The POVERTY video reels

As I watched the video reel that I uploaded on the topic of "POVERTY", my mind was brought back to Nov 2005, where I was being exposed to the reconstruction work in Koh-Hlau, an island where the Sea-gypsies lived, which was destroyed by Tsunami.

If you screened through each video reel, you will see children were being highlighted in hunger and poverty. Different sources were used, different philosophies were being employed, but for one motive, "Save the children! Stop poverty!"

It is easy to shout a slogan, to plan a campaign, but that is when we stand outside the circle, and presuming that we know all about it by watching a few video clips, reading a few reports, analysing a few statistics. It is often harder when we are in the midst of them.

In the mission trip to Koh-Hlau, there was nothing much that we could do. We flowed along with the existing team in that place, observing and learning how the more fortunate one in the village provided help and food for the people.

There was one lady, she was a Thai, but she stayed in the island together with them, she owned a little grocery store. She was saved after the Tsunami, and she began to provide the children free lunch everyday. Wonderful lady.

There were definitely hygiene problems, there is no pure and clean water supply, the children were skinny and bonnie, with a large stomach that were full of worms. Ring worm disease was very prevalence in the community. Lack of medical treatment, medicines in Archan Vichai's house were basically being brought and left over by the mission teams.

We taught them English, bible stories, played with them, hugged them, dewormed them, taking photographs. That's all that we could do, and that little thing that we did, made the children happy. Simple things. But then, we couldn't do much for the poverty. The needs were tremendous! It takes tremendous human effort, even to think of how to solve the problems. The hungry people were not only the children, the adults were hungry too! The people were starving! Many were sick, having high fever, conjunctivitis, sores, weak. These Sea-gypsies didn't even had a nationality! That means it is illegal for them to step into the land of Thailand or Myanmanr. That also means they can seek help no way unless there are volunteers who bring medication and education to them.

The best memory that I had in the trip was the house visitation after the deworming program. Listening to them, comforting them, teaching them how to cope with the children who kept vomiting worms and perching, laying hands on their wounds and prayed for them! Soothing their rough infected skins with our bare hands, examine the wounds and flaked skins...... Those were the most memorable part in this trip! And that was the little thing that I believe that had the most impact in their lives!

Mission is about putting ourselves down, and begin to step into the shoes of the needs, and begin to SERVE!


Poverty, is not an easy issue to deal with!




just thoughts: Children had been used for many scene, some for political issues, some for human rights issue. It seems that children are the best bullet, a distinct secret weapon that lead to world attention.

Christ and Health

I personally believe that Christ is about public health. Don't ask me why, don't ask me how. It will take me very long to explain this. But nevertheless, this is a conviction in me.

I believe that Christ is for everybody, just as I believe that health is for everybody. Not all people will choose the same way to live to obtain health. There are many circumstances, many situations, where we aren't empowered to choose to live the desirable way of living, including obtaining basic health.

In different part of the world, we have a different definition for health or wealth. Samething with God or Creator.

A different definition, a different need in health do not mean that health is just not important for people. Health is important in all sector! That is the fight of public health workers! The challenge is how to remove the scale and free them to see! To give those who are in needs strength and power to pursue an equity in health! The degree of wanting health or desire of a healthy body is universal, do not let the mask of poverty fools us!



There is a deep hole in our hearts that acts as a dark hole, mystery of universe! Where do we come from? Why do we exist? Who am I? Who are you? What am I doing here? What is need of me? Who is calling me? We asked these when we were kids, the same questions in every where, all parts of the world, regardless the boundary of culture or nations, poor or rich. But as we grow, we had been shut down for answers. We had been shut in! BUT then, it does not mean that what had been suppressed are not there anymore! Those childlike ideas and craving just blown up to the air, and burst like bubbles? No way.


The essential of truth will always remain, it became clearer, when we totally lost it. Often, that is the minute before we grasp our last breathe. Our necks are really hard to break!

Cho Seung-hui

The incident of Victoria Tech last Monday is a hard subject to write about.

Fear, pain, tear, anger, embarrassment, sadness, sickness all aroused and became a confused mess-up mixture.

As the killer had been highly marked, "ASIAN", Korean, many were surprised indeed when they found out that this "Korean" boy had came to US at the age of 8. Why are they calling him a "Korean" then? Wasn't him an American too?

Tension increased while hateful comments aimed at Koreans being posted on the website Facebook and on various blog sites.

The media and critiques had continued to use titles like "KOREAN", "ASIAN", "KOREAN-BORN GUNMAN", as if that's what Cho was recognized as. Quoted from The New York Time last Friday,

Professor Park in LA said she was troubled that Cho's ethnicity had quickly become central to the narrative of his crime. "Calling him a South Korean native as if he arrived yesterday, doesn't make sense to me," She said of Cho, who arrived in the US with his parents at the age of eight. "

It doesn't make sense, I agree.

Some said, "we're very worried about Koreans being harassed now." "They're scared. They're shocked to death. When the news media said it was an Asian, we prayed,'Not Korean, not Korean'."

A large fear was introduced to the Korean-American Community. To share with you, when the news media said it was an Asian, the Chinese also prayed, "Not Chinese, not Chinese". My Chinese friend called her relatives in US, and found the fear that laid deep inside them.

I am not surprised that such fear occurred. The influence of the media is great, indeed.

The description of Cho Seung-hui has some resemblance of Hikikomori personalities, social isolation. But then, if a "Korean/Asian" that is what he was recognized as, even in fact he was an American; and the great fear of the Korean-American to admit themselves as a Korean after the incident. The problem is clearly more than an aftermath of massacre.

It seems to me adding to it are social nonacceptance and social inequities. Then, it would not add to my surprise that Asians are stereotyped as loner and antisocial. Without a clear will of the society to include its minority in its games, there is lack of empowerment for the people to choose the right choice.

Viewing the disturbing video record that Cho made, something that he said kept echo in my ears. "you forced me into a corner".

Is that the cry of Hikikomori? I wonder.

韩国：超过日本的自杀大国 Korea: A suicide nation that had surpassed Japan

统计
韩国统计厅公布的报告显示，韩国每10万名死亡人口中，死于自杀的平均人数为26.1名。
As of the official statistic of South Korea, in every 100,000 that deceased, average number of the suiciders is 26.1.

韩国的自杀率已经超过了位居第二的匈牙利（22.8人）和第三位的日本（20.3人），居经济合作与发展组织（OECD）成员国首位。
The suicide rate in Korea had surpassed Hungary (22.8), Japan (20.3), became the champion among the members of OECD.

韩国的烧酒、威士忌等蒸馏酒和烈性酒的年消费量居全球第4位，仅次于俄罗斯、拉脱维亚和罗马尼亚。
The sales of spirit, wine, hard liquor is no.4 in the world, second to Russia, Latvia and Romania.


原因 Factors
韩国人产生各种心理问题主要同经济发展有关。调查显示，10％的韩国国民曾产生“自杀冲动”。产生自杀想法的原因，回答最多的是经济困难（48.2％），其后依次为家庭不和睦（15.4％）、寂寞孤独（12％）。
The root of the pyschological problems of the Koreans is believed to be related with the development of the economy. According to the survey, 10% of the nation had a thought of suicide. The reason for that thought, the most frequent answer to that is "financial difficulties" (48.2%). Second is "Deformed family relationship (15.4%), loneliness and isolation (12%).

演艺界人士主要因为竞争压力和社会舆论压力，深受抑郁症的煎熬。
The celebrirites basically suicide because of extreme stress in competitions annd forceful social comments , many are suffered along with depression.

韩国社会保健研究院研究员徐东宇说，经济长期萧条，沦为贫困阶层的人们陷入赌博、信用卡透支和家庭崩溃的困境，因而自杀率剧增。
徐东宇from the institute of Korean Society Research said, the prolonged economic depression, had caused many of those who fell into poverty, trapped in gambling, overuse of credit cards, collapse of family. Therefor, we see an increase in the suicide rate.


一些上班族认为，压力大，甚至患上抑郁症的原因是“与上司的矛盾”，紧随其后的是“自己能力有限所带来的精神压力”及“有可能被炒鱿鱼”等。
Some white-collar workers believed that, overstress, and the source of depression begins with "the conflict with supervisor/boss". What follows is the stress of feeling disablity in performance, as well as fear of being fired from the job.

Re: 2007-3-2 14:06:39 环球时报 http://www.21jk.com/p/WJGY/articlecontent.asp?channelId=52&columnName=%D7%D4%C9%B1%CF%E0%B9%D8%B8%C5%C0%C0&topicName=%B9%FA%C4%DA%CD%E2%D3%EB%D7%D4%C9%B1%D3%D0%B9%D8%B5%C4%BB%E1%D2%E9%D0%C5%CF%A2&articleId=46411)

Post: Original in Chinese, translation by Rose.

Identifying Self-Cut

http://www.msnbc.msn.com/id/9593427

If self-cut is a coping action, there are a lot more behind that awaited to be explored.

It takes hearts to understand these.

We cannot treat the coping action without treating the underline problem!

Self Abuse

Self injuries. Angelina Jolie said in Ananova.com, "I grabbed a knife and cut my boy friend. He cut me back. Then, whenever I felt trapped, I'd cut myself. I have a lot of scars."

Some say that, " I do this to escape problem."
some say, " I don't know why."
Some say, " I want to make sure I'm alive."
Some say, " It just another way to cope with stress."
Some say, " I harm myself so I won't harm you."

There could be many other explanations that had never comeacross our minds. But one thing that is ultimate true in the emotion of these people, that is feeling of pain.

A deep pain the emotion, that only self abuse can make it seems less.

The video reel on the "self-injury" and "depression", reminded me of something in the past, that I know, once I got out from it, I AM NOT GOING BACK AGAIN!

Understanding Syndrome... Hikikomori

It was suggested that Hikikomori in Japan is under-reported, Saito Tamaki, a psychiatrist estimated that it is about one million.

In the same line with suicide and mental illness, Hikikomori tend to be stigmatized. It has negative meanings which attached to the affected person, family members and neighborhood. It is contrary to a society which being well known as its social capital and support. Just as the 'shame' that was discussed earlier, or depicted with the teacher whom had a son that played tokokyohi, the hikikomori became more secluded, and more withdraw.

hiki　引き = Withdraw
komori 籠り= Cage

Hikikomori simply means, "Withdraw into a Cage"。
The symtoms itself sugest that these people are hiding. It is extremely hard to dig someone out when their intention is to hide from others. This make identification difficult.

How can we understand this syndrom better? Health promotion is challenged in this area, not only by the effectiveness of implementation, but even the point to start and what to be implement!

Tokokyohi 登校拒否

A teacher with a tokokyohi 登校拒否son writes that, when she wanted to show the report she had written about her son to her colleague, she was advised that she shouldn't show such a thing' but 'should conceal' her son's tokokyohi. (Ishikawa et al. 1995.85)

Tokokyohi means that the children refuse to go to school.

If you have a child who refuse to attend school, you tried all ways that you could, but nothing worked. And then the child became more reclusive, and even refused to communicate with the family members. What will you do? Will you seek help?

Do you think that not going to school is 'shameful'?

Do you think that it is okay not to go to school?

I think not going to school is not okay to many people in many societies, especially in the cities. I would suspect that this phenomena, seeing tokokyohi as a 'shameful' act is quite dominant in the Asia countries. Of course, we could have people who hysterically screamed out that, "NO, it's our children choice, how could you say that?" Perhaps, but with the middle class, I do see many were moulded in this way. "You need to go to school, education is a must, and you need to learn!" That tune wouldn't really change much.

Maybe one would say, I should do some research and gain supporting statements before I could claim this. Hmm... I don't know. Since this is a journal/diary, I can just put in so much, even without evidence, to jot down what I felt, before I forget it.

But then, perhaps, 'Shame' is a term with different meaning in different society. The toleration or reaction to 'shame' is certainly different with East and West. Even within East, Chinese, Korean and Japanese might see 'shame' in different lights.

Coming back to the above statement of what the teacher should do: if the above statement was true, where the teacher 'should conceal' her son's tokokyohi rather than 'exposing' it, the community support in this area seems to be very weak.


That will lead me to another question: Japanese is well known as their strong social capital, in local or overseas. So, these seem strange for me. Another question could be rude in asking, but that include a Chinese clan support that I knew back in Malaysia: Community support exist where there is a need in the community, or it exist to look good?

Hikikomori...

If ill health does not happen by chance or through bad luck. Must it has relationship with biological factors, lifestyle factors, environmental factors? Of course, not forgetting the extent and nature of health service.

In most cases, the formal three are not hard to recognize. As for the latter, it takes more to explore the reality of it. Ill health that is caused by the extent and nature of health service can happened in the cities as well as the rural. One normally is hard to identify it when one was not exposed.

Poverty, social injustice, social stratification etc., are easily contribute to this factor.

Does Hikikomori fit into any of these? Can I identify the factors influencing the development of Hikikomori, thus identify the 'fields' in which 'health' can be promoted?

Think......

Harajuku teens
- the aggressive teens that dressed out to express themselves.


Pachinko Housewives
- the housewives who neglected their children, so much immerse into Pachinko, and had let to several cases of death of their children because of their neglegiance.


Hikikomori People
- the people who shut themselvs in, withdraw from social communication, for six months and above.




What are the main differences? What are the similarities?

Questions for non-Hikikomori

Questions: (based on the literature readings, and first 3 interviews)

1. Have you heard about Hikikomori?
2. Do you know anyone who is/was a Hikikomori? (if no, go to Q.4)
3. What is your relationship with him/her?
4. How do you feel about Hikikomori?
5. How do you think they come about?

Analyse the questions and answers, suggesting keywords: school bullying, school failure, job failure, death.

6. Do you see any different in their circumstances at this time, compare to the circumstances at your time? If it is different, how does it differ? If it is not different, how had you cope with it?

7. How do you look at this phenomenon in relation to the society?

Does knowledge help in promotion of Blue Sky Campaign?

Copyright South China Morning Post Ltd. Mar 22, 2007: A study by the Environmental Protection Department released in 2002 found that more than 80 per cent of polluting emissions came from the region.

In contrast, university scientists used air quality monitors in Hong Kong and the Pearl River Delta, wind data from the Observatory and satellite pictures to confirm the sources of air pollution. They also found that local sources played the biggest role in pollution from April to August, whereas regional sources affected air quality mainly in winter, from November to March.


Does knowledge help in promotion of BLUE SKY?

Who shall we target the promotion program to? How should we propose it? In the sight of the Expatriates, Government, People? Which group will serve to be more effective in this communication?

The government had been reserve in concluding the problem,what had been troubling their mind?

All these things would need to be considered and addressed, before we can run a effective program. Knowing who to target, what kind of strategy that we should approach, and time for pushing and holding back, would be a key to more likely to success with reduced wasted efforts and manpower.

The Poor

POVERTY , you need to treat them first!

Poverty is the greatest Disease!

In the story of "Akahige", a Japanese story directed by Akira Kurosawa in 1965 featured a charitable hospital and the various kinds of patients whether they falls into  charity welfare or damyo (landlord). In the movie, dr. Niite was angry, he said, "Poverty is the disease!" "What is the government doing about poverty? Nothing! They were doing nothing!" Forceful remarks, yet so much truth, more than we can withhold.

Isn't that what happens now? In various country, in various government. Regardless how steep the GDP grows, how stable the GDP takes it foot on, there are always disparity between rich and poor.

Blame it on poverty, mental illness or physical illness, all are about poverty!

I remember that was once we had a discussion on a similar issue with a Chinese friend, casually taking the disparity in China as an example, when we talked about Mercury poisoning, environmental pollution... she became defensive.  "It is not our fault!" But the fact was no one was pointing the finger on anyone in that conversation. Nothing really solid was being mentioned.

There is a certain pain in her, just as an innocent child who had been exposed to many unaccepted truth,  or ugliness in her search of life, the face that she had never had a chance to see, or she had immune herself to think about, in this process, formed into such vivid images, that she had no way to hide. She could not deny it, or ignore it, so she became defensive whenever people started to talk about the issue. She became sensitive and protective.

"Why do you accused us for having a better opportunity?"
"You cannot blame us for us having a better opportunity than others! Have you thought about we also have our own problems?"
"We just cannot afford to care so much of all people!"
"These are natural selection, that some will loose and some will gain! That is the only way!"


She is a public health student.

She is not wrong either.

But yet, how should we promote public health? Who should promote public health? Does an attitude of the person who sit on this seat count?

The principles of Health Economy do not work in place of extreme poverty with stiff competitions to grow and getting out from it.

The rich and the poor; power and money, these will birth forth a new set of rules and principles. And these principles will rule, and be accepted by its own nation, social norm takes place.

When power and wealth are goals, when people became fearless, when the love in men begin to fade......

After all, health is not so important when one is in extreme poverty. Just like a believe system does not hold, when one is hungry. BUT then, we standing outside the circle, we know that is a complete lie. Without health, there is nothing that we can achieve. There might be different standards in health in various situations. Nevertheless, health is the essential thing to hold our breath together. Without health, is DEATH.

"We use health to buy wealth when we are young;
We use wealth to buy health when we are old."

This is a cycle that we need to break!

Refining research question (1)

While I do a search for the definition of Hikikomori through Oxford Online Premium, it was stated that:

1. hikikomori n.A culture-bound syndrome found almost exclusively in Japan, most com-monly among male teenagers and young adults, especially eldest sons, although about a quarter of cases are female. It is character-ized by extreme social withdrawal and near-total ...
(From A Dictionary of Psychology in Politics & Social Sciences)

In South China Morning Post Ltd. Jan 15, 2007 was reported that the number of young people who spend their lives locked in their bedrooms has tripled in the past two years to as many as 18,500 according to the estimation of a welfare group.
Of these young hermits, some had isolated themselves for as long as six years, with the youngest being just 12.

These lock up young people were reported that they would kill time surfing the internet or playing computer games, or watch television or idle away the hours in a dark corner at home. It had been also suggested that the phenomenon partly to the increasing competition at school and pressure to succeed within the community.

"Many of them become evasive and eventually choose to lock themselves up in their bedrooms during the day and only came out to have food or take a shower,"

Is Hikikomori still, a culture-bound syndrome found almost exclusively in Japan? Or is it a epidemic in Mega cities? Does Hikikomori happen in Hong Kong? Or had the term had been loosely used? If it was loosely used, why? What is the attraction of this term, or phenomena? When the term was loosely used, was it suggesting or predicting something? What are the psychologist and sociologist have to say?



I think those are the questions that I would like to find out at this moment.

Indian's youth reflect Disparity

CNN reported on the "Indian Youth reflect Disparities" today. It was a series of interviews and video taping in different areas in Calcutta in contrast of city and the rural. The program exposed the contrast in thier living circumstances, conditions, opportunities and expectations in life.

In every 2 minutes, a chld is borned in India. The fertility rate is high. GDP is fast growing, and same as China, the disparty in this nation is huge.

In the city, the youth are sitting in starbucks, shopping thier clothes in one of the most branded shop in town, chatting about their dreams in making a difference in the business sector. The country itself is heading for a good future. A female college student said, " I don't think I need to go any where else, India is having plenty of golden opportunities these days."



The rural, a boy who hold a rope that ties on a cow in his hand, "I am to take over my father's job in next few years. I am to take over the responsibility of being the head of family."

In the villages, the villagers are still struggling with poor sanitation, unclean water, no electricity supply, average income less than 2 U.s. a day. By contrast, in the cities, teenage girls sitting in the coffee longue, shopping in the branded boutique shops, having educations in comfortable highly equipped institutions. Both, were aware of the existence of one another.

What kind of health promotion is needed here? I wonder?
Which is the greatest need of India today?
How shall the money of the government to b e spent in health?
Building more maternity ward in the city, bringing more qualified highly professionals. sufficient ultrasound machines and operation theaters?
OR to improve water sanitation, building electric and water supply system in the rural? Sending doctors and nurses in to the rural, setting up clinics and hospitals in a futile land?

Education is nontheless important! Again, how do we make the villagers to understand this and allow their children to got o school? We can have schools in the rural, in the village, but are they being empowered to pursue dreams by having education? In the rural, children are needed to take care of the younger ones at home. Older children are needed to be on the paddy field, or shepherding, or take over the jobs of their parents when their parents or grandparents are sick! How do we help them to pursue education? How could equity be set into this place? The school or education might exist, however the feasibility of them, or the ability to choose education over bread on the table might just not there.

First RCT in Bible

RCT in Bible

In the class of Evidence-based Epidemiology, Prof. Gabriel challenged us to think about at least one biblical reference of randomized controlled trial. I thought for a long time, no trials registered.

Which verse? Which chapter? Which incident in the bible was actually:
First, it must be an intervention;
Second, the allocation of the intervention group and control group were randomised; the allocation concealment was achieved. No one knows what was going to happen next, not even the researcher. Everyone had a fair chance to participate in the game.
Which means no bias, no preference, no favoritism was involved.
Third, there were a proper time of follow up of both groups.

Incidence of Babel Tower: Random allocation, but no intervention involved.
Noah's ark: The Flood was an intervention, but the participants were not randomized, or at least no proof of randomization.

This is really hard, isn't it? Even as I claim that I am trying hard to study bible and public health side by side. I couldn't do this just on the spot either. But then, this is really a good lesson to me!

Think hard, analyze and map what I read with what I know and what I anticipate. So that I know what I am off to :-)

Shalom! May Peace be unto you!

When Rabbies Attack

Rabies deah toll promts warning of new dog cull. Hunan-Deputy Hunan governor Gan Lin has announced plans to kill all dogs hat have not been vaccinated against rabies. Sixty-one people in the province died from the disease in the first two months of this year, Xinhua reports.

An announcement of "Killing all dogs that have not been vaccinated against rabies" would be an effective healh education from the local official.

First of all, there are as much as 61 victims that died from the disease in the first 2 months of this year, certainly this is an public health issue, and clearly something that has to be done!

Taking action on the unvaccinated dogs, will result increase of awareness of the public against rabies.
The act/ annoucement would result a several attitude and responses of the public:
1) The dog owners will make sure if their dogs were vaccinated.
2) Strangers will stay away from the stray dogs, or any dogs which they are not familiar with.
3) People will start taking precautions when they see dogs.
4) People will be aware that what going on was serious enough for such action to be taken.
5) People will be alarmed to take immediate action once bitten by dog.


I think that is a good step of public health promotion and intervention.

Perhpas one thing that I would suggest to this, is set up poles in different areas, with a sign, "Beware of dogs! Beware of Rabies!". :-)