Drivers, Facilitators, and Sources of Stigma Among Akha and Lahu Hill Tribe People who used Methamphetamine in Thailand: A Qualitative Approach

Background: The stigma related to drug use has several impacts, including effects on users’ physical and mental health. Methamphetamine is the major drug that is used among hill tribes living in the border areas of Thailand and Myanmar. This study aimed to understand the drivers, facilitators, sources and outcomes of the stigma surrounding drug use, including the expectations among Akha and Lau hill tribe people who use methamphetamine in Thailand.Methods: Qualitative data were used to elicit information from the key informants, members of the hill tribes who used methamphetamine. Questions guild was developed from a literature review and tested for validity before use. In-depth interviews were used to gather information confidentially from the participants in private rooms in villages. Each interview lasted 45 minute, and a thematic analysis was conducted to examine the findings.Results: A total of 46 participants were recruited to provide information; 95.7% were male, and 50.0% were aged between 15-34 years. The majority were married (47.8%), 76.1% were Christian, and 45.7% graduated high school. Six drivers of stigma were detected, being: poor, illiterate, unemployed, working age, female sex, and marital status. Culture and tribe acted as facilitators of the stigma attached to methamphetamine use. Four sources of stigma were found: self, family members, peers, and community members. Three outcomes stigma were determined, poor: physical health, mental health, and relationships with others. There were four levels of expectations: no expectations, expectations for themselves, expectations for their family members, and expectations for their community members.Conclusions: Many personal traits, people living nearby, and socioeconomic factors, including culture and tribes, act as drivers, facilitators, and sources of stigma among hill tribe people who use methamphetamine. A program to reduce methamphetamine use among hill tribes should be implemented, which could eventually minimize stigma.

The Customs of Conquest: Legal Primitivism and British Paramountcy in Northeast India

The discourse around indigeneity, customary rights of possession and claims to political autonomy in Northeast India conventionally traces the postcolonial protectionist legislation for ‘tribes’ to various acts passed under the late colonial state, the most significant precursor being seen as the Government of India Act, 1935. This article will argue that one can in fact trace the ‘original moment’ in the idea of customary law for ‘tribes’ much further back in history, to the early decades of the nineteenth century. This historical moment was anchored in the beginnings of the East India Company’s conquest of the Garo hills in the late eighteenth and early nineteenth centuries, in the appropriation of the land and revenue of the Garos and in the ethnogenesis of the ‘hill Garo’. The article will explore the ways in which the beginning of the invention of customary law and traditional authority in Northeast India under East India Company rule was impelled by the Company’s demands for revenue and was shielded and secured by the deployment of military power across the hills. Over the course of the nineteenth century, the strategies of imperial control first introduced in the region were reproduced across the rest of Northeast India, underscoring the significance of the Garo hills as the first ‘laboratory’ of colonial rule in the region as well as sharpening our understanding of the character of the early colonial state. The article thus takes as its task the historicization of the categories of ‘customary law’, ‘traditional/indigenous authority’ and the ‘hill tribe’, all of which form the basis of late colonial and postcolonial legislation on the ‘tribe’.

Estimation of Optimum Alum Doses of Mountain Water for Water Supply Treatment in Hill Tribe Villages in Chiang Rai Province, Thailand

Hill tribe villages are located in mountainous and remote areas. Primary water supply and drinking water sources are mountain water from a small weir on the mountain. Most mountain waters found turbidity higher than 1 NTU, and water quality was unclean to use and drink. This research applied different concentrations of alum doses to observe turbidity reduction. Optimum alum does apply to reduce turbidity for mountain water samples from Hmong, Karen, Lahu, and Lisu for three seasons. The optimum alum dose is between 20 - 40 mg/l in rainy seasons and 10 – 40 mg/l in summer. The cold season was low optimum alum dose at 10 mg/l for all hill tribe villages. Therefore, alum coagulants can be used to treat the mountain water supply and drinking that can implement the main problem of mountain water in hill tribe village.

Pesticide Spraying and Reduced Cholinesterase Activity among Hill Tribe Farmers in Thailand

Background. Farming is an important occupation in Thai hill tribe communities, which are often remote, and lack other economic opportunities along with basic educational, health care, and occupational health and safety services. Additionally, these communities have a unique culture and language. Objectives. The present study was conducted in northern Thailand to evaluate pesticide exposures and associated health impacts among hill tribe farmers, and to compare them to Thai farmers. Methods. Lahu hill tribe farmers in a mountain community were recruited by public health hospital staff, along with a reference group of lowland Thai farmers. Participants completed a survey on demographic factors and work practices, and blood and urine samples were collected by a trained nurse. Acetylcholinesterase activity (AChE) was quantified to assess pesticide exposure, whereas liver and kidney functions were evaluated using clinical biomarkers. Results. A large fraction (nearly 50%) of Lahu farmers were illiterate and could not speak Thai. Thai farmers worked fewer hours per week (39.4) than did Lahu farmers. Among Lahu farmers, AChE levels were significantly lower (worse) than those of Thai farmers. However, other health outcomes in these populations were similar. Formal education and language skills were not associated with pesticide exposures or health outcomes. Pesticide spraying was found to be a significant predictor of reduced AChE (OR=8.5, 95% CI 1.1–69.6). Conclusions. Pesticide exposures are a significant occupational health hazard among Thai hill tribe farmers. Training, potentially delivered by community health volunteers, is needed to communicate safe pesticide work practices to these farmers. Participant Consent. Obtained Ethics Approval. The study protocol was approved by the Institutional Review Board of Mae Fah Luang University (REH-61080). Competing Interests. The authors declare no competing financial interests.

Learning Innovation of Area-Based Approach to Sustainable Development Goals of Highland Community Resources Management of Social Studies Teachers in the Northern Thailand

The research aimed to study the context of area-based approach learning management and guidelines of area-based approach learning management for sustainable highland community resource management of social studies teachers in the learning center for Thai hill tribe communities in northern Thailand. The method of qualitative research was used. Purposive sampling was conducted to obtain key informants which were social studies teachers of the highland learning center, accounting for 285 people. This area is a development area of the royal project. Learning center for Thai hill tribe communities in northern Thailand have accessed to organize social studies teaching at the basic education level. The tools used in the research consisted of in-depth interviews and focus group discussion recording. Then, content analysis was conducted. From the research result, it was found that the context of area-based approach learning management for sustainable highland community resources management of social studies teachers consisted of: executing the process of area-based management by surveying and collecting village data to be used as knowledge in learning management for pre-school students and students of basic education and the illiterate; developing occupations for the interested group in communities; developing life skills by using the method of coordination with community leaders; building local networks; participating in meeting with the community ;and exchanging information in order to inform people in the community of external exchanges. Regarding the use of area-based knowledge of social studies teachers, they have implemented the knowledge until this has brought about guidelines for promoting community resources management. For example, the community has participatory development plans. The community has networks of natural resources and environmental conservation and citizens have local conscience. Results of sustainable highland development are the fact that the community has strong power in conserving traditions, inheriting tribe cultures, establishing local herbal plants groups to take care of community health. Moreover, there are groups developing local products, building community declarations and regulations for living together in the community peacefully. The guidelines of area-based approach learning management for sustainable highland community resource management of social studies teachers consisted of 5 components which were FPCIL, namely (1) F: Facilitator, (2) P: Participatory assessment and planning, (3) C: Community capital value added, (4) I: Innovation of knowledge and (5) L: Lesson-learned.

Prevalence of and factors associated with depression in the hill tribe population aged 40 years and older in northern Thailand

Background Depression is globally recognized as a major mental health problem in all age categories, particularly among those living in poor economic conditions and with low levels of education, including the hill tribe people in northern Thailand. Methods This cross-sectional study aimed to estimate the prevalence of depression and determine the factors associated with depression in the hill tribe population aged 40 and over in northern Thailand. Hill tribe people who lived in the selected villages and met the inclusion criteria were invited to participate in the study. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection. An interview was conducted in a private and confidential room in the selected villages between January and April 2019. Logistic regression was used to determine the factors associated with depression at a significance level of α = 0.05. Results A total of 601 participants were recruited into the study. More than half (64.23%) were women, 46.76% were Akha, 61.90% were aged 40–59 years, and 76.37% were married. Half of the participants were Christian (57.07%) and had no monthly income (51.25%), and 85% were illiterate. The overall prevalence of depression was 39.10%: 75.74% had mild depression, 17.88% had moderate depression, and 6.38% had severe depression. In the multivariate model, three variables were found to be associated with depression: being female, having a history of substance abuse, and experiencing stress six months prior. Compared to men, women were 2.09 times (95% CI 1.30–3.35) more likely to have depression. Those who had a history of substance abuse were more likely to have depression than those who did not have a history of substance abuse (AOR = 1.97; 95% CI 1.25–3.10). Those who had a history of stress in the prior 6 months were more likely to have depression than those who did not (AOR = 6.43; 95% CI 4.20–9.85). Conclusion Public health screening programs to identify depression in the hill tribe population are urgently needed, particularly for women, those who have abused psychoactive substances, and those who have experienced stress.