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Sugar’s bitter reality
Although data is scarce, experts believe that as many as 7 out of every 50 people in Myanmar’s urban areas have diabetes – an illness which can be fatal if left untreated
SHWE YEE SAW MYINT
poepwintphyu2011@gmail.com

U Hla Myo was diagnosed with Type I diabetes, also known as juvenile diabetes, as a five-year-old and now, at 58, he has Type II diabetes. He can barely see and had to close his business last year after having an operation, which was the result of a complication from the life-long disease. One way diabetes has attacked his body is through his skin. Over the years U Hla Myo has had several operations for skin disease. His body takes much longer to recover from operations than most, because his skin cells take longer to repair and his blood doesn’t clot as it should. “I’ve had the disease since I was five, but I never paid any attention to what I ate and I never exercised,” he said. Type II diabetes is primarily caused by obesity in people with a genetic predisposition to the disease. Diabetes has given him a lot of trouble in his life, he said, and he feels sad for himself, for the fact that he did not take the correct prevention methods even though he knew early in his life that he had the condition. Dr Ko Ko, who is the assistant manager of the Myanmar Diabetes Project, said that after the age of 40, everyone should take a blood test to check for diabetes. However, he said, most people avoid the test because “it can be very difficult for people to accept they might

have diabetes and think it will make more trouble for them if they find out.” Diabetes is believed to be brought on by several factors in addition to a high-fat and high-sugar diet and genetic predisposition. A lack of exercise, fluctuating blood levels, blood pressure and cholesterol are also contributing factors to the onset of the disease. Keeping these factors in balance and close to normal levels, Dr Ko Ko said, can help delay or prevent diabetes and its complications. People who already have the disease need regular monitoring, with insulin treatment continuing indefinitely for many people. In addition, those with diabetes have a higher risk of developing infections should they suffer from other diseases, Dr Ko Ko explained. People with diabetes also have an increased risk of developing a number of serious health problems, affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. Diabetes is also the leading cause of blindness in Myanmar, according to research released this year, Dr Ko Ko said. Myanmar lacks adequate data concerning diabetes, but four regional surveys will be taken in Myanmar in October this year with the support of the World Health Organization (WHO), the Ministry of Health and the National Diabetes Federation, Dr Ko Ko said. According to the statistics from a 2010 Ministry of Health study, estimates show that 6 percent of people in Myanmar between the age of 25 and 70 have diabetes. Figures are higher in the

Consuming excessive amounts of sugar and fat contributes to the onset of diabetes. Photo: Aung Htay Hlaing

cities, where it is estimated that 14 pc of urban dwellers (due to food and life style) are diabetic, with 7 pc of the rural population diagnosed with the disease. The government estimates that 5 million people in the entire country have diabetes, Dr Ko Ko added.

“Western-style fast foods are becoming popular in cities,” Dr Ko Ko said. “We are now seeing obesity in children because they are playing video games every day and eating a lot of fast food.” While a change in diet is contributing to the increase in child obesity, Dr Ko Ko

“We are now seeing obesity in children because they are playing video games every day and eating a lot of fast food.” - Dr Ko Ko
He said there is evidence that the problem is getting worse in both children and adults in Myanmar. He cited a less active lifestyle and a change in diet as contributing to this more recent increase in the prevalence of the disease. said Western food is not the only, nor greatest, factor contributing to the increase in the disease. “Local people also eat a lot of rice, which is also problematic for causing the onset of diabetes,” he said. Rice is full of carbo-

hydrates, which converts to sugar in the blood, he explained. Diabetes is a chronic disease that occurs when the pancreas is no longer able to make insulin or when the body cannot make good use of the insulin it produces. Insulin is a hormone made by the pancreas that acts like a key to let glucose (sugar) from the food we eat, passing from the blood stream into cells in the body to produce energy. Fifty percent of Type II patients risk developing health problems when this happens, he added. “Most diabetes patients cannot afford to treatment because it’s too expensive, particularly when there are complications, such as requiring a kidney transplant or having heart disease,” he said. Ma Khin Lay Kyu lives in Bago Region and she never had a problem with her health until she was in her late 40s: One day she fainted while eating a mango. “I had a fainting attack [known as a “syncope”] after eating a mango, when I was 48 years old. This is the first time I had such a fainting attack and my family didn’t know why it happened. But the doctor said I had diabetes. It was devastating.” After a while, she said, she felt better but as she was unaware of the impact lifestyle has on the condition, she didn’t take any steps to improve her health. It wasn’t until she moved from her village to Yangon that she began seeing a specialist. The damage, however, is irreparable. “I have had three checkups now because my eye-

sight is weakening and I’m always drowsy,” she said. The key to increasing survival rates and reducing complications, said Dr Ko Ko, is to educate the public and bring awareness to people about the symptoms and options for treatment. Doctors in Myanmar have the medicine and knowledge to treat the disease, he said, but they don’t always give out enough information about how to prevent it. One step that has been taken to improve things came when the Department of Endocrinology opened in North Okkalapa General Hospital this past April, which is Myanmar’s first department dedicated to the treatment and prevention of diabetes. But to date, Dr Ko Ko said, the hospital has treated few patients because the public is largely unaware it exists. There are also two groups implementing disease prevention programs for diabetes in Myanmar: the Myanmar Diabetes Project, under the Ministry of Health, and the Myanmar Society of Endocrinology, which is organised by doctors under the Myanmar Medical Association. The Myanmar Diabetes Association is also in the process of registering with the government and it is expected to be launched soon, said Dr Ko Ko. “If we don’t address the issue of prevention among the public, then in the next five years I am certain diabetes rates will escalate,” he said. “So I want to tell people to have regular medical checkups – don’t carry an enemy in your waist.”

HEALTHY LIVING
A Myanmar Times Special Report
Editors: Myo Lwin, Jessica Mudditt Writers: Ei Ei Thu, Shwe Yee Saw Myint, Mya Kay Khine, Mark Sisson, Jessica Mudditt, Zarzar Khin, Sabine Tonkin, Phyo Wai Kyaw, Douglas Long, Christoph Gelsdorf, Phyo Arbidans, Michelle Schaner, Kyaw Zin Hlaing, Aung Kyaw Nyunt For enquiries and feedback: myolwin@myanmartimes.com.mm jess.mudditt@gmail.com Cover & Layout Design: Tin Zaw Htway, Ko Pxyo, Khin Zaw Cover Model: Su Nandar Aung Photographers: Aung Htay Hlaing, Ko Taik, Boothee, Douglas Long, Khin Maung Win, Phyo Wai Kyaw

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An insect hawker on 19th Street in downtown Yangon. Photo: Boothee

Wack Wax
SABINE TONKIN
REMEMBER the old adage, beauty is pain? Instead of a corset or high heels, the 21st century equivalent is the bikini wax. The key to a good bikini wax is an experienced professional with a quick hand. Heat the wax, strip the cloth, apply, pull (wince): no more than 15 minutes and you’re done. At Le Coiffeur, which I recently visited, the motto is slow, steady and sadist. Two very young women entered. The smell of burning wax filled the room. The wax should be hot, but not that hot. Without the use of cloth strips, waxing by an inexperienced young girls went from bad to worse. Two pairs of scissors appeared. Ignoring any prior maintenance to the bikini line, they proceeded to explain that the shorter the hair, the better. On the contrary, hair must grow out a fair bit for the pain to lessen and the waxing to be “clean”. Thirty minutes later, wax continued to pour onto my red, burnt skin. The landscaping was worse than before. Ten minutes later, tweezers: an attempt to individually attack the many tiny hairs missed by the socalled professionals. One more slow pull of the wax and the humiliation and pain were too much to bear. Defeated, the bikini wax was put to an end, and despite the tears of the tortured, only half of the money returned. Forget leaving feeling sexy. To wax or not to wax? Wait for that visa run to Bangkok, ladies. Yangon and Le Coiffeur is not the place.

Insects: the new protein
Regardless of whether you love them or hate them, insects such as those sold on Yangon’s 19th Street may just be the food of the future, says the United Nations
Times, “I feel disgusted by the idea of eating [insects] and therefore I’ve never tried them. I also cannot remember any of my friends eating them.” However, Spanish photographer Juan Gallardo took the plunge while in Yangon and described fried insects as “I like the fried crickets from my native town,” she said. “The taste is different from those sold in Yangon because they are very fresh.” Ma Htwe Htwe said she didn’t know that eating crickets or other insects was a UN-endorsed source of nutrition. She just likes them and eating them with her family when she was young. Don’t like crickets? Don’t worry: They’re not the only edible insect for sale. Even ants can be a good source of protein, Ma Htwe Htwe said. She particularly enjoys a kind of a winged white ant called palu, which has a plumper Myanmar. “Fried crickets are famous here,” Dr Aye Aye Thaw said, “as a way of generating income and jobs by selling insects and also as an additional source of protein.” They’re also low-impact: According to the UNFAO’s report, a cricket requires 12 times less food than a cow does to produce an equivalent amount of protein. Traditional forms of livestock produce a much higher percentage of harmful greenhouse gases, not to mention the large quantities of chemicals often used in raising them that later leech into our food and land. To borrow a saying from another context, that’s just not cricket.

EI EI THU
91.eieithu@gmail.com

THE United Nations doesn’t usually offer restaurant recommendations, but next time you’re tired of the same, its Food and Agriculture Organization (FAO) says it may have just the thing for you in the form of the newest high-protein, high-mineral content, low pollution-causing snack of choice: insects. Whether the advice seems obvious or surprising, of course, depends largely on where in the world you’re living. According to a report published this year by the FAO, more than 2 billion people in the world already look to insects as a nutrition-boosting snack. While the practice may seem repulsive to those from Western countries, those in other parts of the world – including Southeast Asia – see nothing odd about feasting on a handful or two of crunchy critters. Most simply taste like salted crisps, albeit with legs (which seasoned consumers tend to rip off before consumption). “Most of my consumers are Myanmar,” said Ko Zaw Zaw, 26, an insect seller on 20th Street in Latha township. He adds, however, that others are curious too. “Now the Chinese, Indians and foreigners are eating crickets in Yangon.” German expat Tobias Esche told The Myanmar

“A cricket requires 12 times less food than a cow does to produce an equivalent amount of protein.” Food and Agriculture Organisation
“yum”. “I had crickets as snacks with a mojito,” he said. Ko Zaw Zaw said the best time of year for sales is during the winter season from November until January, because the crickets are large and fresh. Unless buying in bulk, 10 crickets will set you back around K1500. Ko Zaw Zaw used to sell king crabs, he said, but they were more expensive and people didn’t buy them as often. Now he makes a whopping K100,000 a day selling about 20,000 crickets, and he’s been in the trade for five years.  “I started selling insects after I saw someone in Yangon selling them. I thought, ‘This work could support my family.’ That’s why I chose it, and I plan to continue doing it.” He added that he buys the crickets that come ready-fried from farms in Mandalay and Mawlamyine, as he considers these to be of superior quality to those in Yangon. Ma Htwe Htwe, 30, agreed that the best crickets come from places other than Myanmar’s biggest city.  – particularly in October around Thadingyut, the festival of lights, when they are cheapest in her home town. Now that she’s living in Yangon, she said, she doesn’t eat them as often, but she has fond memories of catching body and a different taste compared to crickets. Dr Aye Aye Thaw, a retired deputy director and nutrition program manager in Nay Pyi Taw, said the value of eating insects – both nutritional and economic – is well known in

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Live long and practise
Is longevity all in the genes or part of a healthy lifestyle? Reporters Kyaw Zin Hlaing and Aung Kyaw Nyunt hit the streets to find out
Translated by Mya Kay Khine and Thae Thae Htwe

U Maung Gyi 93 years old, North Okkalapa township, Yangon My wife passed away long ago and I have three sons and two daughters. One daughter and one son have passed away. Now I live with my daughter. I used to eat instant noodles but they are salty and I am worried about high blood pressure, so I have boiled vermicelli instead. I don’t smoke or chew betel leaf. My home town is Kyae Mon village in Monywa district. When I lived in Myatpar, Mandalay, I joined the army as a lieutenant under a Japanese commander, Thayet Tha Min, in the northwest command. When the revolution against the Japanese happened, I faced the Japanese forces at Daik-Oo and sustained an injury to my leg. I rolled into the ditch and ran away into the forest. I met with villagers from Kyokyar Myaing village. They sent me to Nat Sin Kon village. From there I reached Tada-Oo and I went to Sin village through Min village monastery and I was finally safe and sound. I retired from Defense in 1960 and then I joined the Defense Services Records Office when I was 60. I haven’t suffered any sickness and I am in good health.

U Khin Maung Maung 96 years old, Ahlone township, Yangon I was a police commissioner and have been retired for 50 years [after taking early retirement]. I played golf until I was 90 years old and I also used to play tennis. I haven’t ever had so much as a drop of alcohol, nor a cigarette. I have been able to live to this age because I keep my moral precepts as a Buddhist. I go to sleep early at 9pm and rise at 5am. I always keep the five precepts. I meditate and count the beads. I also read about golf on the internet. I have written a novel about golf and many articles about sport. I don’t eat meat but I do eat fish and I eat vegetables almost every day. I stay away from sweet or salty foods. Sometimes I drink milk. I have suffered from serious kidney disease for the last 30 years and one of my kidneys has been removed. But I haven’t suffered from any other diseases. I want young people not to follow their five senses excessively but to live moderately. I myself have four children. I want to pass my life living well and living moderately. I don’t obsess over anything. I don’t feel weary mentally. I had stress when I worked in the past, but I solved it by doing meditation. I try to get enough sleep because if I don’t, my body doesn’t feel good – and vice versa. I enjoy performing acts of philanthropy. I donate to Free Funeral Services, a home for the aged and a school for the deaf. I am happy with my family and regularly attend donation ceremonies.

U Kyaw Shein 98 years old, Mawbi township, Yangon Region I was a farmer and retired about 40 years ago. I am single. I was adopted into my family. When they moved to another country, I was left on my own. I’ve never killed an animal and I avoid misdeeds. I want to tell young people to be highly moral: It’s important. I don’t do any significant physical exercise. I am happy here in this home for the elderly. Now that I have grown old, I live according to the doctrine of Buddha. I think I’ve lived this long because I always practise Buddhist meditation.

Daw KV Laxmi 94 years old, Pazundaung township, Yangon I don’t exercise or avoid any foods for health reasons. Since childhood I’ve gone to bed early and woken up early. After getting up, I pay respect to Buddha. I have a bath, apply thick thanakha: As I see it, being beautiful can help a person to stay healthy. I don’t eat out because I don’t like the food sold from roadside stalls. I only eat homemade snacks. I didn’t run my own business but have always done a lot of household chores. I haven’t suffered from any serious diseases – I’ve only ever had common sicknesses. I think I have been able to live until this age thanks to the three gems [Buddha, monks and nuns and teachings]. If I don’t have any work to do, I count the beads [of my rosary] and it helps keep my state of mind positive. I have two children, four grandchildren and three great-grandchildren. I have none of the diseases which happen in old age, such as diabetes or heart disease. My husband died at the age of 80. I have a glass of milk and bread every night. Young people use alcohol and cigarettes and it destroys their health.

Daw Tin May 95 years old, Kyonebyaw, Ayeyarwady Region I was a farmer. I came to Yangon when I was 25, and since then I’ve never been back to my village. I had five children but all have died. Three of my five grandchildren are still alive, and I also have two great-grandchildren. I practise Buddhist meditation and I believe that if I am knowledgeable about the doctrine of Buddha, I will have a good life after I die. When I meditate, I recover from illness quickly. I haven’t had many diseases. I have pains in my knee and my waist sometimes. My hobbies are sewing clothes and arranging flowers. If I can’t sleep in the night, I recite the attributes of Buddha. I wake up at 4am each morning. I avoid mixed salads, beans and sour foods in my diet because they make me ill.

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An immodest price to pay for beauty
ZARZAR KHIN
AFTER weeks of dreary monsoon weather and feeling generally lethargic, the idea of being pampered at a day spa was more than just tempting. At the time, I had been enduring cold showers at home, as many of us living in Myanmar must do. After leaping in and out of a stream of cold water for days on end, I was also feeling that I could do with a more thorough yet relaxing cleansing, so I finally made the decision to outsource my hygiene in full. Choosing a Sunday afternoon at the Inya Day Spa, I booked in for the French Thalgo products “rebalancing” facial (K63,000) and a natural body mask treatment (K40,000). I’ve undergone a facial treatment many times before but it was to be my first body mask so I wasn’t really sure what to expect. Arriving at the spa located on Inya Road (which it’s named after), I walked into a cool, calm sanctuary. The raindrops all of a sudden felt soothing and watching them bounce off the koi fish pond had a hypnotising effect. I skipped the Boost Juice bar where a range of smoothies are offered – mainly because I was so eager to start relaxing. I started out with the body mask treatment, which involved a delicious smelling scrub made of rice, green tea and tamarind – a divine blend. Beware though: This is no time to be shy as I quickly discovPhoto supplied by Inya Day Spa

my arms up, bend my knees and erm, let her rub the paste across my chest. It was a startling moment that broke my reverie, but I quickly tried to get over the embarrassment and remember my mantra to relax. This was just the first round of that

“I was covered for the third time in dark green mud and wrapped like a mummy in cling film.”
ered. Whereas I am used to having massages where the attendant offers a towel to cover up private body parts, the woman slathering me with the rich paste had no qualms about asking me to strip down, lift “thorough” cleanse I had been chasing. After the initial scrubbing down and a shower, I was then covered in a deep moisturising cleanser and then shown into a sauna – which proved to be heavenly. For some

reason, a hot, humid box seemed to be a thousand times more enticing than the hot, humid environment outside. Another shower later and I was covered for the third time in dark green mud and wrapped like a mummy in cling film. While allowing the mud to work its magic, the facial treatment was applied. It was gentle but possibly not as soothing as it could have been because I was trying not to hyperventilate from a short bout of claustrophobia that ensued as my eyes were covered. That being said, I felt like a new woman after the experience. My skin was soft and

supple, I felt like I had just finished a bout of yoga without actually having to move and I’d discovered a newfound sense of empowerment – in Myanmar of all places – of being mature enough to have my breasts massaged by another woman without breaking into giggles. All par for the course, really.
Inya Day Spa is located at 16/2 Inya Road, Yangon. 01 537907 www.inyaspa.com Thaya Day Spa is located: Building 17, 3rd Floor, Junction Square, Yangon. 01 973173973 www.thayaspa.com

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Yangon’s yogis offer deepe
“Health is a state of complete harmony of the body, mind and spirit. When one is free from physical disabilities and mental distractions, the
MICHELLE SCHANER
mschaner@gmail.com

IT’S 6pm on a Wednesday evening and I am rushing through Yangon’s traffic in a taxi. I’m worried that I am late – late for my yoga class, late for my effort to find some peace of mind and tranquility at the end of a stressful day. When we pull up I pay the taxi, check the address on the crumpled piece of paper in my pocket and then make my way down an alley toward an apartment building. I breathe a sigh of relief when I see others with yoga mats under their arms, marching – like me – toward their safe haven. That safe haven is a small, cramped apartment six floors up. Inside, Siu Sue Mark, an international development consultant and yoga teacher from the United States, is rearranging her furniture to prepare for the onslaught of students. We arrive in pairs and alone, lay our mats down and take our places on the living room floor, avoiding the television and furniture now set aside. Initially, some of the other faces show concern – maybe it will be too crowded, awkward, or uncomfortable for a yoga class – but within five minutes the room is focused, all are engaged and the journey into the practice of yoga begins. In many cities around Asia and throughout the world, finding a place to practise yoga is easy. But finding a qualified teacher

Yoga teacher Jenny leading a class. Photo: Aung Htay Hlaing

and studio in Yangon often depends on which email list you belong to and whether you are an English or Myanmar speaker. The good news is Yangon’s yoga scene – like the city itself – has a character all its own, with authentic, dedicated teachers in both languages. Classes may take place in a studio or in a teacher’s cramped, sweaty apartment, and may not adhere to a consistent schedule, but prices are reasonable and students rarely leave dissatisfied. For Ms Mark, the journey into yoga began nine years ago at a fitness centre in

Washington DC. It was not her intention back then to become a “yogini” or female yogi, Ms Mark said. Rather, she was intrigued about yoga’s physical aspects. She

other types of yoga she has tried, she said, it is “more intellectual” and “requires more depth to understand”. In the beginning, she said, her own practice

Yangon’s yoga scene - like the city itself - has a character all its own, with authentic, dedicated teachers in both languages.
began taking classes with a teacher who practised Iyengar yoga, a discipline which focuses on careful poise and mindful breathing. Ms Mark described Iyengar as being “a bit like classical ballet”, integrating anatomy and alignment. Compared with was less disciplined and more about exercise. That changed when she moved overseas seven years ago and started practising every day on her own in her apartment. “Other types of exercise were less accessible to me [overseas],” Ms Mark said. “[Yoga] was something that I incorporated into my daily life. Living in different places with different people, it served to stabilise my mindset … It started to become much more a part

of my life.” When her friends began to ask her for advice about yoga, requesting that she teach a class or two on the side, she started teaching casually, offering classes at her house. After a few years, she felt she did not know enough to teach properly and attended her first teacher training course in the United States in 2010. She said the training made both her teaching and her practice more formal and refined. “Before it was just an open, free service that I did for the community,” she said. “I was just doing what I felt like but didn’t have the fundamentals and good teaching methods. I knew that I enjoyed teaching, but I wanted to do it better.” That same desire to improve is what led Jing Li – “Jenny”, to her stu-

dents in Yangon – to seek out teacher training in China in 2009. After being introduced to yoga as a university student, Ms Li first started daily practice while travelling around Asia with her husband. She too had been informally teaching friends, but one day she had a fateful meeting with one of China’s most famous yoga teachers, a woman named Qu Ying. The two soon became “good friends”, Ms Li said, and Qu Ying encouraged her to go for further training. For six months she studied at the International Yoga School in Beijing, learning the Iyengar philosophy under two Chinese teachers and a teacher from India. When she moved to Yangon with her husband just over a year ago, Ms Li – with the encouragement of her friends and the help of her Myanmar language teacher and her husband – opened a studio of her own. Jenny Yoga is a bright, sunny space in a downtown condominium off Anawratha Road in Chinatown. Ms Li said many of her students are Burmese, but she has a mix of expatriates, mostly Thai, Korean, Chinese and some Japanese students, as well as a few from Western countries. Her classes, often taught in the Myanmar language, are mostly led by Myanmar teachers she has trained. The opposite is true for Ms Mark, whose classes are taught in English and whose students are mainly from Western countries. Ms Mark has a few steady Myanmar patrons, she said, but she would love to have more. But she said she has found many Myanmar people don’t consider yoga a sport and are therefore unaware of its benefits. “It’s abstract,” said Ms Mark. “It’s not meant to be

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er, fuller path to health
gates of the soul open.” – BKS Iyengar, founder of the Iyengar school of yoga
very accessible.” Ms Li said that she has also had difficulty attracting Myanmar students, even though her business is growing and she has a lot of students from other backgrounds. One reason, she said, is that “yoga is not only a sport. It is also an attitude.” “In other countries, people like to train their body,” Ms Li said, “but most [Myanmar people] don’t practise yoga or do other sports.” There are several Myanmar teachers in Yangon who offer yoga classes, but they are somewhat difficult to find. The only listing that can be found through both the internet and the phone book is Jenny Yoga. Classes run by Ms Mark and other expatriates are publicised through email lists or on Facebook. If there are Myanmar teachers offering their own classes, there is no simple way to search for them. Once you’ve found a group of likeminded practitioners, however, you can continue developing no matter your current level. Ms Mark recently went to India to train at the centre of the Iyengar tradition. Ms Li took a trip to China to work more closely with her original teachers. For both women, the additional study, which focused on the spiritual more than the physical aspects of yoga, has profoundly influenced their practice. “Yoga is more about one’s heart,” said Ms Li. “It’s actually not too much about the body.” Ms Li and Ms Mark both said the purpose of teaching yoga, for them, is really about trying to help the student connect with their body and spirit. To do this, it’s important to make beginners feel comfortable. “Everyone comes in at a different level,” Ms Mark said. “I try to give a tone that it’s okay wherever you’re at.” “I let them know I enjoy teaching and let them enjoy practising,” Ms Li agreed. She added that the point of yoga is to “know how to listen to your body and try to understand how it works”. It’s an understanding that benefits students like me – for whom classes are a chance to recentre in the midst of a stressful week – as well as the teachers themselves. “Thoughtfulness gives the aura of mindfulness,” Ms Mark said. “I really enjoy when I can create that”. “Even if they come once a week, and do it a little on their own, it makes me happy.”
For more information, visit “Jenny Yoga” or Sie Sue’s “Yangon Yogis” on Facebook

Breathing deeply is an essential part of yoga. Photo: Aung Htay Hlaing

8

The ‘Asian Paradox’: why rice can be

Health expert and power blogger Mark Sisson explains how it’s possible for Asian populations to consume large amounts of rice without the conseq

Photo: Ko Taik

MARK SISSON
YOU know the French Paradox and how it confounds the experts. To mention all those smug “surrender monkeys” with their brie and their butter and their duck confit and their Gauloises and their seeming imperviousness to heart attacks is to make the physician Dean Ornish binge on bran and pull out tuft after tuft of frizzy hair. And then there’s the lesserknown Israeli Paradox, which attempts to answer why Israelis have skyrocketing rates of heart disease despite a skyrocketing intake of “healthy” omega-6 fatty acids. In its wake, nutrition researcher Walter Willet might be found weeping into a mug of safflower oil. There’s even an American Paradox – those who ate the most saturated fat had the least coronary heart disease – that had the minds of researchers thoroughly boggled. But what about the Asian Paradox? How can people in Asian countries consume so much white rice and so many noodles and remain so thin? If carbohydrates make you fat, how do they eat so many of them? Moving frequently at a slow pace Whenever I’m in a large city with a sizable Asian immigrant popula-

tion, I notice a different approach to walking. For instance, my wife Carrie and I were recently visiting San Francisco’s Golden Gate Park. We spent the day just walking around and getting sort of lost, and we both noticed the difference. Of all the multitudes of people walking, jogging and otherwise being active, everyone but the older Asian folks seemed to be actively exercising. Exercising on purpose. Trying to “burn calories” or “improve VO2 max”. We noticed as a young mother with strollered child power-walked down the path, wearing compression tights, a baseball cap and the latest running shoes, while the elderly

by on a simple 10-speed. I got the distinct impression that walking or cycling or just getting around using your own limbs as the vehicle was simply a way to get from here to there for the older Asian folks. It wasn’t a special occasion. It was an everyday occurrence. It was normal. For everyone else, it was exercise. It was a big event that you had to get geared up and spend money for. Exercise is great, and walking with intent of getting healthier is great – I do it all the time. But my observations speak to a huge cultural difference between the way older Asian folks who immigrated over (and, presumably, the cultures back at home) and Americans treat

better mood, lowered blood pressure and triglycerides, and greater longevity.  America is a car country, and has been for about 100 years. We don’t – and haven’t for over 50 years – have to walk to get around. Heck, oftentimes we can’t walk to get where we want to go even if we wanted to walk, since many of us live in a kind of suburban sprawl that requires the use of cars just to buy groceries or take the kids to school. The result is a country that takes fewer steps per day than the rest of the world. As Asians start buying more cars, relying more on vehicular transportation and moving further away from labourintensive work, I suspect you’ll see

more than in Western nations, but the downward trend is clear. The same study found the proportion of overweight children also increased by the year 2000. An otherwise unprocessed, nutritious diet Traditional Asian food is highly nutritious. Go to a Vietnamese noodle house and the signature dish is pho, a big bowl of homemade beef marrow bone broth, tripe, tendons, brisket and rice noodles. Go to a real Thai restaurant and get bone broth soup with cubes of pork blood, greens, rice noodles and a duck egg. Go to a Chinese restaurant and get sautéed (alas, in soybean or corn oil these days) pork kidneys with Chinese broccoli and rice on the side. Go to a Japanese restaurant and get wild caught salmon eggs rolled with seaweed and rice, mackerel sashimi and some fermented miso soup with kelp strips. Go to a Korean barbecue and eat a dozen different kinds of kimchi, grilled short ribs, beef tongue and liver all wrapped in lettuce, with rice on the side. In all these foods, rice is present, but so are real bone broth, fresh meat, fermented cabbage, offal and vegetables. The presence of rice does not invalidate or negate the presence of every other nutrient. Of course, that’s restaurant food.

You can’t reduce a diet down to a single constituent food.
Chinese grandma she passed wore some Keds and a knit sweater. Two seemingly identical joggers with Bluetooth earpieces jabbed at each other with business-speak opposite a pair of old friends strolling along and loudly speaking (in another language) of politics and times long past (again, it was another language) in well-worn suits and loafers. A group of cyclists could have passed for pros with all their gear and advertisements and special cycling shoes, while an older Asian gentleman wearing a collared shirt and slacks cruised moving frequently at a slow pace. People living in Asian countries have historically been more active than people living in the United States. It’s not that they’re all lifting weights and running sprints and joining gyms; it’s that their average daily activity levels are higher. And as everyone probably already knows, the simple act of walking on a regular basis does wonders for one’s health. Daily walking is consistently associated with (among other health benefits) improved insulin sensitivity (better tolerance of carbohydrates like white rice), more carbohydrate intolerance, fat gain and general ill health begin to emerge. It’s already happening, as you’ll see. I think daily activity levels are probably the biggest determinant in tolerance to carbs. In American cities where walking is required or more convenient than driving, like New York, people are generally healthier, slimmer and longerlived. Things are changing, though. In 1989, 65 percent of Chinese performed heavy labour on a daily basis. By 2000, that proportion had dropped to 50pc – still far

9

nice for the Asian waistline
If you want to get an idea of how Asian folks cook at home, go to their supermarkets and note what people are buying. It’s not as fancy or flavourful, but it’s just as nutritious. Stand by the register and you’ll see 20 kinds of whole fish; live oysters, mussels, clams, crabs, snails and sea urchins; a pig’s entire digestive tract; buckets of chicken feet; bags full of strange leafy green things and exotic vegetables like bitter melon; all sorts of herbs, roots and teas; fermented, pickled foods; a dozen different kinds of root vegetable; and yes, rice. If you want to isolate the rice from that list of nutrient-dense offerings and say “What about that?” be my guest, but not me. I’ll be admiring the handsome beef foot oozing collagen and marrow and imagining all the wonderful dishes it could make (while I mentally compare the contents of shopping carts in Asian markets to the contents of shopping carts in standard American grocery stores … guess who wins). Until recently, Asians ate less refined sugar and used animal fats for cooking. Sugar intake is rising now, of course, and cooking oils made from corn and soybean have largely replaced lard and tallow, but rice in the context of a low-sugar, no-high-fructose corn syrup, low-vegetable oil, nose-totail nutrient-dense diet is (or was) acceptable. You can’t reduce a food down to its constituent parts and focus on, say, the bit of fructose in a blueberry and then condemn the entire berry because of it. Similarly, you can’t reduce a diet down to a single constituent food and condemn – or praise – it based on that single food. You have to look at the entire picture, and the Asian diet is largely a nutritious one. More rice, less wheat Thanks to regular monsoons, 90pc of the world’s rice production is located in Asia. It’s been cultivated in the region for close to 10,000 years, so the region’s occupants tend to eat a fair amount of the stuff. Luckily for them, rice, especially white rice (the favoured type across most of Asia; as a Thai friend of mine who grew up there and came to Hollywood in the 60s told me, “rice bran was for the chickens”), is a mostly non-toxic source of glucose. On the grain spectrum, where wheat and other gluten grains reside at one end, rice relaxes at the opposite end. It’s not “good”, but it’s also not “bad”. It just is. It’s pretty much neutral. Whether you can handle (or need) the glucose load is another thing, but you can rest assured that white rice will be generally free of gut irritants, phytic acid and deleterious lectins. If you’re eating wheat, on the other hand, you have gluten, wheat germ agglutinin and a host of other anti-nutrients with which to contend. And, as Ned Kock has posted online in a masterful (and under-appreciated) series of stats posts on the China study data, rice intake is associated with a reduction in cardiovascular disease while wheat flour intake is associated with an increase in cardiovascular disease. The upper level of rice intake did correlate with a slight increase in coronary heart disease, however, but not a major one. All else being equal, people will be healthier on a rice-heavy junk food diet than on a wheat-heavy junk food diet. Is Asia even all that much healthier anymore? Healthy, long-lived Asia isn’t so healthy and long-lived. Both China and India are facing diabetes epidemics. In Taiwan, Korea, Vietnam and Thailand, diabetes is also increasing. The perfect storm – of sedentary living, processed junk food full of carbs and bad fats, and poor sleep – that has ravaged America and other industrialised nations for almost a century and led to a host of debilitating illnesses is beginning to descend upon Asia. Cooking oils have displaced traditional animal fats and sugar intake is rising. People walk less and eat more wheat. Even the low body mass indexes (BMIs) of Asian countries are misleading. At equal BMIs, Asians generally have more body fat than other groups. So, on average, the American or the Pacific Islander with a BMI of 25 has less body fat than the Chinese guy with a BMI of 25. It’s not clear whether these higher body fat levels (at lower BMIs) correspond to increased risks for certain diseases, but it does suggest that BMI is an unreliable barometer for a country’s leanness on a particular diet. You can be skinny-fat with a low BMI – and it appears that significant numbers of Asians with low BMIs fit that profile. So, like every other one before it, the Asian Paradox topples: There is actually no paradox. Asian countries remain lean (if they’re actually lean, that is) on a rice-heavy diet by virtue of lots of low-level aerobic activity to promote insulin sensitivity, lots of nutrient-dense food to go with that rice and because rice is the least offensive grain.
Mark Sisson is the author of Primal Blueprint and the publisher of marksdailyapple.com

quence of weight gain, but cautions that changing lifestyles could be a game changer

10

From longyi to lycra: women’s bo
Female bodybuilders in Myanmar have overcome social prejudice and gone on to achieve international success in a sport that takes healthy living
petitions.” That all changed in 2009, when the federation changed its name – to the Myanmar Bodybuilding and Physique Sports Federation – and its rules, allowing women to show their muscles as well. That same year, the World Bodybuilding and Physique Sports Federation was founded, with the approval of the International Olympic Committee, and women bodybuilders at last had a venue to display their skills. “After the World Bodybuilding and Physique Sports Federation was founded ... female athletes were granted a special category,” said U Hla Myint Swe. “Miss Universe and Miss World are assessed on beauty, talent and action [while] the current competition marks bodybuilding, a lack of body fat and sports sections.” The change was dramatic for Myanmar entrants. Although U Hla Myint Swe said that competitors from the previous competitions, who competed wearing a longyi, can’t compete in new competitions, it nevertheless brought a measure of equality to the sport, with women now showing their physiques in front, left, right and back poses just as the men do.

MYA KAY KHINE
mya.simplefly@gmail.com

THE popularity of bodybuilding in Myanmar waned in the 1970s but is now regaining strength, which is in no small part due to the recent success of its female athletes. Before 1948, bodybuilding competitions were held under the Myanmar Bodybuilding and Weightlifting Federation, which allowed women to participate in two-piece clothing. Following independence, men were allowed to carry on weightlifting but women were barred from doing so. In 1990, the federation founded the Myanmar Bodybuilding and Physical Beauty Contest. Male athletes showed off their muscles, while female athletes, wearing longyis, were confined to showing off their physique, which was deemed to be more in keeping with Myanmar traditions. “For a long time it wasn’t considered a sport,” said U Hla Myint Swe, the federation’s president. “So contestants competed wearing longyis but were therefore unable couldn’t break into international com-

Aye Aye Soe is pictured onstage, third from left. Photo supplied by Myanmar Bodybuilding and Physique Sport Federation

There are two kinds of competition for women, he said. In Athletic Physique, competitors are judged on low body fat, bodybuilding and muscles. In Model Physique, competitors are judged on body proportions, low body fat and bodybuilding. “I started this sport after high school,” said 24-year-

Myanmar wasn’t expected to win a prize at the 46th Asian Bodybuilding and Physique Sports Competition, which was held in Bangkok, Thailand, in September 2012, but Aye Aye Soe walked away with a bronze medal. Three months later, she also won sixth place in her category at the 4th World Bodybuild-

“This sport carves your body like wood.”
- Aye Aye Soe

old Aye Aye Soe, one of Myanmar’s top bodybuilders. “Now I have been doing it for seven years and I’m addicted to it.” She said she was drawn to bodybuilding because she admired the fit appearance of the female actresses she saw in foreign movies. At that time, female bodybuilding was far from being a popular pursuit in Myanmar, and she faced resistance from her family and friends. But her trainer encouraged her to continue, telling her that her struggle would be acknowledged one day. When women’s bodybuilding became a sport in Myanmar, she started entering competitions. Her efforts paid off.
From left to right: Aye Aye Soe, Nan Htet Htet Lin and Khaw Win. Photo: Aung Htay Hlaing

ing and Physique Sports competition, which took place in Bangkok. After winning a silver medal on June 27 at Yangon’s Olympic Day Bodybuilding and Physique Sports Competition, Aye Aye Soe and two other medal-winners will go on to compete at the next Asian Bodybuilding and Physique Sports Competition, to be held at the end of August in Vietnam. She has taken leave from her job as a personal trainer at Yangon’s Sedona Hotel to focus on her training. “I very much hope to [succeed] in Vietnam so I’ve left my job for three months and I am training hard,” she said, adding, “This sport carves your body like wood.”

The first-place finisher in Yangon, Nan Htet Htet Lin from Kayan State, will also be heading to Vietnam. She’s a third-year physics student at the University of Hpa-an and has been active in the sport for a year. “My relatives said I was slim,” she said. “So I worked out at the gym to bulk up and the trainers encouraged me.” She works out twice a day each day, for one-and-a-half or two hours each session. “I start working on my waist and stomach at 8am. I take a rest in the afternoon because I’m naturally slim – people who are slim should sleep in the afternoon – and then restart, working my upper body and lower body in the evening.” Khaw Win said people are becoming more interested in sports lately, especially those in Yangon who are sitting all day long in offices and feel the need for a healthy outlet. Her fellow bodybuilder, Khaw Win, 27, from Kyitkyina, got into the sport for exactly this reason. She has been active in sports since her childhood and won prizes as a sprinter. When she moved to Yangon in 2009,

11

odybuilding
to its extreme
emphasise sport, so this is good for all women.” Daw Nwe Ni Win said those who work out are able to eat more because they need – and can burn – the calories as part of their training. Those who stop going to the gym, however, often do not adjust their diet, and many end up putting weight on very quickly. “If someone goes to the gym for beauty, they tend to stop after three and four months. But if someone goes to the gym for sport, especially elder people, they must work out continuously” to avoid putting weight back on, she said. She said that adjusting competitors’ diets should take six months to a year, but there’s not much time before the upcoming Asian competition. While she said women don’t need to control their diet as much as male athletes do, because men need to eat more in order to bulk up. Nonetheless, a lot of planning goes into what female bodybuilders eat. The diet is high in protein – chicken, beef, goat – all boiled and without so much as a trace of oil. MSG is strictly avoided, and fish is steamed. Also, she says, it’s important to eat eggs – lots and lots of eggs. “I feed them seven to ten eggs [each day],” Daw Nwe Ni Win said. “Not yolks, only egg whites.” Daw Ye Ye Win, 62, is also helping to prepare the athletes for competition. She’s a trainer for the Myanmar Bodybuilding and Physique Sports Federation, but she also holds a referee certificate, after the federation sent her to study the Asian competition. She also acts as a trainer for the Yangon Sport Department, as well as volunteering for NGOs. The difference between athletes at the world competitions, she said, is that Myanmar athletes have less pronounced muscle lines, while the European women, who have been training for over ten years, have muscles like the men’s. But Myanmar’s female athletes, she added, have had to overcome difficulties those from other countries haven’t, which is why their strong start has her feeling optimistic for the future. “First, we struggled to change from wearing longyis to Lycra shorts,” she said, but “officials allowed it and approved bodybuilding as a sport. “I believe the future of this sport will burn bright.”

Photo supplied by Myanmar Bodybuilding and Physique Sport Federation

however, she found that her job as a designer required her to be sitting down all day long. She started working out at the gym, then began competing as a bodybuilder. She took a bronze at the Olympic Day competition and will also be heading to Vietnam later in the month. “I worked with a trainer closely for 8 months,” Khaw Win said. “Each day, I work out for up to four hours. As the competition nears, I work out the whole day.” Women in Yangon can choose between two types of gym, either female-only or co-ed. Daw Nwe Ni Win is the owner of Top One Female Special Gym, which is just for women. She held the title of Miss Myanmar in 1995 and currently serves as an executive of the Myanmar Bodybuilding and Physique Sports Federation. She said the desired lack of body fat has been a constant since she competed, but she’s also seen a change in the competition. “The competitions in 1995 were really different from current competitions. At that time, competitions emphasised beauty, tradition and femininity,” she said. “Now, competitions

12

1

Gym bunny 101
4

2

Model: Su Nandar Aung Photos: Aung Htay Hlaing REGULAR exercise keeps a person in the best possible mental and physical shape. The Myanmar Times met with Vasurat Yaban Peang (John), a fitness trainer at Real Fitness gym in Bahan township. He provided the following tips for an ideal workout following a 10-15 minute warm-up: Walking or jogging on the treadmill (1) and using an exercise bike (2) are ideal forms of aerobic and cardiovascular activity. Cardio is important for improving lung capacity and keeping the heart strong. John said that although it’s not strictly necessary to work up a sweat in order to lose weight, you should aim to raise your heart rate (the maximum heart rate is calculated by subtracting your age from 220). As a guide, if you can chat away on your mobile phone while doing cardio activity, you’re not working out hard enough. John said the treadmill in particular is great because it uses every muscle: “If you run for more than 20 minutes, your shoulders start getting a workout,” he said. On the other hand, exercise bikes and other cross-training equipment are better suited for people with ankle, back or joint injuries, because it’s a lower impact exercise. Free weights (3) and strength resistance training (4) and (5) are aimed at improving muscle strength. Build up the number of repetitions slowly so as not to cause injury. The benefit of this type of regular exercise is a trim and toned body. John’s tips: • If you feel dizzy at any point during your workout, take a break and do some stretching. • After exercising for 20 minutes, be sure to drink plenty of water to avoid dehydration. • Consult a doctor before embarking on an exercise regime if you are aged 45 years or above. Real Fitness - 20 Pearl St, Bahan www.realfitness.com +95 9 420165094

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3

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Who says healthy must be bland?
PHYO ARBIDANS
phyo.arbidans@gmail.com

 

The Myanmar Times’ resident chef provides two chicken salads with flavours inspired by regional neighbours that are guaranteed to put some added zing into your menu
Indian spice with Myanmar salad to create a hot, sour, salty dish that’s bound to be popular with all your guests. While most cooks would traditionally use all parts of the chicken in the salad – feet, wings, neck and thigh bones, skin liver and giblets, all cut up into bite-sized pieces – and it can be fun to crack through all the bones if you’re used to it, others might prefer less muss and fuss. This recipe doesn’t skimp on authenticity, but it does use boneless chicken breasts instead, making it a more accessible introduction to Myanmar cuisine for visitors. Ingredients For the salad 500 grams boneless chicken breast fillets  2/3 teaspoon turmeric powder 2 teaspoons salt 2 onions, sliced 1 cup fresh mint leaves 1 cup fresh coriander leaves 200 grams cabbage  For the gravy 1 tablespoon chickpea powder, roasted 1½ cups cold water ½ teaspoon vegetable oil ½ onion, sliced ½ teaspoon salt for taste For the mix 3 tablespoons lime juice 3½ tablespoons fish sauce 1½ tablespoons soy sauce 1 large red chilli, chopped 1½ teaspoons masala Preparation Wash the boneless chicken breast fillets and drain well. Marinate the chicken in a mix of turmeric powder and salt for 30 minutes.   Then arrange the chicken breasts in a pot and add enough cold water to just cover them. Heat gently until water boils then turn down heat. Simmer the chicken, turning once, for 10-15 minutes or until cooked through. Drain, remove from pot and let cool. Shred into small pieces and set aside. Slice the onions. Chop the mints and coriander. Slice the cabbage, discarding the hard cores. To prepare the gravy, slowly add roasted chickpea powder into cold water, mixing as you go until there are no lumps remaining. Then heat vegetable oil in a pot over medium heat, add the onions and sauté for few minutes. Then add the chickpea-powder-and-water mixture into the pot. Heat until boiling then simmer for 10 minutes. The mixture should be kept a bit runny: You don’t want it to thicken. If you need to add water, don’t use more than a ½ cup. You should end up with at least 1 cup of gravy.  Combine shredded chicken, chickpea gravy, herbs, lime juice, fish sauce, soy sauce and chopped-up chilli in a large bowl and mix well. Taste the mixture: If you prefer a saltier taste, add more fish sauce. For extra sourness, add more lime juice. Serve with extra chopped onions and lime wedges on the side.  

Indian-style chicken salad (Serves 6)
HERE’s a dish that might be described as an IndianMyanmar fusion: It combines

Phyo’s quick tip I use Hmwe-brand roasted chickpea powder and Kalalay masala, which can be found in supermarkets or wet markets.

Vietnamese-style chicken salad (Serves 6)
THIS Vietnamese-style chicken salad is made with fresh herbs and spiced poached chicken. The aroma of star anise will tickle the appetite and the sweet-andsour dressing will spark the taste buds. It’s quick and easy to prepare as well as healthy to eat: With fresh herbs and oil-free chicken, meals like this are sure to keep you in fine form. The dish is high in protein but low in fat, so if you’re on a diet, it will help you control your weight. Best of all, it’s versatile, and works well for snacks, lunch or dinner. Ingredients For the meal 500 grams boneless chicken breast fillets 2 cloves 2 star anise 4 spring onions, white parts only 100 grams bean sprouts 2/3 cup fresh mint leaves 1 cup fresh coriander leaves 2/3 cup fresh Vietnamese or Thai basil leaves 1 large cucumber 2 carrots 500 grams Chinese cabbage (roughly half a medium-sized Chinese cabbage) ½ cup roasted salted peanuts, crushed For the dressing 1/3 cup lime juice 1/3 cup fish sauce 4 small red chillies, deseeded and finely chopped 2 tablespoons brown sugar Preparation Wash the boneless chicken breasts and drain them well. In a pot, arrange the chicken breasts with cloves and star anise and add just enough cold water to cover them. Boil gently till bubbling, then turn down heat. Simmer the chicken, turning once, for 10-15 minutes or until cooked through. Drain, discard spices, and let the chicken cool down before shredding. Cut the whites of the spring onions diagonally into small pieces. Trim the bean sprouts and finely chop the herb leaves. Cut the cucumber in half lengthwise and discard the seeds, then julienne (cut into short, thin strips). Peel the carrots and julienne as well. Slice the Chinese cabbage leaves only, discarding the hard parts (or saving them for another dish). Mix the ingredients for the dressing by combining them in a jar and shaking well. In a large bowl, add chicken, herbs, peanuts and dressing. Toss well just before serving.

15

Untying the knots: the benefits of traditional Myanmar massage
JESSICA MUDDITT
jess.mudditt@gmail.com

FOLLOWING ankle surgery in February, Mandy (not her real name) was unable to walk for four months. Even afterward, she fell flat on her face the first time she attempted to jog. After two sessions of traditional Myanmar massage, however, Mandy said the benefits are already apparent. “It’s not that physiotherapy hadn’t worked for me, but in the United States it’s prohibitively expensive. I was busy and lazy so I wasn’t doing my exercises at home either,” she said. Mandy stresses that Burmese traditional massage isn’t designed with relaxation in mind, though that can be an additional benefit. “It’s a treatment, a no-frills experience,” she explained. “You don’t need the candles and the music and you’re highly unlikely to fall asleep.” Her practitioner is Ko Min Min Soe, whose knowledge about the therapy was passed down to him from his grandfather, who was a professional masseur. “In Burmese culture it’s traditional for a parent or grandparent to ask their children to tend to their aches and pains by giving them a massage,” he said. “That’s how my interest in it began. My grandfather taught me everything I know.” Ko Min Min Soe’s grandfather’s own mentor was a monk, who had himself spent several years in India studying traditional medicine and subsequently combined this knowledge with Chinese massage skills to develop a unique form of traditional Myanmar massage. According to Ko Min Min Soe, traditional Burmese massage predates Buddhism. He added that the Pali word for “masseuse” is listed along with other members of royal palace households in Myanmar. The hand massage treatment doesn’t require oils and focuses on the body’s multitude of pressure points – pressure is applied for an extended period before release, when the renewed blood-flow creates a warm sensation where the pressure was applied. It’s not out-

right painful, but it’s not for wimps either: The sensation can be somewhatdisconcerting, depending on your level of sensitivity. With a skilled practitioner, however, it can be invigorating. Mandy said, “[Ko Min Min Soe] is very intuitive with his hands – he im-

builds up, and are thus always an important part of administering traditional Burmese massage. Ko Min Min Soe also prescribes home exercises to maintain suppleness and overall health in between visits. However, it isn’t necessary to be suffering from a physi-

Myanmar traditional massage at Yangon Home Stay. Photo: Aldrich Sawbwa

and sleeping better than before. Ko Min Min Soe said the only time it would be counterproductive to have a

“My grandfather taught me everything I know.” - Ko Min Min Soe
mediately knows where the problem lies.” The massages have been so successful that she intends on making them a weekly regimen. Ko Min Min Soe has teamed up with the owner of Yangon Home Stay, Aldrich Sawbwa, and two months ago they began offering traditional massage services to the public three times a week. A one-hour session costs K15,000; for K20,000, it’s possible to have warm herbs in a bulb-shaped sack incorporated, to speed recovery from injuries. By day, Ko Min Min Soe works as a driver – although he said he’d gladly make the switch to being a full-time masseuse if he could. First, though, he has to think of family finances. He said going full-time would be “like opening a shop – I could have 10 customers one day and then one on another. I need to support my wife and children.” Until the situation changes, Ko Min Min Soe administers treatments twice weekly in a gym at 9 Mile and at Yangon Home Stay on 16th Street in Chinatown on Sundays. Aldrich told The Myanmar Times, “I’m a personal trainer and I also play a lot of sport, so I get injured frequently. Burmese traditional massage is very popular among locals but I thought it would be good to introduce it to expats.” The feedback so far has been positive. One person, a 38-year-old furniture mover, responded to a post on Yangon Expat Connection by declaring it “better than physio”. “Before the treatment I felt pain every time I turned around,” he wrote, after a session with Ko Min Min Soe. “Now it’s gone. I definitely recommend it.” Ko Min Min Soe said of the patient, “The pain was in his back but the treatment doesn’t focus on the problem spot alone.” He explained that the soles of the feet are where tension in the body cal ailment to benefit from Ko Min Min Soe’s magic. A session will reduce stress as well as improve blood circulation, which leaves a person feeling refreshed, energised traditional Myanmar massage is if someone is suffering from internal injuries. When asked for how long he can keep massaging patients before getting weary,

he responded by saying that it depends on the needs of the individual. “Some people require more energy, such as those who are in rehabilitation after a stroke, or suffer from serious scar tissue.” Does the masseur enjoy a massage himself? His answer was somewhat ambivalent: “It feels ticklish,” he said with a laugh.

To book a traditional Myanmar massage with Ko Min Min Soe, call Aldrich Sawbwa on 09420280430, email aldrich@fitnesswharf.com or visit www.facebook. com/burmesemassage

16

Mountain biking adventures made easy
Mini getaways from Yangon by Bike World Explores Myanmar offer offbeat adventures on a Sunday afternoon
DOUGLAS LONG
dlong125@gmail.com

NEITHER of us paid much attention to the bullock cart parked in the middle of the trail. It sat as if abandoned, with neither driver nor cows anywhere to be seen, so we simply pedalled past and continued down the narrow dirt path on our mountain bikes. A few minutes later our two-way radio crackled to life. My cycling companion – Australian Jeff Parry, a longtime resident of Yangon – was carrying the device in the back pocket of his cycling jersey. The other radio was in the hands of a group of Myanmar cyclists with whom we were exploring the hilly terrain around Nga Su Taung village, about 40 kilometres (25 miles) north of Yangon. We pulled over to answer the call. The other riders were somewhere behind us, and their shouted message wasn’t entirely clear through the radio static. We could only make out a few disjointed words – “elephant”, “hunting” and “come back” among them – which were enough to prompt us to turn around and hightail it out of there. Turns out the cart had been parked on the path for a reason: It had been intended as a warning against proceeding farther down the trail. A farmer had seen me and Parry fly past on our bikes and had flagged down the following riders to tell them that heavily armed soldiers were

tramping through the brush up ahead, hunting a wild elephant that had, over the course of the past few weeks, trampled several villagers to death. Needless to say, we spent the rest of the day exploring in other directions. The elephant incident occurred in 2006, when local cyclists had just discovered Nga Su Taung and its environs. Since then, the area’s dirt roads and pathways have been thoroughly explored by mountain bikers, and a handful of safe but challenging routes have been mapped out for riders to follow. Nga Su Taung might

The rides attract cyclists of widely varying abilities, from shaky first-timers to iron-thighed veterans.
sound like a remote destination, but it can be easily reached by joining the cyclists who visit the area every Sunday morning. The excursions start at 6:30am, when a light truck loaded with riders and their bikes departs from the headquarters of local travel company Bike World Explores Myanmar (BWEM). The drive takes a bit more than an hour, and the cyclists usually eat a light breakfast (fried rice or mohinga) in the village. The riding start around 8:30am and lasts for about three hours, followed by some casual time back in the village, which usually involves drinking local beer and trading stories about the ride. Arrival time back in Yangon is 2pm to 3pm.

Typical rides are about 25 kilometres (15 miles) on dirt roads and trails, through terrain that offers challenges but not overwhelming obstacles. There are some hills, and a few of them are quite steep, but they’re also short. Even for those who need to dismount and walk, it never takes too long to get to the top. Likewise, downhill sections aren’t too technical, so advanced mountain biking skills are not required. Seasonal changes bring their own unique challenges: During the dry season, sections of the trail can be sandy, while the monsoon introduces mud, water crossings and rutted roads into the mix. Trail conditions are best just after the rainy season ends, in November and December. The rides attract cyclists of widely varying abilities, from shaky first-timers to iron-thighed veterans. But there are frequent stops to regroup, so slower riders never fall too far behind. An experienced guide brings up the rear to make sure no one goes astray and to help those who might experience mechanical problems such as a flat tyre. Of course, mountain biking around Nga Su Taung brings the same health benefits as cycling anywhere: It’s a low-impact exercise that increases cardiovascular fitness, builds strength and muscle tone, boosts stamina and burns loads of calories. According to the website of the Australian government’s Better Health Channel (betterhealth.vic.gov.au), cycling “is one of the best ways to reduce your risk of health problems such as

A cyclist crosses a footbridge in Nga Su Taung. Photo: Douglas Long

Sunday cycling trips offer mini adventures away from the stresses of a Yangon working week.

stroke, heart attack, some cancers, depression, diabetes, obesity and arthritis”. Among other statistics, the website cites a Danish study conducted over 14 years with 30,000 people aged 20 to 93 years, which found that regular cycling protects people from heart disease. In addition to the health benefits of cycling, simply getting out of Yangon for

a few hours constitutes a mini adventure holiday and therefore helps relieve stress accumulated during the work week. It’s a great excuse to focus on something other than the pressures of day-to-day life, and allows participants to enjoy the weather, breathe fresh country air, commune with nature and come into close contact with traditional vil-

lage life in Myanmar. Parry, a technical consultant for BWEM and the organiser of the Sunday rides, says the latter point about observing rural lifestyle is one of the biggest attractions for cyclists who are visiting from outside of Myanmar. (About 80 percent of the riders are locals and expats living in Myanmar, while 20pc are

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Riders return to Nga Su Taung at the end of a 25 kilometre ride. Photo: Douglas Long

Photo: Khin Maung Win

tourists.) “Many tourists say they saw more and learned more about the rural Myanmar lifestyle during the Sunday bike ride than by doing touristy things around the country,” he says. “They can see water buffalo at work, kids riding water buffalo, rubber production, a cashew nut plantation and more.”

This enthusiasm is reflected in the many fourand five-star ratings the rides have earned on Trip Advisor (www.tripadvisor.com), where they are ranked second on a list of 22 things to do in Yangon. The reviews are enthusiastic. Typical examples: “The Sunday group ride was a great opportunity to meet other bikers and view some off-the-beaten-path sites near Yangon,” writes Adam M. from Beijing. Lorraine P. from Australia says that mountain biking is not something she would normally do, but adds she was glad she went on the ride: “Went through some great countryside; saw rubber-making from scratch; the local school supported by BWEM, and will never forget the small children running out everywhere shouting ‘Mingelabar’ [sic] as we passed by.” Her quote refers to an added bonus of the Sunday rides: The cycling group supports a rural school run by a Buddhist monk, which teaches about 60 students from first through seventh standard. With the money raised, the school has been able to hire a full-time teacher, provide educational materials for the students and pay school fees for kids who cannot afford them. “The funds are raised through donations from the cyclists,” says Parry. “Some tourists have given as much as $100, and one Swiss man donated K600,000 just before he left Myanmar rather

than changing it back to foreign currency. One rider with connections to a local shoe factory gave slippers to all the children.” As already mentioned, following the ride, the cyclists get the chance to relax and enjoy beer or soft drinks before heading back to the city. Everyone will have a story to tell about their mountain biking experience. It might not be as dramatic as accidentally wandering into an elephant-hunting zone, but it’s guaranteed to be memorable.

Bike World Explores Myanmar is located on 10F Khabaung Road, off Pyay Road at 6-Mile, Hlaing township, or phone +95-1 527-636 or 527-109. The fee to participate is K20,000 a person if two or three cyclists join the ride, and K10,000 if the group numbers four or more. (Rides during monsoon typically attract half a dozen riders, while the dry season sees the number increase to 10 or more.) The fee includes breakfast, transport, guide, mechanical assistance, helmets and water. Those who don’t have their own mountain bike can rent one for K20,000.

18

120 years young
She could be the world’s oldest person, but Daw Mya Kyi remains youthful at heart
PHYO WAI KYAW
pwkyaw@gmail.com

PEOPLE used to pray that they would “live long until 120” but few expect these prayers to actually come true. For one woman in Mandalay Region, however, that’s what’s happened. According to her identity card, Daw Mya Kyi will be turning 121 this October. If that number could be verified by officials from Guinness World Records, it would make her a half-decade older than the woman currently listed as the world’s oldest person, Misao Okawa from Japan, who compared to Daw Mya Kyi is but a spritely 115. In fact, it would put her only a year and a half behind the oldest verified person ever, 122-year-old Frenchwoman Jeanne Calment, who died in 1997. As yet, however, no attempts have been made to have Daw Mya Kyi’s name listed in the Guinness book. To those who know her, though, she is already a treasure. It is about one-and-a-half hours by motorcycle from downtown Mandalay to Daw Mya Kyi’s home in Pauk Chaing Kone village in Amarapura township. The village consists of about 30 houses, and since 2006 I have visited once or twice a year

to distribute donations on behalf of others. It used to be that 62nd Street, the main road passing through the nearby industrial zone, might well have been bumpier than the surface of the moon. Reaching the road leading to the village entrance, it used to be too muddy to drive any further and we had to get off the motorcycle and push. I kept a strong stick to scratch away the mud. Now, much to my relief, the road has been replaced by rough stone, making visits much easier. Daw Mya Kyi’s house is inside the village’s monastery compound. Whenever I reach it, she is always sitting on the floor by the entrance holding a lit cheroot in her fingers. She makes for an unusual sight because her appearance does not change from one year to the next. She is in excellent shape for a woman who celebrated her 100th birthday two decades ago. I spoke with her in the first week of July, at which time I asked her for the se-

there has been nothing to get irritated over. “Once when I was young and was angry with my mother, I cried and my mom slapped me. Now, when I am confused, I lie down on the floor and roll over. When I do this I can release my stress all by myself.” Daw Mya Gyi eats a simple lunch of rice and pounded peanuts, though she said she likes nan bat chin (fermented sesame oil cake) for dessert. She said she’s also fond of Ensure nutrition powder: “One of my donors sends me a tin every month.” She also keeps a regular schedule. “I go to bed at 8pm or 9pm and I sleep soundly. I wake up at 4am and then I pay respect to Lord Buddha.” I couldn’t help asking Daw Mya Gyi about that everpresent cheroot: How does that fit in with her extraordinary health? “I started smoking from the time

Daw Mya Kyi at home. Photo: Phyo Wai Kyaw

Whatever the secret – vegetarianism or stress relief or Buddhism or cheroots – her longevity means that she has outlived everyone else of her generation. “My friends have passed away,” she said. Three of her children have also passed on, and the youngest of her two remaining children is 75 years old. Now, she said, she looks to a

“I’ve eaten only vegetables since I was 30 years old.” - Daw Mya Kyi
cret to her extraordinary longevity. “I’ve eaten only vegetables since I was 30 years old,” Daw Mya Kyi told me. “Because of that habit I have been able to live so long until this age. Doing it didn’t mean any effort because I don’t like meat. “Another reason is living happily throughout my life. I haven’t had feelings of annoyance and I was seven years old, lighting my father’s cheroot,” she said. “So I can’t give up completely. The doctor instructs me not to keep smoking. When guests come to visit me, they say that too. I demonstrate throwing away the cheroot in front of them. Then I collect them again one by one and continue smoking when they leave.” younger generation for interaction. “I want to hold a donation ceremony with my grandchildren.” Ko Aung Naing, 35, lives in the same village. In spite of the steady stream of visitors, he said, his grandmother lives alone in her small house and turns down help getting around outside, even when it is raining heavily.

Since last year, however, she has had one steady companion: A small hen has started living nearby, he said, and she has lately grown very fond it. Her physician Dr Aung Khaing Oo said her health is very good, with a heartbeat as strong as anyone’s. Although her longterm memory has faded quite a lot, she promptly responds to questions about present events. You often have to repeat yourself when speaking to her, but only twice – for someone of her age, that’s enough to say her hearing remains good. When I said goodbye, she said she wished I would live to be over 100 years old. I don’t believe I will live to be over 100 but I do believe she will be waiting for me when I come to see her again next year. - Translated by Thae Thae Htwe

Medical tourism: a passport to health
For those who can afford it, quality medical care often means booking a flight out of Myanmar
SHWE YEE SAW MYINT
MALAYSIA used to be a place – such as Myanmar – that people left if they could afford to seek better medical treatment elsewhere. However all that’s changed in recent times: Malaysia not only meets the needs of its own citizens, its doctors say, but is actively marketing itself as a destination for patients from other countries, including Myanmar, who don’t yet feel they can trust the service they’ll receive at home. “For the last 50 years we have gone to Singapore for health treatment,” said Dr Chan Kok Ewe, one of the directors of Island Hospital in Penang, Malaysia. “Now we don’t go because our healthcare system is improving and has reached high international standards. “We are busy with our local patients but we are also urging the government to promote our medical market to other countries.” The promotion seems to be working. In 2012 Malaysia received 664,000 international medical tourists, 16 percent more than in 2011. Of these, 7260 were from Myanmar. At about 20 a day, that number may be less than the numbers of Myanmar patients who opt for more well-known medical tourism destinations such as Thailand, Singapore or India, but it does represent a jump of more than 32pc compared to Malaysia’s figures for the year before. Steering this success is the Malaysia Healthcare Travel Council, an organisation set up by the Malaysian Ministry of Health to promote Malaysia as – in the words of the website – “the medical tourism haven in Southeast Asia”. “Our country’s main medical tourist market is Indonesian patients,” said chief executive officer Mary Wong Lai Lin, “but we would like to extend into other countries’ markets, like Myanmar’s”. Myanmar’s healthcare system was long-neglected under the former military government, meaning it now faces a number of challenges to delivering effective and affordable care. Patients say central hospitals lack basic supplies, medication and equipment and many forms of treatment continue to be cost-prohibitive. As a result, said Dr Mei Mei Ko, who is chief editor of the medical magazine Ziwaka, patients who can manage it are often opting to travel to other countries. The trend started 15 years ago, she said, when promotions and advertising led patients – especially cancer, heart, liver and kidney patients – to start crossing borders for treatment. “[Hospitals in other countries] give great service and a lot of time for patients, with treatment from a whole network,” Dr Mei Mei Ko said. “I have never seen service like this in our hospitals.” She said patients in Myanmar can expect to spend between K5000 and K7000 just to spend a few minutes in front of a specialist. While they’ll spend more – much more, in some cases, even upward of K5 million (US$5128) – for treatment in foreign hospitals, some feel the need for quality care leaves them with no choice, Dr Mei Mei Ko said. “We need to change our healthcare system to match [the needs of] our patients.” One of those patients is U Hla Thaung. At 68 years old, he has been battling coronary artery diseases for the past eight years. Since 2011 he’s travelled twice to Bangkok for treatment, but he said he doesn’t worry about the cost. “Nothing is as important as life. We can find money if we are still alive but we want safe services and proper treatment.” He said Myanmar physicians usually support patients’ decisions to go elsewhere. “When my heart problem grew worse my doctor said I needed to have an operation. Then he asked me where I want to have the operation. If I had the money, he said, I should go to Bangkok, because it is safe and has good service.” In Myanmar, only Yangon General Hospital offers heart surgery. Long lines, however, can mean patients face waits of up to three months. To avoid the wait, U Hla Thaung – at the suggestion of relatives who are doctors – enquired at a Bangkok hospital representative office in Yangon. Unexpectedly, he found there was a waiting list there as well, so popular was his decision among fellow patients. “When I arrived at this office I saw there were at least 15 patients waiting in this office to go to medical treatment in Thailand.” He said it was easy to arrange the treatment in advance at the office, and was even given his choice of practitioner. “They showed me ten pictures and profiles of heart surgeons in this [Bangkok] hospital. I had a choice of which doctor I wished to operate on me for my disease. Then they arranged a time and date for the operation with the doctor.” While he doesn’t regret the decision at all, he did add that such care remains prohibitively expensive for many. “I like their service but I spent a lot of money, about K1 million for my treatment,” he said. “If we had hospitals like this I would never go to a foreign country for treatment.”

19

Play by play
The Myanmar Times’ health columnist assesses the state of play for kids in Myanmar’s urban areas – and says parents need to toss out the day planner
CHRISTOPH
livingwellmyanmar@gmail.com

Photo: Boothee

GELSDORF

ONE of the many challenges of parenting is organising a child’s day to offer a balanced range of activities that support development. Many priorities – including school, organised social activities, extra academics, sports, hobbies and family events – compete for time, and a hurried lifestyle combined with the logistical challenges of getting around Myanmar’s cities quickly may mean having to make tough decisions on what to leave out. Speaking with parents about childrearing strategies, however, I find that we often neglect to set aside adequate time for one of the most important parts of a child’s experience – free play. The benefits of free, unstructured play are well established by medical and psychological research. The American Academy of Pediatrics has outlined the numerous benefits of play for children’s healthy physiological and emotional development. Play increases cognitive capacity and the ability to store information, and also promotes physical dexterity. Undirected play – in which children interact with the world, create approaches to problem solving, experience negotiation and learn selfadvocacy, fosters emotional development and teaches them about group dynamics and leadership skills. By

experimenting, kids discover personal areas of interest. Free play also tends to promote physical activity, thereby supporting healthy bodies. So what is free play? Basically, it is child-directed activity that can be individual or involve others. While group activity with other kids can – or, depending on the activity, should – be supervised, it should not be directed. While free play can and frequently should include a parent, it should be driven by the child. The important thing is for there to be no adult-presented guidelines for how free

computers or other electronic devices. The medical journal Pediatrics clearly states the distinction: “In sharp contrast to the health benefits of active, creative play and the known developmental benefits of an appropriate level of organised activities, there is ample evidence that this passive entertainment is not protective and, in fact, has some harmful effects.” In my opinion the data on the

to teaching environments, builds readiness to learn, teaches learning behaviours and develops problem-solving skills. The pros and cons of pursuing more defined activities at free play’s expense need to be carefully considered. For parents, the main thing to remember from all of this is that free play is a fundamental part of a healthy childhood. The

benefits of using traditional toys such as blocks, dolls and cars rather than packaged activities are well-known. Such activities should be active, child-directed and occur frequently from the age of two-and-a-half years old onward. By encouraging free play, parents can feel comfortable that they are being great caregivers and supporting their child’s future.

Christoph Gelsdorf is a family physician in Yangon and teaches medicine in the United States. He is an honorary member of the Myanmar Medical Association and writes a bi-weekly column, “Living Well In Myanmar”, for The Myanmar Times.

Play increases cognitive capacity and the ability to store information.
play time will be spent.  Remember too that packaged activities marketed as ways to develop a child’s intellect are not the same as free play. Parenting magazines and the media often suggest that good parents provide tools for enriching their child’s development: These can include computer programs, videos, music, specialised toys and games, and after-school programs. Many parents of my young patients pursue these options with the intention of doing the best for their children. However, these “kid genius” items typically lack validated evidence of making long-term contributions to a child’s success. It’s also important to note that free play is different from the “free time” kids might use for passive entertainment via television, dangers of TV and computers is not yet definitive, but I do try to work with parents to establish an amount of daily “screen time” they feel is appropriate for their child. My personal preference is no more than 1-2 hours daily, with some autonomy given to older children about how to schedule the screen time each day. Talking with parents, I find that setting aside time for free play competes most frequently with efforts to improve a child’s academic accomplishments via math tutoring, language classes, piano lessons and so forth. These activities are obviously well intentioned and provide great benefits. However, we know from many medical studies that free play itself is important in academic development. It helps children adjust

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