Editor’s Note: I first met Jim Mielke about 20 years ago at the East West Center in Honolulu. I had just washed ashore in Hawaii from San Francisco and Jim, a native of Buffalo, was finishing his doctorate in Public Health at the University of Hawaii. A former YMCA Volunteer in Samoa, Jim and I had a lot of common experiences in the South Pacific and became fast friends. Jim had suffered a great deal as a young man but learned to live with a disability. The lesson is that his disability that ceased to become an issue. In a sense he wore it on his sleeve. After graduation he left Hawaii and had a successful career as a public health doc in Southeast Asia. The piece below is the second of a two part series by Jim who will soon be publishing his memoirs.


by Jim Mielke

Eventually however, it became clear that I needed further technical training in order to progress professionally, and to contribute more effectively to international health and development. In particular, an early experience on a grass-roots primary health care project in northern Thailand had revealed to me the central importance of integrated, multi-sector and multi-disciplinary approaches to development. So I returned to the USA long enough to complete my Masters and Doctoral degrees in Public Health at the University of Hawaii, funded by a US Government grant administered through the East-West Center research institute in Honolulu, Hawaii.

JM5Returning to school after eight years overseas was pure luxury, and although I did my graduate studies in beautiful Hawaii, I quickly became immersed in books – at last I had the time to read – and with access to stimulating pieces that articulated, analyzed and helped to explain so much of what I had been experiencing.  I also learned technical tools of the trade, including how to do scientific research.

The resulting combination of field experience and academic skills has enabled me to function with increased confidence and competence, both independently and working with other professionals in international health and development programming and research. Returning to school for specialized training has also greatly enhanced my employment options, with greater overall job preference and an expanded professional capacity for continued learning and contribution. Professional contacts made during my time in school also helped to open doors for employment.

My MPH summer research project reviewed State and National polices and programs affecting Alaska Native health, and could have extended into a full-time job following graduation.  However, as much as I enjoyed working on Native issues, I was not willing to face the Alaskan winter. I did my doctoral research in Thailand under the sponsorship of a major Thai university, which lent some credibility to my research there.

JM2UNICEF Thailand ultimately identified my research topic – a serious and pressing issue that could be investigated inexpensively by a student. I also benefited by getting published in a major collaborative study, involving the East-West Center in Hawaii, my graduate program funding source, and the Thai Red Cross Society, a former employer – facilitating further exposure and credibility for my subsequent appointment to UNICEF, Cambodia.

Finally, after five stimulating and comfortable years in graduate school, I began to feel increasingly out of touch with the real world – after all, I was living in Hawaii!  And yet, after receiving my doctorate, a full two years of job searching passed without a single job offer.  So, the obvious choice was — to go sailing!

So I joined a couple of my college buddies on a 26-foot sloop for two seasons of glorious sailing through the South Pacific, eventually getting off the boat in Fiji Islands, to begin a 6-month consulting assignment with UNICEF, Fiji. I went on to join UNICEF staff as a Project Officer in Cambodia for two years, and then to Vietnam for a UNAIDS consultancy, followed by an AusAID-funded primary health care project.

Now, after 35 years of health and development work in over 20 countries, including youth leadership development, HIV/AIDS prevention and care, primary health care, and women and child health, as well as adventure travel to exotic destinations throughout the world, I am living in Thailand where, until my most recent surgery, I was overseeing the health component of a $24 million USAID-funded Burmese refugee and migrant health and education project.

Having enjoyed many years of full living and excellent health, it seems that my ileostomy, which had served me so well over the years, had finally worn out. So indeed, with this latest episode (emergency surgery in May 2006 for fist-sized abdominal hernia, resection of gangrene ileum, reconstructed ileostomy, and strangulated groin hernia with groin and abdominal mesh implants), I have felt a bit like a well used car in need of servicing – getting all the repairs done while in the shop, sort of like one-stop shopping. As some parts needed to be removed or replaced, and others have been repaired, I can look forward now to being rolled out onto the street again – all shiny and good as new – just like a sturdy, dependable car that simply came due for a tune-up.

JM3Making it to my 50th in January 2007, I decided to take a break from the working world for a while – freed up again to focus on the important things in life. I moved from Bangkok to my seaside villa in a peaceful, natural setting on the southern Thai resort island of Phuket. The whole scene had become too much of an effort – like swimming up-stream, when I really need to go with the flow on to the ocean, or wherever it takes me.

My body is trying to tell me something. The universe is telling me something – and for once, I am listening. Amazingly, having decided to make the break, once again it all seems like a blessing in disguise – a needed push from supposed security to the blessed freedom that uncertainty brings. It’s like witnessing the evolution of my soul, with a whole range of possibilities opening up. Life is full of mystery, uncertainty and opportunities, and the possibilities are endless.  Now, I am so excited about the next chapter about to unfold, I can hardly stand it!