Chiang Mai Parents Needed

[lordofdelusion]

I posted this in the family section and got no responses!? Are there no parents in Ching Mai?? Anyway, what I was lookinng for was feedback from parents of little ones regarding any problems or experiences with the air quality in Chiang Mai. The air quality being an oft debated subject on this forum, but I was looking for specific info on the effects, if any, on kids. Secondly I was looking for comments on the availability of quality pediatric care.

Thanks

[chiangmaibruce]

Hi. See my post in this Forum entitled "Seeking really goods childrens doctor" ... use search button below

[too true]

For the first 3 years of my son's life he seemed to have chronic ear infections, coupled with either a sinus infection or bronchitis. He also spent 4 days in the hospital with pneumonia when he was around 2.

Now we've been in Bangkok for almost a year and he's only just had his first cold (which was probably brought on by spending Songkran back in Chiang Mai and being wet and doused with filthy water for a few days).

I'm convinced his problems were environmental and the pediatrician we used also suggested that the best way to improve his health would be to move or only let him travel in a closed car. I can't remember her name, but she was a young and beautiful doctor from Ram. Whenever we took him in to see her I would have already looked everything up on the internet and had a thousand questions for her. She took her time and answered all of them, never rushing us to get out of the office.

Good luck,

TT

[p1p]

Two of my children have health problems caused, according to the doctors, by the air quality. My other two children go to school overseas.

I have another close friend with a much larger family, all of whom have needed medical care because of the smog. He removed six of them from school this year and took them to Phuket because their coughing, headaches, ear and sinus infections and nose bleeds became so bad.

[Jefferson]

I don't want to detract to all of the posts above, but, pollution can cause pneumonia?

This does not leave me with a very factual/scientific feel to the overall discussion.

The closest I can get to actual fact finding is the daily reports from the government Pollution Control department, which will tell you that with the very notable exception of March (sometimes including late Feb, or early April) the quality of the air in Chiang Mai is much better than Bangkok (obviously, but hey).

In March just go holiday in the Antarctic or summin.

Edited May 6, 2008 by Jefferson

[Priceless]

I don't want to detract to all of the posts above, but, pollution can cause pneumonia?

..This does not leave me with a very factual/scientific feel to the overall discussion..

According to Wikipedia ( http://en.wikipedia.org/wiki/Pneumonia ) it seems it can:

"Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs."

If the pollution is aggressive enough, I guess it could cause "chemical or physical injury". What worries me more about the discussion is the presumption that Chiang Mai is extremely polluted. In fact, judging by yearly average pollution, it is not. In this respect, Chiang Mai is among the least polluted places in Thailand, less polluted than e.g. Phuket. The big difference is A/ the Chiang Mai pollution peak in March every year, when the pollution level is twice that of Phuket, and B/ the months of May-September, when Chiang Mai is at approximately half the Phuket levels.

I have no medical training, so I wouldn't know, but I can guess that the very high Chiang Mai levels in March can be the initial cause of a respiratory problem, but I somehow doubt that a subsequent move to Phuket would cure that. (My impression of Thai doctors is that they are as susceptible to "urban myths" as anybody else, so I'm not surprised that they blame Chiang Mai's "extreme pollution" for anything respiratory.)

The ideal solution would probably be to live in Chiang Mai 10-11 months of the year but to stay in Phuket, or some similar place, during March each year.

/ Priceless

[adjan jb]

Two of my children have health problems caused, according to the doctors, by the air quality. My other two children go to school overseas.

I have another close friend with a much larger family, all of whom have needed medical care because of the smog. He removed six of them from school this year and took them to Phuket because their coughing, headaches, ear and sinus infections and nose bleeds became so bad.

I used to live downtown (Ratchadamnoen Rd). Since I moved to the countryside, my son doesn't cough anymore. No more nose bleeds either.

[Priceless]

Two of my children have health problems caused, according to the doctors, by the air quality. My other two children go to school overseas.

I have another close friend with a much larger family, all of whom have needed medical care because of the smog. He removed six of them from school this year and took them to Phuket because their coughing, headaches, ear and sinus infections and nose bleeds became so bad.

I used to live downtown (Ratchadamnoen Rd). Since I moved to the countryside, my son doesn't cough anymore. No more nose bleeds either.

I think this is a VERY important observation. Pollution levels tend to vary a lot between places that are fairly close to each other, in connection to weather it is called "microclimate". I sometimes think that we overestimate the importance of rural burning etc, while seriously underestimating the importance of vehicle emissions (think tuk-tuks and sawng taews ).

/ Priceless

[john b good]

I don't want to detract to all of the posts above, but, pollution can cause pneumonia?

This does not leave me with a very factual/scientific feel to the overall discussion.

The closest I can get to actual fact finding is the daily reports from the government Pollution Control department, which will tell you that with the very notable exception of March (sometimes including late Feb, or early April) the quality of the air in Chiang Mai is much better than Bangkok (obviously, but hey).

In March just go holiday in the Antarctic or summin.

Your recommendation is really not the answer (I would hope that you were making a frivolous attempt to inject some levity into the thread)

The thread (the topic) is a serious one and should be treated accordingly. It brings to mind something along the lines of "if you do not have anything pertinent or relevant to contribute it is better just to stay away from it"

[lordofdelusion]

Thanks for the replies. I don't know if I'm any closer to deciding where to live. Kids get sick everywhere but I don't want to take any unneccessary risk. I worked in children's hospitals for years and sometimes siblings wouldn't even get sick at the same time with the same illness. So much depends on the individual and their system. And as someone pointed out, the micro environment around your own place may have a lot to do with allergies. Mold in your house may also be an issue. Still I haven't heard from any parent in CM yet that says their kids are always healthy. Hmmm, or anywhere else for that matter

Maybe I'm just overprotective of my 1st and last child.

[Jefferson]

Your recommendation is really not the answer (I would hope that you were making a frivolous attempt to inject some levity into the thread) The thread (the topic) is a serious one and should be treated accordingly. It brings to mind something along the lines of 'if you do not have anything pertinent or relevant to contribute it is better just to stay away from it.'

LOL!!!!!!!! Well that's rich.. you mean like your contribution to this topic, quoted above, in full? That's very, 'pertinent'.. whoa lovely pertinence.. too much!! too much!!

[Jefferson]

So much depends on the individual and their system. And as someone pointed out, the micro environment around your own place may have a lot to do with allergies. Mold in your house may also be an issue. Still I haven't heard from any parent in CM yet that says their kids are always healthy.

Well, who's kids are always healthy? They get colds, bump into things, etc.

But no, my kids don't suffer from pollution as far as I can tell. And that would be consistent with factual reports on pollution for Chiang Mai, indicating beyond any doubt that the air is really quite good, with the exception of March. (The very statement someone took offense to, even though it was so inredibly pertinent, it nearly broke my Scale of Pertinence and went off the chart. It was beyond ridiculous how pertinent it was.)

And boy was it relevant, .... oh, ok. I'll stop now. Or I will truly become delusional. I like cherish my lusionality.

Edited May 7, 2008 by Jefferson

[chiangmaiexpat]

We have two small kids. The pollution doesn't seem to affect them negatively, except in the peak days during March/April when they were coughing for a couple of days. My symptoms during that time were actually worse. Since last year we make it a habit to take a long Eastern vacation and leave Chiang Mai around that time. I think that Chiang Mai is generally a better place for kids to grow up than Bangkok. Outside of the burining season, air pollution in Chiang Mai is lower than in most other Thai cities. My oldest daughter had an ear infection earlier this year. Given that ear infections are very common for small children, I am not sure if it was pollution-related. Apparently high pollution levels increase the risk of such an infection. For pediatrics we usually go to the Chiangmai Ram hospital in town.

Cheers, CMX

Edited May 7, 2008 by chiangmaiexpat

[higgy88]

I have two kids. The oldest, a boy, is now 14 and as an infant he was sick just about every other week. When he was about 5 he spent a week in the hospital because he started running a very high temperature, and after the week it just went away as quickly as it came and the doctors were never able to identify what the problem was. When he turned about 9 he just stopped getting sick. My youngest, a girl, is now 10 and other than very minor colds she has never had a sick day in her life. Go figure. I would like to add that my wife is a nurse.

higgy

Thanks for the replies. I don't know if I'm any closer to deciding where to live. Kids get sick everywhere but I don't want to take any unneccessary risk. I worked in children's hospitals for years and sometimes siblings wouldn't even get sick at the same time with the same illness. So much depends on the individual and their system. And as someone pointed out, the micro environment around your own place may have a lot to do with allergies. Mold in your house may also be an issue. Still I haven't heard from any parent in CM yet that says their kids are always healthy. Hmmm, or anywhere else for that matter

Maybe I'm just overprotective of my 1st and last child.

[jaideeguy]

My daughter [3-4yrs old, then] used to get at least 5 or 6 respiratory infections per year when we lived in a crowded development near a superhiway, then when we moved a little further out of town and away from the superhiways, her infections went away.

The air quality near major hiways is so dirty that I had to clean a black soot off the fans at least every month, and now we only have to clean the fan blades once a year and it is a grey [dust].

If you have respiratory problems, get away from the superhiways and downtown areas!!!

[chiangmaiexpat]

Also avoid antibiotics especially with children. These drugs destroy their immune system. Go to a Chinese doctor or whatever.

I suppose in case of a common cold that is good advice, but with an ear infection or a respiratory tract infection you are probably better off with antibiotics. As several posters already mentioned, the air quality differs greatly with location. Near the roadside it can get very dusty, no matter whether you are in Chiang Mai or anywhere else here in Thailand. I think the "superhighway" is particularly bad, but also the emissions in the city around the moat area are nasty. It's a completely different story if you live in the suburbs or out in the sticks.

Cheers, CMX

[Mapguy]

<br>

I don't want to detract to all of the posts above, but, pollution can cause pneumonia?<br><br>..This does not leave me with a very factual/scientific feel to the overall discussion..

<br><br>According to Wikipedia ( <a href="http://en.wikipedia.org/wiki/Pneumonia" target="_blank">http://en.wikipedia.org/wiki/Pneumonia</a> ) it seems it can:<br><font color="#0000ff">"Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and <b>chemical or physical injury </b>to the lungs."</font><br><br>If the pollution is aggressive enough, I guess it could cause "chemical or physical injury". What worries me more about the discussion is the presumption that Chiang Mai is extremely polluted. In fact, judging by <i>yearly average pollution</i>, it is <b>not</b>. In this respect, Chiang Mai is among the least polluted places in Thailand, less polluted than e.g. Phuket. The big difference is A/ the Chiang Mai pollution peak in March every year, when the pollution level is twice that of Phuket, and B/ the months of May-September, when Chiang Mai is at approximately half the Phuket levels.<br><br>I have no medical training, so I wouldn't know, but I can <b>guess </b>that the very high Chiang Mai levels in March can be the <b>initial </b>cause of a respiratory problem, but I somehow doubt that a subsequent move to Phuket would cure that. (My impression of Thai doctors is that they are as susceptible to "urban myths" as anybody else, so I'm not surprised that they blame Chiang Mai's "extreme pollution" for anything respiratory.)<br><br>The ideal solution would probably be to live in Chiang Mai 10-11 months of the year but to stay in Phuket, or some similar place, during March each year.<br><br>/ Priceless<br>

<br><br>"Ideal solution to live in Chiang Mai 10 -11 months of the year."   Yes, I suppose so, but not a  <i>practical </i>one, is it, except for the rich and idle.  So, how useful is such a "solution?!"<br><br>Priceless, who <i>is</i> concerned about air pollution in Chiang Mai, has offered forum readers much statistical information (based on best available data) about  (PM<10) pollution levels, but I believe comparing mean pollution levels from place to place is really pointless when pollution peaks in the February - April period.<br><br>Of course there are a variety of reasons for respiratory illness, but micro climate and/or macro climate, there's a pollution problem that is NOT an urban myth in Chiang Mai.  And it does cause varying problems, especially for children, old folks, and those unfortunately predisposed to respiratory difficuties or infection.<br><br>There are only so many statisticians who can dance on the head of a pin!  Oy! Just wet your thumb and stick it up in the breeze during the bad months and, after long enough, you'd find it just as black and gritty as the blades on the fan or the filters on the air conditioner you are now cleaning.  Of course, if done outside, you might also attract quite a crowd!<br><br><br>

[jaideeguy]

I do have concerns about the abuse of antibiotics, but as CMX pointed out, they are appropriate in some instances. Normally, I try to treat the symptoms first and if that doesn't work [with resparitory infections] after 3 days, then we'll go with the standard amoxycillin....a low grade broad spectrum antibiotic that the dr's Rx for everything.

[Priceless]

[...] Of course there are a variety of reasons for respiratory illness, but micro climate and/or macro climate, there's a pollution problem that is NOT an urban myth in Chiang Mai.

And it does cause varying problems, especially for children, old folks, and those unfortunately predisposed to respiratory difficuties or infection

The same is true for just about all other cities in the world. Before I moved to Thailand, I lived in Stockholm, Sweden, which is supposedly one of the least polluted cities in the world (shared second place on the World Bank list [ http://siteresources.worldbank.org/DATASTA...s/table3_13.pdf ]). In spite of this, the particular area where I lived was WAY over the European Union targets, being near one of the main traffic arteries.

What I have been trying to point out is that Chiang Mai is, on average, one of the least polluted cities in Thailand. However, in March of each year we normally get a "peak" which is quite high (though not as high as in e.g. Lampang or Samut Prakarn). It must then be up to each individual, whether parent or not, to decide if one prefers a low average pollution level or a low peak pollution level.

What one decides on must partly depend on one's preferences: I am not medically trained or experienced, but I understand from what I've read that a low average level gives less risk for e.g. lung cancer and other "chronic" diseases, a low peak level gives less risk for asthma and other more "acute" ailments.

If one decides that one demands both low average and low peak pollution levels, that probably means moving to some place right on the ocean, in some country other than Thailand (Perth in Australia, Oslo in Norway and Vancouver in Canada come to mind).

Finally, to those that have not already been bored to death by my graphs and tables, here's a graph of average monthly pollution levels during 2000-2008 for four popular "farang areas" in Thailand. This may help the OP in his decision making process.

(It may also be worth noting that the levels in Chiang Mai for the first four months of this year have been from 9% to 26% lower than what is shown in the chart, wheras they in Din Daeng, BKK, have been from 2% to 21% higher.)

/ Priceless

[Jefferson]

That's a VERY nice and helpful graph, Priceless, I have bookmarked it for the next time this issue comes up somewhere.

And I can't help but be happy that this supports my recommendation of 'live in Chiang Mai, and take the kids for a holiday in March.'

Maybe your graph isn't relevant too, though?

[chiangmaibruce]

Well our little one - discussed in another thread - is still not OK. Ears OK but still has chronic cough -usually in the evenings. At the suggestion of another TV member we are now attending the kids clinic at McCormick. And so the diagnosis/treatment changes yet again.

We have gone from infection (3 different antibiotics) to allergy (three different medications incl cortisone spray), and now finally two different asthma meds (one oral and one with big inhaler thing). This despite the fact that his only symptom is the cough - no wheezing etc.

Are we getting the feeling the doctors are a bit clueless and just using his little 2.5yo body as a test tube, yup dead right we are.

[ILovedogs]

Well, I have a kid in Chiang Mai, that I am trying to adopt, and when she first started living with me, she was sick all the time, and her family gave me loads of medications that they were sure she needed, and wanted me to take her to the "clinic" every other day. (We had a transistion period where her grandmother lived with us for a while).

I stopped giving her EVERY medication, since it was all antihistamine, and tylenol, in various forms, and some other meds, to stop her from throwing up which she did a lot of. She got one maybe real sickness, with a fever, where I actually took her temp, and everyone though I was the devil because I didn't take her to the hosptial, to do that, because I know how to work one of those things, and can spend 1000 baht to buy one, and I actually have books to advise me about what to do, what temp is too high, etc. Since I had 4 western medical books for children, all very current, and was following them, and she wasn't having any unusual symptoms, I opted to follow that and NOT follow all the crap from the "clinic".

I would suggest if you are moving here to buy some good books that you trust, if you can. And to read those. And use those for the basic, day to day stuff, if you feel confident about what you know. If you do not feel confident, by all means, go to the hospital. I have some medical background, not with kids, but having some books gives me the added info I need to make some basic decisions and not freak out.

In my situation, the meds were making my kid worse, and shorty after she stopped taking all that crap, she improved. Her diet improved, she had a growth spurt, and basically, every single thing that was a problem has gone away in a matter of months. It may have helped that she changed schools also. I have to say that what kids are exposed to is going to effect what they catch. This probably is not a problem for most farangs here, or any farangs here, but if your kid is going to some "poor" school just like in our own country, poor people cannot afford to miss work as easily, and will send their kids to babysitiing or school, no matter what, if they can get away with it. Cheaper schools might have less strict rules about accepting sick kids there, might not notice sick kids because they have less workers per kid, whatever.

Kids, in general, that stay home, and don't go to any kind of daycare, get sick less often. I happen to get sick less often when I stay home all the time, don't have a job in an office, etc. Please some people don't write me that I am some elitist because I wrote this. It is a medical fact, you can read it, in any book about children.

I don't think kids are getting sick in Chiang Mai from pollution unless they have some weakness already that predisposes them to that, or that they are especially exposed to pollution, like they live in a roadside stall, ride on motorbikes all the time, their school is in a bad location, etc.

I think all of the major hospitals are okay for regular child care, if your kid has something very special, then you would need to check further into a specialty, but you might need to do that even in London or New York. Just don't trust the small local "clinics" as being great. They might be good, or they might not, because I believe they cater to Thai taste which is, for one thing, "to get a lot for their money" which in medical terms, means getting prescribed lots of meds, no matter if you need them or not. That is why they give you aspirin, vitamins, antibitotics, and usually at least one other pill, because it makes Thai people feel that they really "got something by going to the doctor." Otherwise they may just go to the "local doctor" who is not a medical doctor at all, and who will pray and chant over your kid and put some herbs on him. Maybe just as effective, depends what is wrong, doesn't it???

If your kid has a cold, just as effective. But gee, if he has something else? Maybe not? But if you are a western person considering moving to Thailand, I don't think you need to worry about the quality of the hospitals or the pollution unless your kid already has something you know about that could be a problem, or if he develops something serious, you can always leave, but then again, you maybe should ask the WHO, or someone who is an expert if you really want an expert opinion. People like me, we already live here, and are biased.

[lordofdelusion]

Thanks for all the good replies. To those parents who have problems with chronic ear infections or sinusitis and bronchitis, how many of you have had your children vaccinated with the relatively new pnuemococcal vaccine? Here is a clip from the world health organization site.

Pneumococcal diseases are a major public health problem all over the world. The etiological agent, Streptococcus pneumoniae (the pneumococcus) is surrounded by a polysaccharide capsule. Differences in the composition of this capsule permit serological differentiation between about 90 capsular types, some of which are frequently associated with pneumococcal disease, others rarely. Invasive pneumococcal infections include pneumonia, meningitis and febrile bacteremia; among the common non-invasive manifestations are otitis media, sinusitis and bronchitis. At least 1 million children die of pneumococcal disease every year, most of these being young children in developing countries

(Otitis media is ear infection)

I know many of you have strong feelings regarding medications and vaccines but I would consider the vaccine.

So it sounds like March and April are a bit of a problem but the rest of the year is better than most places. Guess maybe just find a nice suburban place away from a major highway.

[Jefferson]

Kids, in general, that stay home, and don't go to any kind of daycare, get sick less often.

Absolutely. However, I think it's good for kids to interact and play with other kids, be in a different environment, get used to school and learning and so on. So I fully accept that occasionally the kid will catch a cold or another typical kid's illness.. Ok they get sick, have a runny nose and perhaps a temperature for a couple of days, but I think that's natural too..

I guess the other extreme is to keep kids in a sterile 'clean room', where indeed they won't get sick.. But they're not getting prepared for life either..