read reports, try to organize the survey and get in a good format for review by the community leaders, and organize meetings. I come home anywhere between 2 and 6, then head back out on the town for dinner and maybe further entertainment. People here seem to work 6 if not 7 days/week, but they don't work very hard. It might average out to 40 hour weeks. I'm trying to go with the flow. I eat most meals out, but it's hard not to when I can get great food, lunch and dinner, for around 4 dollars total. Mae Sot actually has a small driving range, and one night some friends and I stopped by to drink beer and hit golf balls. There's not much to do, so it takes some creativity.

I am not nor do I feel as compelled to delve into the communities as I did in Venezuela. If I could speak some Burmese, I might have the option, but I don't. Still I am starting to understand more about the situation. Many people I have seen are in Thailand illegally, but since they have left Burma, they will be marked if they go back in. So they are stuck. There are no signs outside the buildings of the organizations I work with. I've been told that groups working on health and education are usually overlooked by the Thai authorities, but those with pro-democracy links in Burma really need to keep their heads down.

Mae Sot is an interesting community. The city is supposedly around 40k, but there are many illegals and also large refugee camps (50k?) within a few miles. And the city is very compressed. There is a large down-town area, basically two one-way streets with an assortment of shops scattered along maybe 3/4 of a mile. I am a block or two to the side of that area. Within walking distance I can buy anything I might need, from grocery stores, an open market, computer and cell phone stores and more. It's really quite nice.

I do feel very much like I'm on the edge of the civilized world. There is a lot of crazy stuff going on not far away, but thankfully there is a national border between me and the conflict. There is a flow of people coming here from the conflict areas though, and I hear news from them, as well as from the ex-pat people I work and hang out with. It's an odd window into a situation that much of the world knows nothing about, and won't know anything about. It's a strange place to be.

What I'm doing and Where I'm doing it

I'm three miles from the Burmese border. This is an interesting place to be. I try to stay up on current events and what goes on around the world. I knew a bit about the situation and that it wasn't great across the border. However, the proximity somehow makes it much more real. For some background on Burma/Myanmar, check out http://en.wikipedia.org/wiki/Myanmar, specifically the history of the last 20 years or so.

I'm staying in a house shared with some public health students working in town. It's a nice place -- a house-mate commented yesterday that it's like we are in a Jane Austin novel, sitting around reading, fanning ourselves, checking email etc amoungst such poverty. It's not perfect, for instance the foot-long lizard that lives in the kitchen, but it's a different experience than I've had before. I spent a few hours today in a air conditioned coffee shop catering to westerners and spent an outrageous amount of money (for this area), about $4 US. I don't really feel bad about it -- I wish I could integrate into the culture more, but the language barrier is significant. The big questions around here is "which language should I learn - Burmese or Thai." A little while ago our land-lady came in and someone said "mingalaba!," which is hello in Burmese. She said "yes, but I am Karen. Hello is 'o-may-weel-eya'"I'll probably come back knowing bits of all three, but not enough to do anything more than order food or introduce myself.

I know more about what I'm doing now, which is nice. Several organizations are working together to perform a survey of various groups of Burmese people. My job is to figure out what they want to ask and then do the grunt work for putting it all together. It's not as overwhelming as I had first thought. Now I'm getting their goals and revising an old survey to reflect the new goals. Then it's just a matter of logistics -- translating, training interviewers, organizing transportation etc. The last step will be analyzing the data. I don't think they are looking to do anything too fancy, so that shouldn't be a challenge. There are plenty of people around who know a lot about it, so I should have help.

I initially had reservations about taking on a job this summer, but I think this will be a good thing. It's something that will serve a purpose, I feel like progress can be made, and it is something I can finish. These are all things that I didn't experience last year in school and am enjoying. Amidst being constantly overwhelmed at school, I didn't realize how much more organized I've become. This is helping me see that.

The longest day of my life??

When moving west at 500+ mph, the sun stays in the sky for a really long time. Maybe 18 hours?

Anyway, that was a few days ago and I've still yet to get much sleep. I left Memphis on Wednesday morning and arrived in Bangkok at 11:00 pm on Thursday. I think that was around 11am in the US. I didn't make it to the hostel until around 2:00 am where I tried to sleep until 9:00. Most of that time was spent tossing and turning. I had an exhausting, hot day in Bangkok and then took a night bus to Mae Sot. I arrived here at about 6:00 am and then had a meeting at 9:00 am that lasted until 4:00.

It's all kind of blur, but somehow I've made it through okay. I think that it's not been so much that I adapted to the new schedule, but that the complete lack of schedule has left me so exhausted that I go to sleep when I lay down (although I often don't stay asleep for more than a few hours).

I haven't had much enthusiasm for the trip thus far, but I'm chalking it up to fatigue -- both from travel and from school. I didn't like Bangkok very much, but I wasn't there long and again, I was really tired and worried about making it to Mae Sot (as opposed to Mae Soi, Mae Sae, and host of other similar cities). I did get a little excited when crossing some mountains this morning just outside of Mae Sot, and I think I'm going to like my co-workers. The students, mostly public health seem cool and the locals are great. I'm understanding more what it is that I'm doing and see it as something I can do. More on that later. I'll write more when I get some rest. I'm going to bed early tonight and doing as little as possible tomorrow.