Riding in Thailand

There are all sorts of reasons to ride to Thailand.  The excellent north south highway makes traversing the Malay Peninsula a matter of a day’s ride.  Hardcore hard arsed riders have made it a point of getting to Hat yai in a day, although personally I have always found riding past Penang or Ipoh around the time of a late lunch very difficult to do without stopping for a little something. I know you could easily do the eating rounds on the way back from Thailand, but somehow its not quite a holiday until the penang kuay teow from Red Garden, the Mee Goreng from Brooke Street or the ipoh guo teow from tianzhen coffee shop is set before me.  So this time finds me spending a night in Georgetown before heading out across into Thailand at the Weng Kerlian crossing. 

For the biker this is hallowed ground; many feel you’re not really an overland traveler that justifies all that wonderful kit on the bike until you crossover from Malaysia.  Then there is the change in riding conditions. The north - south highway is a smooth as silk ribbon of perfect engineering that goes on for miles and miles. The main danger isn’t the road conditions, it’s trying to stay engaged.  Look carefully that the crashes that one invariably sees on this highway – especially those in the hours of darkness -  and what you notice is the absence of tyre marks before the wreck at the side of the road – a sure sign that someone’s fallen asleep.

Once in Thailand all that changes.  There is a highway system that allows an easy 400 km a day but its nothing like what you leave in Malaysia.   For the biker I suppose what sums up the situation more clearly than any other is this road sign:

You see in Thailand bikes are meant to be limited with bicycles on the road shoulder, not mixing it up with the rest of the traffic,and certainly not overtaking anybody.  In many ways this is consistent with the local situation.  There are hardly any local bikes larger than 100ccs on these rural roads.  Most hardly travel above bicycle speeds.  Making allowances for a five hundred pound one liter bike is unthinkable.

What this means is that the spider-sense needs to be modified.  Under usual riding conditions outside Thailand the most dangerous time on a trunk road is when overtaking against oncoming traffic.  In Thailand it’s when you have this nice straight piece of road all to yourself in your direction and some traffic coming the opposite way is stuck behind a slower vehicle.  What has happened on numerous occasions is that they all start overtaking and seem to disregard your right of way.  What has been explained to me is that they know you’re a bike and you should be on the shoulder.  Similar situation when you have a faster moving vehicle coming up behind you: they will go through you rather than overtake because you’re supposed to be on the shoulder. 

There seems to be some solutions to this. One is to make your bike obviously not the kapcai they think you are.  A friend of mine on a gorgeous Kawasaki voyager has no such problems because he actually has three lights forward headlights.  Some others have added on interesting bits of lighting although it should be said that some kapcais have this as well. The other solution is to obey the law and actually stick to that shoulder. This will be a bit of a trick, because what can be found on that shoulder includes livestock, monks, bikes heading the other way.

The third alternative I think is the most sensible.  Slow down, forget you have horsepower far in excess of requirements, behave as though you are a local kapcai and take in the scenery.  It’s  not so much an issue of making the required miles as seeing as much of the place as you can. And a lot of the scenery is simply fabulous and more than makes up for the change in riding habits.  Riding outside of Trang the limestone formations come right up to the edge of the road.

On a whim I actually followed one of the road signs that suggested an off road turn would lead to a nice waterfall.  Completely off the planned route and not indicated on the GPS or the Michelin maps. Pretty soon I’m enjoying a genuine blast of some gravel trails and catchup with some locals and their off road vehicles.  At the back of my mind was the Schedule.  There were miles to make and only so much daytime left, but I figured this was a wandering trip and I might never pass this way again.  I’m really glad I did. In the middle of nowhere was proof that if you behave like a local you might just see what the locals keep to themselves.

Dare Greatly

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat”

Theodore Roosevelt April 1910

Thought to give a glimpse of what has gone into putting this trip together. One reason is to acknowledge the tremendous amount of support so many people have given us; another to give prospective overland travellers an inkling of just what is required.  Ever since this project has got the green light it has been a whirlwind of activity and it is impossible to overstate just how much it has taken over our lives.  Based on previous travellers it has about a one in three chance of success and although we try to make plans as detailed as possible, we know it’ll all go to pot as soon as we cross the causeway.  It would not be an adventure if it didn’t. There is a sensation that we have already made so much progress when in reality we haven’t even set off yet! 

It might sound a little odd but the first hurdle to cross when this idea was mooted was the need to be persuaded to actually go.   This trip is a big hit on time, finances and just calling in favors and as we put things together at the initial phases there was almost this hope that someone would pull the plug as early on so that we wouldn’t get our hopes raised only to have them dashed.  There were many potential dealbreakers.  The bosses could say this was barmy and get back to work.  The wives could say, well pretty much the same thing.  Experienced travellers could try to talk us out of it, or that with the time constraints it would be an impossibility. Colleagues could say they would not do without our services for four months. 

As it transpired there was none of the above.  The bosses not only thought it would be a good idea, they wanted to come along for parts of the journey.  In this regard Prof CN Lee, our immediate boss has been a real stalwart for the cause, putting us in touch with his wealth of contacts from Russia, Kazakhstan, India, China, Myanmar.  We have met a host of very accomplished people who share the common traits of wanting to travel more, see more, learn more. Of these the most intriguing has been the indefatigable Mr Jim Rogers who has been around the world not once but twice! (see “the Investment Biker” for a perfect combination of adventure travelog and financial risk prediction – a gem of a book I think only he could write)

Support has come from patients and their relatives, students, cabinet ministers, hotel owners, bike shop operators, colleagues from across the continent.  it's like a cocker spaniel you cannot help but pat: There seems to be something about this trip that captures the imagination in a way that makes no difficulty insurmountable and everyone wants to plug in in whatever way possible. 

A special word should be said about Goh Mia Chun and his lovely wife Samantha. This affable and generous couple were the first Singaporeans to circumnavigate the world on their Honda African Twin some three years ago with far less resources than we have to call upon. Their wonderful blog can be found at singaporedream-rtw If anyone needs inspiration to get on their bike and get going.  Goh has been invaluable and unstinting in the practical details that worry the uninitiated – border crossings, lodgings, tyre changes, bike modification, route planning. Most importantly just being in his company makes us realize that this journey will be a mental voyage as much as a physical one, and that the most important equipment is a mind that will adapt, stay focused and not fussed, and quietly get the challenges sorted.

The first challenge was the bikes. Mike has a BMW GSA – a beast of a bike tailor made for this kind of go – anywhere do – anything trip.  Look at Ewan and Charlie’s TV programmes and  they considered no other bike suitable for the task.  I’ve taken a different approach.  A Suzuki Vstrom 1000 eats roads and hills but needs a lot of modifications to make the grade – a chance for tailoring the bike to me and knowing what its limitations are.   Its now got steel hoses for the hydraulics, Hepco and Becker panniers and crash bars, HH brake setup, 4mm custom made bashplate, higher windscreen. As the date approaches it will be cranked up suspension, new chain and sprockets, all cables and fluids changed.  The bikes will be asked to make a 30 000km journey in the space of just over three months.  Essentially asking it to do three years wear and tear in three months –so everything that can be anticipated to need changing will be sorted before we leave.   Unfortunately my proposed custom paint job did not go down too well.  Some feel it goes against the common sense approach to not stand out.  You decide.

The second most important consideration is the route.   This has taken a Kindle with all the Lonely Planets for all the countries in Europe and asia, and 24 road maps which now adorn the office walls.  Invaluable to planning has been two websites www.advrider.com and www.horizonsunlimited.com.  These not only provide more information that you will ever need about travelling from where you are to anywhere you want on a bike, but also detailed accounts of over 150 intercontinental bike rides.  Some have been going for over four years, and if anything provide reassurance that if you think you’ve got a bad case of wanderlust, they have got it a lot worse than you have.

 Most trips like this have taken at least half a year, so with only four months we have to choose the fastest safest route.   This has been hard.  I think we are down to plan E now.  The world is a wonderful place and there is so much of it we are going to pass by without any chance of stopping.  I wanted to dip by the ghats in Varanasi, walk the corridors of a palace in Jaipur, pay my respects at two tennis courts in Kohima..  It has been frustrating sometimes to find one detailed plan has to be hashed because of some development or other.  I was really keen to ride through Myanmar and in the last three months two groups of bikers have been the first to bring their own bikes to this newly opened border. Unfortunately recent ethnic riots and killing have put paid to this.  Cannot really plan a route through that and tell friends and family I have planned responsibly.  No Myanmar unfortunately means also no India, Nepal and Pakistan.  No karakoram highway.  This means not visiting some cancer collaborators and cancer hospitals where we feel their cancer experience really needs to be told. Ah well, another trip then, when things have settled a bit.  As things are now we will be riding Shangri La, from Laos to Yunnan and then through Tibet into Xinjiang and then on the Almaty and the ‘Stans before Iran and Turkey.  Stunning scenery and truly desolate roads await us, but it will take some time before I completely get over the disappointment of not riding into Darjeeling,  Kathmandu and Lucknow…

Can you please play some ABBA?

Growing up in a completely different part of the world I try to see as much of South East Asia as I can while I’m here.  Bali is of course one of the must visit destinations when you live in Singapore. My first trip there was in 2009 with my parents. My mom and step dad arrived in Singapore and we flew out together. This was my first encounter with Indonesia. The visa granted on arrival had two options; one week or 30 days, we were offered the 30 day option despite having tickets that showed we were leaving 7 days later. We started an impossible argument based on what we thought were well presented reasons and after a while the officer scanned the larger in comparison Swede standing at his desk, sighed and relented, granting us the one week visa. I claimed victory which you will shortly see was not long lived. In parallel my parents had been pulled into a separate room since my dad’s passport did not have one completely free page to stick the visa onto. The following accounts are now from my dad… So while they were in the backroom that looked like a 70’s gangster film, fan in the celling, smoking officers, plastic brown leather furniture etc. The Officer wearing all the trappings of being in charge: overweight with a protruding beer belly, lots of brightly coloured medals and a broad brimmed hat informed my dad he could not enter Bali. Instead he had to return to Singapore and get a new passport from the American embassy. My mom who is a tad impatient kicked him on the leg and whispered in a not precisely low voice ‘Just pay him!’ My dad being a bit more subtle went through the necessary albeit painful motions of finding a ‘junior officer’ who could do what the senior officer could not, i.e. accept donations. My parents, being of course very happy and grateful for this service, made a voluntary contribution to the custom officers pension fund.*

Bali Rides

 

Just as we starting sighing with relief that this is finally over we are now told that our newly purchased visas will not cover us and we will be fined some large sum upon exiting and once we have purchased this short term pass an entirely new pass must be bought (Read: New negotiations in the same room my parents are sitting in). Yes, we made another similar contribution to the pension fund in gratitude to the junior officer who sorted out this unfortunate mistake*

Bali is both marvellous and a bit overcrowded, completely jammed with cars, full of t-shirt shops and bursting with tattoo parlours. Trying to escape the crowd is doable if you exit Kuta and make your way up the hills. Here it is rather soothing. We rented some bikes and trekked down from the Batur Krater which is a live volcano and went through a number of native villages. Outside the small villages we saw collections of coconuts hanging from trees tied up with strings. A little puzzled we asked what they were and our guide told us that it was a fertility ritual where the placenta of the newly delivered baby is hung up to dry. Being a true epidemiologist I was happy to estimate a very promising birth rate- far more placentas (coconuts) than adults in the village.

 

Bali has a thriving restaurant and bar culture. We took recommendations from the Luxe guide, (quite a funny well, researched guide book). It even teaches you Bahasa: “Villa saya lebih besar dari punya anda": my villa is bigger than yours! Or offers practical advice (from the Hanoi book): If you don’t want the world to fall out of your bottom stay away from the vegetables. Anyway, we were off to Ku De Ta based on their recommendation, located in Seminyak on the beach, very cool, with all the right people, dimmed lights, hip music etc. My mom a practical 70 year old lady who grew up by the arctic circle, walks over to the DJ if she can please play some ABBA and by the way, ‘Please turn up the light so I can read the menu’. The DJ looked at her a bit bewildered but kindly replied we are not ‘that kind’ of place. The food was fantastic, although I am not completely sure what we ate- probably Lamb, it was a bit dark.

The second trip to Bali was about 6 months ago when my step brother Mark who lives in California came to visit. He took off before me from Singapore to spend a few days in Ubud and arranged for both of us to stay at the Four Seasons in a quaint little villa (at a huge discount).  Mark was already checked in when I arrived and ready for lunch. We had the best vegetarian lunch ever. 

Mark and our vegetarian lunch

He did mention that the villa was great but the sleeping arrangements may need some adjustments. After lunch I understood what exactly he meant. The villa had a double bed with a single blanket. I do like Mark but spooning was certainly not on either of our agendas. We went to the reception and asked if this could be fixed. We did mention that we are brothers. Understandably their confusion results from the fact that Mark is Italian, darker, shorter, heavy beard while I am Swedish, taller, blondish, not able to grow a beard even if the Mullahs insisted. They looked at us with smirks and said ahaa, yes brothers.. I am sure they were thinking Eat, Pray and Love. A few minutes later they reported: -Yes, Mr Mark everything is fixed. Back at the room we now had 1 bed, 2 blankets and a small wall of pillows dividing the bed in half.  Brilliant stuff! The staff presumably still considered us a gay couple but they did politely build us a Berlin wall. Four days in Bali went by quickly, Hobie cat sailing, a great night at the Apache Reggae and meeting  a Russian pianist (you tube) who tried to convince both of us that love in relationships only last 3 years so better to live with a friend and find love on the side. Admittedly she had consumed a fair bit of Saketini’s at this point. I went back to Singapore and Mark continued to Phi Phi Island. 

My most recent experience was a trip to Sanur on the lower east coast of Bali just north of Denpasar to discuss Screening for Cancer in Asia. We were planning to meet Japanese collaborators to set up a joint program to increase breast cancer screening participation in both Japan and Singapore. This time I didn’t argue with the visa officer and avoided meeting the junior immigration officer with the voluntary (read: compulsory) donation to the pension fund. Due to some mix up the planned hotel transport did not show up and since I never actually read any instructions I really did not know the name or address of my hotel. A bit of a problem at 10 pm… nonetheless I jump into a cab a told him to go to Sanur. Which hotel he asked? ‘Sanur’ I said feeling a little less than confident. The following 2 hours the driver took me for a door to door excursion among the largest hotels in the city. I turned out I was staying at the 4^th largest one. It is honestly very difficult to use sign language to describe ‘public health conference’ and get directions to the right hotel. Must work on that. When we finally arrived I gave the cabbie a nice tip! This is the kind of pension fund one should donate monies to. Conference went by quickly, research plans were drawn up leaving time for what I truly enjoy- mountain biking. 

I had through my Singapore biking friends gotten a hold of Ramang who runs Bali-Rides (http://www.bali-rides.com/index.php). Ramang organized an absolutely stunning 40+km ride from the edge of Mt Agung at the Besakih Temple down to the coastline. My rear brakes went out one third into the ride making the downhill bits quite exciting. 

Nose dive into the scenery

The other rider Owen actually managed to catch my nose dive into to the elephant grass (picture falling).

Ramang

Ramang did not even break a sweat and left Owen and I unable to speak after the final uphill. The less travelled roads of Bali are amazing and completely different from the congested areas around Kuta. The remaining ride was uneventful and we finished off at Ramang’s house north of Sanur followed by a quick shower, packing the bike (This was accomplished by reverse engineering- had taken 10 pics when I unpacked it) and a flight back to Singapore. Philip has told me we need to achieve a V0₂ of 40% - which means you need to be in decent shape to suck up oxygen in your blood to enjoy the Long Ride so this is a step in the right direction.

*Disclaimer: all persons, facts and situations are fictional and if they accidentally correspond to real life people or situations it is purely unintentional.

"Thank you, we are still trying"

“Our understanding of breast cancer continues to grow; if the pace of advance seems at times bewildering, remember that for some of our patients it will never be fast enough”

Umberto Veronesi

Former Scientific Director and
Minister of Health of Italy

European Institute of Oncology

Milan, Italy

[Forward to Breast Cancer: A Practical Guide; Elsevier Science 2000]

In 1998 I was doing my PhD in breast cancer genetics with Professor Roger Blamey in Nottingham, was a year into my thesis work and pretty much completely all at sea.  The experiments weren’t running, the field seemed to be progressing faster just about everywhere else but in my lab, and everything that I thought would be a good idea to start work on was about to be presented at some upcoming meeting – it seemed that everyone had a jump on me.  It was then that I first met Professor Veronesi who was delivering the keynote opening address at the Annual Breast Meeting that year. 

The Nottingham meeting is not the typical breast cancer symposium and most of us were proud of it.  The lack of the usual six star luxury hotels and convention centres meant that some world leaders in breast cancer research were decking it out like the rest of us in post graduate digs; in those days Nottingham did not have its present monorail system and I think I drove the head of the Netherlands Cancer Institute back to his bed and breakfast in a borrowed Fiat Uno.  the informal setting allowed for a frank exchange of ideas  over beer in jeans and anoraks (it always pays to have raingear in the midlands) and the relaxed air was the perfect antidote to a conference season with too many stuffed shirts and stuffed egos.  In short, I was in clinical research fellow’s heaven. 

I had got to the Nottingham unit on the recommendation of a former colleague of Prof Blamey’s who had told him that “this boy has the irritating habit of asking questions – please see what you can do with him”.  The likes of Blamey and Veronesi were not called clinician – scientists then, but that describes them perfectly.   After my short time with them I came to understand how just doing the clinical service was not ever going to be enough for me.  There were daily encounters with patients who deserved better answers than the ones we could offer.  I would explain the diagnosis of breast cancer, the treatment options and answer the immediate questions – how much would it cost, how would a breast conservation breast look like,  what were the side effects, what the survival likelihood; and then that pause as it all sank in. followed usually in a softer voice as she hopes you’re not going to take this the wrong way, “ So are those the only options?” “Why is it cancer when I’ve been doing my mammograms?” “ Are my daughters safe?”  “How long has the cancer been there?” “Is it something I ate?” And at this clinic when I first tell them their worst fears are now a reality, before the peace that comes with time and friends and caring husbands and excellent nurses, at this first clinic that look they give – “can’t you make it go away?”

In the National University Breast Unit we see patients with different breast issues at different clinics.  The “counselling clinic” is the term for that first clinic when we tell these women their cancer result in the presence of the breast care nurses.   The reason is apparently organisational – so that the partnership of surgeon and nurse comes at regular hours each week.  But in truth I think there is another reason: when Veronesi gave his keynote address in Nottingham he did not quite use the closing words as printed in the forward quoted at the start of this blog. Instead of “patients” he used, “mothers, sisters, wives and daughters”.  That started the change. And makes Counselling Clinics so hard that we find it easier to face at an appointed time each week.  And why we need to challenge convention and ask questions.  

Ganiyari

A few years ago I spent some time in an obscure village in India called Ganiyari. Ganiyari was like most Indian villages, small and unremarkable in most ways; except one. Sometime in the year 2000 a diverse group of highly trained doctors, all from what is considered the Parnassus of training institutions in India, the All India Institute of Medical Sciences, had at the end of a long and gruelling emotional, philosophical and geographical journey finally set up shop in Ganiyari. The four men, a paediatric oncologist, an internist, a paediatric surgeon, and a microbiologist were not quite your average, run of the mill doctors. Besides distinguishing themselves academically they went a step further reflecting on medical practice and the state of health in India (natural you may think, but in fact unusual in their context) and gave up what could have been highly lucrative practices in any metropolis for a life in rural India, a place they felt ‘they were actually needed’.

JSS Village Program - Ganiyari in the lower right corner

Coincidence and possibly some foresight had it so that they each married medical professionals too. Add to this already impressive mix another internist, another paediatrician, an obstetrician-gynaecologist and an ENT surgeon. This rather opportune of combinations led them after much scouting to Ganiyari, situated in one of the poorest and underdeveloped states in India, Chhattisgarh. Here they managed to rent out an old, abandoned public utilities building and the small piece of land attached to it. After much restoration to the crumbling edifice, they set up a 15 bed ward, outpatient clinics, a delivery room, an operation theatre, and even basic laboratory services thanks to the microbiologist, who also ensured asepsis. They also had outreach clinics once a week in nearby villages. They called it Jan Swasthya Sahyog (JSS),

The Jaanchkaksh or Laboratory

loosely translated as People’s Health Collaborative. Ganiyari was close enough to a small town, Bilaspur where they were able to stay with their families and commute daily to the hospital, one or the other being on overnight call. The intention initially was to stay on the premises, but I hear the wives objected and with persuasive arguments about the children’s schooling convinced the men to hunker down in Bilaspur. 

By the time I joined them, a good 7 years later, they had expanded to a ‘theatre complex’ with two large, bright theatres, (right above which I was given a room), had x-ray and ultrasound facilities; bed numbers remained the same though patients would put their heads down wherever there was place (and you had to be careful not to trip on them when called at night), and clinics at ‘nearby villages’ had grown into a health worker program with outreach clinics as far as a 100km away, scenically situated on the top of a mountain amidst dense forest, and which was a nightmare to get to on the dirt tracks. They also had a few ‘junior doctors’ like me willing to slave away for a while early in their careers, hungry and eager to learn. And most important was a new and much improved ‘International School’ in Bilaspur for the children. JSS had grown in popularity, largely due to an archaic and nearly extinct public health system which often if not always failed to provide adequate care, but also due to the competence, range of services and high standard of care at incredibly low prices. Outpatient clinic cost Rs 7 for the first visit and Rs 5 (10 Singapore cents) for subsequent ones. Costs were kept low by meagre salaries, generic drugs, many low cost innovations (including the substitution of a junior doctor for neonatal ICU services) and some small donations. 

An 'Easy Read' thermometer for the health workers with
abnormal temperatures marked in red

My time here was to put it mildly, phenomenal. I could write pages on the medicine I learnt, the cases I saw, the real life versions of textbook medical problems that we had been lulled into believing were a thing of the past. My first ever case of exomphalos woke me up at 2:30 am. My groggy first glance almost caused me to yelp out loud as I saw this 800 g baby, barely breathing, almost as cold as ice, lying in a basket because the parents were too scared they would harm her if they tried to touch her. She had been born the night before; the parents had set out at break of dawn and travelled all day and almost all night to get here because of the miraculous doctor they had heard about (our paediatric surgeon), but she hadn’t been fed a thing. We operated, and she survived, giving me another nightmarish night as I waited and waited (and waited and waited) for the first few drops of urine to form. She was lucky; many others I saw in very similar circumstances didn’t fare so well. It was very common practice for patients to turn up at our doors this late at night. They often came from very far away, and would travel many, many kilometres through the day, a large part on foot, before they reached us in the middle of the night, giving us juniors the kind of night calls we’d never experienced as interns. 

Health Worker Pamphlet on identifying poisonous snakes in the area

I learnt a lot, to say the least. I saw all sorts of cases, connective tissue disorders, rheumatic heart diseases, valvular disease, cancers of all sorts (once again too many cervical cancers than there should have been, we diagnosed them by nose; by the smell of so badly a fungating and infected growth that they had finally been forced to seek health care. We could smell them as they sat waiting patiently on their benches, the OBGYN would simply look up, sniff, point and they would be ushered straight into the examining room ahead of everyone else), a lot of sickle cell anaemias, some thalassemias, poisoning, animal bites, the insidious nutritional anaemias, skinny diabetics (so many that I almost thought the rah rah about obesity a joke), cleft lips and palates, hernias, hydrocoeles, you name it we saw it and if I could, operated on it. 

A typical Phulwari (Day care centre) - Sarees hung from the beams served as swings by day and cradles for the little  ones to sleep in the afternoon

What left a lasting impression on me though was not as I may have implied the knowledge I acquired or the medicine I learnt, but the people I met, and the stories they told me. Why it was that the smelly woman with cervical cancer had come to us so late, why it was that the fifteen year old boy had caught falciparum malaria (the first death I ever certified) in the middle of winter and not the monsoon as was believed to be common, about the siblings with severe rickets, about families full of XDR TB. How when food was scarce and money even more so I was always given tea, lunch and biscuits in every village I visited. I loved to listen and watch as young fathers proudly held their new born daughters and told their neighbours that boys were useless these days, girls would always take care of you.

Most of the stories were sad, of a young 23 yr old woman who fell off a tree plucking mangoes for her little children and died after three days of agony, of a young farmer consuming cans of pesticide in an attempt to escape the trials of this life, of a mother insisting her dead son was still alive because when she held his hand he was still warm to the touch. Some were amusing like women who had had so many children that they often gave birth while at work in the fields or jungles, fed the child and then just carried on working brining the little tyke home at dusk. Some were ironic, like the time I was invited, big city girl that I was, to bathe in the river with the local women and then told that this was one of the last few times they would be bathing here since the government had seized the land their village had stood on for generations in the name of conservation, or of the cholera epidemic that converted our little hospital to a war zone punctuated with gallons of ORS in which we proudly claimed we had not a single fatality except for the two abrupt miscarriages. In the midst of all this strife the stoic resilience of the people never failed to amaze me, the determination that life must somehow go on, that we must continue to provide for the children we have left, the parents we owe everything to, and give them a better life than we could ever imagine. It’s these kinds of people that Philip and Mikael will meet as they travel through similar places. It’s these kinds of stories that they will hear and I hope will be able to tell, of despair, and hopelessness, of resignation and sufferance, of the depth and strength of care and love, of the undying will to keep going on. Because no matter what their story and how it ended, with a chuckle or a tear, it was worth listening to, worth retelling.