[Music][A Family Question]
[Produced in cooperation with the Family Health Section, Ministry of Public Health, Royal Thai Government;]
[The Office of Public Health, United States Operations Mission to Thailand, and The Population Council.]
[Technical consultant:Dr. Sasichan Vimuktanon]
[Music]
[Narrator:] Thailand is loved by her own people
and envied by many others as a place uniquely blessed.
Historically independent, quietly prosperous,
it achieved long ago a balance between the yield of its soil
and the number and needs of its people.
It was almost an article of faith
that because the land was so fruitful,
it would always have room and food enough
for all whose destiny caused them to be born Thai.
But as the world grew, Thailand grew.
Though the acreage of paddy fields and orchards and ponds remained the same or diminished.
For ten million people, there had been room and food enough,
even for thrice that number half a century later.
But will there be in the next half century?
Think about it.
[Music]
Let us look at some people of Thailand today and ask the question again of ourselves.
Boa is the wife of Somsak, a wise and prominent villager,
and Chalan is the wife of their youngest son.
Boa and Somsak grew up in poor and crowded homes,
but they've worked hard and planned well
and made for their own three children a good and solid life.
[Singing]
Now Chalan will soon bear her second child.
She is strong and healthy, as is her first child,
and she rejoices at the prospect of another.
[Singing]
Nian, the wife of Pricha, a poor fisherman,
comes to the temple in sorrow and humility.
In her 31 years, she has borne nine children.
Seven of them survive.
Not since the first has she felt strong,
and she has forgotten what it is to feel joyful.
Because a handful of coins must feed her family tomorrow,
she can make only a tiny gesture of merit
and honor to the lord Buddha,
who himself once suffered privation on the road to enlightenment.
[Music]
[Singing]
So there are those for whom the riches of the land
are not enough.
Pricha's boat is too frail for the open sea.
Out of the back waters, he rarely brings enough fish,
even to feed his own family well.
In such a situation, it is usually the mother who fares worst.
Nian could endure that, but now she no longer has enough milk,
and the youngest suffers, too.
The loss of her own strength was the first price she paid
for bearing babies at intervals too brief.
But they too paid a price.
Dust-colored hair and curving backs mean malnutrition.
And Santi, the eldest, is sixteen in the body of a twelve-year-old.
But then, Pricha's family is more fortunate than some
because Pricha has another talent.
He can play a trumpet for weddings and ceremonies.
The money is little enough, but it brings in some rice.
[Nian:] [Thai speaking]
[Narrator:] "Will you be late?"
[Pricha:] [Thai speaking]
[Narrator:] "No, not so late. It's nearby.
I'm going to borrow the trumpet now."
[Narrator:] One of these days, out of these random engagements,
Pricha hopes to save enough money to buy a trumpet of his own.
[Santi:] Papa!
[Narrator:] "Papa, wait."
[Santi:] [Thai speaking]
[Narrator:] "I want to tell you something."
[Pricha:] [Thai speaking]
[Narrator:] "Not now. I have to hurry."
[Narrator:] Poor Santi.
He had found enough courage to say that he was going to leave the hopeless fishing
and the crowded house and go to town to find a job.
He has little education and no training.
How can he stay here?
Must his mother always be so tired and unsmiling?
The truth is, Santi's mother needs help from the village health center.
If she's too timid, or if lack of education has left her too ill-informed to seek it,
help must be brought to her and thousands like her before they are overwhelmed.
Trained midwives, nurses, and doctors have done much to raise the general health
in the Thai countryside.
Now, they have another responsibility,
to help poor mothers have fewer children.
Boa, waiting while Chalan visits the midwife,
counts the doctor and his staff as friends
and seeks their help for her children and grandchildren.
But what of those other women who continue in ignorance or superstition about health care?
Their need for help is greater than that of the fortunate Chalan,
and helping them will be a harder job.
[Music]
A start on the job has been made, not only in the health centers,
but in the province hospitals like this one,
where the royal Thai government's health services are working on a basic concept
that the children who are born in Thailand should be those who are wanted
and can be cared for.
The Family Health Project is dedicated to the improvement of health and well-being of all families.
[Music]
Doctors trained to carry out this program are leading their nurses and midwives in the study of their challenging new role,
that of guiding rural and urban women
in the preservation of their own and their family's health.
[Doctor:] [Thai speaking]
[Narrator:] "I urge you to devote your energies to the health and welfare of mothers and children
so as to promote the future happiness of the whole family."
[Narrator:] If the welfare of Santi's family had been anyone's particular concern a dozen years ago,
it might have made all the difference to him today.
[Lek:] [Thai speaking]
[Narrator:] "Hey, Santi, [INAUDIBLE]. Come here a minute."
[Music]
[Narrator:] Lek and Suin are tough and ruthless and confident.
Santi admires them a little, their clothes,
their cleverness, and is more than a little afraid of them.
Now, they're being friendly. Why?
[Lek:] [Thai speaking]
[Narrator:] "Look, we have a little job for you, and you can make some money.
You know old Somsak, the gem seller?
Well, tomorrow night, he's coming back from town, he's made a good sale, and
we know where he keeps the money."
[Narrator:] Ah, so that's it.
Santi is beginning to understand.
Lek has a brother who works a sapphire mine for old Somsak.
Santi has seen him there.
It is not exactly a mine.
They dig deep holes in the rubber forests and bring up baskets of earth
and sift over it, sometimes for days.
That's how Somsak got his start.
First a rubber tapper, then the digger for gemstones,
hard and grubby and ill-paid work at this stage.
But once in a while, they uncover rough blue or red or black stones.
They grind and grind slowly.
They polish and check and again polish.
With every step, the stones become tinier,
but more precious, until one day
they are ready to be sold, and sometimes, the sales are very good indeed.
Then it seems like easy money.
[Music]
Lek and Suin think some of this easy money should be shared
and Santi thinks, would this not be a quick way of getting money for his mother?
Nian knows nothing of Santi's crisis, and just as well.
To keep her schoolchildren in clean clothing
and fed, however inadequately, takes all her attention and all her strength.
A note from the teacher, but Nian has forgotten most of her schooling.
[Nian:] [Thai speaking]
[Narrator:] "You'd better read it to me."
[Noya:] [Thai speaking]
[Narrator:] "There is something I must bring to your notice.
Noya is having difficulties with her lessons.
Sometimes she falls asleep in class,
although she says she is not sick.
Perhaps she needs more rest at home and better food.
This could become serious.
Could you come to talk to me about this matter?"
[Narrator:] This is another blow.
Nian hoped that at least one or two of her children could stay in school.
But it is hard to rest at night in the crowded house where the baby's always fretful.
There has never been food enough.
Every new child, there has been less.
Why has she borne so many children?
How can they go on living this way?
How can there be enough food to go around?
[Music]
How different the colors and pungent odors of Boa's kitchen.
Unlike Nian, who never had enough to eat during her pregnancies,
Boa and her daughters ate well and wisely then to protect themselves and their children.
The baby's glossy hair and round cheeks
mean that her family has made a rule of good nutrition.
It would be easy to say, looking at the family of Somsak,
that of course they are happy because they are prosperous.
Rather, it should be said that they are prosperous because Somsak and Boa planned their lives.
If they had had nine children instead of three,
would Somsak have been able to leave the laborer's job,
put his small savings into his own business?
If his young son Sakda had had to share money for food and clothing and education
with eight other brothers and sisters instead of two,
would he now be working at a good trade
and seriously considering keeping that ruby for Chalan?
[Music]
Somsak is a wise and disciplined man.
Not all men can be as wise or disciplined,
but trained practitioners in family health
can supply the advice and support they need.
Somsak's world is one; Santi's is another.
A dark world he shares with Lek and Suin and their kind.
He is small enough to creep through that one unguarded window.
He needs the money he's been promised for the theft.
He is afraid, so he will hide and wait.
[Thai speaking]
[Narrator:] So Sakda is going off to a meeting at the temple.
That may delay matters, but the family will go to bed eventually.
Santi may as well wait. He has nothing else to do,
and he is somehow hypnotized by the scene he is watching.
It is as though he were looking through a window at a different life, an orderly, friendly life.
How different from his own house.
There, the people live almost as though among strangers
without enough light for cheer or comfort,
without smiles or quiet kindness.
But in the house of Somsak, how friendly they are with one another,
and how gentle with the girl who is to have a child.
[Narrator:] Santi waits, sleepy and sad and envious.
[Boa:] [Thai speaking]
[Narrator:] Now what? Is the girl ill?
Is the baby coming?
[Boa:] [Thai speaking]
[Narrator:] "You'd better send for the midwife."
[Somsak:] Singh?
[Narrator:] "Singh? Hey, Singh?"
Where is that boy, Singh?
Somsak's house boy is often absent, usually at inconvenient times.
[Somsak:] [Thai speaking]
[Narrator:] "Here, who's that?
Come here."
[Somsak:] [Thai speaking]
[Narrator:] "Oh, I know you.
What are you doing here, Santi?"
[Somsak:] [Thai speaking]
"Never mind. I need you to do something for me.
You know my son, Sakda? He's at the temple.
Go there and tell him to come home quickly.
His wife is having much pain, and I have to go to the health center to fetch the midwife.
Will you do that right away?
Good.
Go along, now."
[Somsak:] [Thai speaking]
[Narrator:] In a household where love and health and sanity combine, the birth of a child
is a time of gladness, not of fear.
Chalan had a daughter three years ago.
Now she is strong enough to have another child.
A little earlier than in her own calculations,
but she is healthy. All will be well.
A midwife can be a good friend to village women
and much more: healer, counselor, loving sister, strong guide,
and finally, the dispenser of the safe, effective means
which can help them have their babies when they want them.
[Music]
Somsak waits and ponders, thankful that the years of stern self-discipline
and careful planning and hard work have given him this day
a small healthy, happy family.
[Music]
Things are going well enough, the midwife can reassure the anxious young husband and father.
[Music]
So Somsak and Sakda wait together.
It is a close and affectionate family.
The joys and problems of one are the joys and problems of all.
But what is that small figure waiting in the shadows?
He followed Sakda back to the house.
[Narrator:] "Ah, Santi.
Sit down."
[Somsak:] [Thai speaking]
[Narrator:] "Here, have some fruit."
Then, Somsak begins to wonder,
what was Santi doing there across the street in the dark?
[Somsak:] [Thai speaking]
[Narrator:] "Santi, what is this all about?"
[Narrator:] "Well, you see, it happened like this."
[Santi:] [Thai speaking]
[Narrator:] He had planned to do a very bad thing,
and he is deeply sorry.
He begins to talk about his home, his weary mother.
Because Somsak is a compassionate man, he listens.
"It's all finished! It's a boy!"
And because she's a friend in the house, the midwife sits down to rest and chat with Somsak.
"You must be tired.
Is everything all right?"
"Yes, quite all right."
[Thai speaking]
"Well, now I wish you would do something for me.
You see, this boy, Santi.
I think his mother needs your help.
It is the family of Pricha, the fisherman."
[Midwife:] [Thai speaking]
[Narrator:] "Yes. I know this family well.
I wish I'd had training in family planning ten years ago.
I could have helped them.
Too bad the mother is not strong."
[Thai speaking]
[Narrator:] "Yes, I know.
I've decided that I'm going to take the boy into the shop here.
Maybe we'll even send him back to school.
But please don't forget, and send someone to talk to his mother."
[Thai speaking]
[Narrator:] "Yes.
Tomorrow, I'll send a friend of mine to see her.
She's just completed a family health course,
and she understands these problems."
[Narrator:] Santi's mother should have had such a conversation long ago.
If she had waited three years between children,
she and they might be well now.
Nian thinks of her poor children,
her harassed husband, her pitiful house,
and for the first time in a long time, of herself.
And she says, as she might not have said a month ago before her trouble became quite so heavy:
[Nian:] [Thai speaking]
[Narrator:] "We do not want to have any more children."
[Narrator:] And the midwife says simply, "I can help you."
For women such as Nian, two courses are open.
The oral contraceptive pill, which she can take on a regular schedule to avert pregnancy.
Another method and equal preventive,
but which must be inserted by a trained technician,
is a plastic loop.
In either case, they mean no more babies
than can be decently cared for.
To Nian, they may mean at least
a chance to regain her strength.
Santi, too, has a chance because Somsak is an understanding man.
[Music]
It may too late for him ever to grow big and strong
as he might have been if he'd been better nourished as a child.
But at least some use can be made of a good brain and a cheerful spirit.
[Music]
Chalan's son is six weeks old, and they are both well.
Chalan says,
"My husband thinks that now we have a girl and a boy, that's enough.
I would like to come in next week for a loop."
And the midwife smiles.
"Yes, the loop is a good idea.
If you decide later you want to have another baby,
you can simply have it removed.
In family planning, there's a good and basic principle:
have only as many children as you can bring up in health and happiness."
[Wedding band playing music]
A wedding calls together most of the village to take part or to watch.
Even among poor people, a wedding is something to bring out the last hoarded coin
for one happy dramatic expression of confidence in tomorrow.
[Wedding band playing music]
The young people who are to be married have reason for confidence.
They have, as most of their forebearers did not,
a choice in their own future,
a chance, for example, to say how many children they will have
and when they will have them.
It is important to Thailand the welfare of such young people and their offspring be guarded.
They come from the core of national strength.
Rural people, strong-bodied, clear-minded,
capable of contributing to their nation's stability and progress.
The single factor which can determine whether this young girl grows into a strong and happy mother of healthy children
or a withered wraith like Nian may well be the trained midwife.
She knows how to answer anxious questions, to give appropriate advice,
to provide or channel the provision of medications or devices of family planning.
The bride can space her babies so that she will be well and rested enough
to give them the loving care they need.
The groom can ensure that his income will suffice to buy a good education
and a balanced life for his children,
not merely a bare existence with the inevitable neglect of physical wants and spiritual needs.
[Music]
The land is rich and can always be
if it is not burdened by blindness and indifference.
A balance between the land and its people can endure
through all the fruitful seasons to come.
The choice is our own to make.
If we are wise, this golden land will have room and food
and education and work and health
for all whose destiny has caused them to be born Thai,
now and for all the generations to come.
[Music]