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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

Money Matters

Life in the Laugh Lane

Your Health & Happiness: Campaign highlights essential treatment and care options for HIV/AIDS

Helping someone with HIV to stay alive is helping families to stay alive

Owen Elias, Health and Development Networks

“In the first three months of 2005 alone, more people have already died from AIDS-related conditions than the total number taking antiretroviral drugs throughout the world. This grim milestone is a stark reminder that as we grapple with the scale-up of global ARV access, we have to keep people with HIV alive in all possible ways,” said Abby Erikson, AIDS Care Watch campaign coordinator.

ACW campaign coordinator, Abby Erikson giving her presentation at the NGO forum

The monthly NGO forum held in Chiang Mai was just one of several events taking place globally to launch the new AIDS Care Watch (ACW) campaign. The forum brought together people living with HIV/AIDS (PWHA), NGO workers and other interested members of the community to discuss the themes of the campaign: Listening to voices that matter, staying alive with HIV.

Introducing the speakers, forum moderator, Ajaarn Laurie Maund, of the Sangha Metta Project emphasized the vital importance of the campaign. He stressed that there are many ways to keep people living with HIV alive.

Abby Erikson opened the forum by showing a series of images representing ‘voices that matter’. The images were of activists, care workers and people living with HIV/AIDS from all over the world. “These people are fighting for the rights of those living with and affected by HIV. They are people who are inciting hope and working hard in their communities to keep people with HIV/AIDS alive and healthy, and often in situations where access to antiretroviral drugs is unavailable or under-available,” said Ms. Erikson. “This is what the campaign is about. It is about listening to civil society and people living with HIV/AIDS. It is about us sitting in this room, coming together to let others know what care and treatment we need in our communities.”

Forum moderator, Ajaarn Laurie Maund, of the Sangha Metta Project

Ms Erikson explained that the idea for the campaign emerged during the last International AIDS Conference held in Bangkok in July 2004, where it became clear that the large-scale AIDS treatment initiatives (such as the World Health Organization’s ‘3 by 5’ initiative and the US’s emergency plan for AIDS relief) will not meet their AIDS treatment goals as soon as expected or needed. The ACW campaign aims to highlight all HIV/AIDS care and treatment options available to people living with HIV. For the millions of people living with HIV who are not able to afford or access ARV treatment in the next few years, there are many ways that their lives can be extended.”

The forum in Chiang Mai focused on three of most pressing care and treatment issues for people living with HIV in Thailand: prevention and treatment of TB; tackling HIV related stigma; and pharmacotherapy for recovering drug users, the speakers that followed illustrated some of the ways in which people can be kept alive with HIV.

Representing the Office of Disease Prevention and Control, Sumalee Amarinsangpen spoke about the importance of providing prevention and treatment of tuberculosis to those living with HIV/AIDS. Northern Thailand has a particularly high rate of TB infection and a high level of TB/HIV co-infection. Sumalee emphasized the role that TB treatment plays in extending the lives of people living with HIV/AIDS. “It is vital that we develop integrated care for HIV and TB,” she said.

Addressing the devastating impact that stigma has on people living with HIV/AIDS, Bounnieum Vongjaikham, vice president of the Thai Upper North Network of people living with HIV/AIDS said, “How can PWHA maintain a good standard of life when society looks on them as germs?” Bounnieum spoke of the high level of ignorance and misconception that still exists in Thailand, partly because of early government campaigns that wrongly purported that ‘AIDS = death’. The stigmatization of people living with HIV/AIDS discourages many from disclosing their condition and seeking help, and restricts access to vital services and information. “Many people with AIDS die of opportunistic infections that are treatable and preventable,” he said.

Pharmacotherapy also plays a vital role in rehabilitating injecting drug users (IDUs) and can be an important way of maintaining the health of PWHA drug users. This was the issue raised by Montira Mayta of the Faa Mai Drug Dependency Treatment Centre. Montira explained how methadone maintenance treatment (MMT) worked and how much success they had had in working with IDUs. Some of the highest rates of HIV infection are to be found among injecting drug users but, Montira stressed, “MMT can help to significantly extend the lives of PWHAs. They no longer need to go back to heroine and no longer share needles, thus avoiding new infections that are detrimental to their health”.

Finally, Mae Chee Wirawan, a nun working with the Clear Sky Project addressed the participants. She talked of the importance of acknowledging our physical suffering and of finding ways to heal our mental pain. Recognizing the harmful effect of stigma, she advised, “No one can hurt us if our heart and mind are strong – this is what the Buddha teaches us.”

In the remaining time for participants to raise issues from the floor ‘stigma’ dominated as an impediment to healthy living for PWHAs. One of the participants called for “moral support for people with HIV to continue their lives”, and added, “Restoration of human dignity among PWHAs is essential.”

Bringing the forum to a close Ajaarn Laurie left us with this thought, “There are many people affected for every one infected. Helping someone with HIV to stay alive is helping families to stay alive.” The NGO forum takes place on the last Tuesday of every month. For more information please contact Owen Elias at Health and Development Networks, [email protected]


The Doctor's Consultation: What a wonderful world we live in

by Dr. Iain Corness

It is not often that I get depressed, but reading some statistics from UNICEF about the plight of children in our world is certainly depressing reading.

According to UNICEF, and as reported in the British Medical Journal, more than half of the children in the world live in extreme deprivation due to poverty, war, and HIV/AIDS. Read that again, “more than half of the children in the world”! UNICEF also argues that these problems are impeding the development of the countries affected.

Whilst I am sure that these problems do impede the development of the countries, what about the development of the individual children?

Again according to the BMJ, children experience poverty differently from adults, and the standard measures of income or consumption fail to capture the impact of poverty on children, the report argues. To gain a clearer picture, the report’s authors, from UNICEF, the London School of Economics, and the University of Bristol, analyzed access to seven services and goods they considered essential to children.

They found that an estimated 1 billion children from the total of 2.2 billion in the world were living in poverty. One in three (640 million) children did not have adequate shelter, 500 million had no access to sanitation, and 400 million did not have access to safe water. Additionally, 90 million children were severely deprived of food and 270 million had no access to healthcare services.

The statistics also showed that poverty was not exclusive to developing countries. The proportion of children living in low income households had increased over the past decade in 11 of the 15 developed countries for which comparable data were available. The UK Child Poverty Index for example shows that in Britain, around 30 percent of children live in poverty! In 1991, 21.8 percent of American children - some 14.3 million in all - lived in families in which total income failed to exceed even the Spartan thresholds used to define poverty by the U.S. Bureau of the Census.

Extreme poverty was considered one of the central causes of conflict, along with poor governance. The report found that 55 of 59 armed conflicts that took place between 1990 and 2003 occurred within, rather than between, countries. Children accounted for nearly half of the 3.6 million people killed in these conflicts. Conflict also had a catastrophic impact on overall health. In a typical five year war, the mortality of children under the age of five years increased by 13%.

The impact of HIV/AIDS on children was seen most dramatically in the number of orphans to AIDS - now totalling 15 million worldwide.

Researchers in America also examined the links between economic deprivation and children’s development, using data from the Infant Health and Development Program, a separate sample of nearly 900 low-birthweight children followed from birth to age five. They sorted the effects of income from the effects of family structure and other factors generally considered together as “socioeconomic status.”

Their conclusions included, “Family income is a far more powerful correlate of a child’s IQ at age 5 than maternal education, ethnicity and growing up in a single-parent family. And the effects of persistent poverty are roughly twice as large as the effects of transient poverty on children’s intelligence. The effects poverty has on children’s behaviour were also significant. Children whose families were poor the entire four years of the study were considerably more likely than those whose families were poor only part of that time to be fearful, anxious, unhappy, or depressed, or to destroy their own things or have temper tantrums.”

(Childhood Under Threat is available at www.unicef.org.)


Agony Column

Dear Hillary,
My friend lost his wife three years ago, he had no child. He was so happy when he fell in love with a Thai lady who was the mother of a very nice little girl of six. He cherish both and look after everything for the mother was always sick (emotion and women’s problems) or jammed with unbelieved family problems, going to her place every week.

He gave them everything he could in a reasonable way for the beginning (I know it was a lot) and he followed all the advices every men, who live with a Thai lady he met in the street, knows. The little girl loved him and of course called him Papa. He was so proud of her. Would you believe the mother asked her daughter to watch and memorise his ATM PIN number. When he went for withdrawals she used to stand back and say “Go with papa, I wait here.”

One morning at 6 a.m. the mother went out to send her daughter to school taking with her his ATM card who was back to bed after giving the breakfast to his step-daughter. She went to the Bangkok Bank thinking the camera was disconnected and she took 150,000 baht out of his account. But he found out, and when the mother saw that he was going to the Police Station, she said she needed water and told him she would be back. She rushed to their hotel, took all her and daughter belongings and go away.

Now, would you believe, she want to come back. Everybody know the old song: Me love you... me sick... too much debt... me sorry... baby want you so mutt...always cry for you, calling papa, papa.

How sad! This man was handsome, clean, not asking too much for sex as she was always sick, he was caring in her sickness and he was willing to give them all he had making them his beloved family. This woman and her little girl would never have any money problem for all their life. Now the three of them are miserable.

His friend
Dear Friend,
What a sad tale it is when people take advantage of genuinely nice people, and use their own children as agents in the deception. There can be no excusing this woman, who will always have a life of problems until she starts to do the ‘right thing’ by everyone, and especially by her daughter. Unfortunately, however, there is a tendency to tar all Thai women with the same brush. Ask many of the expat men why they are in Thailand, and you will find that the reason is that they were taken down in their own countries, by their own countrywomen. There are also many women in all the countries of the world, who have been taken advantage of by men from all the countries of the world. This is a universal problem, Petal, not just a female or Thai problem.

I know it is an ‘old-fashioned’ concept these days, but long courtships gave both parties the time to really assess the other. Those just in it for material gain get tired very quickly and move on to more unsuspecting partners.

The answer is always to take time to get to know the other person, no matter how breathtakingly beautiful or attentive. Trust is something that takes time to build up, and has to be something that both people work on. It is not something that happens overnight, or over one night! Most of the problems I read come from those who cannot understand the difference between love and infatuation.

Time will heal your friend’s heart.
Dear Hillary,
I have come over here from the UK to handle my elderly father affairs (72 years old) who has been living here for two years. When I spoke to him from England I got the impression that he was still pining for my late mother who died two years ago, but when I got here that seems to be nothing like the reality of it. He is going to go-go bars at night and I have seen these women, one quarter of his age fondling him in a most indiscreet manner. How can he let himself be handled in this way? I find it disgusting and would like your advice on how I get him to stop this sort of thing, as I am sure you will be just as disgusted by someone who used to be a loving husband and father. Is it a medical problem, or just due to his age?

Agnes
Dear Agnes,
No my Petal, it is not a medical problem, it is a daughter problem. I understand that you came over to handle his problems, but now you see that he is being more than adequately handled by others! You should be pleased that your 72 year old father is still showing signs of life and share in his enjoyment of it. Life is for living, no matter what age you are. Time for you to lighten up, Petal. If you want to do something for your father in a constructive way get him a medical check up and a packet of Vitamin V if he is fit enough.


Camera Class: How to shoot competition winners

by Harry Flashman

There are many photographic competitions that you should enter. Even some of the local organizations will run photo comps, and with the advent of digital images and the internet, it is quite simple for you to enter competitions overseas as well as in Thailand.

One ‘amazing’ fact I have found over the years is that many people have shot award winners, but are actually too shy to enter these competitions. But for those of you who think you haven’t got a winner, let me help you a little.

Imagine a competition called “Amazing Thailand”, and although the words get done to death, Thailand is still an amazing place. There are just so many aspects of life and the scenery here which will fit the theme. Take these for example - when did you ever see five people on a motor cycle in Montana? Or nineteen workers in the back of a pick up truck in Pittsburgh? A motorized hang glider with pontoons in Paris? Or a Songkran soaking in Saskatchewan?

We have all become too used to the funny little vagaries of life here, which really do say “Amazing Thailand”. Have a look in that photo drawer again and see if you have a nice shot of some of the things you found “amazing” when you came here first!

Of course, if you haven’t got a nice shot, load the camera with film and go and get it. But do so with a few concepts in mind first. Here are a few.

Sock it to ‘em with colour!

Now I do know what judges look for in a photograph, having been one many times. In amateur photography competitions they will be drawn by bright colours, believe me. Really sock it to ‘em with bright colours which jump out of the photo, if you can. Look for bright, bright contrasting colours - reds against yellow sand, whites with blue skies, light purples against black. Anything which draws their attention to your photograph is a plus in your direction. So do not forget colour contrasts, or the polarizing filter that enhances these.

Pull on their heart strings!

Judges are merely human and have just the same emotions as everyone else. The things in life which make you laugh or cry will make the judges laugh and cry too. Pull at their heart strings, make them laugh, get that handkerchief out of their pockets, make them remember when they last played that game or jumped that rope. As soon as a judge relates to the subject of your photograph, you have that judge hooked!

One of the easiest ways to see which of your photographs is a winner is to show them to friends and listen to their responses. An “Oh, isn’t that nice!” reaction is enough to tell you that the photo has an immediate appeal. An appeal which could win you some prizes if it grabs one of the judges the same way!

Don’t be afraid of tourist destinations.

We’ve all been to the tourist attractions so many times with friends, who come here for vacations, that we forget just how “amazing” some of these are. Just because you pass the place every day on the way to the shops doesn’t mean that it’s not worth a photograph or two. These attractions are set up for tourist photography - so you may as well get that advantage too.

Don’t be too critical of your own work.

Generally, the greatest critic of our own work is not your family and friends, but yourself! Because you personally took the picture you become very personally involved with it. You remember why you took it, what you were trying to show and you will judge it as a successful picture if it recreates those feelings for you. However, even if it doesn’t “say” everything you had in mind at the time, it does not mean it is a “bad” or “failed” photograph. It is probably a brilliant shot that creates different feelings for different people.

I suggest some of the schools should try a photography competition, and you be the first to enter!


Dr Byte's Computer Conundrums

by Dr Byte, Citec Asia

It seems from the first days of webcams there have been websites to visit in order to peek at what’s going on in other people’s neighbourhoods, even their lives. When there’s not much to do over a weekend or maybe during the holidays, the whole family can enjoy seeing through someone else’s eyes and what a choice there is.

View across the world: The first place to stop is the grand-daddy of webcams - earthcam.com. Here you can get a bird’s-eye view of streets around the world, including those near the Paris Hotel in Las Vegas, so you can enjoy all the traffic jams, but without the road rage.

If you’re more an “off the beaten track” person, from earthcam.com, visit the Sedona webcam in the middle of Arizona. While the scenery doesn’t change much, the camera turns to view what’s around the site. Stop by at sunset (about 8 a.m. Chiang Mai time) to see nature put on a stunning display.

You’ll find plenty of interesting US sites to visit and, then, when you’re ready, head across the pond by clicking the London webcams link. You’ll find live footage from Trafalgar Square. The impatient can click the 24-hour time-lapse view for a quick summary of what happened. It’s amazing just how many double-decker buses travel around Trafalgar Square at 2 a.m.

If you were never treated to a drinking-bird toy that teeters downwards to sip water, stands upright, waits and then does it all over again, check on the Drinking Bird cam (go to: http://www.happydrinkingbird. com/). It’s a funny retro experience for the first five minutes, and a cure for insomnia thereafter.

Travel the Southern Hemisphere: A little closer to home, visit the Antarctic any time of the year, from the Australian Antarctic Division website (http://www.aad.gov.au/). There are live webcams at Casey, Davis, Macquarie Island and Mawson. You have to feel sorry for the folks at Macquarie Island - the webcam is supposed to update every 15 minutes, but often it’s too wet to capture a picture. It looked pretty wet and miserable when I last visited.

If sun and surf is more to your liking, visit webcam .caloundra.qld.gov.au/webcam.htm and watch the waves at Caloundra from the lifeguard cam perched high over the beach.

Or why not cross the Tasman to New Zealand, where you might be lucky enough to see a rare purple dragon that hangs about inside the White Island volcanic crater. Photos taken each hour from the webcam in the crater appear on the GeoNet Project web site (http://www.geonet.org.nz/). Courtesy of a tourist with a sense of humour, you’ll see a small purple dragon in the bottom left corner of the pictures.

Here’s a project for the kids during the holidays or if all this has given you a hankering to do it yourself, why not grab a USB webcam and check the trial Active WebCam software from www.pysoft.com? DIY web cams for your own home page and let the family everywhere else enjoy a view of their nearest and dearest here in Thailand. Once installed, launch the program, choose Create New Camera and use the New Camera From Wizard option to configure your camera and internet settings. Then choose Local Camera and select your webcam name and click Next to continue.

Set the broadcast method to FTP Upload and click the FTP Settings option and enter your website’s FTP details. Click Next and, in the Recording options, set the number of images to Record and Preview - use a mid-to-low range for both, until you’re sure your computer can process the data quickly enough. Disable Live Recording, click to create a web page to display your webcam pictures and click Next. Configure a template and a delivery method and click Upload to FTP Server. Your new page and applet will be uploaded to your site and you can test the result. Then, all you need do is sit back, smile at the camera and tell everyone where to go to watch you.

In the next column, I have a few more Questions and Answers to share with you. Don’t forget to keep your preferred anti-virus and spysweepers up to date. Do a full hard disc scan and sweep at least once a week. Don’t open e-mails with funny attachments if your not expecting them and last but not least, make sure your firewall is on.

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.


Money Matters: The China Syndrome

A five-dimension analytical model for deciding when (and when not) to purchase from the East (Part 2)

Alan Hall
MBMG International Ltd.

Five Dimensions

The five-dimension analytical model readily leads procurement executives to a set of significant matters they need to consider when making sourcing decisions.

1. Manufacturing Cost. China can provide Western parts and materials buyers significant benefits in overhead and raw material costs. Total overhead rates in China vary significantly by supplier, but can be less than half of Western levels.

Chinese labour rates also are extremely attractive relative to those of other countries. Including hourly wage rates and benefits, Chinese wages are about 10 percent of salaries in the U.S. and Western Europe and 50 percent of the average wage in Mexico. There is still a large supply of low cost labour throughout the country, and manufacturers in major cities (Shanghai, for example) are supported by government efforts to keep wages low by bringing additional workers to urban areas.

Nevertheless, as more and more companies purchase supplies from China, there has been wage inflation in some large cities. As a result, labour-intensive supplier relationships, such as some automotive OEM programs, are moving inland, where wages remain lower. Honda, for example, is establishing its manufacturing centre, automotive assembly, and supporting component operations in Dongfeng, in central China. Moving inland, though, makes shipment scheduling more difficult and often more costly, because of poor roads and the lack of developed logistics infrastructures.

These trends show how executives should evaluate manufacturing cost when making procurement decisions:

The total labour content (direct and indirect) of a product is the primary driver for China procurement savings. For a product with a large labour component (i.e., 25 percent or more of the product cost structure), low Chinese wages represent a meaningful benefit. In these cases, the labour savings - applied labour hours multiplied by the difference in the labour rate - can be significant. But for some products, such as shoot-and-ship injection-moulded plastics, for which one operator manages several high-speed machines, the labour requirements are too low for China sourcing to be the best option.

Real overhead savings can be realized in China. Local labour rates are embedded in the price of many of the goods and services that are critical components of overhead costs. And many suppliers use local machinery, which can also cost as little as half the price of imported equipment.

Savings on raw materials in China are possible when these materials are locally sourced from competitive suppliers. Electronic components and some lower-end steel grades are areas where local competition can lead to raw-material savings. However, when Chinese suppliers have to import materials - such as high-quality steel alloys - there can be a significant cost penalty in a procurement agreement.

To gain the highest potential returns from a Chinese procurement effort, the amount of labour should be maximized. It often pays to think beyond the purchase of the part, and to include machining and assembly activities in the sourcing contract. For example, when an automotive company attempted to purchase raw aluminium castings from China, the Chinese supplier offered savings of only 1 percent over the bid of a U.S. supplier. By redoing the bid to include finished machining of the parts and the incremental labour, handling, and overhead, the automotive company realized a 15 percent total cost savings from the same supplier.

2. Transportation Efficiency. Procurement from China naturally increases transportation cost over more local sourcing arrangements. In China, a product must go from the factory to the port, onto a ship, and then to the U.S. or another major market, where it is unloaded and trucked to its destination. The cost of ocean transport alone from China to the U.S. is $2,500 to $3,000 per container. For a $12 casting, the total incremental transportation cost is $1.10, compared with $0.30 for a typical Mexican supplier shipping to the U.S.

Financial assessment of China sourcing should be made on the total landed cost of a product, which includes the manufacturing cost differential as well as the full logistics cost - hence two major considerations when assessing transportation costs:

Measure the ratio of transport cost to total product cost. Since ocean transportation costs are essentially a fixed cost per volume shipped, economics favour China when smaller, higher-value items are involved. For instance, thousands of small electric motors can be packed in one container, spreading the fixed costs over numerous units. Conversely, plastics and stamping assemblies for auto interiors require protective packaging that results in low packing density and fewer parts to share the burden.

If airfreight is required - for instance, to meet lead time requirements shorter than ocean freight allows - the savings generated by lower-wage-rate manufacturing in China are usually eliminated. Airfreight costs about $1.51 per pound; ocean transport, $0.06 per pound. Only products with very high packing density and high value per unit (for example, printed circuit boards) can support the costs associated with airfreight.

Next week: 3rd, 4th and 5th dimensions…

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Alan Hall on [email protected]


Life in the Laugh Lane: Think Thai or Die: Got a Light?

by Scott Jones

I think Thais come out of the womb simultaneously singing, playing the guitar, cooking and riding a motorbike. On a 100cc Honda Wave, they can carry anything - their entire extended family with pets, several computers, 1100 newspapers, live or dead pigs, 358 food-filled plastic bags, massive bookcases and bedroom furniture - maybe all at the same time. It takes practice, balance and intelligence. So why do they ride with no lights at night?

Motorbike at night with no lights, viewed from behind, ahead or the side, before or after the accident.

In most countries, besides being the law, driving at night with lights on is a simple survival technique: a tail light prevents a speeding truck, tourist bus, or me from killing you from behind, and a head light keeps you from killing yourself…in a pothole the size of Laos, in the butt of a water buffalo with no tail light or in the recent wreckage of the bike with the live pig (now dead) that was just hit by the bus. What’s their rationale for riding with no lights? Wearing dark clothes on a black bike? On the wrong side of the road?

1) “I’m an escaped criminal. I’m hiding.”

2) “I’m hunting escaped criminals who are hiding.”

3) “I’m invisible. And if I can’t see you, I’m safe,” said the Ostrich with his head in the sand.

4) “I don’t want to wear out my lights. They’re more valuable than my life.”

5) “I’m an alien. I have advanced infrared vision and a powerful force field around me.”

6) “It’s just like riding around in the womb.”

Likewise, the issue of turn signals: handy, colored beacons that clearly communicate your course so the 13 drivers behind you don’t have to rely on their non-existent mind-reading capabilities. During the entire year of 2004, only three bikers actually used them, probably unintentionally, and then left them flashing for the rest of the day. In heavy traffic these lights are generally replaced by vague hand or finger gestures that are not particularly visible at night.

Sometimes there’s a Human Turn Signal sitting on the back of the bike, randomly pointing with a purse, perhaps just waving to a friend or maybe talking with one hand with a mobile phone in the other. Is the biker completely unaware of the mass of mankind on his tail driving heavy, dangerous machines? “I’m a self-absorbed idiot and the rest of the world has to take care of me. Besides, when I learned to ride, my brother’s Wave was only one other bike in the womb. And the walls were very soft.”

Think Thai or die. Or kill. They’re not going to change so you have to take care of them…and yourself. It’s your choice: the womb or the tomb.

One signal is used here zealously. When someone’s flashing their headlights, do NOT think American. In the USA, drivers may flash them once you’ve passed to tell you it’s safe to pull back in the lane. Or to alert you there’s a patrolman ahead with a radar gun. Or to gently remind you to turn on your headlights. Here, from ahead or behind, it means one thing: “I’m driving very fast. I’m bigger than you. Get the hell out of my way or I’ll take you home on my bumper as a souvenir.”