Yangon, Myanmar: Facts about a Relatively Unknown Nation - May 2016

Nestled alongside India, China and Thailand, sits the enchanting Southeast Asian nation of Myanmar. Formerly known as Burma, the country is now stepping out from its tumultuous history plagued with civil war, occupation and military rule. Known for its towering golden pagodas and devout Buddhist followers, there is more to this formerly closed nation than meets the eye.

• Burma was renamed Myanmar in 1989, however some western nations, like the U.S., refuse to recognize the change.
• The Shwedagon Pagoda in Yangon is the country's most famous site and a revered Buddhist monument; it was erected more than 2,500 years ago using 22,041 solid bars of gold.
• Traditional Burmese dance features double-jointed performers who bend wrists, elbows, knees, ankles, fingers and toes to stylized choreography.
• In Burmese culture, white, or albino, elephants are worshipped. The animals are collected by politicians to bring good luck in elections. Currently eight white elephants are actively involved in blessing the country's affairs.
• About 5,000 elephants are employed throughout the country in forestry operations to haul logs. Elephants start timber-work at age five and typically retire at age 53.
• Burmese women and children smear fragrant paste made from tree bark, called thanaka, on their faces to combat the sun.
• In the mountainous northeastern regions of Myanmar, the local diet consists of insect larvae, ants and grasshoppers.
• Burmese people don't only drink tea, but eat it as well. Lahpet, or tea-leaf salad, consists of fermented tea leaves packed into bamboo tubes along with a variety of spices and accompaniments.
• The Myanmar border with Laos and Thailand is often referred to as the "Golden Triangle." It is regarded as lawless badlands overrun with drug lords, arms dealers and insurgent armies, and is the primary poppy crop region for opium production.
  
• Myanmar is the second-largest producer of opium in the world after Afghanistan, producing around a fifth of the world's supply.
• 100 days after the birth of a child, the parents invite family and friends to a naming ceremony where the baby is given a name based on astrological calculations.
• There are no family surnames in Burmese culture or shared names between children and parents; Burmese women keep their maiden names upon marriage.
• The term "U" is added to the names of senior figures in Burmese culture to signify honor and respect.
• Burmese girls mark the end of childhood at age 9 with an ear-piercing ceremony.
• The Chin people inhabiting the western part of the country are known for their dying tradition of facial tattooing. Worn by women, the tattoos cover the entire face with a blue-green spider's-web pattern. A German photographer showcases the tradition on his site: www.bloodfaces.com 

Kyaiktiyo, Myanmar: Our Pilgrimage to Golden Rock Pagoda - May 2016

Precariously perched on the top of rock dangerously close to a mountain's edge, a granite boulder covered in gold hoists a 24-foot-tall pagoda into the sky. Legend has it that the golden rock balances on a single thread of the Buddha's hair. The Golden Rock Pagoda is one of the world's most revered Buddhist sites; it is said that one look at the gravity-defying wonder is enough to inspire any person to become a follower of the faith.

Our pilgrimage to the Golden Rock Pagoda began in Yangon. We were up at dawn waving goodbye to the city as we drove east into the Burmese countryside. Wooden stands with thatch roofs flanked the roadways selling fruits and fish. Past the rice paddy fields and river valleys, we met the mountains upon entering the Mon state.

After nearly four hours of driving we reached the small town of Kyaiktiyo. "Base camp" as they referred to it was a crowded bus depot on the outskirts of town. We were pulled out of our air-conditioned car and thrust into the blanketing 107 degree Fahrenheit heat.

A young Burmese boy motioned for us to climb onto a platform and wait our turn to be loaded into a truck. The back of the truck was open with seven wooden pew-like planks. The noticeably over-heated driver was strict in enforcing six people per plank. After nearly an hour of waiting and organizing in the back of the truck, we held on tight to the metal bar in front of our seat as we began the ascent of Mount Kyaiktiyo with forty of our 'closest' Burmese friends.

The heat was suffocating and the sun scorched our skin. Two children behind us were pulling at my hair and an Indian woman in front was somehow sitting on my knees. We were crammed in so tight we couldn't move. The 45-minute journey to the top of the forested mountain took us up a steep switch back paved road. Tree branches beat the truck. Our only relief was the breeze that sometimes penetrated the pile of cramped pilgrims and the sight of the towering pagoda we would steal every once and again.

Upon reaching the top of the mountain, all of the pilgrims eagerly jumped out of the truck and into the arms of the sweat-drenched locals surrounding the truck peddling everything from straw hats and umbrellas, to snake oil. After pushing through the crowd, we proceeded down a narrow road lined with stores and hotels towards the pagoda.

A few moments later we reached the entrance to the religious area. There we removed our sandals out of respect and left them in a crate. The rest of our journey was to be done barefoot on marble slabs. Our walk turned into a jog as we jumped for the white and gray marble bricks which seemed much cooler than the darker ones. After nearly one mile by foot we finally set our sights on the pagoda.

It was smaller than we had expected but the way in which the boulder appeared to balance on the mountain face was awe-inspiring. The men were permitted to purchase gold leaves to press onto the golden rock. Incense swirled in the air and a line of newly appointed monks marched past us. Hundreds of fellow pilgrims crowded the site many preparing blankets and food to spend the night on the marble grounds. It appeared that from every angle the golden rock glowed a differing hue of gold-yellow-orange as it reflected the light. As the sun set behind the Golden Rock Pagoda it was hard not to be entranced by the beauty of this sacred site.

Weekend Travel Bag Checklist - April 2016

Planning to spend a few days away? Don't weigh yourself down with too much luggage; use this Weekend Travel Bag Checklist to ensure you've packed the necessities for your trip.

Athens, Ohio: "Asylum for the Insane," Flashback - March 2002

The Ridges, once referred to as the Athens Asylum for the Insane, is a former health services facility located in the hills of southeastern Ohio. The facility no longer houses patients but is now maintained by Ohio University.  

A travel destination in its own right, the former mental health facility still attracts visitors from all over the country; those interested in history or many intrigued by the many haunting tales walk the grounds daily.

 

While I attended Ohio University from 1998-2002, I was captivated by the ornately decorated mansion that towered over our campus. Majoring in journalism with a minor in psychology, I dedicated a significant period of time to researching the facility and creating a website to educate others on the history of mental illness and The Ridges. While the University-hosted website is no longer available, the content has been cited frequently in online publications, periodicals, books and movies. Included below is an excerpt from the former website inspired by The Ridges.

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"The History of Mental Illness"

by Kimberly Leupo (2002)

1st Revolution: Hospitalization

2nd Revolution: Moral Management

3rd Revolution: Societal Cooperation & Interaction

Treating public illness has long been a process of trial and error guided by public attitudes and medical theory.

The colonial American society referred to those suffering from mental illnesses as ‘lunatics” which interestingly enough was derived from the root word lunar meaning, “moon.” Through astrological reasoning it was believed that insanity was caused by a full moon at the time of a baby’s birth or a baby sleeping under the light of a full moon. Colonists declared these lunatics possessed by the devil, and usually they were removed from society and locked away.

Those considered lunatics were grouped into two categories: mania and melancholy. The only medical procedures centered around the idea of catharsis. Colonists believed to cure an individual it was necessary to undergo cathartic medical treatment, and to either catalyze crisis or expel crisis from the individual. Such medical procedures involved submerging patients in ice baths until they lost consciousness or executing a massive shock to the brain. Means to expel crisis from the patient included inducing vomiting and the notorious “bleeding” practice. The bleeding practice entailed draining the "bad" blood from the individual; unfortunately this inhumane practice normally resulted in death or the need for lifelong care. At best the odds were one in three that this procedure would actually lead to an improvement in the patient’s health. Although the colonial era’s methods of handling the mentally ill and medical procedures could be considered barbaric by present- day standards, the vast majority of people were content because the lunatics were no longer visible in society.

Around the turn of the 19th century, Europeans introduced a new approach to the treatment of the mentally ill known as “Moral Management.” This approach was based on the belief that the environment played a vital role in the treatment of the mentally ill. Creating a more domestic environment, beds, pictures and decorations replaced shackles, chains and cement cells. It was thought that recovery would more likely occur if conditions and surroundings resembled the comfort of home. Treatment also took a more benign approach. Phrenology was introduced which studies the shape of the brain to explain illnesses and render diagnosis. Animal magnetism was another popular practice, concentrating on the benefits of hypnosis and relaxation. Problems surfaced, however, with patients becoming unruly due to lack of restraints, and concern arose with how patients were to occupy their time. To combat these issues, work programs and recreational activities were devised for patients in asylums significantly moving to bridge the gap between society and the hospital. 

A pivotal point in the history of the mental illness was the Civil War. After the Civil War in America a great number of servicemen suffered from postwar trauma; war wounds that were emotionally and mentally ingrained as opposed to physical injuries. These inflicted persons were passed on to state mental hospitals and asylums, where the public displayed much interest in their care and treatment. Although, the public eye watched very closely how their ‘war boys’ were treated, institutions had no choice but to reinstate old procedures due to the serious issue of overcrowding. Restraints and shock therapy were reintroduced, along with new drug treatments such as opium.

To accommodate the rising need to find placement for those suffering from mental illnesses, asylums began opening all over the country. Thomas Story Kirkbride was a designer of asylums at the time, and became well- known for his popular architectural ideas.

With aid from the state and federal money, the community of Athens adopted the Kirkbride Plan and constructed their own mental asylum. Doors opened in January of 1874 with the institution dawning the name “Athens Asylum for the Insane.” The asylum was an attractive, ornate structure built to please the public’s eye but also to withstand the harshest conditions from within. The original 544-room construction consisted of two staggered wings branching out from a central building. The architecture was such that it allowed exit and entrance only from the center building and the design was ideal for cross- ventilation and patient control. The design called for the least disturbed patients to be placed closer to the center building to encourage interaction with the staff, and as the patients’ conditions worsened their placement would extend respectively throughout each wing toward the back of the structure.

The institutional compound grew into a very efficient community housing farms, a dairy barn, greenhouses, a transportation system and graveyards. The patients took part in tasks both indoors and out to benefit their living situation, much like that of a family. In accordance with European ideals at the time, patients at the Athens Asylum also engaged in recreational activities such as dancing, picnics, boating and church. All up and coming communities housed large and attractive asylums; it wasn’t uncommon to see postcards circulating featuring picturesque asylums with beautiful landscaping. The reputation of these institutions was significantly impressive leading parents and friends of patients to have increasing confidence in their patient’s care. Thus helping in small part to lessen the stigmatism associated with the mentally ill.

With the strengthening credibility of these institutions, the populations skyrocketed. It was common for homeless people, tramps and hobos to become ‘patients’ of the asylums seasonally for shelter and food, and then "elope," or slip away when the good weather returned. Families would often submit their elderly relatives to asylums because they lacked the resources or time to deal with them appropriately. The problem with overcrowding developed because the institutions had no established criteria for accepting or rejecting patients into their care. Rapid growth in populations caused patient care to suffer. In the Athens Asylum the patient population jumped from 200 to nearly 1800, with an insignificant alteration in staffing. The community found that these institutions were an easy means to remove unwanted people from society. There was no effort to provide any other programs or support, because the state was paying for the asylum.

The severe overcrowding led to a sharp decline in patient care and once again, the revival of old procedures and medical treatments. Restraints returned. Instead of sleeping in single rooms as the Kirkbride Plan had designed, patients were sleeping in wooden cribs stacked three patients high. Ice water baths were once again used, along with shock machines and electro-convulsive therapy. And in the early 1930s the notorious lobotomy was introduced into American medical culture.

The original lobotomy was a medical procedure where the neural passages from the front of the brain were surgically separated from those in the back of the brain. The common result of this procedure was the patient forgetting their depressing or discouraging feelings or tendencies. This was a very delicate, time-consuming procedure that required great skill and training from the practicing surgeons. Because the lobotomy appeared to effectively alter the mental health of patients, great effort was invested into developing a more practical procedure with similar desired results.

To the satisfaction of his peers and the mental health community, Walter J. Freeman developed the trans-orbital lobotomy. This new medical procedure could be performed quickly and required limited after-care for the patient. The procedure was performed as follows:

• To induce sedation, inflict two quick shocks to the head.
• Roll back one of the patients’ eyelids.
• Insert a device, 2/3 the size of a pencil, through the upper eyelid into the patients’ head.
• Guided by the markings indicating depth, tap the device with a hammer into the patients’ head/ frontal lobe.
• After the appropriate depth is achieved, manipulate the device back and forth in a swiping motion within the patient’s head.

Because this new form of lobotomy could be performed so quickly and easily, the trans-orbital craze swept the nation’s asylums. Freeman himself performed over 3,000 lobotomies and was labeled the traveling lobotomist. Trans-orbital lobotomies were performed on hundreds of Athens Asylum patients in the early 1950s. In a local newspaper, on November 20, 1953, the headline read “Lobotomies are Performed on 31 Athens State Hospital Patients,” and the article boasted that nearly 25 of those who received the surgery would be able to go home to their families. Freeman and the trans-orbital lobotomy stirred up harsh criticism from those who learned of his flamboyant methodology. Due to the number of complications and deaths that resulted from the procedure, it was referred to as “psychic mercy killing” and “euthanasia of the mind.” This was by far mental health care’s darkest hour.

Along with the common use of lobotomy procedures in asylums, electro-convulsive shock treatment continued to be a dominant practice. The numbers continued to rise in the institutions, and caregivers and attendants remained scarce. Rumors of abuse and neglect flooded communities who once were proud of their community asylums. In the 1950s, the Athens Asylum reached its peak population of nearly two thousand patients.

Shortly after the asylum population explosion in the mid 1900s, when mental health treatment was arguably at its worst, an apparent salvation emerged. Psychotropic medication was pioneered. In 1954 the medical community introduced an anti-psychotic drug called Thorazine for the treatment of the mentally ill. In rapid succession, other psychotropic medications became available making it possible to cut substantially the length of time patients stayed in mental institutions. This breakthrough led to a significant decline in asylum populations, and the gradual discontinuation of less humane treatments and procedures.

Reflecting the changes in the treatment of the mentally ill brought about by drug therapy, and state and federal public policies in the 1960s, state institutions changed their procedures resembling the previous moral management revolution.  There was an emphasis on protecting the human rights of the mental patients that had historically been overlooked. New employees were hired to be less hierarchical and environmentally-controlling as their predecessors. Treatments were geared to the individual and proved to be more effective then group cure-alls. There also was a notable move to de-institutionalize mental patients. In 1960 there were over 500,000 patients in mental institutions in America. It had become increasingly clear that there were many inmates in asylums in custodial care who were able to function in society with adequate out-patient care. Institutions continued to provide 24-hour, long term in-patient care, but now introduced outpatient services, day and night hospitalization, diagnostic services, pre-care and after-care, and more extensive training and research.

Simultaneous with the breakthrough in medical treatment, the community mental health movement became a centerpiece of President John F. Kennedy’s congressional program. There were concurrent shifts in insurance coverage for the mentally ill provided by the Comprehensive Mental Health bill in 1964, and the Medicare and Medicaid Acts in 1966. All of these national movements led to a reduction of the use of existing mental health hospitals and an explosive growth in private hospitals, general hospitals with psychiatric wings, and community mental health centers. As a result states greatly restricted long-term, full-care services in state mental institutions in the late 1960s and early 1970s.

In 1972, a federal court ruled that patients in mental health facilities could no longer work at institutions without pay. The impact of this ruling further changed the nature of the mental health center, for now the remainder of the agricultural pursuits and dairy farming had to go, as well as the upkeep of much of the grounds. The institutions didn’t have enough money to pay the patients for their contributions and also didn’t have adequate finances or staffing to occupy patients with their new found abundance of free time. The cost of housing patients increased dramatically; patients became bored and felt they lacked the purpose they once clung to, thus the need to de-institutionalize was more prevalent than ever.

As more patients were de-institutionalized, cottages and buildings were gradually closed at the Athens mental institution. Budgets because increasingly restricted and utilities to unused buildings had to be cut off. Farming and dairy activities gradually ceased, leaving large tracts of land fallow.

During the de-institutionalization process, three out of every four patients were released from the Athens Asylum. The relocating trauma was great; patients were released to their families, nursing homes, and half- way houses. The homeless population soared with its the mentally ill population representing nearly a third. The state pushed this process along by offering monetary rewards for decreasing the number of full-time patients in asylums.

By the mid-1970s the long and short-term inpatient population at the Athens Asylum for the Insane was reduced to 300-400 patients. In 1981, the management of the 344 acres of land which housed the Athens Asylum was transferred to Ohio University. The number of patients in mental institutions in the United States was reduced to 100,000 by 1986.

In 1993 the doors to the Athens Asylum closed and its remaining patients were bussed to a smaller, newly built mental health center across town. Ohio University has since renovated the buildings of the former asylum and uses the complex for classrooms, offices and a museum.