Adventures in International Living, Self-Discovery, and a Life of Meaning
An Inspirational Memoir by James Cameron Mielke
Author’s Note: In June 1988, I joined an American non-governmental organization (NGO) and the Royal Thai Government Ministry of Public Health to manage a cooperative health and development project. The purpose was to provide comprehensive health services to highland residents of a remote, underserved region in the extreme north of Thailand along the Burmese border. Innovative community-based health and development strategies such as gravity-fed village water systems, household gardening, vector-borne disease control and opium detoxification were also introduced.
The experience set the stage for my eventual entry into graduate school in Hawaii, USA — but not before accepting a one-year position with the Catholic Relief Services, another American NGO, which supported refugee relief work on the Khmer border and community health development in poor, rural communities in Thailand.
Can you imagine running a small, isolated field hospital without electricity or running water in the remote, lawless mountains along the Thai-Burma border?
What if it was built by an opium warlord for his breakaway revolutionary army, and staffed with undocumented workers from nine ethnic groups, each speaking a different language?
And what if you had to transport medicine and patients by horseback to and from the nearest town and referral hospital when the one and only road gets washed away each rainy season? What if you had to lie low at the hospital while the local drug warlords fling mortars at each other in their fight over the narcotics trafficking route that ran through our village?
“While carrying out the body of one of our patients who died of Malaria — it came as a stark realization that providing rural health care with no electricity or running water was going to be a bit different from my earlier YMCA experiences!”
Book Two takes us from Thailand’s rugged and lawless northern frontier, before transporting us to the modern, glitzy capital city of Bangkok and the contrasting cushy and enjoyable urban ‘expat’ lifestyle. I was responsible for overseeing improvement of rural healthcare in Thailand, and for Khmer refugees living in camps along the Thai-Cambodian border who were fleeing the horrors of genocide.
"A lady died tonight in the IPD – cerebral malaria (as I scratch yet another mosquito welt)… Three hunters were brought in – gored badly by a wild boar. Miraculously they survived – later presenting us with a thick slab of the meat. A couple stabbed each other. The man was stable, but with just lantern light to work by, our MD could not stop the wife’s bleeding – her life literally draining out before our eyes. We had to convince a local truck driver she would not die on the way down the mountain (if so, he believes his truck will be cursed). Our medics held the artery through the night down the rough mountain track to the lowland hospital – and she survived… A family walked for days from somewhere inside Burma to reach us – two kids died on the way, the third one died soon after arriving… Two men were shot – one died in the ER because no one would drive them to the district hospital in the lowland – afraid of ambush… Heavy shelling here all last week – but all quiet now."
"A great week helping villagers build a water system – hacking through the bush to lay the pipeline, pouring two cement tanks for water storage. Fantastic to see this giant change in their lives – bathing right in the village – the kids are loving it!… The one bridge that doesn’t get washed away each rainy season was built by local drug barons – to ensure a steady flow of heroin down the mountain. The struggle continues – people here make the most of the situation, but the bottom line is that they are not free – without citizenship, they could be forced from their homes at any moment – while seeking to combat their poverty, legal and otherwise – so it goes on…"
Eventually, we return to Hawaii, where I pursue my graduate studies in Public Health, which included field research on the impact of State and National policies on Alaska Native health. With Federal Government funding awarded through the East West Center in Honolulu, I continue on to earn my doctorate in Community Health Development from the University of Hawaii.
Returning to Thailand, my initial research on HIV/AIDS in Bangkok’s largest slum helped refine the focus of my doctoral research. At that time, Thailand was experiencing one of the most devastating and rapidly spreading HIV/AIDS epidemics in the world. During this time a mysterious and dramatic rise in child abandonment was threatening to overwhelm the social welfare services in northern Thailand. My independent investigation assessed the magnitude and nature of problems within a context of rapid social change and proposed options for prevention and community-based management of abandoned children. The findings were published in a major collaborative study to assist national and regional planning and policy development.
Join me for another epic journey spanning nearly a decade of personal growth and professional contributions to international health and development. Tag along for low-cost leisure travel and more exotic adventures in Thailand, Vietnam, Sri Lanka and the Maldives before returning to Hawaii. Meet the rare mix of people along the way, and learn about the steps taken to achieve these goals and aspirations. Discover the deeper meaning and potential derived from overseas cross-cultural experiences and perspectives – as a humanitarian aid worker!
“The Warlord’s Hospital and Other Stories” is my second book in the “Adventures in International Living” series. Drawing on 45 years of personal journal entries, the series chronicles some of my experiences living and working in developing countries throughout the Asia-Pacific region.
Make sure to check out the book! I can’t wait to hear what you think!