Migration from the countryside to urban provincial centres and capital cities is a major reason why rural communities in southeast Asia suffer extensively from acute poverty and ill health. In Thailand, as elsewhere, it is principally the young and able who move to the cities in search of jobs, and whose departure impoverishes even more their home communities. The Thai Sangha has traditionally accommodated this pattern of migration by providing educational opportunities for those who ordain at an early age, but in recent years a variety of schemes has enabled monks to learn secular skills which equip them to become “practitioners of development” in their home regions. This training has gone hand in hand with attempts by leading scholar monks to reformulate Buddhist teaching to emphasise the importance of living in self-reliant communities which are alert to the most up-to-date scientific information available on health care and environmental protection.