Columns
HEADLINES [click on headline to view story]:

Your Health & Happiness

The Doctor's Consultation 

Agony Column

Camera Class by Snapshot

Dr Byte's Computer Conundrums

Letters from Lek

Mrs. DoLittle’s Corner

Life in the Laugh Lane

Your Health & Happiness:  How antiretroviral side effects can change the life of HIV+ people

Health and Development Networks

Health and Development Networks (HDN) hosted a monthly NGO Forum for non-profit organizations on September 28. The topic of discussion, suggested by participants from the last NGO Forum, was “ARVs (Antiretroviral): the problem of side effects, and possible solutions”.

Three panellists, each from the PWHA (People living with HIV and AIDS) community, the medical and the NGO sectors, were invited to share their perspectives.

Antiretroviral drugs and related issues such as access to treatment, adherence patterns and administration of the drugs figured prominently in the international debate and at this year’s International AIDS Conference. Several countries, including Thailand, have launched policies facilitating access to ARV treatment. Currently with a little over 40,000 people regularly receiving some combination of ARVs in Thailand, the lack of ARVs here is felt less acutely than in other parts of the world.

The NGO Forum began with a hands-on activity aimed to raise awareness among participants. Everyone was asked to illustrate in a handout and share with the forum the changes they notice in themselves and/or others after taking ARVs.

The forum moderator proceeded to summarise relevant ARV-related developments. ARV treatment was first provided to only 1,500 patients in Thailand as part of the ATC Project. Now, the Napa Project aims to provide treatment to 50,000 patients by the end of 2004. At the IAC in Bangkok this year, the Prime Minister announced that ARVs would be included in the country’s general health insurance scheme by 2006.

On a global scale, the World Health Organisation’s (WHO) ambitious “3x5” programme aims to give three million people access to ARVs by 2005.

Currently the only regimen - and the cheapest option - available to PWHA in Thailand is GPO-VIR, which costs 1,200 baht per month; the drugs are generics and produced domestically. Other regimens can cost between 20,000-50,000 baht a month.

There is a growing concern of various ARVs side effects such as lipodystrophy among people living with HIV/AIDS across the country. A small but vocal group of affected community members is drawing attention to this issue.

The panellist from the medical sector noted that in the past, the typical characteristics associated with PWHA were thinness, newly grown hair, diarrhoea, skin spots and a grim facial expression. Since many Thais experience visible physical symptoms at a very late stage, they would resort to treatment late. Despite being diagnosed as HIV+, some only seek medical assistance in the final stage, thinking that ARV treatment is the last resort. Had they known their status sooner, they could have taken care of themselves better and suffered less pain.

The panellist representing the PWHA community recounted that she took usual care of herself and took herbs for many years after being diagnosed as HIV+. She switched to ARV treatment when pain started. Initially, she stopped having opportunistic infections and gained ten kilos. However, she started experiencing side effects such as sharp pains, shaky hands and legs, weight loss, a thinner and darker complexion. She became stressed out, stayed indoors and began eating more meat and protein. When her condition improved, her friends sold their cows and other assets to be able to afford the same food.

The NGO panellist, who is also a nurse, noted that people who are HIV+ want ARVs, believing them the only solution to curing AIDS. None considered related issues such as: readiness (one’s own and the family’s) to adhere to a regimen and adjust to physical changes; side effects; seeking appropriate solutions to problems.

Participants noted that side effects have changed the symptoms “traditionally” associated with PWHA to rounder faces and increased abdominal girth, forcing PWHA to fight against new social stigma as well as existing government policy. Participants expressed fears that methadone or TB medication taken alongside the ARV regimen may cancel out its effectiveness.

Furthermore, PWHA tend to focus exclusively on ARVs once they realise that opportunistic infections decrease after taking them. Yet the information gap increases, as patients fail to realise that side effects of ARVs are not only physical, but also social and cultural.

In response to a question about the usefulness of herbs, the medical panellist explained that herbs can be used either as part of self-care prior to receiving or during ARVs treatment. Although herbs do not cure AIDS, they can boost the immune system and thus aid in preventing opportunistic infections. The NGO representative added tips for easing lipodystrophy such as protein and careful monitoring of food intake, as well as plenty of sleep and exercise.

Using ARVs means extending one’s life, but “extending life” does not only mean we continue breathing. It means living with other people, accepting our appearance and maintaining our overall health. The question remains: how can we do this successfully?

The next monthly NGO Forum meeting will be held on Tuesday, October 26. The Forum is open to everyone in the community. For more information, please contact Health and Development Networks (HDN) by email: [email protected] or tel. 66 53 418 438.


The Doctor's Consultation: The 100 percent vegetable diet to a longer life

by Dr. Iain Corness

The following lifestyle diet was sent to me by an old friend George Comino, wondering if he should take it up. Here is the proposal:

Q: I’ve heard that cardiovascular exercise can prolong life. Is this true?

A: Your heart is only good for so many beats, and that’s it. Don’t waste them on exercise. Everything wears out eventually. Speeding up your heart will not make you live longer; that’s like saying you can extend the life of your car by driving it faster. Want to live longer? Take a nap.

Q: Should I cut down on meat and eat more fruits and vegetables?

A: You must grasp logistical efficiencies. What does a cow eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more than an efficient mechanism of delivering vegetables to your system. Need grain? Eat chicken. Beef is also a good source of field grass (green leafy vegetable). And a pork chop can give you 100% of your recommended daily allowance of vegetable products.

Q: Should I reduce my alcohol intake?

A: No, not at all. Wine is made from fruit. Brandy is distilled wine, that means they take the water out of the fruity bit so you get even more of the goodness that way. Beer is also made out of grain. Bottoms up!

Q: How can I calculate my body/fat ratio?

A: Well, if you have a body and you have body fat, your ratio is one to one. If you have two bodies, your ratio is two to one, etc.

Q: What are some of the advantages of participating in a regular exercise program?

A: Can’t think of a single one, sorry. My philosophy is: No Pain. Good.

Q: Aren’t fried foods bad for you?

A: You’re not listening! Foods are fried these days in vegetable oil. In fact, they’re permeated in it. How could getting more vegetables be bad for you?

Q: Will sit-ups help prevent me from getting a little soft around the middle?

A: Definitely not! When you exercise a muscle, it gets bigger. You should only be doing sit-ups if you want a bigger stomach.

Q: Is chocolate bad for me?

A: Are you crazy? Hello - Cocoa beans - another vegetable! It’s the best feel-good food around!

Q: Is swimming good for your figure?

A: If swimming is good for your figure, explain whales to me.

Q: Is getting in-shape important for my lifestyle?

A: Hey! ‘Round’ is a shape!

Well, I hope this has cleared up any misconceptions you may have had about food and diets and remember, “Life should NOT be a journey to the grave with the intention of arriving safely in an attractive and well preserved body, but rather to skid in sideways - Chardonnay in one hand - strawberries in the other - body thoroughly used up, totally worn out, and screaming - Woo Hoo! What a Ride!”

And now the REAL situation

George, my dear old friend, with the suggestions above, you won’t be a dear old friend much longer. A dear departed old friend more like it. However, you are not totally incorrect when you mention the 100 percent vegetable diet for a longer life. Even Dr. Spock turned vegetarian in his later years and lived to be 95, but he got his vegetables from the garden, not pre-processed via the cow, or distilled in the vineyards. However, laughter is always the best medicine, and I enjoyed my dose today.
Dr. Iain


Agony Column

Dear Hillary,
I will be coming to Thailand in December and I like to rent motorbike and ride all over your beautiful country. I arrive Chiang Mai and go Bangkok after two weeks. Is possible? Yes or no? Where do I get the bike? I do not need big bike as I am small man. I ride Vespa in Paris, so I am OK in the saddle. Is it with insurance and can I ride with French license? Thank you.
Pierre.

Dear Pierre,
You have certainly got plenty of questions, especially for a small man, as you so quaintly put it. I really think that you should sit down on the seat of your trusty Vespa and think again, Pierre. I have been to Paris and seen the standard of hair-raising driving there - but, Pierre my Petal, it is nothing compared to the driving in this country. When you ride a motorcycle here it is not a case of “if” you have an accident, it is “when” you have an accident. You don’t meet another Vespa coming up the Champs Elysee the wrong way, now do you? The gendarmes would not allow it. Here it is a different story. Going the wrong way down a one-way street is normal in Thailand. This country has one of the highest road tolls in the world, and that is just one of the reasons why. Forget it Pierre. Take a tour bus.
Dear Hillary,
This is a real problem for me, and I do hope you can help (don’t treat this lightly please, as I have nobody else I could possibly ask, and I definitely couldn’t ask my husband). One of my former women friends in the UK, from the same village as me is coming to Thailand next month, with another couple of her girlfriends. We are all in out 50s, so we’re not scatty teenagers. She shocked me when she wrote and said they wanted to see a “sex show” while they are here. Do you think it’s proper for me to take them to some of the more outrageous places, or what? I’m really blown away by this. What do you recommend, Hillary?
Sex-pot

Dear Sex-pot,
There is nothing to worry about, my Petal. Everybody knows we don’t have sex shows in Thailand. The nice man from the Ministry of Fun told me so, and so did the nice policeman. If you’re really worried, get your husband to take them.
Dear Hillary,
I love coming to Thailand, it is really such an exciting place to visit. There are only a couple of downsides for me. Bartering and tipping. Can you give us some pointers on how to do it, and how much to leave as a tip? If the establishment charges a “service” fee, should you tip as well? What do you do as someone living there, for example? I believe that the wages are not high for some of the people in bars and restaurants and they need the tips, but I do not want to throw money away either? What’s your tip about tipping?
Tippy

Dear Tippy,
Half the fun of coming here on holiday is the bartering side of buying. Don’t get too hung up about it. They will give you a starting price and I generally come back with about 40 percent of that. The shopkeeper will then come down a little, you go up a little and so on. Keep smiling, it’s a game remember! If you find you are haggling over 20 baht, convert that to your home currency (30 British new pence or 50 cents US) and see if it is worth the hassle of continuing. Don’t leave something you want for the sake of 50 cents!
Tipping? There are two situations here - service charge or no service charge. If the establishment adds on 10 percent (the usual amount), then as far as Hillary is concerned - that’s the tip. There are some places that no doubt pocket the service charge, but that’s not anything of our doing, nor can we change it. That is something between the employees and the owners to work out. However, if Hillary feels that the waiter or service provider has gone well beyond that which could be expected, then I reward with a little extra something for that person, irrespective. You know the sort of things I like - a little fawning, grovelling and lots of compliments. In an establishment that has no standard add on service charge, then it really is up to you. Small change left over or up to 10 percent is quite acceptable. The Thai people are grateful for anything you leave them. It all adds up by the end of the day.
Dear Hillary
I see so many old and ugly expats here running around with beautiful young girls that it makes me sick. Do they think these girls actually like them? It’s only their money that they’re after.
Young and handsome

Dear Young and handsome,
Look forward to the day when you are old and ugly too, young man. If you are clever and have put some money aside, then you too might have a beautiful young girl to look after you too. Time to live and let live. Are they doing anybody any harm? Does it matter that they are keeping several herds of buffalo in luxury? No!


Camera Class: How to improve - the equipment and the basics

by Harry Flashman

In my time I have bought and sold many cameras, including Nikon, Hasselblad, Voigtlander, Cambo and Minolta. There was also one I threw away, called a Golden Dream Pigeon. I threw it away, not because it didn’t work, but because it took lousy photographs. It had also cost 90 baht, including the film, so I was not losing much!

What I learned from my Golden Dream Pigeon was simply the old adage - you get what you pay for! Unfortunately, all of us fall into the trap of the tight fist. Why spend big baht when a much cheaper article will surely do the same job just as well. I rationalized Golden Dream Pigeon’s purchase in this way as I did not think that it could be quite as dreadful as it was!

As justification you tell yourself that all you are paying for is the “name” plus very expensive packaging with the high ticket items. Unfortunately, in photography, you pay for more than the “name”. You are paying for that other ingredient called Photographic Quality.

The interesting feature about photography is that the measure of excellence is always the end result. In other words, the photo says it all. A clear, sharp and well exposed shot shows the lab did a good job in printing, the film was top quality, the camera set at the correct exposure, the lens let the light rays through without distortion and the image was focussed correctly.

So let’s look at some of these basic factors. First, let’s deal with the camera. What is often not realized is that the principle function of the camera body is really just to hold the film flat and be able to alter the shutter speed and aperture required for correct exposure. It’s still just like a Box Brownie - but smaller with built-in goodies.

The cost of the camera body today depends on the degree of sophistication in its built-in features. Electronic multi-pattern metering, motor driven film advance, auto rewinding, DX coding to set the film speed automatically, different exposure modes, smart cards and memory stick replaceable electronic gadgetry, LED viewfinder displays, dedicated flash electronic circuitry and ergonomics in design all add to the cost. None of the above were available in the Golden Dream Pigeon, by the way.

Next item is the lens. The equipment necessary for the super sharp snap is the super sharp lens. The sad fact is that no matter how good or expensive your camera body, you will only get lousy pictures if you use a lousy lens. A good lens is just as important as a good camera body.

If excellence is your pursuit, look at good quality “fast” (f 2.8 or better) fixed focal length lenses from the same manufacturer as your good quality camera body. Sure, you can get a “bargain” at some camera shops (and Duty Free outlets) who will sell you a Nagasaki 28 - 3000 zoom for your new Nikon or Canon or whatever. Certainly it will be cheaper outfit than a Nikon lens on a Nikon camera - but in saving a few baht you just lost out on excellence.

Now let’s look at some very simple fixes for some common problems. Blurry photographs can be fixed by selecting shutter speeds of 1/125th second or faster. Hold the camera with two hands. None of this one handed technique, waving one-two-three fingers with the other hand as a count-down.

There are six simple steps on the road to improvement:

1. Use more film. At least one roll each time, taking notes to check your results later.

2. Move in closer. Many shots fail by being too distant.

3. Keep it simple. Photos are far more effective with one subject and no background clutter.

4. Specialize. Take pictures of one subject, say boats or trees, until it is mastered.

5. Read books on the subject. Kodak “How to ...” books are instructive and easy to follow.

6. Edit your own work by constantly sorting through your photos and discarding the failed shots. Be ruthless! And remember just “why” the shot failed.


Dr Byte's Computer Conundrums

by Dr Byte, Citec Asia

In my last column, I promised that I would explore the world of file sharing on the internet (peer to peer) in more detail and I also promised some killer applications to think about.

Before I begin, let me state that most file sharing activities are focused on illegal, unethical, or immoral activity. Downloading of copyrighted music, copyrighted software, pornographic material, and even child pornography are the most common uses of peer-to-peer file sharing. It’s also risky and one of the risks is to unknowingly download a computer virus or Trojan Horse onto your computer.

Not so long ago, Napster, the grandfather of peer to peer networking, was simply providing an easy way of sharing music through their own system. 20 million sharers later, the record industry basically shut down the company (for making it too easy to share music) and only three years ago, followed this by mounting legal actions against Music City, Grokster and Kazaa (sons of grandfather). This suite marked the fourth major legal action to try to restrain millions of people from sharing copies of songs and movies online.

Within months of this 4th lawsuit, more than 34 million downloads from just one source (download.com) shows just how many people recognised the opportunity. Collectively, these and other rivals have kept file swapping alive and well in Napster’s absence. Analysis company Webnoize estimated that 3.05 billion files were downloaded using these networks within months of that lawsuit.

The concept has attracted the attention of companies like HP, IBM and others. The potential to set up business networks using the same kind of protocols is obvious. Imagine your company head office in New York simply shares a folder on their local computer, and you have access to the latest product updates, brochures and so on (and its available to those with the right access).

Millions and millions of computers (and of-course owners) are now sharing images, music, movies, videos and files and the US record industry is having problems policing millions and millions sharing their favorite movie or sound tracks.

The good news is that recent legal actions failed and a US Federal Judge handed down a stunning court victory for file-swapping services, dismissing most of the lawsuits. In essence, there is nothing illegal about use of the application. Its also noteworthy that when users search for and initiate transfers of files using peer-to-peer networks, they do so without any information being transmitted to or through any computers owned or controlled by the authors of these applications. If any of the authors of these peer-to-peer applications (clients) closed their doors, users of their products could continue sharing files with little or no interruption.

Kazaa is an Australian product that most of us have heard of. Its one of the biggies and they openly admit that it comes with integrated spyware that monitors your internet activity and reports back on web sites visited and so on. K-Lite is a light version with no spyware but doesn’t have the same features. Kazaa changed hands and is now owned by Sharman Industries. Go to www.kazaa.com for your download. This application is free but only gets 1 Star for paying its way by selling and peddling your personal web surfing habits.

Grokster comes in two versions but do beware, like Kazaa, Grokster comes with integrated spyware. A paid for US$29.95 Pro version and a free light version are available. Grokster can be downloaded from www.grokster.com and gets 0.5 of a Star because it not only pays its way by spying on you, it also makes money selling its Pro version.

Son of Napster is still around but now it’s highly ethical and only provides access to licensed music which you have to pay for. Costing $9.95 US a month you can download Napster from www.napster.com. Napster only gets 2 stars.

Limewire is another Aussie application and very good too. There are two versions with a free light version and pay for Pro version. The light version has constant pop up messages imploring you to buy the Pro version and get faster downloads etc and I got the feeling (but can’t prove it) the free version was deliberately slow. Go to www.limewire.com to download either version. Try the free version first and then maybe buy the Pro version later. 3 Stars.

WinMx produced by Frontcode is very easy to use, with a cluttered but easy interface. Download and share any file type, multiple source downloading, chat, queuing and many other features. This application guarantees no spyware, no centralised monitoring of shares, bandwidth management and the list goes on. WinMX finds files very fast and depending on your internet connection, can download as fast as your connection allows.

WinMx gets 4.5 stars (lose 0.5 for a cluttered look); go and get it from www.winmx.com

Shareaza is probably the smoothest looking of this list. Networks to Gnutella2, Edonkey 2000 and BitTorrent, this open source application has received over 200 updates to improve your file-sharing experience. An excellent FAQ module simply adds one more reason on top of a long, long list of features. Completely free, no spyware and more importantly can block unwanted attention with the help of security block lists, a highly-sophisticated IP and client filter and has the ability to block malicious companies and clients. Searching for files was very slow and downloading even slower. Go to www.shareazaa.com to download and check out. This application gets 3.0 stars.

Last and not least for this week, Neo-NETS Morpheus claims fast downloads and searches include all other major file-sharing networks with simultaneous connecting to millions of users of Kazaa, iMesh, eDonkey, LimeWire, Gnutella, Grokster, G2 and others to find more digital media. Morpheus is the only American file-sharing software ruled legal by U.S. federal courts. It protects your privacy with access to public proxy networks and has options to prevent others from snooping on you; works with your antivirus software to prevent unwanted malicious files; enables simultaneous searches for all media file types including MP3 audio, video, games, software, pictures and documents; returns fast multi-source downloads; provides bitzi anti-spoofing lookups and contains absolutely no spyware. There are several warnings about Morpheus users being attacked by hackers, so be warned. Go to www.morpheus.com to download and get the free. Morpheus gets 4 stars.

In the next column, I’ll be updating you on what has been happening to Chiang Mai’s internet options since August. And yes, a possible solution for businesses in the city area.

Dr Byte appears in Chiangmai Mail every 2 weeks and if you have any questions or suggestions you would like to make, you can contact me at Dr Byte, Chiangmai Mail.


Letters from Lek

Hi Kids!
Here is another game, which is especially good for a birthday party.

It is very easy, but you are not allowed to let anyone see the preparations, because that could give them a clue what kind of game it is, and some of them might even know the game, so that it wouldn’t be fun anymore.

The game is called:
“What is on the Paper?”
You need:
glue,
at least 10 pieces of paper,
3 shells,
some stones,
dried orange peals,
leaves,
small bits of wood,
small bits of cloth,
buttons,
1 or 2 rubbers, 2 bottle tops
and a small piece of cardboard or other small things.

Preparations:
Stick all the things that are listed above on several pieces of paper (one item on one sheet). Then hide it at a place where the other children probably won’t go.

The game:
Blindfold a child and take it to the place where you hid the sheets of paper.
There you tell the kid that it has to guess what is on the paper, which it gets.
If they guess right you note down one point (don’t forget to write the child’s name, too, because you might get dazzled if you have many children wanting to play the game), if they guess wrong they don’t get a point. They only have one guess per paper and the person with the most points wins the game.

Joke of the week:
Does somebody live on the moon?
Of course, you can see the light every night!

Alright now, have a nice week!
Lek


Mrs. DoLittle’s Corner: How to live with a calculating civet cat

Mrs. DoLittle

How to live with a calculating civet cat? The best way in reality is don’t! However, just in case someone, like Mrs. DoLittle, will find themselves forced by circumstances beyond their control, to share their abode with one of these mischievous little creatures, here are a few tips.

Hugo the civet cat

Yes, these little monsters can actually outsmart you if you are not careful. It starts from the very beginning. Even the name, Common Palm Civet, it’s a trick! It implies a normal “civet-lized” sort of an animal having some kind of relationship with palm trees. Nothing could be further from the truth! That is only a name that has been derived by scientists, so that zookeepers will think it is really cute and want to care for it. Once you get close enough, the little rascal jumps on your face and bites your nose off. By the time you work out what hit you, the little cutie is sitting on top of the curtain rod, waiting for you to turn your back so it can jump on your head and rip your ears off.

Mrs. DoLittle found that the only way to stop the attack was to pretend it wasn’t happening. Start humming and eventually it dozes off. Hopefully by the time this happens you are still recognizable and won’t need plastic surgery.

Of course something has to be said in defense of the species. I mean, they don’t really mean to rip your ears off. No, it’s just that living with humans they don’t get to kill anything. Living in the forest, every little thing that moves gets jumped on, wrestled and munched. Living with a civet cat, one has to allow for this.

Civet cats are really smart. They sleep all day and get away with it by declaring themselves nocturnal. This also means that in the morning when you are full of energy, ready for a challenge, with some possibility of winning, they are never around. They are clever enough to know that the best time to ‘kill’ you is at the end of the day when you are half dead already. Don’t worry, the nightly ambushes are only a passing phase and also a great opportunity to test your own pain tolerance level. What other species can offer you this?

It is extremely important to allow yourself to get ‘killed’ during this period of getting to know each other. Learn to play ‘dead’, otherwise it will want to kill you for the rest of its life.

After Mrs. DoLittle outsmarted Happy, her first civet cat and played dead for approximately three months, it stopped biting. I was still alive so I was able to enjoy this new period in our relationship. Friends commented on how normal I looked. Now I was able to sit and read a book and Happy would just attack the book.

It did leave a lot of missing pages but at least I had my arms and legs. This is phase two, known as the ‘jealousy stage’. This lasts the rest of its life. At this point it’s time to give away all your possessions and dedicate the rest of your life to entertaining your darling little cat. Civet cats are masters of monopoly. Follow these tips and one day your civet cat may get to “like” you … maybe.

The moral of this story is: Leave wildlife to go wild in the wild!


Life in the Laugh Lane: Let sleeping dogs lie-die

by Scott Jones

The bravery or audacity of Thai dogs is astounding. They will try to eat, attack or mate with anything at anytime. And they can sleep anywhere at anytime: in the shade, in the baking sun, on tables, chairs and windowsills, in baskets on speeding scooters, but preferably in the middle of the road. The exact middle of the road. On the line, if possible. It’s not cool, soft or safe. It’s hot, hard and life threatening. Are they just tired of their cushy dogs’ life and dream of being with Buddha later on today?

Another famous Thai species is the ‘table dog’.

How many times have you seen a hound lying on the shoulder, centimeters from traffic on a busy city street, testing tire treads with his tail? How many times have I ridden through a sleepy town with an apparent road kill in the middle of the road and its apparent owners dead to the world nearby on a bamboo platform? The roar of my motorcycle wakens the canine from its coma and it barely ambles out of my way. Or decides that my foot could be a tasty afternoon snack. Or if I stop long enough, mounts my leg for a spontaneous romantic interlude.

Chiang Mai friends had visited a bike shop several times in an attempt to whittle down the price of a big Kawasaki. The resident mutt was always splayed out on the cement, here or there, anywhere. One day, the dog was stretched out on his side underneath the desired motorcycle and my friend remarked in jest, is your dog dead or what? With a flourish, the owner said something like, “No, he’s fine” and gave it a swift kick. Perfectly motionless and rigid, the dog slid a half a meter in the direction of the kick. Dead tired? No, just dead. Rigor Mortis the Dog.

“Gosh, he was such a good dog! Slept all day, hardly ate a thing, never attacked anything and guarded that spot 24/7. Mai pen rai. We can still use it as a door stop.”