Why Aids remains a major problem in Thailand – Field trip with Rejoice

This week we have made a field trip to Chiangdao and Phrao with Gee, Wi and Arm from Rejoice.

Rejoice works predominantly with HIV-positive persons and those suffering from Aids in the North of Thailand. We have visited clinics and made home visits in order to distribute free medication to those followed by Rejoice.

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Rejoice does not distribute anti-viral medication which is only available in hospitals. Rejoice offers treatment for side-effects of the anti-viral medication and accompanying sickness of Aids.

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Before the field trip we have met Alan Wheeler of Rejoice UK in Chiang Mai who has told us a lot about HIV in Thailand. As Don Willcox and Saovanee Nilavongse have already told us, Rejoice has difficulties to obtain donations directly in Thailand. According to Alan, 90% of Rejoice’s funds come from abroad. Many Thai people prefer to donate to temples rather than to humanitarian organisations.

Chiang Mai was the epicentre of Aids in Thailand 15 years ago and even though the situation has improved, the region still struggles with the repercussions. Especially the rural population is affected by the virus.

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As of today, the public Thai health system provides free medical care for persons suffering from Aids. Further, the HIV tests are paid for by the Thai health insurance which is available for all Thai persons which are registered. A good example of state measures is that HIV test are mandatory for pregnant women in order to prevent a possible transmission of the virus to the new born.

Even though Alan has qualified the governmental action as “good,” several problems persist and HIV and Aids remain a major issue in Thailand.

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All people living in Thailand are not registered and thus have no access to free health care. Especially hill tribes, which speak different languages and often do not speak Thai, do not make the necessary procedures. Further, there are many migrant workers which come from neighbouring countries and which often are in Thailand without a work permit.

According to Alan, another problem is the transportation to the hospitals and clinics. Don has told us about the same problem. The most vulnerable often live far from medical care institutions. The transportation is relatively expensive for the rural population and takes a lot of time which often means one lost day of work.

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Further, and this leads us to the third major problem, going to a hospital could attract the neighbours’ curiosity. HIV and Aids, just like handicaps, remain stigmatised in Thailand. Bad information of the transmission of HIV make that HIV-positive persons are socially rejected and isolated.

We have noticed that Gee has taken a lot of time to talk to the patients. Unfortunately, we do not yet understand Thai, but the discussions seemed very amicable. Gee explained that many persons suffering from Aids stop taking the anti-viral medication when they start to feel better. Even though the medication is free for most, many do not consider it necessary when the symptoms of the sickness disappear.

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Our field trip with Gee has shown us that HIV and Aids remain a problem in Thailand in terms of prevention, treatment and information. Alan and Gee have told us much more about HIV and Aids in Thailand and about the persons suffering from it. If you have any questions you can contact us. You can also read Rejoice’s last report.

PS : On our way to Chiangdao and Phrao we stopped at a primary school in Chiangdao to distribute fruits to the children whose parents are mostly field workers. There is no direct link to Rejoice work on HIV and Aids, but it shows the diversity of its work. Here are some pictures:

 

Wheel chairs may not be sexy, but super important – Meeting with Don Willcox

Today we have met Don Willcox of the “Foundation to Encourage the Potential of Disabled Persons.” Don has previously worked with disabled persons in Nepal and has now settles down with this Thai wife Pirana in Borgsan, close to Chiang Mai.

Don and Pirana work with disabled persons and today mainly provide wheel chairs to those who cannot afford to buy one themselves.

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Our meeting with Don was very interesting. He has confirmed what we have learned from Saovanee (we have met her in Bangkok one month ago) that disabled persons are often discredited in Thailand. Many Buddhists believe that a handicap is the “payback” for a bad previous life. Thus, disabled persons “deserve” their faith; supporting them could attract bad karma.

Don told us, for example, that he had problems in the past with his neighbours which felt perturbed by the presence of disabled persons. Main objections, according to Don, came however from the monks and temples. As Saovanee told us previously, monks mostly encourage the donation to temples in order to “improve” one’s karma rather than helping people.

Don himself is a practising Buddhist, but he prefers to stand back from certain Thai customs. He compared the Thai Buddhism to the catholic religion in Europe: Practitioners are often far away from the “real” religious ideas. Don, however, stressed that one should not generalise, there are “veritable” Buddhists here, too.

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When we asked Don on governmental action taken for disabled persons, he responded very critically. Even though the situation improves in Thailand, many disabled persons still have no access to care, education, work or even a dignified life.

Don explained that there is an increasing number of public facilities providing medical and therapeutical care to disabled people, but the people often have no access to these facilities. According to Don the main problem is transportation.

In Thailand it is usual that the grand-parents take care of a disabled child, so the parents can continue working. But the grand-parents themselves often have health issues and/or do not dispose of adapted transportation for the disabled family member(s). Don further told us, that sometimes men abandon their families if a disabled child is born, in order to found a new family with another woman.

Another main problem is the financial governmental support for disabled persons. Even if a disabled person has been trained and could work, he or she are rarely hired – mainly because of the bad image Thai people have of disabled persons. The Thai government grants 500 Baht to each disabled person per month, which is hardly enough for food – and there is accommodation and possibly necessary medication and special equipment which adds on.

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The wheel chairs Don and Piranan supply mostly come from international donors, mainly the US and Australia. Even though the donations come obviously for free and normally there is no additional tax (according to Thai law, donations are exempt from taxes), Don told us that they have a lot of expenses when bringing the wheel chairs from Bangkok Harbour to Chiang Mai. Numerous administrations apparently want to enrich themselves and without paying a bribe, the wheel chairs would never arrive in Chiang Mai.

Don has shown us a couple of wheel chair models he distributes. According to him, the Westerners often think “too complicated.” The wheel chairs are adaptable in many ways what seems practical, but what does not correspond to the needs in Thailand. The technology is too complicated for many recipients. Further, the wheel chairs are more fragile with all the “jan-ken-pon.” Don has told his concerns to the constructors, but no prolific adjustments had been made so far.

Don and Piranan not only supply wheel chairs since 1993, but also medical care, education and moral support to disabled persons in Northern Thailand.

The moral support seems to be an important point. As disabled persons are often disregarded, their self-esteem is low. Don has shown us books – mainly for children – which the foundation distributes in order to show disabled persons that they are just as important and that they have the right to a dignified life.

The meeting with Don was very moving for us. The situation of disabled persons in Thailand is precarious, especially in rural regions. Even though there has been improvement over the last years, many still have no access to necessary care and are socially isolated. Don has told us so much more, but this article is already long enough. If you have any further questions, please contact us or write an email to Don.

Arrived in Chiang Mai

We have arrived in Chiang Mai and will contact NGOs in Chiang Mai in order to see how they work in the North of Thailand in comparaison to Bangkok. We will also visit FFAC, a foundation which works with orphants and which we have already met in Bangkok.

The city of Chiang Mai is in a valley, surrounded by mountains. In the province of Chiang Mai, 82,6% of the area is covered by forest while 11,2% is used for agriculture. Agriculture is one of the most important resources in the North of Thailand, especially rice cultivation. The North of Thailand counts many different ethnic groups. Close to the border to Myanmar, a lot of refugees live in camps. Humanitarian stakes are numerous and we will talk about it more in our future articles.

Rice field at Mae Wang near Chiang Mai. Thailand.

Many NGOs have an office in the North of Thailand. As the region is very rural, it is poorer than the touristic South. In addition to meet local NGOs, we will also travel around the city in order to meet the rural population.

Duang Prateep Foundation: Working in Bangkok’s Khlong Toei Slum

This week, we have met with Mr Khantong from the Duang Prateep Foundation which works in Bangkok in the area of the Khlong Toei Slum.
The habitants of Khlong Toei are struggling with several problems:

  • No legal claim of residence and fear of relocation
  • Unaffordable education costs, no leisure activities for the young
  • No secure employments, no fair wages, long working hours
  • Drug consumption and traffic, prostitution
  • Elderly persons living in precarious conditions
  • Fire risk in the slum

Mr Khantong has explained to us several of the issues in detail and we could visit DPF’s kindergarten and a part of Khlong Toei.

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Khlong Toei is divided into 42 different communities which are headed by different “leaders.” Mr Khantong explained to us that DPF has to go and talk to the leaders to be given “approval” before implementing a project or talking to the slum dwellers. DPF has been working for more than 40 years in Khlong Toei and knows the area, the leaders and part of the population very well.

There are a lot of NGOs working in Khlong Toei, many are catholic missions. But according to Mr Khantong there is no “religious problem” between the Buddhists, Muslims and Catholics and no missionary work from neither religion. The NGOs discuss their agenda between them in order to make their work as efficient as possible. There is a division between competences as the NGOs work on different issues in the same area.

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Khlong Toei is situated close to Bangkok’s harbour and thus to the harbour’s industry. The area is a swamp and when we were visiting Khlong Toei we could see than most houses are built on water. When we asked if there are no health problems linked to the proximity of the highly polluted water and the habitations, Mr Khantong said health issues are “under control.” Local health volunteers work in Khlong Toei and during our visit we saw several posters for health prevention.

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Mr Khantong, however, said that many slum dwellers were complaining about stomach problems. DPF researched the origins of the health problem and found that many people drink unclean water. He explained that most houses have access to drinking water of individual or community water filters. One problem, according to Mr Khantong is that the filters are not changed regularly and thus lose their efficiency. A new water filter costs 2,000 Bath (50€) which is a lot of money for the slum dwellers. DPF is working on changing the filters within the limits of its financial resources.

Mr Khantong has talked about several problems DPF is working on.

One main problem seems to be the “selling of fatherhood.” In order to have a Thai nationality when born, the children’s parents need to be domiciled in Thailand for at least five years. Certain men “sell” their signature on the birth certificate to foreign women for 10,000 Bath in order to facilitate the child obtaining the Thai nationality.

DPF also works with elderly people. We were surprised to learn that many elderly people refuse to leave Khlong Toei. In certain cases, their children have managed to leave the slum and want their parents live with them in a nicer neighbourhood. Mr Khantong explained that the elderly often refuse their children’s offer, because they do not want to leave the familiar environment and their friends. DPF supports the elderly of Khlong Toei in health issues and organises gatherings with food, music and dancing.

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DPF also works in drug prevention as the consumption and traffic of drugs are a major problem in Khlong Toei. When we were visiting Khlong Toei we have observed that Mr Khantong was smelling the Pepsi bottle of three young boys. When we asked what he was doing, he explained that the young sometimes put a drug into their drink, so nobody in school will recognise they are consuming. In this case, the bottle only contained Pepsi, but it was troubling to learn that even the young take drugs at school.

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DPF takes care of children which find themselves alone, because both parents are in jail. DPF feeds the children and makes sure they go to school.

Mr Khantong has talked about much more issues in Khlong Toei and what DPF is doing. This article is too short to enumerate them all. In the end, we would like to talk about DPF’s kindergarten which is an amazingly well organised project.

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When visiting the kindergarten we were amazed by the well thought-through equipment and the beautiful and caring decoration of the building. We both thought that we would have liked to be in such a kindergarten. Mr Khantong explained that the kindergarten is a Montessori kindergarten. It prepares the children of Khlong Toei for school, but also teaches them daily customs like growing plants, cooking, sewing, cleaning and so much more.

We were really amazed by the kindergarten. Check the pictures below, they explain better than words.

Before ending the article, we would like to say how inspiring the visit with Mr Khantong was. He really took a lot of time to show us around and explained a lot of things. DPF’s work is truly amazing and even though, the visit of the slum was a little difficult, we could see that Khlong Toei’s community is organised and fights for its rights. This is thanks to the work of DPF and the other NGOs.

Visiting the Raks Thai Foundation in Bangkok

This week we have decided to visit a bigger NGO than last week. We have met with Prasong Lertpayub, the director of human resources of the Raks Thai Foundation.

Raks Thai is a Thai NGO, affiliated to Care International (Raks means “care” in Thai.) Mr Lertpayub admitted that the work in a big structure has advantages, but also disadvantages.

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For example, Raks Thai had to adapt its logo to the one of Care International. Further, the work of Raks Thai is supervised by Care which means additional administrative work for Raks Thai. Mr Lertpayub has further compared the structure of Care International with the UN: The one contributing to most money, is the one making the most important decisions. In South East Asia these are mainly Care US and Care Australia.

But the work in a big organisation has advantages as well. Means and knowledge can be put together and used commonly, the NGO is more renown and cross-border projects can be financed.

We have further asked Mr Lertpayub if the military putsch has brought any consequences for the work of NGOs. He said there are no major differences for Raks Thai. He could, however, imagine that NGOs which work on political topics, or topics relevant to policy, could feel more pressure.

Raks Thai works on several projects in different area like victims of violence, addicts, HIV, education, agriculture, forestation and others.

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Raks Thai also works with Burmese immigrants who want to settle in Thailand.

This is a subject we were very interested in, because Mr Lertpayub did not speak of “refugees,” but “work migrants.” There are currently thousands of Burmese refugees in Thai refugee camps which only wait for their repatriation. Many leave the camps in order to work in Thailand, for most of the time under illegal conditions. Without a work permit, most are exploited.

We have not insisted on the subject, because the topic is not one of Raks Thai’s main subjects. Raks Thai already makes an amazing work in different areas. Further, there a more specialised NGOs like the Red Cross and Doctors Without Borders.

Refugee camp Ei Tu Hta, IDP-Area bordering Thailand near Mae Sariang, Birma

At the end we have asked Mr Lertpayub how one can officially register their NGO in Thailand. This would be an interesting step for us, because we would benefit from the one-year visa “O” instead of extending our tourist visa every three months.

A registration is possible at the Ministry of Foreign Affairs or the Ministry of Labour. But according to Mr Lerpayub the proceedings are complicated, protracted and actually not doable without the help of an English speaking Thai person.

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Mr Lertpayub told us than many, especially small NGOs, work with tourist visa and cross the border every three months in order to extent the visa. We have decided to do the same for the moment.

The meeting with Mr Lertpayub was interesting for us in two regards: We now know that it is possible to work with Burmese refugees without risking an expulsion of the country and we have learned that we can work for Omakua using our tourist visa.

Mr Lerpayub has further connected us with the Raks Thai team in the North (Chiang Mai). We will be able to visit a project of a big NGO directly on the field.

Meeting “Friends For All Children Fondation” in Bangkok

Today we met with Saovanee Nilavongse from the Friends For All Children Foundation (FFAC) in Bangkok with two additional centers in Chiang Mai and Nong Kai. FFAC is a private, non-profit organisation which exists since 1977. FFAC’s nurseries provide residential care for children who may need temporary or permanent homes due to family difficulties. Some of the children can return to their parents or relatives, some remain under the care of FFAC until adoptive parents are found.

We have sent an email to Saovanee and she immediately responded to us and invited us to visit one of the nurseries. She is a lovely and very dedicated woman. We talked to her a lot and visited the centre. This kind of transparency is what we expect from a NGO. We have emailed a lot of NGOs, but only a few responded and invited us. This was a first big asset for FFAC! Thank you so much Saovanee for receiving us.

Saovanee told us about the importance of residential children’s care in Thailand. Certain children are abandoned by their parents due to several reasons. Poverty is one of the main reasons. Many parents cannot take care of their children and are forced to give them away. We were particular surprised to learn that in Thailand many children are abandoned due to physical malformation or mental handicap.

Saovanee explained that in the Buddhist religion – which believes in reincarnation – physical or mental handicaps can be often seen as a “punishment” for the previous life. Certain believe that handicapped persons have been “bad persons” previously; helping them could bring bad Karma for you.

Saovanee told us that she has been lucky in the past to receive donations for FFAC. Even though she explained, some times are harder than others (FFAC had, for example, move to a smaller house due to lacking funds for paying the renouset of the bigger h) she has received very generous donations, mainly from foreigners. If you want to contribute, you can make a donation of any amount.

FFAC’s centre in Bangkok currently counts 11 children. Most of them came after their birth and have never experienced anything else than the orphanage. Even though Saovanee and her team take really good care of the children, this will never substitute a family.

If the children cannot go back to their parents, they are giving to adoption after one year. The adoption progress, however, is very long and most children will have to wait two to three years before going with a family. Especially for handicapped children an adoption is difficult and in some cases FFAC takes care of them their whole life.

It was very inspiring meeting FFAC. Unfortunately we will not stay in Bangkok long enough to put together a project helping FFAC, but we will go to the centre in Chiang Mai, where we will stay longer and see if and how Omakua can contribute to FFAC’s amazing work.

We have learned much more about FFAC than displayed in this short article. If you have any further questions about FFAC you can email us or FFAC directly.

Arrived in Bangkok

We have arrived in Bangkok and start our work for Omakua. At first we will make contact with local NGOs in order to learn more about the humanitarian work in Thailand.We want to know where help is needed and what difficulties we might encounter. Besides, we have started learning Thai. But it will take a little while before we can actually have a conversation.

 

Monday, 9 February, we will meet the Foundation Friends for all Children (FFAC). They work (as the name suggests) with children. You will learn more about FFAC once we have met them. 🙂

Say, what is a NGO?

Very interesting question! Maybe you know the meaning of these three words:

  • Non
  • Governmental
  • Organisation

 

But what does this term actually mean?

The word NGO was used for the first time in 1945 by the United Nations Economic and Social Council (ECOSOC). The initial aim was to differentiate governmental organisations from non governmental organisation.

The resolution 288 B (X) of the ECOSOC define an NGO as “every international organisation which is not based on a state treaty.”

What does a NGO exactly do?

A NGO must fit these criteria:

  • it must be private and non governmental
  • it must not be profit-orientated
  • it must be financially independent
  • it must be politically independent

There is yet no legal status of NGOs, most NGOs are legally associations or foundations.

The capital of a NGO mainly comes from private donations (you, I, your neighbour etc.). This is  to guarantee its independence. But money can come as well as from official donors (France AFD, EuropeAid, UNO etc.).

The work of NGOs is versatile:

  • Human Rights
  • Fight against hunger
  • Fight against diseases
  • Child protection
  • Education
  • Economy
  • Environment protection
  • animal protection
  • etc..

How are NGOs controlled? How is made sure that their work and structure fit the criteria?

NGOs are private organisations and only subject to the regulations of their legal status (mainly association and foundation). But there are other ways of control:

  • Many NGOs publish annual reports about their structure and work
  • Big donors like the UNO or the EU demand account details and reports
  • There are several independent structures which evaluate the work of NGOs, for example the French Label IDEA

At last…

Most NGOs, like Omakua, are small structures compared to the top 10 NGOs. The work of these small NGOs is important and complementary to the work of big NGOs. Small and local NGOs often have a better knowledge of the culture and people on the field.

Our advise: If you want to support a small NGO, but you have questions about their work – just contact them! On the contrary of big NGOs, the communication with small structures is often easier and more personal.

 

Sources:

Quelques repères sur les associations en France aujourd’hui – Edith Archambault – Viviane Tchernonog – Centre d’Economie de la Sorbonne – CNRS – Université de Paris 1 Panthéon-Sorbonne (mars 2012)

CCD, Coordination SUD et le ministère des Affaires étrangères

Where does the money go?

That is a really good question! After the tsunami in Asia in 2004, the French Court of Auditors has obliged French NGOs to show the exact repartition of the donation’s expenditure. This allows the donors to follow if their donations are used 100% for the projects or if parts of it go into the financing of the administration of the NGO.

In 2004, one week after the tsunami, Médecins Sans Frontières (MSF) has shaken the humanitarian world when demanding a stop of donations for emergency help in Asia. At this time, MSF already had enough financial means for the emergency actions in the region. This was welcomed by the French Court of Auditors. Other NGOs spend more money than necessary in Asia and financed impertinent projects. Some NGOs also refunded donations.

A Sri Lankan Red Cross volunteer carries boxes of humanitarian aid brought for tsunami survivors ...

Certains NGOs redistributed the money to other projects without informing the donors, even though the French Court of Auditors had requested that donors must be informed if the destination of their donation is changed. The donors can also be refunded. MSF for example, has demanded the donors’ permission to employ the money for different projects. Only 1% of the donors has demanded refunding.

Furthermore, the French Court of Auditors has recommended that NGOs must display transparently how much money of the donations goes into the project and how much is used for the NGO’s administration. In Haiti, for example, many NGOs had received donations for specific actions, but used part of the money for they operating costs.

MSF for example has clearly stated on its website which part of the donations is used for the administration and operating (11.2%) :

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Unfortunately, most NGOs only realised the importance of transparency after scandals like Haiti and Thailand had popped up.

Concerning Omakua, 100% of your donation will be used for the projects. (We both continue working half-time in order to finance our living expenses.)

 

 

Sources:

 Page 19 de la synthèse du rapport de la cour des comptes
Scandale de l’ARC
Remboursement donateurs MSF

The Moken people in Thailand

After the Tsunami in Thailand in 2004, numerous NGOs started to implement reconstruction and development projects in order to come to the aid of the affected people.

Especially the South of Thailand has been hit by the catastrophe:

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One of the most concerned population are the Moken. These people are traditionally fishermen who have been living at the seaboard which is why they have been particularly hit by the Tsunami. After the tsunami, the Moken became a NGO priority in the region.

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Photos © 

The Moken have been living in fisher villages at a 200km coastline between Phuket and Khura Burri. Their living space has changed drastically after the tsunami. Much territory which was populated by the Moken before has been bought by real-estate companies; entire fisher villages were rehoused.

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What happened?

For many decades the Moken people have been living at the seaboard. They were perfectly accepted by the other locals and the royalty. They paid property tax, but as their ground was regulated by the right of use, there are no deeds of property.

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After the tsunami the Thai government has made it clear that affected people of the coastline will be resettled. This decision was also influenced by the real-estate and tourism sector.

To implement reconstruction projects, the NGOs needed these deeds of property. As there were no deeds of property, it was easier to simply rehouse entire villages than to deal with the Thai legislation. Like this the populations which have been living at the coastline were resettled from one day to the next and lost their access to the sea. The NGOs did not consider this. Reconstruction was evaluated more important – wherever it was possible.

The Moken had the choice: Staying at the coastline without anything or leaving the coast with the prospect of a new house and compensations.

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Four years after the tsunami, the village of Kokhloi for example, is crowded with hotels. The fishermen are not allowed any more to put in their boats at the beaches, because they are private property now.

Furthermore, the NGOs’ work included the supply with boats at fishing equipment for the Moken. The NGOs have chosen small boats and fishing nets. For the fishermen who are used to fish offshore, the 5 meter boats were not adapted to their way of fishing. Many of the fishermen were forced to change their activity; others ran into debt because they had to buy new fishing nets and put expensive petrol into their boats.

Reconstruction without considering the needs of the local people has thus created a state of instability which has not existed before 2004.

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With Omakua, we want to do things differently.

We want to help people with small projects which are adapted to their way of life. Our main point is the communication with the local population. This will take time, but we are convinced that this is the way to achieve development while respecting the local traditions and ways of life.