The Doctor's Consultation: by Dr. Iain Corness
Dengue Fever - again and again and again
We are about to enter that
phase of collective insanity in Thailand called Songkran. There will be many
puddles of water left, despite water shortages, the ideal breeding ground
for the Aedes aegypti mosquito to breed. The Aedes aegypti is not some opera
(that’s Aida), but is the name of the mosquito which carries the Dengue
We see many westerners in my hospital with Dengue Fever. These are not an
isolated group that caught it from drinking out of damp glasses in the same
bar. And if you don’t think it is important, there were 10 fatalities last
year. That’s more than died from the SARS epidemic that had people cringing
in their homes afraid to go out without a gas mask.
So, despite my previous pleas (and those of the Public Health Department),
Dengue Fever and its potentially fatal variant, Dengue Haemorrhagic Fever
(DHF) is still with us. The latest figures have now prompted me to repeat my
advice on this subject. If you remember reading about it before, I
apologize, but the subject matter is very important. This is an important
ailment that can be avoided.
However, first you should understand a little more about Dengue. It was
first described in 1780 by a Benjamin Rush in Philadelphia (so it didn’t
start here), when the name Break Bone Fever was applied, with the symptoms
of pain in the bones and rise in temperature. The name “Dengue” came in 1828
during an epidemic in Cuba. The new name was a Spanish attempt at a Swahili
phrase “ki denga pepo” which describes a sudden cramping seizure caused by
an evil spirit! Let me assure you that the local brand of Dengue Fever owes
nothing to spirits, evil, bottled or otherwise.
Like Malaria, the virus is carried by mosquitoes. The virus itself is
related to Japanese encephalitis, Murray Valley encephalitis and Yellow
fever, and there are four “serotypes” or subgroups of it.
The mosquito lays its eggs in water containers, preferring the clean water
found in water tanks and pots, in the saucers under pot plants and even
under the pet’s food dish (or left over from Songkran). Inside discarded car
tyres is another favorite spot. These mosquitoes are not of the adventurous
type and feed during the day and spend their time within 200 meters of their
hatchery. Consequently, the eradication of any local breeding areas becomes
very important towards maintaining your own health, as you can see. Keep
your home free from lying water for a radius of 200 metres and you’re
Simple Dengue (if you can call it that) has an incubation period of around
four to seven days and then the full blown symptoms of high fever and
headache begin. The headache is usually behind the eyes and is made worse by
eye movement. From there the pains progress to the limbs with acute muscle
pains, which gave it the old name “Break Bone Fever”. Interestingly, some
patients complain of a metallic taste in the mouth. (Please don’t ask - I
have no idea why!)
On the other hand, Dengue Haemorrhagic Fever can certainly be fatal! It
appears that Serotype 2 may be the culprit here, but does not usually
produce DHF unless you have been previously bitten by types 1, 3 or 4. In
addition to the symptoms of Classical Dengue the skin begins to bruise very
easily as the blood haemorrhages into the skin. Children are also more
susceptible to this than adults. This also becomes much more of an emergency
and is best treated in the Intensive Care Unit (ICU) of your favorite
With our ability to treat the viral ailments being very limited, the defense
against the Dengue virus lies in the preventive measures. The other
precautions are to wear long trousers and long sleeved shirts, especially at
sun up and sun down, when the mosquito is at its most ravenous. The other
factor to remember is “D” for Dengue and “D” for DEET. DEET is the magic
ingredient in mosquito repellents, so when you go to buy some, check the
label - if it has DEET, then get it. And then remember to use it!
Heart to Heart
I have heard some comments about some Thai bar girls, who I think should
be called ladies, as I have never had a bad experience with one. I made
my 1st trip to Thailand last December for a couple of weeks. I spent the
1st week in Bangkok, which I found too commercialized and crowded, being
a country boy. I heard Chiang Mai was a lot quieter, so I went to have a
look. I soon found the bar area, and settled into a seat, when a young
attractive lady welcomed me, hello sexy man she said, I was impressed as
I thought that was a nice greeting which I never received in OZ. After
we had a few drinks, I said to her what is your job here are you a bar
girl? She asked me how long I was there for and I told her a week, she
then told me she was the cashier, but the boss’s daughter was there for
a week, so she was doing her job for a week and all she did was pick up
the empty glasses and cleaned the tables and did not go with any man.
She left me and did some work and stopped and talked to some men, so I
thought she must know them. Near closing time she came back to me, so I
thought I would ask her to come back to my hotel, and she agreed. When
we got back to the hotel, I said to her I had a crook knee so I will
walk up to the 5th floor for exercise and you take the lift, half an
hour later I got to my room and I had to wake her to let me in, she said
she had a woman’s problem and had to go back to bed. In the morning she
told me I owed her 3000 baht for her stay at the hotel, so I felt I had
We had just finished breakfast when she received a phone call, when she
finished she appeared upset, and I asked what was wrong, she said her
mother said her father was out in the rice field when his buffalo trod
in a hole and broke its leg, it then stumbled and stepped on her fathers
foot who then fell and pushed over a tin of pesticide which ran into the
rice field, then his pet dog drank some water and had to go to the vet.
I said can I do anything to help, she said she had B. 1000 saved but she
said she needed B. 24,000 more to pay for all the damage. I felt
terrible but she could be my future wife so I offered to pay her if she
would pay me back when I returned and she said she would. When I got
back to OZ I found out my job had gone to Asia and I could not afford my
rent so I had to go to a boarding house, which isn’t too bad, there are
a couple of people who speak broken English. My job center asked me what
I wanted to do and when I told him he said there wasn’t much call for a
70 year old animal carer at the zoo, any way the local church puts on a
good lunch every day.
What trials and tribulations you have been through, my Petal. And all
since last December, barely four months ago. But I do have a glimmer of
hope for you Scotty. At 70 years of age you must be eligible for an old
age pension, although in your case, it might be a mental invalid
pension, I fear. What you have to do is come back to Chiang Mai and get
a job as an animal carer at the Chiang Mai Safari Zoo, but bring your
pension entitlement with you. Your future wife will be waiting, picking
up empty glasses and cleaning the tables as before, as the boss’s
daughter will be enjoying the cashier’s job so much she will have
continued in the post.
Just like you, I hope the buffalo has recovered, but if not, don’t
worry, the rice farmers usually have two, one for use in emergencies,
but still prone to breaking legs and getting trench mouth as well as
other expensive diseases. It might be cheaper to just buy Papa a
tractor. And make sure you give your intended the bank book for the
monthly pension check, so she can budget properly for you both.
Pater has suggested that I give you a stiff one! What’s your bottom
line, Hillary, a dram of Speyside’s finest, cognac de la belle France or
aunties’ favourite, G & T? Bottom line, please!
If you don’t know by now that Hillary’s favorite tipple is French
champagne (vintage of course and you won’t go wrong with Veuve Clicquot,
and La Grand Dame if you’re feeling flush) then you are even slower on
the uptake than I imagined. Why don’t you and Pater and all your uncles
pop back to Blighty for an extended holiday and leave us all in peace?
That’s a good chap. And remember to take your tablets!
by Harry Flashman
Portraits packing a punch
This week let’s put some punch into your photographs. Remember
that the most commonly photographed subject is neither elephants
nor local politicians, but is a person you know. Be that wife,
parents, children or country cousins, the main subject for the
majority of amateur photographers is people. Take a look at your
photo albums if you don’t believe me. For many of those photos
they are of the type, Mum and Dad at the zoo or the kids at the
beach, or your sister in Chiang Mai.
white and yellow contrasts.
What you have to consider is “why” you are recording this split
second in time for posterity (because that is what a photograph
is - a slice of time ‘frozen’ for posterity). When you realize
“why” - your shots will improve.
It is simple really - in actual fact, you are recording a time
“when” your relative was “in” a particular place. Consequently,
you have two important items to show in the shot - “who” and
Take “where” first. This is the background to the shot, and in
many ways a most important item. While you may know that the
shot was taken in Chiang Mai, nobody else does, and certainly
not in a few years time, unless there is something in the
photograph that relates to the location.
So rule number one is to make the background “specific” for the
location. Mum and Dad with a giraffe probably does mean a zoo
somewhere, but a sign always helps to pinpoint the location.
Likewise with your sister in Chiang Mai. Get somewhere in the
city that either says Chiang Mai, or use some local landmark
that is unmistakable, like the moat in Chiang Mai or the bay in
Now remember that after you have found a good background
location, you have to stick a person in it too, and the concept
here is not to make the subject (Mum, Dad or your sister) part
of the background. You have to well and truly separate the two.
The subject is the “hero”, so bring the subject up close. So
rule number two is to bring the subject away from the
background, to make sure the subject is the principal item of
What you do now is to juggle the two items around so that you
get the best shot possible. Try taking one shot where the
subject is central, and the background extends on both sides.
The next two shots should be taken with the subject 1/3rd in
from the left border for one and similar placement in from the
right border of the shot for the second photo (back to the Rule
The third tip is to look again at the background before you pop
the shutter button. This requires you to practice looking
through the viewfinder with the critical eye. It means that you
look beyond the breathtakingly beautiful model posed before your
lens and stretch your focus through to the background. Now look
This simply means to have a light background if the person you
are shooting has dark hair, and the reverse for those with
blonde or white hair. Now to get this may require you to move
the model, move yourself or move the location again. This is
worthwhile. No matter how good the shot looks as you try so
diligently to get a pin point focus on your subject - if there
is no contrast between subject and background you will be
disappointed in the final photograph. The person’s hair will
disappear into the background. This is especially so when
photographing the very dark haired people of Thailand. Just look
at some of the social page photographs in this issue of the
Mail and you will see just what I mean.
Probably the last item to consider is color. When all else
fails, or is impossible, position your subject against a
contrasting colored background. A yellow dress in front of a red
door, for example, will always stand out. Blue and white are
also good contrasts. And of course, never forget stark black and
white, the ultimate contrast!
Money Matters: Paul Gambles MBMG International Ltd.
Practicing the Golden Rule is not a sacrifice; it is an investment
The reason that MK (Marshallian
K - the money-relative-to GDP ratio) has any influence at all on the value of
gold is that, as stated last week, many still believe it has a monetary
standard. Thus when deflation is around and governments try to devalue
currencies in order to reflate their economies, gold goes up in value.
However, this does open up a potential can of worms. As we know, the world is,
putting it less than technically, in the pooh at the moment. Most nations when
they get to this stage adopt devaluation as a strategy to kick start the economy
again without worrying about inflation. However, if all countries did this then,
in reality, no currency would be devalued.
This would then lead to a decline in interest rate, yet more money in
circulation and constant revaluation of the money standard. To put it in context
and, in particular Point 3, if there is no currency devaluation then all of
them, especially the US dollar, must be devalued against gold.
Some people think that a rising money-relative-to-GDP ratio can actually lead to
an increase in inflation. However, there is nothing to support this as, over the
last thirty years, the link between MK and inflation has been negative.
Basically, an increase in money-relative-to-nominal GDP has coincided with a
decrease in inflation.
As mentioned above, there are also other areas that impact the value of gold.
The safe haven to guard against political and economic crisis is one. Gold is
seen as the place for wealth preservation.
Despite all this, the most important question on everyone’s lips is how long
will the present gold bull market last and can it go up even more?
Anyone who is a long term reader of this column knows that I am a great believer
in cyclical trends and the one for gold is very bullish. Nonetheless, there are
a couple of problems that need getting out the way first. For instance, monetary
reflation is not good enough and is stifling gold prices. With the recent
announcement of the Fed saying it was going to buy bad debt then this has eased
a bit but it needs more. Also, everyone is bullish on gold so there may be a
short term correction soon.
Nonetheless, with the breakdown of economic activity and share prices falling
through the floor means that the central banks are going to have to combat debt
deflation by printing yet more money. There is a good possibility of a
depression knocking at the door and quantitative easing will only increase as
seen by the Fed and promises from the Bank of England to do the same. Without
doubt, the Fed is being aggressive. On top of what it has already, the Fed has
committed to Term Auction Lending Facility (TALF) and the Public-Private
Investment Fund (PPIF) which could add another USD2 trillion to its balance
To put things more succinctly, the Fed has already doubled its balance sheet
since September last year. It is about to double it again. With all this and the
printing of yet more money the USD price of gold should finally break out to new
record highs. This is just in America. What about the rest?
The UK has already committed and is in the same boat as the US.
The Bank of Japan is having massive pressure put on it to print money. Indeed,
the country could well be in depression already. Industrial production is down
by over 30% and exports have dived by 44%. If the authorities do weaken and edge
to quantitative easing then the yen will weaken and the JPY price of gold will
go up dramatically.
The European Central Bank is being cagey about its next step. However, it is in
unchartered territory as a few countries have already fallen into debt
deflation. In the past, these nations (usually the PIGS - Portugal, Italy,
Greece and Spain) would just devalue accordingly. This time they do not have
this option. With ever increasing losses in the banking system, the question is
who will bail out Europe? Some analysts are even asking if there will be a euro
when all this is finished. Whatever the final decision is, it will probably
include some sort of quantitative easing.
What all of this points to is that global MK will increase more and more as the
central banks have to grow their balance books to combat the problems seen
today. This war on deflation, and possible depression, could last a long time as
could the continuous printing of money. All of this means the outlook for gold
is good for many years to come.
For yet more confirmation that gold is still in a position of good health then
look at a Gold Indicator as it should be based on real interest rates,
trade-weighted USD and G7 MK. At the moment, the arrow is still pointing upward
showing the market to be intact. This should attract new investors as they will
regard gold as an investment, a hedge against major currencies AND a safe haven
from any further economic and political uncertainty.
So, to conclude, the case for gold is good. The bull market is set to run for a
few years yet. Yes, as stated before in this article, there will be ups and
downs but the trend will be upward. In a deflationary era the central banks have
to print money and all currencies must devalue against the monetary standard.
This is especially true for the US dollar.
We would hold that as part of an actively managed, diversified, multi-asset
class portfolio, investors should have 10%-15% invested in gold. If one looks at
a regression model then the following may well occur:
Scenario A – Marshallian K grows 25% + US Dollar falls 10% = Gold at USD1,400
Scenario B – Marshallian K grows 40% + US Dollar falls 30% = Gold at USD2,500
Scenario C – Marshallian K grows 25% + US Dollar rises 20% = Gold at USD900 p.oz
This then is another sign that gold will end up anywhere between USD900 and
USD2,500 per ounce. I would be amazed if it was less than USD1,400 p.oz. in
three years time.
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 Paul Gambles on
Let's Go To The Movies:
Race to Witch Mountain: US, Adventure/ Fantasy – A perfectly
acceptable and innocuous action film for children (mostly) with all the
standard chills and thrills, chase-movie suspense, and wisecracking humor –
and a few slam-bang action setpieces. Well done of its type, and the
ex-Rock Dwayne Johnson is (mostly) charming as a Las Vegas cabbie who
enlists the help of a UFO expert to protect two children with paranormal
powers from the clutches of an organization that wants to use the kids for
their nefarious plans. Mixed or average reviews.
Monsters vs. Aliens:
US, Animation/ Sci-Fi – Has gotten some rave reviews from a number of
reviewers, and some highly critical. I found it half imaginative and
amusing, half irritating – the really irritating part being Reese
Witherspoon’s shrill voice and creepy character. Mixed or average reviews.
Thai, Horror/ Romance – Starring Love of Siam heartthrob Mario
Maurer and Cherman Boonyasak, who played his sister in that film. It’s a
sequel to Yuthalert Sipapak’s famous horror films Bup Pha Rahtree and
Rahtree Returns, set in the same apartment where the haunting story
has been told before. Straight razors and a barber’s chair are featured
prominently in the posters for this film. Shades of Sweeney Todd,
Fast & Furious 4: US,
Action – Vin Diesel and Paul Walker re-team for the ultimate chapter of this
film franchise built on speed and exotic cars, which started in 2001 with
The Fast and the Furious, an unexpected hit movie. It’s almost entirely
about car races and car crashes. There are some who like that! Mixed or
The Shinjuku Incident:
China, Action/ Drama – Featuring Jackie Chan in a dramatic rather than a
fighting mode. In the planning stages for almost 10 years, according to
director Derek Yee, it now seems the film will not be exhibited in mainland
China at all, due to censorship concerns over the portrayal of Chinese
living abroad. This will really hurt the financial prospects for this film,
China being Chan’s biggest market. Shown here in a Thai-dubbed version
only, without English subtitles.
Sassy Player / Taew Nak
Te Teen Rabert: Thai, Comedy/ Drama – A gay teen soccer comedy in the
vein of Iron Ladies, the internationally popular comedy about a gay
and transgender men’s volleyball team. There’s a little bit of everything
in this film. It’s fun. Directed by Poj Arnon (Bangkok Love Story).
US, Drama/ Thriller – Delightful! And a lot of fun, particularly if you
like Nicolas Cage. A teacher opens a time capsule that has been dug up at
his son’s elementary school; in it are some chilling predictions – some that
have already occurred and others that are about to. Mixed or average
Khan Kluay 2: Thai,
Animation/ Adventure – The legendary elephant is back in action in this
sequel to the animated movie Khan Kluay.
Scheduled for Apr 16
State of Play: US/
UK, Crime/ Drama/ Thriller – With Russell Crowe, Rachel McAdams, Ben
Affleck, Jason Bateman, and Helen Mirren. Handsome, unflappable U.S.
Congressman Stephen Collins (Ben Affleck) is the future of his political
party: an honorable appointee who serves as the chairman of a committee
overseeing defense spending. All eyes are upon the rising star to be his
party’s contender for the upcoming presidential race. Until his research
assistant or mistress is brutally murdered and buried secrets come tumbling
out. Based on the BBC mini-series of the same title, a team of
investigative reporters work alongside a police detective to try to solve
the murder of a congressman’s mistress.
US/ Germany/ UK, Crime/ Thriller – With Clive Owen and Naomi Watts. An
Interpol agent attempts to expose a high-profile financial institution’s
role in an international arms dealing ring. In this gripping thriller
Interpol Agent Louis Salinger (Clive Owen) and Manhattan Assistant District
Attorney Eleanor Whitman (Naomi Watts) are determined to bring to justice
one of the world’s most powerful banks. Uncovering myriad and reprehensible
illegal activities, Salinger and Whitman follow the money from Berlin to
Milan to New York to Istanbul. Finding themselves in a high-stakes chase
across the globe, their relentless tenacity puts their own lives at risk as
their targets will stop at nothing – even murder – to continue financing
terror and war. Rated R in the US for some sequences of violence and
language. Mixed or average reviews.
Crank: High Voltage:
US, Action – The indestructible hopped-up hitman Chev Chelios, played to
the hilt once again by Jason Statham, returns in Crank 2: High Voltage,
picking up where the first film left off - except this time, Chelios is
chasing a Chinese gangster who hijacked his heart and substituted it with a
mechanical one that needs to be jolted regularly with an electric charge to
stay pumping. Rated R in the US for frenetic strong bloody violence
throughout, crude and graphic sexual content, nudity, and pervasive
Bridge in Paradise :
by Neil Robinson
This hand was dealt in a game with Chris Hedges, Graham Forshaw and John
McDermed earlier this month. East-West were vulnerable and West dealt:
S: 108 S: 95
H: 43 H: QJ106
D: A1098 D: KJ6
C: AQ732 C: J1094
The bidding was straightforward::
West North East
The four of hearts was led.
The problem is how to make the contract. Put yourself in South’s seat and
decide on a plan before reading on. It is tempting to take the ace and king
of hearts and then try and cross-ruff the hand out without pulling trumps.
If you can make all nine trumps separately you will take eleven tricks for
an overtrick, losing only two diamonds. The difficulty is that you run the
risk of being over-ruffed at some point. Declarer tried this tempting line
of play at the table and ended up going down one.
The alternative is to pull
trumps first. But, if you do this, how can you set up your hand? You have
eight potentially losing cards in the minors. One can be thrown on the ace
of hearts. Even if you can pull trumps in only two rounds you will be left
with only three trumps on board to ruff your losers in hand. That still
leaves four losers and you go one down..
The solution lies in dummy’s
six card heart suit. Dummy has no trump losers (when combined with the high
trumps in hand), no club losers and only two diamond losers. If you can play
the heart suit for only one loser, then you have the contract made. As the
cards lie, trumps split. Pull them in two rounds, ending on board. Then play
the ace of hearts and ruff a low heart. Cross back to dummy by ruffing a
club and ruff another low heart with your last trump. Now dummy’s remaining
hearts are good, and you lose only two diamonds. Eleven tricks made. Even if
trumps are not quite so friendly and need three rounds to pull them, you
will still make the contract after conceding a heart to set them up. You
take five trump tricks, one heart ruff, two high hearts and two long hearts
for ten tricks. This play is called a dummy reverse. It is often useful,
particularly when dummy has a long suit, but sometimes difficult to see. All
of us tend to focus on setting up our own hand, rather then dummy. If your
plan of play for this hand was a dummy reverse, congratulations!
Chiang Mai now has an
official bridge club – the Bridge Club of Chiang Mai. We welcome new
players. For information on the Club please contact Chris Hedges at
[email protected] If you have bridge questions, or to send me
your interesting hands, please contact me at [email protected] I look
forward to meeting you at the bridge table.