Helping The Locals/family

[Ajarn]

I too smell a tall story. Kindly stay on topic, how can we as foreigners improve medical assistance for the poor in the villages.

Not at all.

You might get to see the doctor without money, but not the resulting treatment.

Drugs cost money is the bottom line.

I remember seeing a little boy in the local gov hospital here.

He had had his operation and needed some medicine, but as Mum had not visited

for a day or two (she was working) he only had the prescription. Not the pills!!

Fortunately Mum did turn up, otherwise I would have paid.

If the kid is a patient, then the hospital will provide all meds as long they are a patient, then the whole bill is settled as they leave... I have never seen any situation to differ from this, except when the hospital asks for perodic security deposits. But I've never heard of a hospital withholding meds from a patient after surgery

Hospital meds are a lot more expensive than if purchased outside, and maybe the mom had told the hospital to let her buy the meds herself, to keep costs down...

Just a guess, of course.

So hard sometimes to know the whole story. Even with our best intentions, we, as humans, can still make incorrect judgements and assumptions about situations where we're not privy to ALL the info, either through language problems, or through incomplete hersay, culture issues, or maybe through a con job for sympathy or money.

Anything is still possible here

[Flummoxed]

We are all aware of the lack of understanding in this country regarding the disease.

I am not aware of it, kindly explain it to me.

How is it in this country?

Calm down Bulldog, I explain-

When I said 'This country', I was referring to Thailand and meant no derogatory overtone when I said so. I refer to the incredible stigma that comes with HIV in Thailand, to the point that some families will reject the infected relative. Also, it is often considered to be a disease that only prostitutes have, regardless of the fact that it is often brought into the family by husbands who cheat and pass it onto their wives. Also, people here have little concept of what the disease actually does to the human body and your chances of logevity.

I must also point out, that I once knew a prostitue who was convinced that she could safely screw customers without a condom if she thoroughly cleaned her vagina after sex. Absolutely clueless about the disease.

I don't wish to sound critical of the Thai public regarding this, it's just that they don't have access to the correct or readily available information.

[sua yai]

flummoxed, no they didn't shoot me. I fainted in the holding cell, fell into the bars and ended up with 20 stitches in my head.

[Flummoxed]

ouch

[Ajarn]

I agree that in some hospitals, there is not much support offered when a test comes back positive....I have been with a couple of friends when they were tested, and got the bad news... And, there was no real concern about keeping voices down.

The exception, in my experience, is Suad Dawk Hospital in Chiang Mai. They immediately have you talk with a counselor in private, who goes over your options... Suan Dawk is also the center of AIDS research in Thailand, and they are very well informed.

Oh, and Flum, I do believe Thais have access to all the information. If you understand Thai, you can see many TV programs discussing these isues openly. In the hospitals, even the government ones, there are pamphlets and even posters with all kinds of health advice, including AIDS.

But, I think many prefer NOT to know, so some do bury their heads in the sand...

[Flummoxed]

I agree that in some hospitals, there is not much support offered when a test comes back positive....I have been with a couple of friends when they were tested, and got the bad news... And, there was no real concern about keeping voices down.

The exception, in my experience, is Suad Dawk Hospital in Chiang Mai. They immediately have you talk with a counselor in private, who goes over your options... Suan Dawk is also the center of AIDS research in Thailand, and they are very well informed.

Oh, and Flum, I do believe Thais have access to all the information. If you understand Thai, you can see many TV programs discussing these isues openly. In the hospitals, even the government ones, there are pamphlets and even posters with all kinds of health advice, including AIDS.

But, I think many prefer NOT to know, so some do bury their heads in the sand...

OK I stand corrected but then why such widespread misunderstanding? Perhaps my experience of this in deepest rural Thailand is different to others.

[sua yai]

Feel I must reply to the HIV/counselling thread.

I have known a Thai lady who has been HIV positive for 4 years. When diagnosed in Bankok her ARV drugs cost 3,000 a month. Obviously, a huge sum for a Thai.

She now goes once a month to the local hospital for cancer checks and to get the medicine. The medicine now costs her 30 Baht a month.

Her CD4 and viral load tests are showing a huge improvement.

Remember the PM's opening speech at the recent AIDS/HIV conference in Bangkok? He promised to provide free ARV drugs for all afflicted in Thailand. Maybe political rhetoric, but in this instance, it has made a big difference to at least one person's life.

She goes for counselling once a month, but dosn't like it. There are apparantly 30+ people there at the same time - all at various stages of illness. It makes her feel sick (ie mentally down) to be in this situation. She was told this month, that if she didn't stay for the counselling, she wouldn't get the medicine. What kind of counselling is that?

She's well, understands the gravity of the situation she is in and is responsible.

[Yohan]

About 2 years ago one of my neighbors by the name of Boon had a daughter who was heavily pregnant.

Unfortunately the birth was breach or some such problem (im not a medic) but the story was true.

The local hospital in Amphur Phen, said that they would do a suzerain if the family had the money.

As they did not have any money the doctors said that they would cut the baby into pieces to get it out.

The 30 B scheme is only very basic.

What is the Hippocratic Oath in Thailand?

..............

He was trying to sell his house (worth nothing) to get the money, no chance.

I paid about £70 to the doctors for the operation .........

Thailands a good place to live ----IF--you mave money

Edd, unlike some other stories here in this thread, I do not doubt at all, that your story is true....

In fact, 30 baht is nothing except to see a doctor, to get some very basic consultation and some cheap medicine.

What is the Hippocratic Oath in Thailand?

The Hippocratic Oath does not mean, that medical doctors have to pay for their work they are doing. They have the right to get a good salary instead.

To perform a Caesarian section is not an easy or cheap task.

You said, you paid only english pounds 70,-(somewhat baht 5000,- maybe?), you can imagine, how cheap Thailand is compared to Western medical fees.

In Thailand it is possible to pay first, and then to ask the government for a refund in such cases (already a posting of another member in this thread about that)

Again, I do not understand, why this Thai family wanted to keep that all in secret, and did not try neighbourhood to help...baht 5000,- or so are quickly collected...

All Thais are aware of that fact, that medical service is NEVER free of charge.

If he has a house and land, and also the land registration papers, then he might offer the original land registration papers as a security of payment to the hospital.. I know 2 cases, where this was done....(even if the house and land has a zero-value)

I think, this Thai family somewhat panicked....you mentioned father and mother of this woman, but where is the husband? Nobody has any income at all? No other relatives around to assist?

Thailands a good place to live ----IF--you have money

This is everywhere like that....Thailand is not an exception, I would say.

Thank you for your help towards this helpless Thai family.

[Flummoxed]

She was told this month, that if she didn't stay for the counselling, she wouldn't get the medicine. What kind of counselling is that?

I rest my case.

I will also add that I refer mainly to public perception of the victims. It seems to me that a lot of people view HIV victims as lepers. Not always but sometimes.

[Ajarn]

I agree that in some hospitals, there is not much support offered when a test comes back positive....I have been with a couple of friends when they were tested, and got the bad news... And, there was no real concern about keeping voices down.

The exception, in my experience, is Suad Dawk Hospital in Chiang Mai. They immediately have you talk with a counselor in private, who goes over your options... Suan Dawk is also the center of AIDS research in Thailand, and they are very well informed.

Oh, and Flum, I do believe Thais have access to all the information. If you understand Thai, you can see many TV programs discussing these isues openly. In the hospitals, even the government ones, there are pamphlets and even posters with all kinds of health advice, including AIDS.

But, I think many prefer NOT to know, so some do bury their heads in the sand...

OK I stand corrected but then why such widespread misunderstanding? Perhaps my experience of this in deepest rural Thailand is different to others.

Maybe, for some, not a misunderstanding as much as a desire to believe some other possiblity not quite as bad, in order to calm themselves. Seems like human nature, to me.

I really appreciate hearing the real concerns for the Thai people being expressed in this thread... I wonder if there's a way for us to channel our energy and resources to provide some real and direct support? Any ideas, anyone?

[sua yai]

hold on a minute. the 30 baht is true and if , over a long period of time someone is showing a positive improvement, how can that be bad? t is NOT just a doctor's consultation

[Johpa]

If a Thai person requires urgently medical help and cannot pay for first aid at the moment, the hospital or clinic usually keeps his/her ID, and such a person is back soon again, or a relative or friend, after collecting some money from all the others living in the same village. - I myself often gave a small donation for somebody in the neighbourhood, never the total medical bill, but when the locals gave 5 or 10 or 20 baht, I gave 100 or 200.....

Just want to confirm that the scenario below is what I also have seen. Just last month we paid 400 baat to the poorest couple in the village after the wife gave birth and the couple did not have the 400 baat to cover the expenses. The ID card was being held until payment was made. I just wished we could have payed to have her tubes tied to prevent another poorly advised conception.

As for common maladies such as dysentary, many rural tambons will have an agricultural extension office that will include a provider of basic medical care such as first aid, birth control, and common aches, pains, fevers, and flus. For more serious care, I have never seen a provincial government hopsital refuse a patient although I have heard of private hospitals in the city deny care. But the more expensive technical treatments may not be provided unless the family is able to make some form of payment, a payment that many rural folks can not afford. But there is no reason for dysentary not to be treated unless the parents simply waited too long to seek treatment, a not uncommon scenario in the rural areas where any interaction with officials cause numerous concerns, including economic fears.

[Flummoxed]

I would now like to hear from anyone who has experience or knowledge of running a charity in Thailand. What are the requirements, legal issues, anticipated set up problems.

Perhaps good idea to open a dialogue with me through PM regarding this.

[bina]

obviously u all come from countries with advanced socialized medical practices;

israel for instance has socialized medicine and therefore all hospitals are supposed to treat u, then u get money back according to one of the four health organizations that you belong and pay to. BUT everyone knows that if you are waiting ofr translplants or operations, there is a very very very long waiting list, so bribery and 'grey medicine' have developed... no money no advanced (super specialized)medical treatment, just basic.... medications: the regular is cheap, the new improved, pay out of your pocket full price

no rooms available in hospital? bed w/iv goes in to hall way

every one gets treated but what happens with the follow up etc is problematic; as is regular doc visits:

my son's symbicort (asthma meds) costs 75 nis... if i dont have money to pay the soc. med. pharmacy, then i would have to use just ventolin and buticort (much cheaper and for him not really effective) so thats what people do: compromise....

we have what is callled vitamin P 'protexia'; that is , a friend in a high place in a hospital, relative of a relative, who can pull strings, etc.... with the doctors.

doesnt sound to different to thailand......

my mother was a nurse in america; cant even begin to tell you all about med. care there!

i've learned: 1. always read the medical chart

2. double check what the docs are injecting or feeding or inserting

3. never leave patient alone cause the nurse will never come to check up on them especially at night (mothers sleep on floor next children in some hospitals , did that many a time)

4. learn where they hide the bedlinens etc cause there is never enough

5. in israel, not lke thailand, the louder you yell, the more likely you will get taken care of faster; those that sit quietly will never never get help!

thai people dont seem to like counselling, that is an american thing.... dont put all of your cultural baggage on an other culture's reatctions to a similar situation

thai people dont ever seem to finish an entire course of antibiotic, the minute the problem is solved, they stop. self treatment is very popular withthem until circumstances get out of hand in which case many times its too late . the mai pen rai attitude goes for a lot of medical things as well.

[Yohan]

obviously u all come from countries with advanced socialized medical practices;

..............................

doesnt sound to different to thailand......

my mother was a nurse in america; cant even begin to tell you all about med. care there!

It is simple like that:

1-

You are sick and you have no money....

2-

You are sick and you have money...

The patient of group No. 1 and No. 2 is not treated in the same way - this is true for all countries in this world .....

It is a big difference concerning your health, if you belong to group No.1 or to group No.2

[Begs]

It is simple like that:

1-

You are sick and you have no money....

2-

You are sick and you have money...

The patient of group No. 1 and No. 2 is not treated in the same way - this is true for all countries in this world .....

It is a big difference concerning your health, if you belong to group No.1 or to group No.2

Exactly............

This is why people from richer countries have better health care, and rich individuals have good health care.

Yohan, has made a simple, but very true statement.

[Ijustwannateach]

^Above is only too true. Though I'm glad to hear the story about the 30B care covering HIV treatment, and it may even be true, considering that Thailand has taken the HIV problem at least a LITTLE bit seriously. It makes sense to government to subsidize treatment for this kind of epidemic to keep it from spreading to others, whether rich or poor- if too many people get it, then there won't be much of a health care system left for anyone.

"Steven"