Some Terminal Patients Left With Few Choices: Thailand

[webfact]

Some terminal patients left with few choices

Chularat Saengpassa

The Nation

Officials from the Issarachon Foundation are seen helping the seriouly ill women in the Sanam Luang area on March 30.

BANGKOK: -- A former sex worker, battling for life at the terminal stage of Aids, was discharged by a private hospital two months ago and told to go die at home.

Except she had no home to go to, and chose to seek shelter in the Sanam Luang area. The Issarachon Foundation found her again in an emaciated state on the street.

"In fact, we got her admitted into hospital on March 30," Natee Saravari of the Issarachon Foundation said.

Natee had gone to Sanam Luang that day to seek public opinion on the Homeless People's Bill at Sanam Luang where he heard her cry for help.

"I carried her to a state hospital but was told to take her to a private hospital where she was entitled to free treatment under the social security scheme," he recounted. "The private hospital then agreed to admit her.

Later, Natee heard that the private hospital treated her for about two weeks and then decided to tell her to leave.

"Your illness is incurable and you will live for no more than a month from now. Please go home," a doctor there was quoted as saying. The doctor also told her that the hospital did not have any spare beds.

When Natee ran into her in Sanam Luang again, he contacted Wat Phra Bat Nampu, the Mercy Centre and another institution that provides care for people living with Aids. However, they all said that their facilities were full.

"She is now making do without medication, because she has nobody to take her to hospital," Natee said.

Meanwhile, Aids Access Foundation director Nimit Tienudom said if the patient was given antiretroviral drugs regularly, complications from the HIV virus would reduce and she would be able to live longer, maybe even lead a normal life. He said he was planning to contact the Issarachon Foundation to find out if she could be given a caretaker.

Natee said that so far, no matter how many times she is asked, the woman would not give any details about her family.

However, he said, she doesn't seem to be all alone in Sanam Luang, because at the very least, other homeless people have been giving her food and drink.

"From what I've heard from the locals, this woman does not hail from this area. She just showed up one day and had been sleeping on the streets for about two weeks before I first ran into her. She does not seem to have any belongings other than a bag of old clothes," he said.

Natee added that though the woman has insisted that she does not want to be hospitalised and plans to die on the streets, he believes that the Public Health Ministry should provide some help.

"You can't let a human being die on the street," he said.

-- The Nation 2012-05-24

[geriatrickid]

"You can't let a human being die on the street"

Well, apparently you can. The article provides an illustration of palliative care and mental health resources for Thailand's poor and destitute.

[jonclark]

To quote Ghandi " A society is judged by how it treats its' most vulnerable citizens."

Wise words.... how should I judge Thailand??

Edited May 24, 2012 by jonclark

[Roadman]

To quote Ghandi " A society is judged by how it treats its' most vulnerable citizens."

Wise words.... how should I judge Thailand??

Accordingly to an article on this site only a few months back from the Thai's themselves regards their health care as being the best in the world, then your judgement should be....yeah I know this is good old corrupt tell them anything Thailand.

[laurentbkk]

in Thailand if you have money you live ... if you are poor you die ..... nothing is more simple than this .

[gand]

So the beggars mafia did not want her either?

[OzMick]

in Thailand if you have money you live ... if you are poor you die ..... nothing is more simple than this .

Even the rich and fatuous die.

[abhaya]

Happens in America too.

[marquess]

A damning inditment against humanity for its lack of humanity!

[gand]

in Thailand if you have money you live ... if you are poor you die ..... nothing is more simple than this .

Even the rich and fatuous die.

Nobody gets out of here alive.

[NowImEasy]

Happens in America too.

Another chance to bash America. We are discussing Thailand on this forum. If you hate America, I'm sure there are countless forums where you can do your whining. In the past decade, America has provided $Bs to Africa to combat AIDS with very few other rich countries doing very much. And I do think you are basically wrong in saying that people die in the streets in the US. Do you have any proof? Americans are very generous in the private aid donated to the poor and homeless.

[gand]

Happens in America too.

Another chance to bash America. We are discussing Thailand on this forum. If you hate America, I'm sure there are countless forums where you can do your whining. In the past decade, America has provided $Bs to Africa to combat AIDS with very few other rich countries doing very much. And I do think you are basically wrong in saying that people die in the streets in the US. Do you have any proof? Americans are very generous in the private aid donated to the poor and homeless.

And the illegal.

[ginjag]

in Thailand if you have money you live ... if you are poor you die ..... nothing is more simple than this .

Even the rich and fatuous die.

Nobody gets out of here alive.

I aim to do. !!!! Sell my burberry to receive treatment.

[Nisa]

though the woman has insisted that she does not want to be hospitalised

[drdoom6996]

"You can't let a human being die on the street"

Well, apparently you can. The article provides an illustration of palliative care and mental health resources for Thailand's poor and destitute.

The political party in power at present has only one agenda. Me Me Me. They don't care about common or poor people. They are all rich and don't want to bring themselves down to that level. But making passports and visas instead of taking care of the flood tipped their hand, even for the common person. PTP, Red Sirts, and UDD want it all and they want it NOW!!!!!!!!!!!!!!!!!!!!!!!

[LuukKoeyKorat]

"You can't let a human being die on the street"

Well, apparently you can. The article provides an illustration of palliative care and mental health resources for Thailand's poor and destitute.

The political party in power at present has only one agenda. Me Me Me. They don't care about common or poor people. They are all rich and don't want to bring themselves down to that level. But making passports and visas instead of taking care of the flood tipped their hand, even for the common person. PTP, Red Sirts, and UDD want it all and they want it NOW!!!!!!!!!!!!!!!!!!!!!!!

You've got some serious issues. Sad case.

[DP25]

And I do think you are basically wrong in saying that people die in the streets in the US. Do you have any proof?

Just drive through certain major US cities and they are littered with homeless. There isn't remotely enough space at shelters for people. Cities like LA, Detroit, and NYC have tens of thousands of homeless people each that are sleeping on the streets every night. LA alone has 80,000 sleeping on the street every night. There are people dieing on the streets every single day. The situation is far, far worse than in Thailand.

[jonclark]

though the woman has insisted that she does not want to be hospitalised

In cases like this it is entirely possible that the lady in question is unable to make the rational and correct decision. As symptoms of advanced HIV / AIDS can include dementia, the loss of some mental faculties and general deterioration in the brains capacity

If a mad man claimed he had wings and could fly, should he be allowed to jump from the tallest building or should those of better judgment and experience intervene on his behalf and save him from a certain death?

[how241]

in Thailand if you have money you live ... if you are poor you die ..... nothing is more simple than this .

Sad truth.

[ginjag]

though the woman has insisted that she does not want to be hospitalised

In cases like this it is entirely possible that the lady in question is unable to make the rational and correct decision. As symptoms of advanced HIV / AIDS can include dementia, the loss of some mental faculties and general deterioration in the brains capacity

If a mad man claimed he had wings and could fly, should he be allowed to jump from the tallest building or should those of better judgment and experience intervene on his behalf and save him from a certain death?

Some posters do not seem to grasp some nomal siuations, I agree with you there are so many very sick cases out there, and too many too sick to understand what is best for them. I only hope that If I am in the situation and not good in my thoughts-someone will come along and do what is best for me. whether it be to put me DOWN or make me well.

[Arkady]

"I carried her to a state hospital but was told to take her to a private hospital where she was entitled to free treatment under the social security scheme," he recounted.

This doesn't stack up. If she was a sex worker, it is unlikely that she was in the social security scheme and entitlement to health care expires I think 6 months after becoming unemployed anyway. She should be entitled to universal healthcare at a government hospital near the address on her ID card just by taking her ID card, even if she has lost the gold card. Perhaps she had already tried that and been turned away or was too weak to travel there if it is not in Bangkok. Telling her she would be dead within a month is a self fulfilling prophecy, if the quack refused her medical care.

Edited May 26, 2012 by metisdead
Defamatory comments removed.

[mca]

"You can't let a human being die on the street"

Well, apparently you can. The article provides an illustration of palliative care and mental health resources for Thailand's poor and destitute.

The political party in power at present has only one agenda. Me Me Me. They don't care about common or poor people. They are all rich and don't want to bring themselves down to that level. But making passports and visas instead of taking care of the flood tipped their hand, even for the common person. PTP, Red Sirts, and UDD want it all and they want it NOW!!!!!!!!!!!!!!!!!!!!!!!

<deleted> - Where's the woefully shaking head emoticon.

[Nisa]

though the woman has insisted that she does not want to be hospitalised

In cases like this it is entirely possible that the lady in question is unable to make the rational and correct decision. As symptoms of advanced HIV / AIDS can include dementia, the loss of some mental faculties and general deterioration in the brains capacity

If a mad man claimed he had wings and could fly, should he be allowed to jump from the tallest building or should those of better judgment and experience intervene on his behalf and save him from a certain death?

The point being is that if SHE wanted to be hospitalized then I can almost assure you this would be a non-story and she wouldn't have been discharged nor wouldn't have been on the street to begin with.

While it certainly is possible she has suffered brain function deterioration, the story doesn't mentions this and there is some indications it is not the case including ..

Meanwhile, Aids Access Foundation director Nimit Tienudom said if the patient was given antiretroviral drugs regularly, complications from the HIV virus would reduce and she would be able to live longer, maybe even lead a normal life. He said he was planning to contact the Issarachon Foundation to find out if she could be given a caretaker.

No doubt she is probably not thinking well due to depression and shame (won't give details about family) but without any indication she is mentally incompetent then she should have every right to choose or not to choose to be hospitalized as long as she poses no risk to others.

Regardless, very sad story.

Edited May 24, 2012 by Nisa

[crazydrummerpauly]

Just so sad - but thank you for sustaining my faith in humanity, Natee Saravari.

[jonclark]

though the woman has insisted that she does not want to be hospitalised

In cases like this it is entirely possible that the lady in question is unable to make the rational and correct decision. As symptoms of advanced HIV / AIDS can include dementia, the loss of some mental faculties and general deterioration in the brains capacity

If a mad man claimed he had wings and could fly, should he be allowed to jump from the tallest building or should those of better judgment and experience intervene on his behalf and save him from a certain death?

The point being is that if SHE wanted to be hospitalized then I can almost assure you this would be a non-story and she wouldn't have been discharged nor wouldn't have been on the street to begin with.

Regardless, very sad story.

"Later, Natee heard that the private hospital treated her for about two weeks and then decided to tell her to leave.

"Your illness is incurable and you will live for no more than a month from now. Please go home," a doctor there was quoted as saying. The doctor also told her that the hospital did not have any spare beds."

Seems to me she was told to leave as opposed to her deciding to leave on her own. Perhaps the shame of being exiled from one hospital has contributed to her current decision

But regardless a sad story such as this shouldn't be turned in a debate.

Lets just hope that this poor lady gets the help, treatment and compassion she needs and can live out the remainder of her life with a modicum of respect, dignity and comfort.

[freebyrd]

Happens in America too.

Khon Thai Jai Dee. Do you hear anything like this in the States about all American people?

[geriatrickid]

"You can't let a human being die on the street"

Well, apparently you can. The article provides an illustration of palliative care and mental health resources for Thailand's poor and destitute.

The political party in power at present has only one agenda. Me Me Me. They don't care about common or poor people. They are all rich and don't want to bring themselves down to that level. But making passports and visas instead of taking care of the flood tipped their hand, even for the common person. PTP, Red Sirts, and UDD want it all and they want it NOW!!!!!!!!!!!!!!!!!!!!!!!

This is an issue that extends far beyond any particular political party. Almost all of the personnel working at the implicated ministries were in their positions when the Democrats and Military were in running things. Attaching a political motive to this problem serves no purpose save to demonstrate your pettiness. Mental health is still a taboo subject in Thailand. That's one of the obstacles to implementing a solution. HRH Galyani made an effort to raise the profile of mental health as part of her public health advocacy and she had an ability to positively impact public perceptions. I suggest you read up on the woman and see some of the struggles she faced going back to the early days when even mentioning the subject would cause people to run away in fear. She got some people to talk about the subject and not to be afraid.

[geriatrickid]

]

Yeah, government hospitals may not be great and badly funded. But unless your implying that the people that work there are heartless bas***ds i don't understand your point. They maybe underfunded, but a large majority of doctors and nurses are good, compassionate and they work hard and could provide the basic human necessities, food, clothing, water, medicines, hygiene. On the streets this womans life is awful

If I may offer perspective, and I am not being critical of your point, because I understand it and appreciate its validity. However, personnel are overworked and understaffed. They have a hard time providing service in the best of times. For example, Patong hospital can have one doctor on shift at times. Patong Hospital is the primary public facility in that part of Phuket and that one physician has to treat a flood of cases. It is difficult to provide proper care. It's not even about money. Thailand has a critical shortage of psychiatrists and clinical psychologists. It takes a decade to get a quality mental health professional (training and field experience). The health services planners don't have an effective plan.

[Galong]

If you pay social security you are entitled to free healthcare at any government hospital. And, you don't have to be employed to get this benefit. I know exactly what I'm talking about as I have a rare lung disease and get superb free healthcare at the Mission Hospital in Phuket.

My doctor told me that when I retire I will still be able to get it as long as I still pay into the very, very afordable social security scheme.

My medicine is very expensive. In my homeland, I would NOT be able to get insurance. I would have to work a second job JUST to pay for my medicine. Thailand takes superb care of me... for which I am extremely grateful.

This woman is an exception here, not the norm.

Edited May 24, 2012 by Galong

[Galong]

I'm not sure about the effectiveness of reversing final stage AIDS, but the HAART meds can keep a person alive and health for a very long time.

From what I've read on the subject, if caught at the earlier stages and HAART started in time, an HIV+ person stands a very good chance of dying of old age.

This medicine is readily available in Thailand. It is obcenely expensive in my home country. Thailand takes better care of her citizens than my home country does, period. For those of you who are slamming Thailand, unless you have personal experience with terminal illness patients or patients who require other expensive medical treatment, may I suggest not assuming that this story is indicative of the overall reality here. It's not. She's fallen through the grate somehow. It looks like she's now getting some help. Step one is often finding someone who gives dam_n about you.