*Public health and personal hygiene in Thailand*
15.11.2011 - 05.12.2011
Air quality and traffic safety
Chiang Mai’s main streets surge with cars, trucks, motor bikes, tuk-tuks and song-thao’s (small open air buses belching particularly egregious black clouds). I have never been anywhere this polluted. I often breathe through a scarf; after doing a Masters in Public Health, I have some idea what all that particulate matter does to the lungs. Plus the air is so full of dust and exhaust that it actually FEELS dirty as you inhale. I don’t think Thailand has much in the way of emissions laws, and it shows.
They do have helmet laws for motorbikes, a good thing considering it is common to see up to five people (usually a couple of them small children) balanced on one bike. The enforcement, however, is spotty and predictable. Perhaps half the people on motorbikes actually wear helmets. Thais and Westerners alike often don them in cop-heavy areas to avoid tickets and remove them once the coast is clear. The benefit of this practice is unclear to me - who wins, really? In contrast to my helmet habits vis a vis rollerblading, I actually wear whenever I find myself on a motorbike, which seems to be almost daily. Maybe it is because as a passenger I am not in control, and there is surely some phenomenon whereby humans, at least the more foolhardy members of the species (among which I openly count myself) feel safer if we are in control. The classic example: Your odds of dying in a car versus a plane crash, juxtaposed with how many people feel safer driving than flying.
As for traffic patterns, and by way of further explanation for why I gladly wear a helmet: At stoplights or in slow traffic, when all the cars and trucks are stymied, the law of nature is evidently that motorbikes flow to the front. In moving traffic as well, they travel along the lane lines, weaving among larger vehicles like water running through pebbles. The chaotic order of it is actually quite elegant. This is emergence theory in action: With relatively little regulation, an efficient, self-organizing system arises from the many individual moving vehicles. Traffic comes to seem like an intelligent being, moving and flowing of its own volition, an endless stream of horns and exhaust and close calls.
Crossing streets as a pedestrian carries its own challenges. Stop lights and walk signals exist at the major intersections. However, at most places – and really, even where there are signal towers – you just wait for a gap in traffic that affords you three or four seconds to dash across. When you look right and left, be sure to account for the fact that cars drive on the ‘wrong’ side of the road, and remember, this is not California - cars definitely do not slow down or stop when you step out into the street. I’d like to think they would swerve to avoid you if it came to that, but I’m not planning to find out. I have many good reasons to live, including…
First, foremost, and above all: The street food is amazing. Definitely one of my favorite things about Thailand. Most items cost fifty cents to a dollar, at which rate you can afford to try a vast array of unknown substances and see what you like. I have found little I don’t like.
There are public health issues, of course. For one thing, the delightful, delicious food vendors often add the much-vilified MSG to their food. Depending how much you care, you can ask them not to put any “choo-rot” into your food. Then there is the problem of controlling intake with all this food around. I could paint this a public health problem: As the obesity epidemic balloons (yes pun intended), human eating habits have been extensively studied and it has been found time and again that, to put it simply, when there is food within easy reach, we eat it. I could also paint this as a personal problem: The abundance of street carts with all manner of food costing almost nothing surely counts as ‘easy reach’ for me.
On the up-side, the food must be pretty safe, because I have yet to get sick and I am not being at all careful. On the down-side, I am not doing much to off-set the caloric intake. On the up-side, I have purchased some comfy new pants with elastic waists, so it’s all good. Except that I do manage to eat a bit too much one day. The next morning I sit down to meditate as usual, and about two minutes into my reverie, something twitches in my gut. I run to the bathroom just in time to answer nature’s sudden and rather urgent call. Happily, I feel fine afterwards and complete my meditation feeling veritably enlightened. This little sequence of events rather reminds me of something catchy. It’s like… Eat, pray, poop. And hey, that conveniently brings me to…
Bathrooms and plumbing
I do not relish using the bathroom in my guesthouse. Baring my nether regions to mosquitoes is one reason. Another is that the floor is usually wet from the shower, which is in no way separate from the rest of the bathroom. Which is a common set-up here, but as Thais don’t wear shoes inside, I am constantly stepping barefoot onto a wet floor, which just feels a little gross. Moreover, there is no toilet paper. At first I spot a roll sitting randomly around the guesthouse and put it in the bathroom where it belongs. It lasts a couple days. Then I switch to the tissue I have left over from camping, figuring any day now Tam will notice we are out of toilet paper and replenish. Instead, I overhear her talking about a plumbing problem she just had to fix, complaining that someone must have put paper down the toilet. I inwardly scratch my head; clearly, toilet paper is not part of the set-up here.
Meanwhile there is this curious feature I am noticing in Thai bathrooms at Lita and elsewhere: In addition to the shower head, there is another little nozzle beside the toilet. The shower head already being ‘telephone’ style, this second sprayer is puzzlingly redundant to me. I wonder if it may be for cleaning the bathroom floor or something. Now, around the time of my toilet paper travails, I hear some people talking about the ‘spray method.’ I think back to that odd little nozzle, and suddenly all is clear: Instead of wiping, you spray. I see, I see. In the wake of my epiphany, I try things the Thai way. You end up clean, but wet. I’m not sure I quite like it. Nonetheless, from now on I respect that paper is generally unwelcome in Thai plumbing systems.
About a week into Thailand, my deodorant runs out. No big deal, I go to Seven Eleven for a replacement. Alas, as Thais consider fair skin desirable, all the deodorants are labeled ‘whitening,’ apparently enhanced with some substance to lighten your armpits for all to admire. First of all I am white enough thankyouverymuch, and secondly, whatever chemicals they use to make your armpits change color, I am not interested. So I start going au naturel. At first I wash all the time, yet still stink to myself. Then a funny thing happens: Either I start stinking less, or I simply get used to it. I have not taken a poll of others’ opinions in the matter, so I have no idea if I am being grossly antisocial. Not that I care terribly much. I am much more taken with how modern life can lead us to become so cut off from our own bodies: How odd that I don’t know what I smell like in the absence of powders and potions. And all those chemicals can’t be good for you. Meanwhile, I haven’t shaved my legs in a month and am wondering why I ever bothered… Bringing me full circle, I feel this might make a good basis for some sort of public health campaign. Only I don’t have time to draft the pamphlets right now because I am well and truly occupied with planning for my mother’s visit December 6-19 and finishing up grad school applications.
I do, however, take a couple days out for an almost obligatory ‘trekking” trip booked through Lita Guesthouse. It is touristy but enjoyable. It includes:
A nice walk through the jungle with a group of people
An overnight stay in an elephant camp, including a ride on the animals. I manage to almost fall off the elephant (I’m pretty close in this picture).
Time to swim in a waterfall. There is a natural waterslide into a deep pool, and it is all delightful.
Delightful, that is, until I manage to actually fall down the wrong part of waterfall: In the course of my usual climbing around I slip on a rock, go down a little chute, and slide until when my knee finds a nice rock to stop on. Most people in the group are on their feet, staring down anxiously, wondering whether I am (1) okay and (2) crazy. As a bruise blooms on my knee with a ruby red bleeding center, I assure them of the former, and there’s not much I can do about the latter.
The last thing we do is white water and bamboo rafting (good fun but not documented because there was no way to keep the camera dry), followed a little time to buy souvenirs. I do not make any purchases, figuring this will serve as my souvenir. I do make sure to apply some Neosporin and a band-aid, said items being an often-used staple component of my day pack – I know myself. Come to think of it, if I had to choose between these and deoderant, no doubt which is more essential.