October 16, 2012: A Memory of Thailand: a small city and a megacity
From now on, Thailand will be forever be connected in my mind and in my heart with my mother. From October 4 until October 14, 2012, I was in Thailand to attend meetings and on October 6 in Canada (October 7 in Thailand), my mother passed away in Wakefield, Quebec.
At the moment that I learned of this, I was listening to the Opening Ceremonies of the Central Asian Regional Meeting of Medical Women’s International Association. I was looking at a stage and podium banked with flowers, jasmine and orchids, the heavily scented floral display that is so typical of Thailand and I thought of how much my mother would have enjoyed the exuberance of this excess. While I immediately felt sad, I did not feel as though I would cry. I was sad because I would never again speak with my mother but, somehow, I knew that she was in a better place.
Eventually I decided, given weather and the length of time it takes to travel between Thailand and Canada, to maintain my schedule in Thailand and so I found myself visiting people and places in the context of this great personal loss.
Chiang Mai is the city I was in when I learned of my mother’s death. Chiang Mai is a little city in the north of Thailand. It is in the northern hills and it is a region where traditional crafts are celebrated. Silk and cotton textiles, ceramics, and wooden carvings are all examples of the crafts that I saw. This northern city is still developing its medical services, however, and their extensive efforts to develop the best medical services in this region was some of what we learned in the meeting.
My own participation in this meeting was to offer comments on the experience in Canada in relation to Children and Youth and Advance Directives. The kindness of my co-participants and the delegates to the meeting were a significant comfort as I made my presentation on this topic about…well…death.
Medical consent is a complex topic in Ontario since, while 16 is widely considered to be “the age of medical consent” in Ontario, the law actually states that any person, regardless of age, who has the capacity to understand the medical condition they have, as well as the consequences of either taking or refusing treatment, has the right to give their own consent. This topic did stimulate a good discussion, especially because it is human nature to want to rush in to care for the vulnerable and so children and youth are often not as well included as they ought to be in medical decisions related to their own care. I was very impressed by the work on Advanced Directives being done in Chiang Mai and enjoyed working with the doctors there.
My last meeting in Thailand was at the World Medical Association in Bangkok. “Megacities,Megahealth” was the theme of this meeting and the urban health issues of Bangkok, Tokyo, Sao Paulo and Chicago were considered. Around the world, people still flock to cities to live, mainly because the opportunities to earn are living are increased in cities.
Whenever I listen to talks about migration to cities, I wonder if we will ever, as humans, rethink this decision to move into large cities. It is so much less expensive to live in small cities or even towns that, if one can make an income from work in such a place, or work from home much of the time, it would take far less expense to live well. Also, the decreased air pollution, noise pollution and, perhaps, the increased sense of community that come from living in a smaller town are all factors that contribute to better health.
I think it is time for me to re-read Jane Jacobs Cities and the Wealth of Nations once again to find the counter argument for my last statement. Megacities or small towns? What are the advantages and disadvantages?