Indonesia, 1972

Here is an abridged account of my short-term consultant appointment for the World Health Organization in Indonesia in 1972; when I get my scanner repaired, I will add a few photos to illustrate this.

In January 1972 my first glimpse of Indonesia was from 10,000 meters above. Through breaks in the monsoon clouds I saw a conical volcano with fumes and steam billowing from the summit. It may have been the 3,000 meter volcano on the island of Bali, which I saw later from sea level but it could as easily have been one of  many volcanoes on Java. 

The heat and humidity hit me like a body blow when I stepped off the plane to the tarmac in Jakarta (no air- conditioned arrival hall in those days).  Dr. Iwan Soutjaja was there to meet me, a short, stocky Chinese Christian Indonesian festooned with gold necklaces, bracelets and rings, who had evaded a recent genocidal assault on the 1000-year old Chinese communities in Jakarta and Surabaya in which over 300,000 died in a little-known and bloody episode of the Cold War (the CIA had started a paranoid rumour that ‘Red China’ was planning to take over Indonesia and install the entirely non-political Chinese merchants and traders as surrogate rulers).  Soutjaja was based in the Ministry of Health. He was the liaison man between the University of Indonesia and the local office of WHO, where my fellow consultant and I went next morning to meet the WHO country representative, a pleasant Dutchman, Dr. Kejir who grew up in what was called Batavia when he was a boy, now Jakarta. My fellow consultant was John Pemberton, professor of social medicine at Queen's University in Belfast. I first met him in 1961 at the home of Will Pickles of Wensleydale, a famous British general practitioner, author of Epidemiology in Country Practice.  At that time, John Pemberton was spending his summer holiday doing a locum for Will Pickles, whose biography he later wrote. John Pemberton and I had been asked to assess the status of teaching and research in public health at medical schools then serving the Indonesian archipelago and its 110 million people. There were plans to establish a school of public health in Jakarta, and our principal task was to advise the Regional Office of WHO whether adequate human and material resources were available. 

I found everything about Indonesia fascinating:.the scenery, the energetic and mainly bright people with whom we were working, the delicious exotic food, the contrasts between luxury hotels for rich tourists and corporate executives of multinational corporations, and the simple, sometimes squalid conditions of the Javanese. John Pemberton was not so happy.  He was often unwell and plagued with increasing deafness. A new hearing aid wasn't helping much because he had recurrent fungus infections of his ears. He was irritable and would ask our hosts to repeat things they had already said, because he hadn't heard clearly the first time, and perhaps also because he was more insistent than I on getting the facts absolutely right. I learnt a lot from him about the need for meticulous attention to detail. Since 1972 I have had feedback from some of those we met then, and from others, about benefits derived from our report and recommendations.    

My first day in Jakarta was a Sunday. I spent it by the swimming pool of the Hotel Indonesia.  I was struck by the number of young and beautiful local women who accompanied the middle-aged corporate executives relaxing around the swimming pool. That sight, and variations on it, recurred at other luxury hotels in Jogjakarta, and in Bali (where there were also, of course, many tourists). Bandung, where my room looked out at a smouldering volcano, was less full of overseas corporate executives, but a bevy of beautiful Javanese girls were waiting in the hotel lobby, in case any came along. We were not distracted from our work by these good-looking girls but business seemed brisk with business men from Europe, USA, Australia and Japan.

After a few days in Jakarta, we grew tired of the expensive and rather boring meals at the Hotel Indonesia, and went exploring. Not far along the road were some interesting Chinese, Indian and Thai restaurants. We tried these and liked them. I mastered the use of chopsticks, and consolidated my affinity for Chinese and Thai food. It was an interesting walk to these restaurants. Our route took us about 500 meters along a sidewalk of concrete blocks, some of which had had the ground underneath scoured out by monsoon rains, so they were tipped and tilted every which way; one or two had subsided a half meter or so below the rest, and in the dim street lighting, we had to watch our steps carefully. This was also the beat for some local ladies of the evening, who did their best, although unsuccessfully, to persuade us to dally on the way to and from our evening meal. The best of these restaurants, to which we returned several times, was called the Sky Room; I have a pair of fake ivory plastic chopsticks from there as a souvenir. 

Altogether we had about three weeks in Jakarta, in several instalments. We met the important dignitaries, officials of the Ministry of Health, staff in the University of Indonesia, local representatives of UN and NGO agencies. Also we used Jakarta as a base to visit interesting nearby experimental health centres. I was very impressed by the competence and dedication of the public health nurses who were educating traditional village midwives in elementary hygiene - teaching them to flame the scissors they used to cut the umbilical cord, to ‘drive out evil spirits’ (pathogens) instead of sprinkling ash from the cooking fire on the crushed end of the umbilical cord. They showed us figures to demonstrate the effect of this simple measure alone in reducing the neonatal death rate due to tetanus from almost 10 percent to near zero in a period of three years. Everywhere we went I was captivated by the beauty of the countryside, the lush green trees and neat paddy fields, the placid water buffalo, tidy villages teeming with cheerful, attractive people. I was struck by their youth - we rarely saw old people. The average age of the population, we discovered when we met the demographers at the University, was just over 20, less than half what it was in Canada. Almost half the population was under the age of 15 - their population bomb had not yet gone off. A very high priority was the national family planning program, which in retrospect can be seen to have been successful.   Later, in central Java and in Surabaya, we had our fill of seeing sick people: there was a gastro-enteritis, perhaps even a cholera epidemic, many kids with severe life-threatening measles, and a few with diphtheria, which I had never before seen.  There were cases too of Japanese B encephalitis and hemorrhagic dengue (almost indistinguishable from yellow fever). These are mosquito-borne diseases, with ubiquitous culex mosquitoes as the principal vectors.  But in the region close to Jakarta, although health problems abounded, we didn't see much that was dramatic, except a man who had been cut to pieces by a train (a common injury, because people cling all over every carriage) and several others who would obviously die from the injuries they had received in severe traffic crashes. One of the weaknesses of Indonesian medicine was revealed by these experiences: the nursing service inherited from the Dutch was very highly specialized. They had tuberculosis nurses, leprosy nurses, yaws nurses, and each could deal with no other condition than the one they had been trained to treat. Hence, a mortally injured man, a victim of a severe traffic crash, whom we saw in a small hospital for tuberculosis patients, got no care at all, because he didn't have TB.  The nurses there were very good at treating patients with tuberculosis but had no idea how to care for a critically injured patient – and no appropriate equipment, not even I-V sets.  In 1972 the Ministry of Health was wondering what to do with the large cadre of smallpox nurses who no longer had jobs because smallpox had been eradicated from the region.  In 1997, I met several senior staff of the Ministry of Health of Indonesia at a WHO conference in Bangkok, and heard that they had eventually managed successfully to redeploy most of these disease-specific nurses into more relevant roles.   

I asked Julie Sulianti, the Minister of Health, about this when John Pemberton and I paid her an official visit.   I had met her some years before when she was a political exile (Sukarno, the previous military dictator, had not been a friend of her family; his successor Suharto was, so she came home). In 1964 while I was at the University of Vermont, she was working with Ken Newell at Tulane University in New Orleans; we had other mutual friends as well, and so got along considerably better than lowly WHO short-term consultants usually would. Having had that previous personal contact was most useful; she smoothed the way in encounters with officials of the government, and arranged at my request for us to visit community development projects in and near Jakarta. 

We travelled around Java by road and air. Our first air trip was memorable. We flew from Jakarta to Semarang, a city on the north coast about half way between Jakarta at the west and Surabaya at the east end of Java. We flew, as on all of our internal flights, in a Fokker Friendship, a sturdy little plane with its wings above the wide windows out of which we could see the ground below on clear days. Often we saw little because this was the monsoon season, so heavy overcast and torrential rains were the norm and as often as not we flew bumpily through heavy cloud. We left Jakarta just before a heavy rain squall hit the airport, and flew through this squall all the way to Semarang, where we circled in the bumpy air for about an hour, looking down at the airport which seemed to be almost entirely under water. We could see the rows of landing lights at both ends of the runway, but the runway itself wasn't visible. Eventually the rain eased up and the pilot came in to land. We hit the water that covered the runway to a depth of a few millimeters. Spray flew high in the air all around us; we skated and slid from side to side, but remained upright and eventually came to a stop at the shed which served as the terminal building. Nobody was there to meet us, but we knew that we were expected at the local government guest house and found a taxi driver who spoke some English, to take us there (we had the address on a typed itinerary that we showed him). It was not a very auspicious beginning. The guest house was a mouldy, dilapidated ruin, a relic of Dutch colonial days, vastly inferior to former British Colonial Office guest houses in which I later stayed on several occasions in India. It was mildewed wood with a corrugated iron roof, and several rooms screened against mosquitoes - but the screens were torn and full of holes. Fortunately our beds had reasonably new and clean mosquito netting. Here, in the tropical steamy heat with incessant rain, mosquitoes were teeming throngs, roosting everywhere. Most were culecine, but we also saw anophelenes, the species that can transmit malaria. At that time, the local malaria parasites were said to respond to chloroquin, and neither of us got malaria, so I suppose this was true.

Dr. Amijojo, our host in Semarang, showed up, full of profuse apologies and explanations an hour or so after we arrived at the guest house. He was perhaps the most interesting and impressive man we met in our travels in Indonesia. He was then quite young, a senior lecturer not a full professor. He had some innovative and workable ideas. His work has been written up since then in Health by the People, a book edited by Ken Newell for WHO, although he was not credited - one of his seniors put his name on the paper. What our young host was doing was at that time, as far as I know, unique. He was deploying teams of students from Semarang University in community development projects in the villages in his district. The teams were made up of medical, engineering, agricultural science, economics and other students, each team about 8 to 10 strong. They would go to a village and assess its needs. The medical students did a health survey, the engineering students assessed the roads, dykes, dams and canals for irrigating rice paddies or sugar cane fields, the bridges, etc; the agricultural science students examined the condition of the rice paddies, the productivity of the chickens, and the economics students examined how the local and regional markets worked. The surveys were just the first step. Next the students dealt with the problems they had identified, first discussing at an open meeting with villagers what they had discovered and their plans to improve matters. Not only was this excellent experience for the students, it greatly benefited the villages. 

We spent four days in Semarang, during which the rain hardly ever stopped. At night it drummed on the iron roof in a steady roar that made conversation almost impossible. One night I awoke in the small hours. Everything was absolutely silent, the rain had stopped, the silence had woken me. Then within a few moments, a new sound arose, the cries and love calls of millions of frogs, including many in my bedroom. I put on the lamp by my bed; it was about 2 am. By the dim light of the lamp I could see hundreds of little green frogs within the small radius that was illuminated. They were puffing their necks in and out, out so far as to be almost translucent. They clung to the walls and hopped across the floor, many of them stopping for a few moments to mate, the male hopping briefly on top of a little female, in an orgiastic frenzy of unrestrained reproduction. When I got out of bed I had to tread carefully to avoid squashing them, and congratulated myself when I got back into bed again without any sticky or slimy remnants on the soles of my feet.

There was no shower at the guest house. Instead, in a curtained corner of my room, was a cubical concrete cistern about a meter and a half long, wide and deep. The house-boy explained that this was for ablutions, not drinking. I could dip a large pail in it and pour the water over myself, or I could immerse myself - get right into it and soap myself. I tried both. Immersion was more pleasant, because there was nowhere convenient for the water to drain if I poured it over myself, whereas when I got into the cistern, the overflow (Archimedes' principle dictated that there had to be an overflow) ran down the far side into a drain. The water was room temperature, that is, comfortably warm all the time. My system was to wash first my shirt, socks and underpants, hang these on a string across the other corner of the room, then lower myself gently into the cistern where I floated and washed for as long as I liked. It was comfortable and relaxing. The sides of the cistern were covered with water weed, and the water contained many mosquito larvae, but no frogs as far as I could see - it would not have been a good place for them, because if they got in, they would have no way to get out again. I quite enjoyed this unusual method of keeping myself clean. 

Our next stop was Surabaya, a steamy seaport which maintained some rivalry with Jakarta. The national tropical disease reference laboratory was in Surabaya, and the staff there and at the medical school were determined that if a school of public health was to be developed, Surabaya was the place for it. This and the rivalry were explained to us by Zbigniew Brzeziński, a Polish epidemiologist whom I had first met at an IEA meeting in Princeton New Jersey in 1964, and would meet again several times over the next few years. He had worked on the WHO smallpox and malaria eradication campaigns, and has a habit of escaping from Warsaw winters to warm, sunny tropical parts of the world. We had a rest day in Surabaya, and he, his wife and small daughter took us for a pleasant excursion to the hills above the city, where at an elevation of 1000 meters or so, the temperature and humidity were more tolerable than the steam-bath atmosphere at sea level. On the way to the resort in the hills, we drove past the bits and pieces of a young man who had been engaging in the local sport of hopping from the roof of one railway carriage to the next, had missed his footing, and had been cut into several recognizably human pieces by the wheels of the train as it passed over him. We first saw a leg, then another leg, and finally his head and part of his badly mangled trunk. Not a pretty sight, but an unforgettable one. It's one of my few clear recollections of the time we spent in Surabaya.  I remember nothing about where we stayed or the meals we had. I described and discussed the hospital conditions in my official report to WHO.  There were several epidemics at the time – severe gastroenteritis that probably included cases of cholera, measles which was killing many infants and children, and mixed with these a few patients with diphtheria and some who may have had mild smallpox, variola minor, although smallpox had supposedly been eradicated from Indonesia some years earlier. It was a splendid place for anyone interested in infectious diseases such as I was and am, or an infectious disease epidemiologist, but in other ways frustrating because of the inadequate surveillance system. Infection control, especially of childhood exanthemata, was a whole other matter! In almost all the hospital wards the occupancy rate was greater than 100%, in other words, several patients shared the same bed.  Pediatric beds often held three children at once and as far as we could tell, no distinction was made on the basis of diagnostic groups.

From Surabaya we were driven by car to Jogjakarta on the southern side of the mountains that form the spine of Java. This was a fascinating trip, through some of the most beautiful country I have ever seen anywhere in the world. There were lush paddy fields, some under water, some green, some with the rice ripened into rich golden colours and waving gently in the breeze under a benign sun. They get four crops of rice a year in that part of Java. There were banana plantations, pineapples, groves of rubber trees, then a picturesque winding road through a pass that crossed the ridge of volcanic mountains running the whole length of Java. At higher altitudes we saw tea and coffee growing. We glimpsed several of the volcanic peaks, but clouds concealed most of the highest mountains. 

Somewhere along that journey we stopped to see the ancient Buddhist temple at Borubador, which is on the summit of a low round hill, perhaps 300 meters above the level of the road and the rest house at which we had had lunch. John Pemberton was unwell and stayed there while I set off alone to climb to the top to see the stupas, the ancient bell-shaped shrines with which the hilltop is covered. These are the only Buddhist remnants in Java, which was conquered and converted to Islam during the great Islamic expansion in about the 12th century. A most surprising thing happened. I climbed up one side of the hill at exactly the same time as another man climbed from the other side. We reached the top simultaneously, and recognized each other at once: the other man was Frank Bell, who had been a classmate of mine at the medical school in Adelaide. We had met once since then, in London when he was doing his FRCS in the early 1950s. He was an orthopedic surgeon in Perth, and had been coming to Java every year for some time, spending a few weeks, teaching -- and learning about some simple and cheap prosthetic devices that could be easily manufactured from bamboo. We had a brief reunion there on the hilltop among the shrines, and then each went on our way, he towards, I away from Surabaya. We agreed to meet for a meal and a longer conversation when we both returned to Jakarta later in our travels, and duly did so.

Jogja, as it is usually known, is the ancient capital of Java, and another fascinating place. This is the home of the shadow puppets for which Indonesia, Java in particular, is famous. We stayed several days in a comfortable hotel with a swimming pool, which we had been advised to avoid because it was inadequately chlorinated  (we saw several hotel guests with itchy skin rashes and very red eyes, which presumably were due to infections acquired in that pool). The medical school there was the modern incarnation of a very ancient college of traditional herbal medicine, and our host, the professor and head of the department of public health, was proud of the connection, also proud of his western training in London. We thought his department had the best program of the six medical schools we visited. The hotel put on nightly displays of shadow puppets, as well as having, like all the other high quality places we stayed in, a troop of gamelin players. Gamelins are brass bells of many sizes that are gently percussed with soft-tipped drumsticks to produce most delightful music. I became and still am very fond of the almost liquid sound of gamelin music. One evening I went to a real shadow puppet play, rather than the ersatz variety at the hotel. I went with one of the junior staff members in the Jogja University department, who explained the plot to me. The characters are of course stylized heroes and villains; there is seemingly only one story, repeated over and over in endless variations, with the shadows of the characters moving on a sheet, lit from behind by lanterns and the voices of the puppeteers intoning the parts as they move. I have never seen an audience more totally absorbed in a performance than that one was. The other notable product of Jogja is the best batiks in Indonesia, that is to say, the best in the world. I bought several lengths of batik there for Wendy, and from these she made some fine evening dresses. I also got for myself an elegant summer shirt decorated with the pictures of shadow puppets. Jogja  is, or was then, a delightful civilized small city, where I would have been happy to stay a lot longer.  My friend David Waltner-Toews, a veterinary epidemiologist at the Ontario Veterinary College in Guelph, spent a year there with his wife and family, and says that it was for all of them a most interesting time, but after a few months they had had enough. By the time he was there, 15 years or so after I was, it had grown in size, had a crime problem and wasn't a safe place after dark. Neither there nor anywhere else in Indonesia did John Pemberton and I ever feel the least bit insecure.

We flew back to Jakarta from Jogjakarta, debriefed, then drove across more lovely country to the corner of Java that has the most volcanic activity, and is the setting for another picturesque city, Bandung.  As was the case in the other cities we visited, Bandung was an interesting mixture of ancient Javanese, Dutch colonial, and modern post-colonial architecture.  It is a thriving centre of commerce and trade, though how this began and evolved seems a bit of a mystery in view of its location and precarious position in the midst of so many active volcanoes – I could see three from my hotel bedroom window, a spectacular but rather unnerving sight. The nearest one could not have been much more than 2-3 kilometers away, and never stopped puffing out sulphur-laden steam the whole time we were there. The ground seemed to be in constant motion, shuddering with little tremors and occasionally more perceptible jolts. 

Then came Bali. I have been very fortunate in so many ways in my life and one is to have seen Bali before it was corrupted by tourism as it now is. In 1972, Denpasar was a sleepy backwater, hardly a city; the tourist invasion had barely begun. There was one hotel of acceptable standard, the Bali Beach Hotel where we stayed, and several cockroach-infested old hotels dating from Dutch colonial days along the main street of Denpasar. Bali was famous for its beautiful women, and for the fact that they wore their sarongs wrapped around their waists with their breasts bare. 

We saw some extraordinarily beautiful girls and young women clad like this, and were among the last to do so, because the regime in Indonesia, while not strictly Islamic, decided the following year that it was unseemly for women to walk the streets and go to the market so ‘improperly’ clad. Like the Christian missionaries who made the Polynesians wear clothes, they enacted a law that obliged the easy-going Balinese to conform to the dress code of women elsewhere in Indonesia. Pity. 

Bali is not only a most beautiful little island, with its tall conical volcano at one end, its palm trees, its paddy fields, streams and water falls; it is also culturally unique. First, the tide of Islam swept past it - in the 12th century when the rest of the Indonesian archipelago was conquered by the expanding frontiers of Islam, Bali somehow was overlooked. The sea between Java and Bali is narrow but can be stormy, and perhaps in those times the rulers of Bali were more warlike than they became later. For whatever reason, Bali was spared, and a unique blend of Hindu and Buddhist cultures evolved there, mixed with more primitive animist beliefs. Monkeys are sacred, and allowed to roam wherever they choose to go, as cows are in India. Every household has a multiplicity of gods, and observes many festivals in honour of each of these gods. One festival we saw celebrated several times was the cheerful rite of passage into adult life of girls who have just had their first menstrual period. This is a fertility rite: the little girl is dressed in ornate clothing festooned with trinkets and garlands of flowers, and is paraded through the village on a throne carried shoulder-high, while drums beat and trumpets sound. Another unique Balinese custom is to have male midwives, called dukuns. Balinese carving is justly famous, the only export trade when I was there. I bought two lovely Balinese wood carvings, carried one home by hand, a little woodland sprite playing a flute; and shipped the other, a dukun delivering a baby. I had long given up hope of ever seeing this again when it finally arrived, six months or so after I had seen it being packed and labelled at the Bali Beach Hotel. Those two wooden carvings are my most precious souvenirs of a brief but unforgettable stay in one of the loveliest places I have ever been. I have always wanted to go back there, although I know that by now the whole place has been so corrupted by mass tourism that it would be sad and even unpleasant to behold.  I was able to learn a lot about Bali in a few days because I met Manny Voulgaropoulos and his wife. They are Americans, he a public health specialist who was working for a small NGO, that had sent him to the medical school then being developed in Denpasar. His wife Joan is a social anthropologist, and it was she who told John Pemberton and me all that I know about Balinese culture and customs. I met them both again several times on future visits across the Pacific, after they moved back to Hawaii, where they were both on the staff of the School of Public Health. Occasionally since then I’ve bumped into Manny at annual meetings of the American Public Health Association.

During one of the interludes in Jakarta between the trips around Java and our final fling in Bali, I met and had a meal and a chat with Frank Bell, catching up on arrears of news.    Our dialogue was aided, like many conversations in Indonesia, by glasses of ice-cold Bintang, the excellent local beer, perhaps the only thing the Dutch colonists left behind that the Indonesians truly appreciated. Frank told me about his work as an orthopedic surgeon in Fremantle and his annual visits to Java to engage in an endless round of elective orthopedic surgery, interspersed with occasional emergencies. One recent experience had made a big impression on him. At the end of a day of elective operations, he was doing a final evening round of the patients he had operated on, and saw, at the far end of the ward, a bed that was carefully screened from all the others. He asked about the patient in this bed, and was told she was a young woman dying of gas gangrene, a complication of a compound fracture of her tibia. Frank was appalled, and asked to see her. The gangrene had extended to midway up her thigh, so if her life was to be saved, she would need a hind-quarter amputation - disarticulation of her hip joint and amputation of her entire leg. Gas gangrene is due to a highly infectious organism, Clostridium welchii, and if that gets loose in an operating theatre, disinfection is time-consuming and costly. He made a quick decision: he called for the necessary instruments and anesthesia, and there and then, over the protests of the staff, he did the life-saving operation with the patient in the bed behind the curtains at the end of the ward. He was pleased to observe over the next week or so that she made a smooth and uneventful recovery. But then, after a week or so, he began to ask about her, who she was, where she came from, who would care for her when she left hospital. That was when the staff told him her story. She was a ‘betja girl’ a rather upper-class whore who plied her trade from a betja, or rickshaw. Her leg had been broken when her betja was hit by a car. She had no family - that was why she was a prostitute. What was to become of her now? She needed months of rehabilitation, a very awkward and expensive kind of prosthesis, a tilting-table walking frame to balance on what remained of her pelvis. How was she, a one-legged prostitute to survive? Frank asked me, a specialist in community medicine, to advise him and his friends who would have to care for her after he went back to Australia, what could be done for her. The problem was not much like anything I had never encountered.  Her only possible future seemed to be in some sort of clerical work, perhaps in a community resource centre dealing with the problems of street people. Was she able to read and write?  Were there any suitable places for her to work? Frank didn’t know, he said he would ask.   It had been an enlightening experience for him: he told me that until the day he saw this girl a week after he had performed his heroic surgery, he had never before thought much about the social context of his patients. Now, never again would he fail to consider this aspect of their care, and in his teaching of the medical students in Perth, it would from now on become an integral part of their medical education. So he left Indonesia at the end of that tour a sadder and wiser man, and probably a better orthopedic surgeon and teacher.

Soon after that, John Pemberton and I left Java too. WHO was more relaxed about travel in those days than it later became. And John Pemberton surprised me: he was determined that we would not only return to the Regional Office in Delhi via Bangkok, we would so arrange our flight schedule that it would be necessary for us to stop overnight in Bangkok. The plan was advanced by strained political relations between Indonesia and Singapore, so the obvious route, Jakarta to Singapore then non-stop to Delhi, was not straightforward. Bangkok was the obvious connection, but flights that required an overnight stop called for creative planning. John Pemberton, aided and abetted by somebody in the British Embassy, managed to work out the only itinerary that would allow this. I am grateful to him for this, because although I was interested in seeing Bangkok, I wouldn't have bothered to go to so much trouble to make it happen; I felt fairly confident that some day I would get there anyway (as indeed I have, half a dozen times). On this occasion, we got there in the middle of the day and did not have an onward connection to Delhi until late on the following afternoon. That gave us time to see many famous Buddhist temples and shrines. They are unique, sometimes breath-takingly beautiful, especially the many spires and the Golden Buddha that had been successfully concealed from the Japanese during the war by painting it all over with thick black paint. Some of this still lingered in crevices, cracks and crannies. After our evening meal, John Pemberton surprised me even more - startled me - by suggesting that we should go to see the notorious red light district of Patpong Road. We chaperoned each other, so to say, to ensure that neither of us misbehaved. It was quite a spectacle. We stopped first at a dance hall where very scantily clad and sometimes stark naked young women squirmed and gyrated all over the floor, being ogled by large numbers of American servicemen on leave from Vietnam -- Bangkok was their principal R&R centre. This place was unfit for human occupation. It assaulted our ears with disco so loud it was physically painful and left us deaf for some time after we beat a hasty retreat; its flickering strobe lights made us feel dizzy; and the smell of sweat and cheap scent from a hundred or more naked female bodies was overpowering. We went next door, to a quiet, dimly lit bar, and came in as a young woman lying along the bar was inserting the end of a beer bottle into her vagina.   We sat for a while drinking a glass of the local beer, but we were tired and when it became clear to the management that we were there only to look at the goods and not to purchase any, we were firmly and not very gently encouraged to leave. By then it was quite late, so we went back to our hotel and to our beds and a peaceful, solitary, night's sleep.  On several later visits to Bangkok, I didn't revisit Patpong Road, but I did go to the Thai equivalent of Disneyland, a theme park with sham temples and canals resembling the real ones in Bangkok, without, however, the teeming throngs of people and constantly hooting car horns, noise, dust and turmoil that can make the real Bangkok an unpleasant city at times, despite its many attractions. Of the many cities I have visited around the world, Bangkok merits a place on the list of those I would recommend with cautionary notes, despite the beauty of its genuine temples. I think we were both glad to leave and get on our way to Delhi for our debriefing at the Regional Office of WHO.       

Debriefing in the World Health Organization South East Asian Regional Office, WHO/SEARO, was done by my former Edinburgh colleague Ray Mills, and was a leisurely process that left abundant time for me to explore some of the fascinating city of Delhi, especially Old Delhi.  I even had time on a convenient weekend break, to visit Agra and see the Taj Mahal for the first time.  But all that is another story I will tell in a future post on this blog.