Video Presentation on the Viet Nam – Australia Primary Health Care for Women and Children Project

014Author’s Note: The video presentation is from an international health and medical sociology conference that was held from 21-23 September 2018 in Dallas, Texas USA

The Vietnam-Australia Primary Health Care for Women and Children Project

James Cameron Mielke, DrPH 

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Women at work in the Mekong Delta Region of Viet Nam

The Viet Nam-Australia Primary Health Care for Women and Children Project (VAPHC) was a six-year primary health care project implemented through the Government of Viet Nam (GOV) Ministry of Health (MOH) and four provincial Departments of Health (DOH); two in the south, and two in the central region. The Project was financed jointly by the GOV and the Australian Agency for International Development (AusAID).

The VAPHC Project commenced in March 1998 and was completed in September 2003. It was co-financed by the Government of Australia: AUD 21 million and the Government of Vietnam: AUD 2.1 million for a total cost of AUD 22.6 million. Four Provinces, two in the south and two in the central highlands were direct development partners.

Key principles of the Project’s implementation strategy were:

  • A strong focus on primary health care as the context for all activities;
  • Strengthening of systems for training, supervision, referral and capacity building;
  • Use of skills based training (SBT) which focuses on the application of skills in the workplace; and
  • Placement of health promotion in the broader context of community development.

The VAPHC Project Goal was:

To improve the quality of primary health care services delivery to women and children and the knowledge and health awareness of communities through training, provision of equipment, strengthening of fixed facilities, health promotion, management support and community development in the provinces of Long An, Ben Tre, Quang Ngai and Gia Lai.

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Health workers received training in health promotion and communication skills and on the use of appropriate information, education and communication (IEC) materials for effective health education in the communities 

The Project’s major objectives are based on the three Components:

Component 1. To improve the quality of health services available to women and children by strengthening health training, referral and supervisory systems; providing equipment and transport and refurbishing selected fixed facilities at provincial, district and commune levels in Ben Tre, Long An, Quang Ngai and Gia Lai provinces;

Component 2.  To improve the capacity of health workers, health volunteers, mass organizations and health volunteers to promote the health and nutrition of women through the provision of appropriate and effective health promotion and communication skills training and health promotion materials, and to support improved community knowledge, awareness and participation through the development and maintenance of community based primary health care activities In Ben Tre, Long An, Quang Ngai and Gai Lai provinces; and

Component 3. To efficiently and effectively manage and implement the project for the achievement of the defined outputs and project objectives.

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A major focus of the project was to improve facilities and capacity for essential obstetric, gynecological and pediatric care

The Project provided support to health services delivery for women and children through improved facilities and capacity for essential obstetric, gynecological and pediatric care, strengthening of systems for skills-based training, supervision, monitoring and referral, and to the users of the public health system through health promotion and community development activities.

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Ethnic minority woman conducting a group discussion in the village as part of the participatory needs assessment (PRA) process

The VAPHC Project aligned with GOV health policy objectives and priorities by: focusing on primary care and community health improvement, safe motherhood, reducing infant and child mortality and improving preventive measures, and anticipated many of the GOV strategies to meet Millennium Development Goals and health development strategies.

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Support was provided to women’s credit savings groups which helped finance village projects to meet locally identified priority needs, such as safe water and better child nutrition

The project’s aims and operating procedures also matched AusAID’s health development framework, for example: strengthening health system fundamentals; addressing priority health needs of women and children; and supporting country-specific priorities to address high-burden health problems. Project managment units within the DOHs managed implementation, guided and supported by an Australian Advisory Team.

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A group of healthy mothers and children

An ex-post evaluation (2007) found sustained impact from improving trends in provincial and individual health center MCH data. The generally positive impact indicators and outcomes cannot be totally attributed to VAPHC (although key informant interviews in many districts and communes referred specifically to the role of the Project in improved processes, outcomes and results).

Rather, VAPHC contributed to overall health improvements in Viet Nam achieved through GOV and international partner activities. VAPHC initiatives have been incorporated into other GOV and donor interventions such as MOH projects supported by the Netherlands and the Asian Development Bank.

Over the past 35 years, Jim Mielke, who has a doctorate in Public Health, has had the privilege of living and working in some of the poorest, most remote and under-served countries (23 so far) in the Asia-Pacific region, where he has assisted governments, international aid agencies and communities to strengthen local and national health systems for improved community-based primary health care, women and child health, and communicable diseases control, including HIV/AIDS prevention, care and support.

In recent years, a big part of Jim’s mission has been to mentor students, members of voluntary organizations and other interested groups on international travel, study, and overseas volunteer and professional opportunities. Jim also enjoys teaching yoga and mindfulness meditation in schools, YMCA conference and family retreat centers, and health and fitness centers in the USA and abroad. You can read more about Jim’s overseas experiences at  Hawaii Reporter. He can also be contacted at  jim_mielke@hotmail.com and on Facebook at James Cameron Mielke.

Jim lives in a quiet seaside setting in southern Thailand.

The Vietnam-Australia Primary Health Care for Women and Children Project

Video presentation by James Cameron Mielke, DrPH:

(Copy and paste the link into your browser): http://www.hawaiireporter.com/video-presentation-on-the-viet-nam-australia-primary-health-care-for-women-and-children-project/

or: https://1drv.ms/f/s!As5_PzObvxoXvxLRFbIBFRQmy6c_

Stay tuned for more stories – coming soon!

You can read more about Jim’s backstory,  here and here.

 

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The Warlord’s Hospital (Part Two)

Author’s Note: In June 1988, I joined an American non-governmental organization (NGO) and the Royal Thai Government Ministry of Public Health to manage a 5-year cooperative health and development project to expand comprehensive health services to highland residents of an isolated, politically sensitive and culturally unspoiled region in the extreme north of Thailand along the Burmese border.

The project included a 10-bed hospital, with outpatient and laboratory services, simple administrative offices, kitchen and staff housing, as well as community-based primary health care, health education and community development in the surrounding villages. Electricity arrived during my second year there, and we used a radio – powered by the truck battery – to contact the district hospital in the lowland.

477The Project developed a locally appropriate model for preventive and clinical health care delivery by training and facilitating the entrance of  hill tribe health workers into the Thai National Health System, together  with innovative community-based health and development strategies such as gravity-fed village water systems, household gardening, opium detoxification, and vector-borne disease control.

Remote and politically unstable, our district was the last one in the country to be developed for primary health care – and for other basics such as piped water, electricity and sealed roads. Many of the area residents are spirit worshipers with little or no understanding of Western medicine or the linkages of proper hygiene and nutrition with good health, and water was scarce in the hilltop villages.

For example, mothers typically keep a child’s head covered with a warm, colorfully woven cap. But due to cultural beliefs and scarce water, they rarely if ever bathed the child’s head. So, it was not uncommon to find a raw, infected and bleeding scalp under a child’s cap.

It was also a challenge to encourage the local people to use pit latrines, and to sleep in bed nets.  Sometimes, a supportive village headman would try to set an example for the community by using a pit latrine at his home. But this was a hard sell to locals who were used to relieving themselves in the bush, and complained that the pit latrines smelled badly. We also provided bed nets for malaria control and conducted studies on their use – as they often ended up being used for fishing.

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Kids enjoying a bath from a newly installed gravity-fed water system

Working with the District Health Department, the Project helped villagers build gravity-fed water systems — hacking through the bush to lay the pipeline and pouring cement tanks for water storage and taps in the village.

A particularly grand sight was joyful kids frolicking under the water taps flowing fresh water into their hilltop villages for the first time ever. These community water projects were jointly financed by our project and the communities themselves – who took out loans against their rice harvest.  Access to clean water is one of the most basic of needs, and was highly valued by our communities.

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Opium addicts participating in a community-based opium detoxification program.

We also did village-based opium detoxification to gradually move addicts off opium and onto the government’s liquid methadone treatment program – an alternative which seeks to reduce the risk related to injecting drugs. Recovering addicts were put to work building a village fish pond while reducing the dosage day by day.

All the addicts in the village were required to participate or they would be forced to leave the village – and this was not easy, especially since some addicts had been smoking or eating opium for 30 years more and had no desire to stop.

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Jim administering immunizations

Ongoing immunization campaigns were of particular importance, as it was not uncommon to see kids dying of immunizable diseases like Diphtheria. So, whenever we were in the field we made it a priority to immunize every woman of child bearing age against Tetanus. Our nursing staff even trained me how to give injections to support these busy campaigns.

Interestingly, the local women typically lined up to get their shots from me – the tall, foreign ‘doctor’ – despite my admonitions that they were more likely to receive a painless shot from our more experienced local nurses.

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Health Team supervisory visits to outlying health stations along the border

Our Project staff also joined government health teams for week-long treks to outlying health stations along the border — flying in by helicopter and then walking out through villages, mountains, dense jungle, rushing streams, and fields of ripe rice — escorted throughout by the Thai Border Police in full combat gear for our security.

Regular skirmishes between the local narcotics traffickers and the Burmese Army were ongoing, and several years earlier, two Russian doctors had been kidnapped from the area and held as ransom for a warlord’s release from Burmese captivity.

As Project Director, my time was divided between a mountain of administrative tasks at the Highland Health Center, and a full schedule of planning and logistical work with our Thai Government counterparts in the lowland.

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The condition of the road was the defining feature of our back-country existence

Thirteen kilometers of our road (and most bridges) washed away each rainy season, so four-hour walks (barefoot for better traction) and moving supplies and medicines by horseback to the nearest road was an on-going adventure from June to October.

Staggering out of the office dazed and bleary-eyed after full and exhausting days — but always in time for a swim in the local reservoir before dinner at our village’s only restaurant, followed by BBQ chicken feet on a stick smothered in hot chili sauce to cover the toe nails and crunchy cartilage — before returning each night to the charming glow of oil lamp light shining from the health center windows.

Whenever possible, brief holiday trips by overnight VIP bus to quiet islands in the Gulf of Siam provided much-needed breaks in the sun, sea, and coconuts.

Stay tuned for more stories – coming soon!

You can read more about Jim’s backstory,  here and here.

 

The Warlord’s Hospital (Part One)

Author’s Note: After two years of budget travel through fifteen Asia-Pacific countries and a wonderful visit to the USA – hosted all along the way by local and national YMCAs, I had settled high in the rugged, jungle-clad mountains along the Burmese border in the extreme north of Thailand. The journey to this remote outpost was like living the most wonderful dream — my thoughts drifted back to warm lagoons, smiling faces, and many friends in grand reunion – yet, with a breaking heart, as happy reunions ended all too soon.  But soon after my arrival — while carrying out the body of one of our patients who died of Malaria — it came as a stark realization that rural health work was going to be a bit different from my earlier YMCA experiences.

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The defining factor of our hill station existence invariably depended upon the state of the 13 kms of dirt road that separated us from the developed settlements in the lowland

In June 1988, I joined an American aid agency on a cooperative project with the Royal Thai Government Ministry of Public Health to help establish and maintain a system of comprehensive health services for 20,000-30,000 highland residents of an isolated, undeveloped, politically unstable and insecure region along the Thai-Burma border in the extreme north of the country.

In addition, to operating a small in-patient/ out-patient facility staffed by area residents from all the major ethnic groups, the Project provided health worker training, supervision, public health services and community development in the local ethnic minority villages.

Our hospital had been built by the infamous Burmese Opium Warlord, Khun Sa, to support the Shan United Revolutionary Army’s struggle for a separate, breakaway Shan State, independent from Rangoon. They were eventually forced from their stronghold in our village, and back into Burma following an intense land and air assault by the Thai military. However, ongoing skirmishes between rival drug warlords could still be heard just across the border as they flung mortars at each other to control the narcotics trading route that ran through our village.

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Harvesting latex from opium poppies

Our district was also part of an area known as The Golden Triangle, that sprawls over the common borders of Thailand, Burma and Laos, and contains some of the world’s largest expanses of opium under cultivation.

In this generally lawless ‘no man’s land’, one could never be certain about the security situation, which at best was not good, with violent deaths and many injuries occurring locally.  The only road from our village to the lowland was unsealed and dangerous, with steep muddy inclines and unprotected drop-offs into the valleys below. But the villagers kept the bamboo along the road cut back to reduce the chances of ambush – whether for robbery or murder.

Widespread poverty, malnutrition, anemia, malaria, tuberculosis, parasites, and opium addiction were common problems. The birth rate in our area was twice that of Thailand as a whole; the death rate almost four times as high. Maternal and child health programs, communicable diseases control, family planning and hospital services were inaccessible to these highlanders because they were too far and difficult to get to, and the significant language and cultural barriers between lowland Thai health care providers and highland consumers.

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Administering life-saving vaccines

Most of our 43 Highland Health Center staff were members of local ethnic groups, known as ‘hill tribes’, who had received Project training and continuing education as medical assistants, health technicians, and community health workers. We had six nurses (three Burmese and three Thai)  along with three American medical personnel who rotated through on six-monthly contracts, and a full-time American Project Director.

Nine different languages were spoken at our health center, which consisted of in-patient and out-patient care facilities, medication dispensary, laboratory services, administration and training facilities, kitchen and staff housing.

Electricity came in during my second year. Up until then, we used kerosene lanterns and could contact the District Hospital in the lowland on a two-way radio powered by the battery of our hospital truck, which also served as an ambulance and supply vehicle to transport medicines and patients up and down the mountain.

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A seriously ill TB patient being transferred to the lowland

In the rainy season, we were often totally isolated because the road was impassible, and most local drivers refused to take severely ill patients if they thought the patient would die in the truck – which they believed would hex the truck, and therefore his business. At times, patients had to be physically carried down the 13 km of steep, slick mud to the main road.

Thai language training was provided to all staff as the bridging language at the health center. For example, general staff meetings were all conducted in Thai language. Translators were also employed to assist communication with patients from the various ethnic groups.

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Our Health Center women’s volleyball team won the championship in the annual community sports festival

It was a wonderful international and intercultural mix. Indeed, the surrounding area seemed more like rural China and Burma than Thailand. In many ways, it was like running a summer camp – nights lit by serene lamplight, a fun, youthful staff, with lively parties, singalongs and creative variety shows.

Most of our staff were ‘stateless’ border residents without formal Thai residence or refugee status, and therefore ineligible to complete the Thai educational requirements to enter MOPH health worker positions or training programs. Therefore, the Project also offered Thai high school classes as a basis for employment as civil servant health workers when the Thai Government assumed total responsibility for the Project in 1991.

Stay tuned for “The Warlord’s Hospital (Part Two)” – coming soon!

You can read more about Jim’s backstory,  here and here.

 

 

 

Asia-Pacific Tour: Return to Paradise

8 May 1988: “Once again, the never-ending problem of too many beautiful women, and too damn many fascinating places – unable to decide where to go next, where to stay, and with whom. The flight attendants are cute – one is Oriental, the other two are Islanders, but I’m trying not to think about them because soon I will leave again – far away, but we already know that story. As usual, I want to have it all — to eat it all up. But there comes a time to stop and digest a bit. I feel as though I need a lifetime to live in each place I go. And here I am again, leaving with a heavy heart. Oh man, I die a hundred times leaving. Someday, I won’t leave alone.”

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Waipi’o Valley, Big Island, Hawai’i

Departing the USA in May, I flew via Honolulu to Western Samoa for a wonderful welcome with far too many friends to see during my short visit there. Simply magical to free-dive in the crystal clear waters of Palolo Deep lagoon.

On Manono island with my Samoan family – the moist air sticking to my skin, a few mosquitoes, delicious island food, lush tropical undergrowth, adorable kids, the family so loving, the sea so soft — waves lapping against the beach, the early morning smoke of the rock ovens (umus) hanging in the air. Re-living the warm, gentle life in Samoa-I-Sisifo.

Returning to Samoa and the South Pacific was like living a dream. It was hard to believe that I was back in Apia seeing old friends and soaking up the sun and sea at Palolo Deep – although a coral infection in my foot was a painful reminder that it was no dream. I had forgotten how warm and cheerful the Samoans are. Everyone seemed the same, although many had become even bigger — some even twice the size they were just two years before!

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Catch of the day, with Uila and Luavalu on Manono Island, Samoa

The relaxed pace can brew up some frustration if you try to keep to a strict schedule. As usual, the physical beauty of the place was astounding – the clouds, the sea, waves breaking on the far reef; lush, tropical forest – the absolute silence of Apai village on tiny Manono Island.

Drinking a coconut atop Mount Vaia by Robert Lewis Stevenson’s grave — not to be confused with the raucous Mount Vaea Night Club — a bottle smashes, then you duck to miss being hit by a table flying by.

Transiting through Tokyo to Seoul – back to Asia again — an adjustment from the USA as well as the Pacific, but it felt good. Beautiful women dressed in high fashion, a wonderful reunion with my friends at the Seoul YMCA, and day trips through beautiful countryside and small towns.

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“Welcome back to Korea!”

On my last day, I was interviewed on live TV’s “Good Morning Korea” for a spot they were doing about backpackers at my guesthouse. I was leaving for the airport and wearing my suit and tie – totally out of character for the budget traveling crowd – but and the camera crew seemed to be drawn to this and came rushing over to interview me.

Then, bathing in the memory of Han Mi Sook – her smiling face and gentle ways – my heart breaking again as the plane lifted over misty mountains, rice paddies, green hills and residential sections of Seoul, Korea.

On to the Philippines – and back to my delightfully dim, airless (and cheap!) pension house room in Manila where the only mirror in the place stretches along-side the bed. Sadly, I missed Jessie – she had married her former American Peace Corps boyfriend and was already living in the States. But I did manage to score a fine, locally crafted guitar.

Arriving at last in Thailand, this travel weary soul headed north to Chiang Mai city – pleasantly small and peaceful after Bangkok, Manila and Seoul – deep green reflecting in the quiet canals, tricycle rickshaws (samlaw), tiny back streets, beautiful old and ornate Buddhist temples – a wealth of history in plain view with a dramatic backdrop of forested mountains. And of course, our memorable ‘haunted’ teak wood house behind the spectacular old temple, Wat Santitham.

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Somporn at The Golden Triangle

Reunions with friends from the Chiang Mai YMCA, and a trip to Chiang Rai province and the Golden Triangle where Thailand, Laos and Burma intersect at the confluence of the Ruak and Mekong Rivers – an area known also for its extensive opium and heroin production.

After 15 Asia-Pacific countries and a wonderful visit to the USA, I had settled high in the rugged mountains in the extreme north of Thailand to manage a primary health care project in cooperation with the Thai Ministry of Public Health.

The journey to this remote outpost — from the USA to the Pacific Islands and back to Asia — was like living the most wonderful dream – thoughts drifted back to warm lagoons, smiling faces, beautiful girls and so many wonderful friends in grand reunion – yet, with a breaking heart — as happy reunions ended all too soon.

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Managing a rural health project in the remote mountains along the Thai-Burma border

But again, the circle had come full. Two years on the road, living out of two small bags. Traveling now in a sharp business suit and dress shoes, and clinging to the back of a wildly pitching pickup truck as made its way up the deeply rutted muddy track to my new mountain home. It would be a nice to stay put for a change.

Rain had been falling steadily since my arrival at Thoed Thai Highland Health Center. Settling into my spartan, but comfortable room, orientation with the out-going Project Director, meeting the (43) mostly local staff, speaking Thai language — and feeling really good.

Stay tuned for “The Warlord’s Hospital” – coming soon!

You can read more about Jim’s backstory,  here and here.

 

 

Asia-Pacific Tour: Back to the USA

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

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Silver Bay YMCA staff winter reunion

I had forgotten so much. Cold, snowy weather, old friends, family reunions, fond memories – it was so much fun! Stately old whitewashed homes separated by neatly manicured lawns and picket fences and nestled in the low-lying hills and forests of central New York and New England.

Good, crisp air. And it seemed like the circle was coming full as I joined my step-family for a wonderful Christmas reunion in New Hampshire before hitting the road again for Dallas, Texas to see my sister, and then to Los Angeles to visit my brother Dave. Then, with barely enough time to catch my breath, I was off to Silver Bay YMCA of the Adirondacks — where so much of this had started for me — for another grand gathering reminiscent of the original ‘Traveling Road Show’ escapades.

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View across Lake George, New York to the Green Mountains of Vermont

A perfect winter day at Silver Bay, we hiked Sunrise Mountain for the spectacular view of bare trees and evergreens against the mountains surrounding Lake George — the Green Mountains of Vermont to the east as clear as ever. It was simply wonderful to return to this one constant in my life.

In Buffalo, New York, I caught up with old neighborhood buddies and former high school teachers. Big, stately old homes, broad streets, winter in the air – although it clouded over and rained while walking through Delaware Park – typical lousy Buffalo weather! Then to Denver and Fort Collins, Colorado for more reunions with friends from college and the YMCA, where I had worked my way through school.

After nearly two months on the road, the USA trip was winding down and I was quite ready to settle somewhere – but where? Indeed, it was bit spooky, but exciting to think of the destiny my next job would bring. Everyone was so helpful, and I looked forward to hosting them in my future, mystery homestead. My sister and brother-in-law were particularly supportive, and put me up while I was looking for my next job. But even with all the excitement and grand reunions, gnawing pangs of sadness and homesickness for my friends and places far away tore at me.

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Silver Bay YMCA on Lake George, New York

The YMCA Overseas Personnel Division of the YMCA of the USA hosted me for three days of debriefing at their corporate office in Chicago. My three-year assignment as a YMCA Young Professional Abroad (YPA) had morphed into nearly five years.

It was great to see my YPA Project Officer, who I had been reporting to over the years, as well as some of the other office staff —  several of whom graciously took me out on the town for dinner.

I presented my detailed report and photo slide presentation on the YMCAs in 15 Asia-Pacific countries, including contact information for American YMCAs interested in developing partnerships for international personnel exchange as well as for management, technical, financial and other forms of support.

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Reunions with old friends in fun places

I was also given a few minutes to meet with the Director of YMCA Overseas Personnel. He was on the phone with someone – probably a big donor – circling above in a private airplane, so my presence was barely tolerated and the meeting was disappointing to say the least.

I told him how keen I was to continue my YMCA career overseas and explained briefly about the past two years of meetings with YMCA leaders in 15 Asia-Pacific countries to support international cooperation, and how it had cost only $8,000 (of my own savings). Busy with the phone call, he turned to me briefly, and suggested I write a book – and then resumed his phone conversation.

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Mighty cold winters in the North Woods

It was Christmas weekend, and by Friday afternoon I had finished my debriefing and someone asked me if I was planning to join the staff Christmas party. But my Project Officer explained that it was a ‘set catered party’ and that there were no extra seats.

Leading me to the door – it was a cold, grey winter Friday afternoon – she pointed down the deserted city street past concrete walls and bits of garbage blowing around to a Burger King, and suggested I eat there.

A bit different from the incredibly warm receptions I had become accustomed to throughout my travels in Asia and the Pacific. A kick in the teeth, to say the least – after nearly five years as a volunteer for the YMCA of the USA – and this was my welcome home. On top of this, I found out that the funding raised by my sponsoring YMCAs to support my third year in Samoa – roughly $4,200 – had instead gone to YMCA corporate office expenses in Chicago.

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Cooling off on a Colorado mountain top

I was however, offered a job with the YMCA in Rockford Illinois – one of my sponsoring YMCAs. Good people, a nice town, but the centerpiece ball-bearing factory and surrounding corn fields of middle America somehow didn’t grab me.

But as ever, new doors were opening for me, and within a few months I was headed back to Thailand to begin work on a health project with an American aid agency there.

 

 

Stay tuned for more stories – coming soon!

You can read more about Jim’s backstory,  here and here.

 

 

Asia-Pacific Tour: Taiwan, Korea and Japan (Part Two)

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

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Traditional multicolored paintwork on a Korean Buddhist mountain shrine

Braving the bitterly cold nights in Seoul – thanks to my toasty mattress on the floor of the ‘yogwan’ (traditional guesthouse) pre-warmed by gas heaters under the floor boards — as icy Manchurian winds whipped down the rocky, barren Korean peninsula.

Dinners out on the town with my Korean friends, followed by coffee at a separate, dedicated coffee lounge, and then to the bar for some Soju — a clear, colorless distilled beverage, typically made from wheat, rice or barely with an alcohol content anywhere from 16% to 54%, and consumed ‘neat’ — straight from the bottle, without being chilled, and without any water, ice, or other mixer – serious stuff!

Even more ‘serious’ was the accompanying bowl of raw garlic cloves (instead of peanuts in the West) taken with the drinks one at a time with chopsticks. Garlic consumption was quite popular in general, and while taking the bus home on these cold winter nights, as the doors swung open, a busload blast of hot garlic breath would issue forth. On other less raucous occasions, we enjoyed drinking a milky-white rice wine called makkole, with a much milder alcohol content of 6% to 9%.

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“Here we go again….” as the masses parted on Seoul’s crowded walkways

In Korea’s homogeneous “single ethnicity” society — with one race and language enduring for centuries, and a culture deeply influenced by Confucianism — conformity is the norm. It seemed like every Korean man on the street was wearing the same conservative grey business suit, white shirt and dark tie. And while white people from advanced or ‘wealthy’ nations were welcomed with open arms, apparently this was not always the case for the less commonly seen ‘people of color’ perceived to be from a less developed  country, and relentlessly looked down upon.

Indeed, I used to kid my friend Bart, who was from Ghana, West Africa, and also volunteering at the Seoul YMCA — suggesting that he must have been the loneliest person in Korea because whenever we walked together down the crowded sidewalks along Seoul’s busy boulevards, the ‘sea of humanity’ would miraculously part as everyone hurried to move away from poor Bart – the only black person in town!

Himeji_castleArriving in Japan on an overnight ferry from Korea’s southern port city of Pusan,  I traveled by train from Shimonoseki City, on the southwestern tip of Japan’s Honshu Island to Kyoto City for a YMCA conference.

While staying with a local Japanese family — eating sushi and sleeping on tatami mats behind sliding paper doors — I proceeded to explore the country — bathing in the simple, balanced harmony flowing through the countryside, the architecture, the arts, and the people.

HiroshimaShukkeienLantern7324From the perfect gardens in Kyoto and the gentle, lilting resonance of a traditional 13-stringed Koto, Japan’s national instrument played by a woman kneeling in a colorful, silk kimono, to the shroud of lingering gloom from the terror enshrined in Hiroshima Peace Park, to medieval castles and mineral spas, and the rural simplicity of Shukoku Island — and cheerful greetings from beautiful women everywhere, with uninhibited smiles, like swaying bamboos — jet black hair hanging long.

TenryujiMomijiSeated in a neatly manicured garden on a bluff overlooking the lights of the city and along the bridge connecting Honshu Island and Kyushu Island. In the cool, dampness of the evening, a maze of bamboos throws shadows in the artificial light, while young people eager to meet a foreigner for a chance to practice speaking English bring together all the soft gentleness of the people and the place.

The Japanese have mastered the art of providing harmony and balance to life – the graceful shrines, temples, gardens, and hot springs offer gentle release to the stresses of the otherwise dazzling glitter and fast-lane lifestyle out on the lively, modern city streets.

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Pusan Harbor, South Korea

But soon the golden brown harvest of ripe corn and grain would be white with snow – carried on the chill winds of Manchuria blowing down the rocky outcroppings of the Korean peninsula. Sad to leave Japan after such a brief visit – and vowing to return for a longer stay next time.

But the music, the food, the brightly colored temples and shrines, the tall, craggy mountains at Sorak-San National Park in the north, and the delightful fishing ports were calling to me as well, as I boarded the ferry back to Korea’s seaport in Pusan, and sold the coveted Japanese bananas for a good price. I had also done well selling Korean apples when I arrived in Japan.

I must remember her eyes – her bright smile and petite elegance. How I would miss the soft gracefulness and warm generosity of the people – especially the women — who radiate genuine pleasure in being noticed, or curt shyness that melts away with perhaps one more meeting, as if we had been close friends for years. But after four wonderful months exploring Taiwan, Korea and Japan, it was time to drag myself away – and the longer I stayed, the harder it was to leave.

Stay tuned for more stories – coming soon!

You can read more about Jim’s backstory,  here and here.

Asia-Pacific Tour: Taiwan, Korea and Japan (Part One)

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

East AsiaExploring the mountains around Tienhisiang town within Taroko National Park, one of nine national parks named for Taroko Gorge, an impressive 19-km-long canyon carved by the Liwu River near Taiwan’s east coast. The name Taroko, means the “magnificent and splendid” in the language of Truku, the aboriginal tribe who resides in the area, which is also well known for its abundant supply of marble leading to its nickname: The Marble Gorge.

After a splendid couple of days wandering and hiking among the amazing gorges, lush, green hillsides, hot springs and across suspension bridges in this particularly scenic are, I returned to the capital Taipei to learn about the YMCA’s range of social and physical education programs, vocational training, language courses, youth camping, child care and kindergarten.

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Suspension Bridge, Toroko Gorge, Taiwan

The Taipei YMCA also runs a hotel and restaurant, and participates in staff and student exchange programs with YMCAs in other countries, such as the International Camp Counselor Program and the Overseas Service Corps of the YMCA (OSCY), for teaching and learning English as a second language.

The OSCY English language program (in cooperation with Japan and the USA YMCAs) was of particular interest to me personally. So deeply taken by the overwhelming charm of the people and the place, I could easily consider a longer commitment in Taiwan (or Japan) to teach English. But for now, it was time to continue on to Korea.

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Toroko Gorge, Taiwan

I often wondered at the serendipity of life – the chance meetings of other travelers at a particular place or point in time, and how it would all have been different had we each taken a different bus or train, at a different time, or had traveled a day earlier or later. Somehow, I was meeting the most extraordinary people all along the way – and many would become lifelong friends. One of the benefits of traveling alone is this added opportunity to meet new friends.

And it was happening again as I boarded the packed bus in Korea’s capital, Seoul. Dropping into the last available seat as the bus pulled away from the station, I turned to see a beautiful young Korean woman seated next to me. Mi Sook spoke fairly good English and was also traveling alone. We chatted a bit and soon learned we were headed to the same destination – Cheju Island, a short ferry ride from the southern coast of South Korea.

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Jim, Mi Sook and a Dol Hareubang on Cheju Island, Korea

Cheju Do, as it is locally known, is a popular holiday spot among locals, and has some of the only swimmable beaches in the country. It is also popular with couples and newlyweds. Large rock statues or Dol Hareubang found throughout the island have come to be known as the symbol of Cheju Do, and are considered to be gods offering both protection and fertility, but this interpretation may have more to do with Cheju Do’s present-day status as a “honeymoon island” than with tradition.

Mi Sook and her mother ran a beautician shop in Seoul, and she was taking this trip to get away from the city for a short holiday. I was on my way to visit the YMCA International Youth Center on the island – a neat, modern building that had been donated by the Japanese YMCAs. I had been treated to impeccable hospitality at the YMCA in Seoul and at other YMCAs throughout the country, and this warm welcome continued at the Youth Center – staying in first class accommodation with meals as guest of the YMCA. My hosts spoke no English, and my Korean was basically zip.

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YMCA Youth Center, Cheju Island, Korea

Still, my YMCA hosts were undaunted, taking me around the island, Mr Kim (it seemed like everyone’s name in Korea was either “Kim”, “Lee” or “Park”) and I joined the multitudes climbing the island’s impressive volcano “Hala-san” – where we literally had to queue up on the trail, but enjoyed the wonderfully cool, bracing air and great views. The change in scenery and climate in this temperate setting was a welcome relief from the heat of the tropics – both refreshing and invigorating.

Stay tuned for Part Two – coming soon!

You can read more about Jim’s backstory,  here and here.

Hong Kong, Macau and China

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

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Colonial Hong Kong, Public Domain

Once again, the Mielke brothers would tempt doom and strike off together for more Asian adventures. This time, we met up in the flea-bitten but affordable traveler flophouses of Hong Kong, where we took day trips around the city, to the outlying islands, and over to Macau.

Entering China, we sailed up the Pearl River on an overnight ferry to Zhaoqing Prefecture, a spectacularly scenic part of southern China’s Guangdong Province where we rented bikes and cycled through open countryside and rice fields spiked with tall “karst” limestone mountains – each topped with a tiny temple.

Popular with Chinese tourists, the dramatic landscape around Zhaoqing is reminiscent of the world famous Guilin Prefecture, one of China’s most popular tourist destinations, but more laid back and much less crowded.

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Celestial Star, the oldest Star Ferry vessel in service
By I, Leockh, CC BY-SA 3.0 Wikimedia Commons

But all of this had to wait until after my release from a three-day stay in hospital. Having just arrived from the States, Dave got a shock when handed a note at the hostel saying that I was in hospital – and set about finding his way to the hospital, with no idea what my condition was.

I had slipped in the shower and developed a nasty infection in my lower leg. But compared to my tiny box-like budget high-rise accommodation at Chung King Mansions — — well known as nearly the cheapest accommodation in Hong Kong, popular with backpackers with names like “Moonbeam”, the well-used sheets alive and itchy with the creepy sensation of minute critters crawling all over your body, and notorious for drugs and other criminal activities — my four-bed shared room at Hong Kong’s Queen’s Hospital was a superbly deluxe accommodation.

Compete with three good meals, color TV, round the clock diligent nursing care, a beautiful view of the harbor from my window, and excellent medical care that brought my infection under control within a few days. And at about $3/day for my in-patient stay (even as a foreigner), it was a much better deal than even the cheapest rooms at Chung King Mansions, and I was sad when I had recovered sufficiently to leave the hospital and return to my tiny flea-bitten hostel room.

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View across Victoria Harbor from the Peak Lookout on Hong Kong Island. By PaddyBriggs, Public Domain

Hong Kong was like a huge, space-age Disney World – but in real life! A spectacularly beautiful, fast-paced city – you practically have to run to keep up with the masses of rushing pedestrians – and with a great harbor, night lights, and efficient public transport. Like a giant computerized machine all programmed to run smoothly – but expensive.

I was able to meet with YMCA leaders at the three YMCA centers while I was there – two on the Kowloon mainland, including the headquarters of the Asia and Pacific Alliance of YMCAs, and one spectacular high-rise residence on Hong Kong Island. As elsewhere in the region, the early Christian missionaries had done well – managing to acquire the choicest pieces of real estate.

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Fortaleza do Monte (Portuguese for Mount Fortress), Macau

The lure of more unexplored territories took us on to Macau by hydrofoil across the channel to the oldest European settlement in the East — leased to Portugal as a trading post in 1557, then handed back over to China in 1999, and now a hugely popular casino and gambling center.

And with over half a million people living in a area of just 30.5 sq kms (about 12 sq miles), it is the most densely populated region in the world. It was intriguing to imagine this place 150 years ago with clipper ships and the early traders as described in James Clavell’s novel “Tai Pan.”

Armed with a simple phrasebook, we crossed the border from Hong Kong into Guangdong Province, China, and made our way up the Pearl River packed in with an overnight boatload of students – stretched out in open, box-like structures that separated our sleeping quarters.

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Zhaoqing Gate, Guangdong Province

At the time (1987) all foreign visitors to China were required to conduct transactions with Foreign Exchange Certificates (FEC) issued by the Bank of China. Only certain, special “Friendship Stores” and specifically designated hotels accepted FECs, which restricted where foreign visitors in China could stay and shop.

Of course, this created a huge black market. Foreigners, fed up with the limited options available with their FECs, wanted to have the local currency to use in regular Chinese restaurants and shops. The Chinese too, wanted FECs so that they could buy the “luxury” goods — like Johnnie Walker Red Label and Marlboro cigarettes.

So, at the border, I exchanged a $20 traveler’s check for the equivalent amount in Chinese FEC, then promptly exchanged this on the street for a huge pile of small, torn and grimy bills – known as ‘The Peoples Money’ or Renminbi. 

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Zhaoqing Prefecture, Guangdong Province, China

Riding local buses past steep, limestone mountains and the surrounding rice fields, we toured the area for 10 days, staying in magnificent old 1930’s era hotels, eating a wide variety of local food – not always sure what it was, and guzzling an assortment of excellent local beers –- all for about $15 US dollars.

When we arrived at the Hong Kong Border, I was informed that the Renminbi could not be taken out of the country.

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Zhaoqing Prefecture, Guangdong Province, China, CC BY-SA 3.0 Wikimedia Commons

So I exchanged my remaining torn and grimy “People’s Money” notes for about five US dollars equivalent in Hong Kong dollars. Clearly the best deal yet for budget traveling – and a very pleasant experience overall!

Stay tuned for Asia-Pacific Tour: Taiwan, Korea and Japan – coming soon!

You can read more about Jim’s backstory,  here and here.

 

Asia-Pacific Tour: The Philippines (Part Two)

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

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Island Girl and Outrigger on Boracay

A real back-to-the-Pacific feeling. After so many months in mainland southeast Asia, the Philippines was a welcome blend of Asia and the Pacific. Excellent sea food, crystal clear water for swimming, spectacular tropical island scenery and of course, beautiful women everywhere.

Considerable ‘popular culture’ American influence was evident in the slang terms and fast-food lifestyle, and some local traditions, like the favorite snack ‘balut’ (an 18-day developing duck embryo cooked in the shell) were a bit hard to take. But I was quite content to take the ‘good’ with the ‘bad’, and clearly had no complaints!

After our adventures in Hong Kong, Macau and China (stay tuned for these stories — coming soon) Dave and I were more than ready to return to these paradise islands for a much needed rest. I had almost forgotten the cheerful exuberance of the rural people here — especially the kids — all bright smiles and laughter. The easy, relaxed movement of the island women, the brilliant green of the rice fields, and the tiny bamboo houses along the quiet dirt roads, or nestled against the forested hills.

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Dave relishing his ‘VIP’ accommodation

The 1986 “People Power” uprising had been confined to Manila, and although we passed a military tank downtown, all was calm again, and we weren’t aware of armed conflict anywhere outside of the capital.

From Manila, Dave and I headed south to our favorite island getaway — Boracay — arriving in time to bask in the late afternoon  breezes moving in the coconut groves and through tall stands of grass. Shadows lengthened along the wide, empty beach, as the sunlight streamed across a shimmering sea.

It had been well over a year since I left Samoa to hit the road with just a backpack, and I was tired of traveling. Digging deep for the energy to continue, I began dreaming about a long-term job somewhere that might lessen the pain of so many difficult departures. The strong breezes of the lingering typhoon would soon be ending — as would Dave’s holiday. But not so the adventures! It had been a much-needed relaxing time for both of us, and Jackie joined us on the island for a few more days before Dave’s departure.

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Jim relaxing in the hammock

Indeed, it was really tough when it came time to leave Boracay, and my daily routine of invigorating morning swims along the long stretches of empty beach to Jonah’s Café for those delicious thick, banana-peanut shakes.

The fantastic tropical island beauty was so peaceful and relaxing in the breezy coconut groves. Waking up in our cottage by the sea, with freshly baked bread and boiled eggs and green drinking coconuts delivered to our door each morning, a fresh fish from the nightly catch, grilled and served with a salad for less than a dollar, and a full schedule of cross-island walks to quiet, white sandy bays, snorkeling in the clear waters, then lounging in the hammock in the soothing coolness of the late afternoon sunlight, with a guitar and some freshly tapped tuba (local alcoholic drink tapped from coconut buds) waiting for the stars to light up the night sky.

After visiting the YMCA in IloiloJackie and I took a ferry to Bacolod City on Negros Island and toughed out 10 hours by bus to Dumaguete (Jackie’s university town), where we caught a boat to Cebu Island. We visited the Cebu YMCA and the “Talasay YMCA Rural Community Development Project” before heading to Moalboal and Pescadores Island for more fantastic (and really cheap!) world-class scuba diving.

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Jim and Jackie in ‘Philipino-ville’

Eventually, we caught a ferry to Tagbilaran Port on Bohol Island, and settled into our breezy cottage on Alona Beach (‘Alona-ville’ in ‘Philippino-ville’ as we christened it!) on Panglao Island, where we indulged in more swimming, eating, sleeping, guitar picking and tuba sipping in this island paradise.

A second typhoon to the north of us left a trail of rain and cold in its wake. On several occasions the tempest rolled in at night with a fury that threatened to blow our bamboo cottage down. But it held firm, and in the morning, the sea was warm and a welcome refuge as I fought off a certain turbulence in my brain. It was hard to see Dave go – damn it was hard. even as he was set adrift on a broken-down outrigger taxi, once again nearly missing his plane.

And soon I would be leaving Jackie as well — for the time being anyway. Parting was so hard, and the time had just flown by. But my visa was finished, and the Traveling Road Show was rolling on! I was so utterly filled up with all of this intense living — it hurt with each new experience, each new friend — because it was always just a matter of time before we would part. Alas — the same old traveling syndrome.

Stay tuned for Asia-Pacific Tour: Hong Kong, China and Taiwan – coming soon!

You can read more about Jim’s backstory,  here and here.

 

Asia-Pacific Tour: The Philippines (Part One)

Author’s Note: This is a series of selected highlights from two years (1986-88) of budget backpacker travel through 15 countries and a half-dozen US States – hosted all along the way by national and local YMCAs – from the Pacific Islands to selected Asian countries including: Indonesia, Singapore, Malaysia, Thailand, Burma, The Philippines, Hong Kong, Macau, China, Taiwan, Korea, Japan – and the USA.

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The CIA Factbook

“Hey Joe!” “Hey Boss!” Why does everybody think my name is Joe? A naturally beautiful country with a pleasant Asia-Pacific mix, the Philippines is loaded with friendly, fun-loving and talented people — especially the musicians, who are truly amazing — and most major hotels have a live band. English is widely spoken as well, so it was easy to connect with the people and the place, even if it didn’t feel as different or “exotic” as some of the other Asian countries I had visited.

But after 500 years of Spanish rule and a further 100 years under the Americans, the culture seemed hopelessly buried beneath Catholicism and the most annoying aspects of American culture. Despite all this, I soon realized it would be easy to stay for awhile.

After a warm welcome at the YMCAs in the capital Manila and Baguio City in northern Luzon, I set off on a three-day trek through rugged mountain terrain in the cool, rain-washed air near the town of Banaue, and past incredible 2000-year-old hand-carved rice terraces reaching to the sky

Staying with the indigenous Ifugao people in pine-forested highlands near the town of Segada, I was led through a huge cave where we waded across ice-cold cascades and used ropes to guide us through dark, narrow crawl spaces. Back in the village, as the warm tropical rains subsided, the women used brooms to swat down mayflies from the swarms drifting lazily skyward, to add to our evening meal.

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WWII ‘Jeepneys’ provide cheap public transport throughout the country

On Palawan Island, also known as “the last frontier” of the Philippines, roadside stalls sold hand towels (probably my most important purchase of the entire trip!) to wrap around our heads and faces to ward off the thick, choking clouds of dust as our WWII vintage ‘Jeepney’ set off from the provincial capital Puerto Princessa.

Barreling wildly along the dusty, rutted tracks, we roared through jungle-clad mountains, past tiny village hamlets and fields of ripe rice backed by sheer limestone cliffs, out to wild, deserted beaches and finally to the scenic port of El Nido, famous for its extraordinary natural beauty and diverse ecosystem.

Back in the capital, tanks rolled into Manila’s central business district, for the “People Power” uprising. Suddenly, shops closed and even the shotgun-wielding bank guards fled the scene — as we did — catching the last flight out before the airport closed. Traveling with Jackie, a local nursing student, we headed south for a month of island hopping through spectacular coastal mountains and braved wild, stormy crossings in dangerously overloaded ferryboats and broken-down outriggers.

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Jim and Jackie on Boracay

Traveling by bus and boat to Mindoro Island, we gave Puerto Galera a miss, and continued instead to the much quieter Talipanan Beach, where we enjoyed some hiking and snorkeling in the crystal clear waters teeming with colorful reef life.

A spectacular Jeepney ride took us through the scenic coastal mountains south of Calapan City, and then by ferry and bus to the City of Roxas, where we embarked on a particularly hair-raising voyage in the midst of a rising typhoon. Clinging to the deck of a badly overloaded outrigger that threatened to disappear into the massive ocean swells, we eventually arrived at Tablas Island and finally, tiny Boracay Island.

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Village kids in Ifugao Province, Luzon

Like Samoa in Polynesia, Phi Phi Island and Krabi in Thailand, Tioman Island in Malaysia, the Spice Islands of Indonesia, and so many other amazing tropical gems – so utterly magical with the seemingly endless exuberance of the rural people, especially the kids – all bright smiles and laughter, the easy movement of the island women, small bamboo houses nestled in the greenest fields of ripe rice, or tucked away against the lush, forested hillsides. Indulging in the sea’s calming surge, warm and gentle – almost therapeutic – and feeding my soul, as did the realization of the ocean’s vast, overwhelming power and mystery. It felt great to get fit and enjoy special friendships, and exchanging smiles and friendly hellos with everybody.

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Dave relishing his island accommodation

But I was also eager to see my brother Dave who would be meeting me in Hong Kong for more adventures that awaited us there. I also had meetings lined up at the regional offices of the Asia Alliance of YMCAs, which is located in Hong Kong.

So, after a brief drift at sea in a broken-down outrigger, Jackie and I reached Tablas Island and boarded a Jeepney for another spectacular drive through the countryside. A plane brought us back to Manila to catch my flight to Hong Kong — and once again, it was killing me to leave. But it was comforting to know that soon I would be returning to this island paradise.

Stay tuned for Asia-Pacific Tour: The Philippines (Part Two)– coming soon!

You can read more about Jim’s backstory,  here and here.