Indonesia Blog 2

Surfing the Back-Roads of Indonesia: A world away brings equity home

I have to start this out with my conclusion: I am incredibly fortunate to have round the clock access to medical care.  As a public health worker, I have had plenty of lessons and experiences in the US on the importance of easy, culturally competent access to medical care for having a society that is overall healthy and happy.  But in my recent trip to rural Indonesia, these lessons became immensely real and extremely frightening.


Lombok is a rather small island quite close to the Eat, Pray, Love setting of Bali. Like it’s famous neighbor, it is blessed with rich mountains, warm waters and kind smiles. In the southern region, it attracts mainly surfers because of its near perfect barrels. According to our local friend, not 30 years ago villagers would travel solely by walking across the 70km island from village to village. Nowadays, motorbikes are the main form of transportation and the main roads are surfaced, allowing an insane dance between giant SUVs and tiny motorbikes, gliding through mountain roads. Through American eyes, it’s like a continuous game of chicken.


While some roads are now surfaced, many are still dirt roads (think mud and boulders) that require equal amounts of skill and assumption of one’s immortality.  As I have neither, I hired a local teen surfer (nick-named Hendrik, after Jimi Hendrix) to help get me to the waves. Having lived abroad some years back, I was used to hopping on the back of a bike and whizzing through the cities. The countryside? Not so much. As we sped away from the small village, my neck was already getting sore from whipping back and forth between the sapphire blue ocean and the emerald green mountains, and the occasional water buffalo.  At the same time, I became more aware that the road was getting worse and worse, the rain heavier and heavier.


Hendrik weaves through mud, between boulders and dodges SUVs like a pro. I breathe deeply and think of the waves at the end of this road. As we round a bend, the road opens into a flat stretch and I sigh for a moment of relief. Looking ahead hoping for more relief, we see the bike ahead of us waver, and then spin out, throwing a man to the road. Within moments, we are with him as he screams in pain holding his head. His head hit a rock and is bleeding on the road. He is German and not speaking English at the moment. Another German is with him and talks to him as I try to find someone with a cell phone to call for help. No one. More motorcyclists arrive as they are traversing the island. All of them stop, maybe 20 people, and no one has a cell phone. Finally, a woman in a mini-van comes across us and agrees to take him to the hospital. By this time he is not talking anymore. He is just silent. Staring at the sky. We move him into her van, she does a U turn and disappears around the bend.

I have no idea what happened to the man. Standing there in the rain, Hendrik and I got back on the motorbike and drove slowly to the next town. He asked if I was ok (“not really”). I asked if he was ok (“sure”). Almost every day since then I have thought about this. Thinking about how much closer to death we are in different settings. In the US, many of us can successfully avoid thinking about our own deaths until we are quite old. The fact is that this closeness to death has so much to do with things that aren’t usually tied to “health” like having a way to call for help and having an ambulance system.


This “infrastructural barrier”, while vivid in rural Indonesia, is no less troubling here in the US and its territories. Journalist and author T.R. Reid starts out his eye-opening book, “The Healing of America,” with a story of a woman living with lupus (a serious, but manageable condition) who died at 32 after not having timely access to medical care, due to lack of insurance to help pay for the high costs of the services she needed. Time Magazine ran a piece by Steven Brill about a year ago on the outrageous costs of healthcare that received huge attention and concern from across the country. In our staff’s work and time in Puerto Rico, we have witnessed countless barriers in getting needed health care, particularly for stigmatized groups like drug users.


Back to the conclusion I started with: I am incredibly fortunate to have round the clock access to medical care. I live in New York City. I have insurance, a phone, a citywide emergency system that I am familiar with, and doctors that speak my language. But this is not the case across the city and country.


This is the definition of inequity.

It is unjust that some have this access and others do not.

Written By: Emily Klukas
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Southern Blossoms on the Ground by Miriam Y. Vega

My obsession with understanding: The étouffée sounds yummy and glorious but the crab will kill me

My obsession with understanding: The étouffée sounds yummy and glorious but the crab will kill me


A few years back, I was with a work colleague conducting an organizational assessment in Florida. We sat with the executive director of said organization, going through the structured interview tool, while also trying to get a real, on the ground understanding of the organization’s work. We talked about the viability and fundraising strategies that community based organization need to take into account considering all the national policy changes. When she inquired as to what we were doing next, I mentioned we had several more organizations to meet with. She narrowed her eyes and scrunched her nose. She noted it was admirable that we were actually working and not hitting the beach. She then extended her arm, placed her hand on my mine and thanked me for the work I was doing. She noted that not many other vice presidents such as me would be so invested in other organizations on the ground.


I was taken aback by that immensely heartfelt gesture of appreciation. I wondered quietly “why wouldn’t I want to visit other organizations which do the same work that my team members do?”   I don’t believe we will reach an end to AIDS locked in an office with a pretty view. Part of my work obsession is enhancing my understanding though boots-on-the-ground research. I love to read articles and books. What I love even more is applying that knowledge. One could say I am obsessed with not holding tightly to an ivory tower perspective and then wondering why so-called evidenced based interventions are not working. Every time I think of such perspectives I hive as if I had just been exposed to a plate filled with crab. The étouffée sounds yummy and glorious but the crab will kill me. I continue to rack up the miles, ball up into seemingly smaller and smaller airplane seats, and listen up a storm. I go home wiser even if everything I previously swore I knew was thrown up in the air.


I was recently in Chapel Hill, North Carolina, an area embedded knee-deep in the “Research Triangle”; a grand land of universities, huge basketball rivalries, and even bigger research grants trying to marry (or at least date) community based funding. It’s an area that has seen growth of an emerging Latino population. I have been to this area on numerous occasions and oftentimes I had heard of this place called Carrboro, a liberal mecca trying to accommodate a growing day-laborer population. Besides just hearing about it for the hundredth time, I wanted to see it. Off we went by car (I do get motion sickness in busses) and did a neighborhood mapping. We didn’t stop to talk to the day-laborers out of respect for their privacy but I did note the glaring disparity between those standing there waiting for work and their surrounding areas, including the nice houses and performance bikes and shops that were all around. No text book can give this context. No tower can give you this bird’s eye view.


Thus, my obsession continues.


Post by Miriam Y. Vega, PhD


Inspired by the daily prompt of: Can’t get it out of my head


Other posts

Psychologistmimi: Obsessed what my spam says about me

Chronicles of an Anglo Swiss

Feeling like a caged animal

I have a question are you bisexual?







Guzzling sweet tea, noshing on peach pie, training up a storm and making new friends: All in a summer day’s work

Traveling the US guzzling sweet tea, noshing on peach pie, training up a storm and making new friends: All in a summer day’s work

Although New York is the city that never sleeps, there is such a thing as casual Fridays in the summertime in some offices. The thought being that kids are out of school, people go on vacations and there is some blistering in the sun going on. Supposedly, the workplace slows down an weensy bitsy bit in the summer. Can’t speak for all my colleagues, but I assuredly am looking forward to replenishing my vitamin D reserves the natural way. That is, out in the sun.

However, the summer time is never a time of calm and quiet for us. How’s this for starters: we will be in Miami, Los Angeles, Houston, St. Paul, Portland, DC, Atlanta, upstate New York, Chapel Hill and many more places. We will be hitting the road to meet up with colleagues, partners and vast audiences.  We will, as a result, see new and familiar landscapes, guzzle a ton of sweet tea, nosh on peach pie and talk a lot.  We will document for you all our successes and travails and keep you updated on our fitness challenge while out on the road. Shhh. My team doesn’t know that last part yet. Let’s keep that between us.

We hope to be releasing reports on the needs of Latinos in the deep south and manuscripts on breaking new twitter data.  We will be busy creating a new leadership institute devoted to innovative organizations?  We will be premiering new trainings per your requests and needs. There is no work respite and we’re like that and with that.

We invite you to join us on our cool summer tour. We have yet to be in Idaho or South Dakota. Here’s hoping one of you sends us an invite out there. We’d love to visit and partner with you as we continue to strive to reach a world without AIDS.

May your summer be filled with zest!

Post by Miriam Y. vega, PhD @miriamyvega

Inspired by the Daily Prompt of In the Summertime

Other thoughts on summertime

Summer Dreams | The Mirror Obscura

The Match (Part 6) Oh, Brother | The Jittery Goat

Summertime Sadness | Life Confusions

Dark Wings and Peacock Hope: Daily Prompt | ALIEN AURA’S BLOG: IT’LL BLOW YOUR MIND!

Daily Prompt: In the Summertime | The WordPress C(h)ronicle

DP Daily Prompt: In the Summertime | Sabethville

Daily Prompt: In the Summertime | littlegirlstory

DAILY PROMPT: In The Summertime | Melissa Holden

the party stayed up | y

Daily Prompt: In the Summertime « Mama Bear Musings

Summertime Sadness: I hope not « psychologistmimi

“Kinda” Excited to Have a Baby | A Crohnie’s Classroom

blog intern


Saudade: a deep emotional state of nostalgic or profound melancholic longing for an absent something or someone that one loves.

The study of linguistics has intrigued me ever since I was little because I grew up learning English and Spanish at the same time. I sometimes would find myself pausing to find the right word to say to my friends in English, but not being sure it existed. As I grew older, I learned that different languages had words for certain feelings and moments that did not exist in English, simply because of culture differences. It was a weird, literally foreign concept to wrap my head around until I was introduced to saudade.

Saudade is a word of Portuguese origin that describes a feeling that can’t be summarized in one word in the English language—it is untranslatable. Saudade was once described as “the love that remains” after someone or something is gone. It often carries a repressed knowledge that the object of longing may never return. In some circumstances, it describes a feeling of intense homesickness. It is an emotion I have seen on my parents’ and relatives’ faces many times when they share memories of growing up in Peru.

It is a feeling that many immigrants feel after they have lived in the United States for several years while raising their children. It is a feeling of longing for what was once home, even if it wasn’t perfect. It is a longing for familiarity that they want to share with their friends but can’t find the words to describe it. It is a feeling of torment, especially if you’re powerless to do anything about it. Undocumented workers who have come here for a better life are stuck in this saudade limbo—thankful to be here, but deeply wistful for what they’ve lost in the battle.

There is another term coined by an American sociologist and anthropologist Ruth Hill Useem that I canrelateto—Third Culture Kid (TCK). A TCK is described as “a person who has spent a significant part of his or her developmental years outside the parents’ culture… and builds relationships to all of the cultures, while not having full ownership in any.” We don’t feel like we belong in this new world we’ve grown up in, but at the same time we’ve lost almost all our ties to where we came from. This is a different state of limbo from saudade. It is a limbo where we have no identity, where “we are neither of one world nor the other, but between.” A TCK is capable of feeling saudade. We have saudade for belonging. We want to be able to say “I’m from X country” and truly feel like it is home, while at the same time feeling at home where we are.

How have you felt saudade in your life?

Written By: Ingrid A Milera, intern at the Latino Commission on AIDS that studies at New York University
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