GlobeMed Grassroots On-Site Work
The Grassroots On-Site Work (GROW) Internship took place in Mae Sot, Thailand from May 12- June 18. Dan, Linda, Mahima, Sruthi, and I worked alongside Social Action for Women (SAW), a non-profit organization on the Thai-Burma Border. During the approximate six weeks of the internship there were four main goals. First, the GROW team wanted to better understand the multitude of programs run by SAW so that as a chapter we can better understand SAW as a whole. The second goal was to discern the strengths and weaknesses in the second and third phase of the Community Health Outreach Programs (CHOP) so that the fourth phase can be improved. Third, the GROW team observed current measurement and evaluation systems in place and developed new systems for the fourth phase of CHOP. The fourth and final goal was to develop deep and meaningful relationships with the SAW staff and to intentionally facilitate conversations with the SAW staff and community members through interviews.
I chose to participate in this experience because I wanted a chance to work on the ground with our partner and to develop real relationships with them to build the partnership. I was also excited to learn about the social determinants of health in Mae Sot and to compare my experiences to those at the community clinic I work in in Cincinnati. I was able to participate actively in the internship by practicing conversational English while at the schools, working alongside the mobile medical team to distribute Vitamin A and deworming pills, participating in the first session of CHOP III, observing all of the SAW programs, and by collecting interviews. The 2014 GROW internship set a foundation for the partnership between GlobeMed and SAW for the upcoming year far beyond what I expected. I will proceed with a well-rounded understanding of the unique faces and stories of our partner organizations and with shared memories that form real relationships. In addition the GROW trip has facilitated the growth of the partnership by allowing each organization to gain an understanding of the available assets that can be shared and with clear communication about future goals. Clear communication with SAW and a previous understanding of logic models, community health, and evaluation will allow me to work alongside my chapter as we develop the Partnership Action Framework for the CHOP IV.
The link below will connect you to the blog kept during the trip. It consists of an overview of the trip on the main page and a link to my personal page under "Individual Blogs".
I chose to participate in this experience because I wanted a chance to work on the ground with our partner and to develop real relationships with them to build the partnership. I was also excited to learn about the social determinants of health in Mae Sot and to compare my experiences to those at the community clinic I work in in Cincinnati. I was able to participate actively in the internship by practicing conversational English while at the schools, working alongside the mobile medical team to distribute Vitamin A and deworming pills, participating in the first session of CHOP III, observing all of the SAW programs, and by collecting interviews. The 2014 GROW internship set a foundation for the partnership between GlobeMed and SAW for the upcoming year far beyond what I expected. I will proceed with a well-rounded understanding of the unique faces and stories of our partner organizations and with shared memories that form real relationships. In addition the GROW trip has facilitated the growth of the partnership by allowing each organization to gain an understanding of the available assets that can be shared and with clear communication about future goals. Clear communication with SAW and a previous understanding of logic models, community health, and evaluation will allow me to work alongside my chapter as we develop the Partnership Action Framework for the CHOP IV.
The link below will connect you to the blog kept during the trip. It consists of an overview of the trip on the main page and a link to my personal page under "Individual Blogs".
To clearly represent the impact of the GROW trip, I have chosen to include the following essay as an artifact of the experience. It clearly shows what I learned from the experience and how I plan to use this experience to guide my steps moving forward.
The Grassroots On-Site Work (GROW) Internship took place in Mae Sot, Thailand from May 12- June 18. Five students, including myself, from GlobeMed at the University of Cincinnati worked alongside Social Action for Women (SAW), a non-profit organization on the Thai-Burma Border. During the approximate six weeks of the internship I observed many of the programs that SAW runs, analyzed past years Community Health Outreach Programs (CHOP), and helped to develop the 2015-2016 Partnership Action Framework (PAF) for CHOP IV. Some of the programs we observed were: The Children’s Crisis Center, the Safe House for orphans, the Green Hope Center for victims of abuse and human trafficking, the Health Care House for women and children with HIV/AIDS, the SAW High School, Gender Based Violence training, Family Talk training, CHOP, the Mobile Medical Team, Migrant Learning Centers, the Mae Tao Clinic, and some Thai schools. I also built relationships with the SAW staff and the community in Mae Sot as well as collected photographs and interviews. However, the fundamental purpose of the internship was to create a partnership between GlobeMed at UC and SAW.
During the stay in Thailand, I was also able to explore the culture by going to the local markets, taking cooking classes, visiting other Non-Governmental Organizations (NGO), eating in the restaurants, exploring the parks, and by simply absorbing all the sights, sounds, and smells of the city while riding around on my bicycle. Before the internship, started I visited Bangkok and after the internship I went to Chiang Mai. Both of these experiences added to a broader understanding of life in Mae Sot, and how it is similar to and different from other cities within Thailand.
The internship consisted of many different activities and pieces, but they came together to form a lens through which I now view the partnership with SAW and Thailand in general. However, if I had to pick the piece that shows the epitome of my experience it would be the interviews. There were four main interview categories: community leaders, community members, peer educators for CHOP, and SAW staff. Each interview flowed from personal “light” questions, to personal “deep” questions, to Strengths Weaknesses Opportunities and Threats (SWAT) question, to their vision for the future, and ending with a silly question. Facilitating deep and meaningful conversations allowed me to begin to see life through the interviewee’s eyes. The interview with Dr. Htin Zaw has had the greatest lasting impact.
Dr. Htin Zaw grew up in a small town in Burma, during this time Aung San Suu Kyi gained more and more influence in the National League for Democracy (NLD). Dr. Htin Zaw was inspired by her passion for democracy and he became a grassroots leader in his community. He was an exceptional student and he attended medical school in the United Kingdom. Compelled to serve his community, he returned to Burma while his brothers and sisters moved to California. He started a family in Burma and his influence in the community grew to the point where the government thought he was a threat. He was arrested and kept as a political prisoner for five years without any visitation from his family. However, he used even this circumstance as an opportunity to serve and he became the doctor for the prison during his stay. After he was released from prison he moved his family to the Thai-Burma border and he went to Johns Hopkins University to receive his Ph.D. in mental health. Once again, he returned to his community. He is now the only doctor who serves the Phop Phra farming communities. Despite every opportunity for wealth and prestige, Dr. Htin Zaw has chosen to live in the community that he serves. At the end of the interview I was overcome by his humility, dedication, and hope for the future.
When I began planning for the GROW internship I had many expectations and to my great delight my experiences exceeded everything that I had hoped for. A key goal was to gain an understanding of unique social barriers to health in the Mae Sot community. I gained an understanding of this topic through the interviews and by simply living in and observing the community for six weeks. The root of the issue is the conflicts in Burma. There are many different ethnic groups and religions with no clear majority or hub of power. The government is constantly being overthrown by the next rising military group. The ethnic strife has led to an ongoing genocide against the Rahkines, leaving less than 500 surviving individuals that have fled the country. In addition, the rising industrialization of the country proceeds without any regulation or safety guidelines. Chinese coal miners poor acid down the mountain sides to clear the land, thus forcing out the native inhabitants. The government also steals land on natural resources from inhabitants. Due to these issues the many ethnic Karens, Kachins, and Rahkines have fled to Thailand and live along the border in towns like Mae Sot. Thailand refuses to grant them refugee status, and the government system to receive documentation is extremely corrupt. Therefore, many migrants live undocumented. This means that they are unable to access healthcare, use their legal rights, and have a difficult time attending Thai schools. Due to these issues many migrants work the lowest paying construction jobs in the city and work on the land in the country. However, many cannot find work and fall victim to human trafficking, working in sweat shops, prostitution and HIV/AIDs, the drug trade, and other illicit activities.
I was able to gain an understanding of these issues because SAW provides prevention and treatment for the specific issues, like human trafficking and HIV, and also provides treatment and legal action. When we shadowed these programs I was able to observe and to also interact more deeply with the participants to gain a more accurate understanding of their life and circumstances. In addition, I learned firsthand from the stories that the communities members shared with me during the formal interviews. Altogether these experiences allowed me to meet one of the global studies learning outcomes, “Interact with individuals from different cultures and express a sensitivity, appreciation and respect for the complex range of experiences of diverse peoples”.
Despite the numerous social barriers to health, I was also able to gain an understanding of the assets of the community. Working alongside the SAW staff allowed me to see the professional skills that they offer to the community including: counseling, medical care, social work, case management, legal action, schooling, entrepreneurial training, and many more. In addition I saw that the community is passionate about carrying for each other, respect the elderly, and possess a deep desire to learn, a strong work ethic, and a willingness to adapt. These characteristics are vital to the survival of the community and are naturally occurring. In addition I observed that the community is seeping with joy and hope. Despite their circumstances, the people in Mae Sot take pride in what they have, they are friendly and happy, and they have a positive outlook on life. I experienced this whenever I walked through town and was greeted with smiles and waves, and also working with the SAW staff and their constant joking and laughter. The community’s hope was shown through their determination for change. Pictures of Aung Sun Suu Kyi are posted in every home and shop showing their support for democracy and their desire for reform.
Another key goal of the internship was to experience the Thai and Burmese culture. One of the main ways I experienced this was through meals. The food itself was a cultural lesson. Most meals are rice and curry based with a variety of vegetables and meats on the side. When I ate in the migrant communities I saw their respect for the “American visitors” by the way they served us first and gave us the best cuts of meat. I was able to talk to the women and children at meals by sitting on the floor with them while eating. In addition meals were a prime opportunity to talk with the SAW staff about non-work related topics and to form more personal relationships. We also learned about the culture by visiting Buddhist temples in Mae Sot and Chiang Mai. 95% of the Thai population is Buddhist so this was a key step towards understanding the culture. In addition I learned about traditional clothing by shopping in the markets and observing the communities. The language was also very unique. Both Thai and Burmese are gender specific and elongation of the words shows the level of respect. Learning these characteristics and common phrases allowed me to feel more of a part of the culture.
One of the requirements of the internship was to develop the PAF for CHOP IV. This experience differed from what I had prepared for. Before the trip I had thought that we would write the PAF while we were there and also further develop the measurement and evaluation standards and collection techniques. However once I was there I gained access to more of their records. It quickly became apparent that my expectations of their record keeping were far from reality. This made our PAF discussions more focused on questions about previous years than on plans for the future. However, I now feel that by better understanding the past I am better equipped to work on the PAF for the future. The skills that I gained to improve the working partnership through the PAF and by understanding the assets of the community allowed me to meet another learning outcome, “Participate in a global society and understand the role of a global citizen”.
Another key departure from my expectations were what skills SAW would request from the GROW team. I had prepared to work with media, to interview, to develop the PAF, and to play games with children. However, upon arrival I found that SAW wanted us to practice conversational English with the migrant students. This required me to be “light on my feet” and to quickly adapt to the situation at hand. It challenged me to go beyond what I was comfortable with and what I had prepared for to meet the true needs of SAW. The impromptu English lessons also gave me an opportunity to interact more closely with the students and to see how quickly they picked up on the new material. I also saw the amazing grasp they already had on the English language. Next year’s GROW team will be sure to better prepare for teaching so that we can continue to improve the partnership.
I believe that the GROW trip was successful in part due to the research that I did before hand to inform my experiential learning work. Thailand and Burma are nations in upheaval, and a deep understanding of the cause of these issues and practical knowledge of where conflicts were localized allowed me to safely navigate the internship. To prepare I read updates from CNN and The New York Times. While I was on the GROW trip I read International SOS updates and updates from The United States Embassy. The news articles informed me about the political strife against the Thai government democracy and the desire for a military council. They also informed me about the genocide in Burma and the migration of many ethnic groups. The ISOS updates and the embassy updates told me on a day to day basis where protests were located and what the military coup had enacted. I could better emphasize with the Mae Sot community because I was informed on current issues and I also knew how to keep myself safe.
Aung San Suu Kyi is the leader of the National League for Democracy in Burma and she symbolizes the Burmese hope for peace and democracy. Before going on the GROW internship I read her Nobel Prize Acceptance Speech and also a brief biography. This was vital to my experience because, as mentioned earlier, one of the assets of the Mae Sot community is their hope. And to understand their hope I must understand Aung San Suu Kyi. Every Burmese school, shop, and home that I visited had a picture of her. In 2015 Burma will hold another election and Aung San Suu Kyi will surely win. I had many conversations with the SAW staff about what change they think her leadership will bring. Many hoped that she would be able to quickly change the nation for the better and that they would be able to move back home. However, others believed that the military would still maintain too much control even if she was elected, and that change would happen very slowly. These critics therefore believed that it would not be safe to move back home for a very long time. I was able to understand these points of view because of my research and they allowed me to see the migrant’s vision for the future.
In addition I read articles about human rights, social development, and the health and poverty cycle. Understanding modern theories allowed me to reflect more deeply on my role in the internship. I wanted to serve SAW as an equal partner during the internship. This meant accepting their way of life as equal to mine. During the internship I grappled with the conflict between wanting to value their way of life while and at the same time working to make changes that would allow them to have “universal” rights. I came to realize that this meant that I could only work to make the changes that they were working for themselves. This also meant that I could only provide opportunities and that I had to leave the choice open for them to take it. For example, reading about the health and poverty cycle made me realize that wealth affects health and access to healthcare. While I was working with the mobile medical team I saw that the poorer the community was, the worse their health was thus proving the theory correct. Many communities suffered from infection, communicable diseases, and poisoning from fertilizers. While I saw that their poverty was a main cause of illness, I knew it was important to accept their way of life. Many western solutions to their illnesses are not suitable. Therefore to improve the health of the community SAW and GlobeMed can only help them help themselves. They can provide prevention treatment because they cannot legally receive treatment at the hospitals. They can provide them facilities to clean water, but the communities themselves have to use them. To place equal value on the community’s way of life means finding solutions to health issues that meet their unique needs and not offering western solutions that are not practical to their way of life. To create sustainable change also means working with the community as partners to create solutions that they value and are willing to implement themselves.
The root of many issues in Mae Sot is due to the fact the migrants cannot afford to receive documentation. To better understand this issue I spoke with Dr. Htin Zaw about the process to receive documentation, the corruption of the system, and trying to find practical solutions. I also attended a workshop run by a coalition of organizations including some Thai immigration officials. I listened to them speak about what they thought the documentation system was. Understanding both sides of the documentation issue allowed me gain a broader understanding, and with that to better understand what my role is as a global citizen. During the trip I made sure to ask during the interviews about issues with documentation so that I could record stories to share. Because I had background knowledge about documentation I was able to actively engage with the migrants as they worked through the issue. Documentation affects the lives of the migrants every day and this was clearly shown to me by Thin Thin, a SAW staff member. Thin Thin’s son lives in Burma and she goes to visit him once a month. She had purchased a temporary passport to legally cross the border. On her way back into Thailand she was stopped by immigration, and even though she had documentation, she was placed in jail until her husband paid the bribe to get her out. Understanding this issue has allowed me to better understand life in Mae Sot.
The GROW Internship was just the beginning of my partnership with SAW; it laid the foundation for many more years of growth. This upcoming year I will be Co-Director of Partnerships for GlobeMed with Linda, another GROW member. In this role I have the great opportunity to be the point contact person between GlobeMed, and by extension the rest of the University of Cincinnati, and SAW in Mae Sot, Thailand. Our partnership is made alive by real relationships that tie us together and I am charged with bringing back my experience so that they can be shared by the rest of the chapter. I plan to do this through different facets. The first is the most formal; the PAF will be submitted by October and shared with the Chapter. This document will be presented piece by piece so that the logistics and finite goals of CHOP can be clearly understood. In addition to that every interview from GROW will be edited and presented to the chapter at meetings. Each member will be able to start to form the relationship with Mae Sot by seeing real faces and hearing real stories. To build on this foundation I will present the other programs that SAW runs using the pictures and information that we gathered. This will allow the chapter to form a holistic view of SAW and to place CHOP within this larger frame.
In addition to sharing the PAF, interviews, and programs, I will connect the chapter to SAW through our bi-monthly Skype calls. The calls will be after meetings so that members can conveniently stay and converse with the SAW staff. On the weeks without Skype calls, GlobeMed and SAW will fill out the Partnership Update Form. This Google Doc updates the both sides on recent activities, growth, setbacks, and personal anecdotes. Therefore, on a weekly basis the chapter will have the opportunity to build their partnership with SAW. I have not had the opportunity to share my experiences yet, but I hope it will be a life giving experience. My experience compels me to share them with others; the partnership depends on it. In order to achieve our chapter’s goals for the following year there must be a reason to work, the relationships. Without this there is no reason to raise money, to advocate, or to grow.
I believe that my sense of self was changed during the GROW trip. I could not help but to grapple with the overwhelming power and privilege I have been given in my life. I was born to educated, wealthy, parents who were native to the country I was born in, I speak the native language, I obtained legal documentation easily, I am able to gain an excellent education for free, I do not have to provide income for my family, and my gender does not limit my opportunities. I am also able to go a University where I can gain the skills needed to go to medical school, I will be able to go to medical school in my native country, and I will then be able to find a job in my native country. In addition to these major facts when people look at me they assume I am telling the truth, am trustworthy, and a safe person to be around, that my checks will cash, and that I have good intentions. The Burmese migrants are viewed by the Thai people without any of the privileges that I have. In addition the government of my country is stable and will not limit the opportunities I have in the future. I have never been more aware of the privilege in my life.
As I move forward in life I am challenged to use the gifts and skills I have been given to benefit the lives of others. I believe that I have been called to work in the medical field and to serve populations in need. However the GROW trip also challenged me to adapt this plan as well. My time in Mae Sot showed the great compassion one human can have on another and also the deep pain that one human can cause another due to the choices that are made. As an organization SAW chooses to show compassion to those who are in need. However, as a person of faith, I believe that human compassion can only go so far. I feel frustrated offering help, healing, and protection that will better this life and not the next. To care for someone in need will always have value, but that human action on its own can only go so far. This experience has shown me that I will only feel fulfilled when medical healing and faith are combined. Moving forward I am excited to look into organizations that have a similar mission.
One such organization is Crossroad Volunteer Internship Program. The longer I was on the GROW trip the more I realized how similar my missions were to that of the Crossroad’s Clinic. Both organizations provide care for undeserved populations and make sacrifices to do so. The Clinic’s staff and the SAW staff both place the value of the patient over their value of themselves. They all work for less pay than they could find elsewhere because the population is important, not the income. Both groups of people provide holistic care, they provide services that meet the needs of the person as a whole and as a community. In addition, both organizations work on public advocacy and direct patient care. This realization showed me that when people come together to care for their neighbors, it does not matter what country you are in, it will look and function the same.
The GROW trip also showed me the value of incarnation, the act of living in your place of service. During the trip I came across a restaurant called Famous Ray’s. It was started by Americans through a nonprofit that works with school-age Burmese refugees. They serve burgers as a "taste of home" for all the American visitors and their mission is also to enable Burmese refugees to become entrepreneurs and to become legally part of the Thai system. I was drawn to the way the Americans were so incarnated in their mission. They moved their families to a foreign country so that they may become one with the people they felt called the serve. I could not help but to admire the fervor with which they loved their work. I also identified with the fact that they were simply providing the opportunity for the refugees to use their skills and passions. In the future I want to live where I serve and to not separate my personal life from the lives of those in need.
The final takeaway that I gained from the GROW trip is the power of awareness, advocacy, and action. The first stage of growth and change is gaining an awareness of the issue, beginning to understand all the sides of the issue. The next stage is to advocate to the change makers in the community; this could mean teachers, the school board, the mayor, state representatives, etc. To advocate means to raise my unique voice to people that I am connected to demand for change and to raise awareness for others. The final step is action, to act in a way to brings into effect the change I want to see. In relationship to Mae Sot, the GROW trip allowed me to gain an awareness. Now the stages of advocacy and action take effect. During the interview with Aye Aye Mar, the founder of SAW, I asked her if we could do one thing to improve the partnership what it would be. She replied, “As American students you have the amazing opportunity to use your voice. Tell people about our situation and what you have seen. Speak to your government”. My goal for our chapter this year is become advocates for Mae Sot because the GROW trip taught me that that is the role of a global citizen.
Overall the GROW internship expanded my view of the world. I can now approach global issues with a broader understanding of the potential costs and benefits. Thailand is no longer a distant country, it the home of dear friends. I am thankful for the opportunity to create these relationships, and I am excited for them to continue to grow. I am confident that our partnership will stand the test of distance and time.
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