Reaching Out in the Rubber Plantation

Deep within the plantation, the darkness creeping before the fall of night, the battery-operated lantern provides some relief to my poor eyesight. This period of decreasing daylight in a rural wooded terrain proves to be a challenge.

Took me almost two days, by land, to reach my destination, yet a worthwhile journey in an ageing train and van. The Thai driver was a bit overzealous behind the steering wheel, and I'm left to nurse a stiff lower-back.

Preparing for this outreach took a bit of time. The travelling to different countries, the long journeys by road and rail, and the never-ending task of rescheduling. But outreach has been on my agenda for ages. I reach out to rural communities, conducting health-related activities, such counselling, skills building and focus group discussions.

The rubber plantation hides a small village in the middle of nowhere in Narathiwat province, where a conflict between ultra-nationalists and military has thrown communities into a bloodied void of social devolution, and misery. Similar hardships are faced in Yala and Pattani, with no prospects of peace on the horizon.

I pause from typing, the nicotine-stained fingers moving only to discard the kretek into the tin cup. My host, an elderly man of Patani descendant, had just left his house to perform his religious devotion at his neighbour's house. He's been at it, apparently the same ritual, after his 68-year-old wife had passed away last year. He prefers the company in nightly prayers, rather than be alone with his thoughts. Pakcik (uncle) Ujang barely saw my nod, as he made his way out from the doorway of his wooden house.

The old man lives in the centre of the village, and has been part of the community for over six decades. His three sons and a daughter are working, each with their own family, but living away from the rural south.

This settlement of 16 families was once bigger with homes and farms. Presently the inhabitants live in modest huts and traditional two-room wooden houses. The structures are elevated by stilts at least three feet from the ground, to ward against flash floods and wild animals. I was told by the villagers that wild boars and poisonous snakes are common in these parts.

I hear the orchestra of insects in their harmonious classical, a tribute to the night. I chuckle. It’s relaxing to hear. I feel a sense of relief, to be away from cities. It’s peaceful here. Surrounded by tall trees, hectares of land, with a foul smell of rubber bled from the trunks, drying somewhere in the open air.

There are long narrow dirt roads, connecting the village to the nearby town. I recall, it’s far, about 12 kilometres away. Mind you, I have no access to a vehicle. There are no street lamps, or proper drains and as far as the eye can see... only trees. Rubber trees.

Healthcare here is in a state of neglect. A villager said that health officers would sometimes visit them once every three months, depending on cases. Even then, often a doctor is not among the visiting team. Villagers don't really know why, though it may just be that there are not many doctors out there who are keen to visit rural Thailand. Not surprising, as it’s the same in most parts of rural Malaysia.

Dengue. A concern among the villagers. According to them, there was one case a couple of months ago. A 10-year-old boy had struggled, and fortunately survived the ordeal. The poor drainage surrounding the homes and in the plantation facilitates dengue during the dry season. Swarms of mosquitoes, a common sight; and worse with all that dreadful blood-sucking.

Army patrols frequently pass the settlement, and are welcomed by the villagers. The soldiers at times bring some medical supply. The medic and their informal mobile “clinic” would distribute basic medication, to treat coughs, fever, muscle aches and allergies. There is also the camera, and some of the soldiers would snap photos of their health work, though the villagers say they don't mind. Everyone seems to be doing that nowadays, I guess. Along with the outreach, the soldiers try to build rapport with the villagers. Part and parcel of the army's attempt to "halt militant influence" in rural south Thailand.

Faith-based outreach activities are conducted by an NGO and informal groups aligned to mosques in the south. They visit the plantation community about twice a year. Part of the dakwah (missionary work) program of urban Thai Muslims. Sometimes they bring their own nurses and medical orderly, sometimes a doctor. The villagers are happier to see them than the soldiers. The dakwah program conducts free services, such as blood pressure checks, distributing basic medication and giving health advice. Always, they are accompanied with sermons and prayers.

Seems well received by the villagers, as the outreach workers consist of civilians and healthcare professionals who are able to communicate in the local dialect.

Poverty increases the hardship of the villagers. They are hard-working folks but feel marginalized due to their poor quality of life. Their main income is heavily dependent on rubber prices, and that's really not comforting as the economy continues its plunge. I wonder whether

Vegetables and fruits help reduce the hardship of living and working in the rubber plantation. The villagers have these as side income, though this is seasonal and at times their gardens are destroyed by flash floods, fierce rain storms and droughts. Depending on the harvest, they would either sell it at the open market or consume it. The villagers do try to adapt to new source of revenues since there is a challenge in the rubber industry. Being milked by middlemen is a widespread problem, and has left this community frustrated at not being able to earn enough. Seems officials in the local agriculture department are aware of this, though so far no sustainable remedy.

Knowledge of health among the villagers: above average. From basic hygiene to first aid. There's a need to improve sanitation. When someone is ill, they depend on a rusted Mitsu pickup truck or motorcycle to transport the sick to the clinic in town. There's no ambulance within easy reach.

My thoughts go deep into the root problem of the poor healthcare. What happened to the national health system under the junta-controlled government? What has the provincial authority done to improve health services for rural constituents? What is the impact of the declining economy, coupled with the increasing household debts, on rural families?

Villagers feel that rural care services are poorly coordinated. Doesn't tackle concerns nor meet the needs. What about regular outreach by medical professionals? And what of mental health and psychiatrists and counsellors?

I'm spent, and the mattress looks inviting. Just as well, the body needs rest, even for a couple of hours. I look forward to a renewal when I'm awake, perhaps to learn something new, offer my assistance or simply to absorb what I can with these tired old eyes.

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