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2 มีนาคม 2549
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Reflections of cultural differences (Medical Care I)

Hello friends,

Thank you very much for your inputs upon my previous reflections. Your thoughts are very valuable.

I have some personal rules in this series. After throwing my thoughts on the issue to all of you, I will let you share yours and I will not interfere. I may send you my thinkings responding to your comments to your personal mailbox.... Basically, schools of thoughts belong to you na krub....

OK! I wrote the previous two favoring the Americans.... Well, many might have thought that I had been "americanized", as a result, I had nothing to criticize them.

You may... That's up to you... :)

I'm a human... so are you, right?.... So, fundamentally, I also involve (directly and indirectly) in birth, aging, sickness and death....

In this issue, I will discuss on number 1 and 3.... reflecting what I've seen between the two cultures once again.

I was working in public hospitals for a few years when I was in Thailand. It was a contractual obligation that I along with many other graduates in medical-related fields had done for quite some time in Thailand; working as a governmental officer for few years after graduation. In that time, because I was heartbroken, so I chose to be working in one of the remote place in Thailand.

To reach my hospital, I had to drive through a moon-surfaced red dirt road for 25 km. The hospital was centrally located in one of the sugarcane plantations in our country. Even behind my very room, it was sugarcane field as far as the eyes could see....

No water for un-necessary activities such as washing my white Nissan Sunny.... As I told you earlier, it was a red dirt road in front of my hospital...So, unavoidably, my white car was always "dressed in red"... :)

I can remember that I would be very happy every time it was raining.... I would run from the hospital right through the garage to push my "red car" out and directly be exposed it with free water from the sky.....

Quite a long irrelevant introductory part I gave you... Anyway I love that life... simple life with patients who needed my services... I learnt that my education/knowledge could make a difference for the first time right there.... in the centrally surrounded sugarcane plantations....

I worked with many people whose had the same fate--- doctors, nurses, dentists, and pharmacists..... we're all there to serve... some were willing and happy to be there... Some weren't...

Even in the most remote area imagineable, there were some degree of medical services for the people.... Of course, the quality cannot be compared to the level it is in the US.... but it is something... at a reasonable price....

Time has flown, I have changed my career... Switching from a humble small hospital to a university, I had obligation to go away from my country.... To another kind of service....

I still am a human being.... Sickness comes and goes from time to time even here in the US.... The most striking one was my dental health... It became worse and worse because I was too scared to see a dentist in the US (because it is darn expensive)... In those whole 3 years, I went to see a dentist once!!!

So, that' s the main reason I had to pay the price.... I had root canal infection plus gum disease which was urgently needed surgery.... I asked for the cost if I would do it here in the US.... The reply from the dental hygenist was expensive enough to make a decision to buy a round-trip ticket back to Thailand instead without any hesitation!!

It was going to be 3000USD.... So, I called one of my dentist friends... asking her to suggest a good place/clinic where it could fix both of those I had.... After I had information, I called the clinic.... They told me that it would be around 5-750USD!!! So, without any hesitation, I flew back to Thailand after dropping every class I registered....

Those dental treatments were done by an American-board dentist (Thai nationality)....So, basically, I had very good treatment by the same quality personnel.... at the fraction of the price in the US....

Even for the Americans, being sick is too scary.... You might have gone bankrupted if you got sick without health insurance!!

One time, my American friend was sick like a dog.... It was obviously bad that bedridding her for almost a week... But she declined to see the doctor because she had no health insurance...

I have to admit that America has the best medicine in the world. But it may be worthless if its people cannot afford it.... That's sad krub....

When I was working in the hospital... In that time, there was no 30-baht-cure-all project... Anyway, similarly, we provided every care we had (dental and medical) to everyone... almost all for free....

Even though we offered medical care for free or very cheap in my perspective (maybe 10-30 baht per visit)... There was a case that I always remember... It was an old lady, she had diabetes (DM).... In her case, her DM was badly controlled.. She had a monthly appointment with us... but, she came to us maybe once in 2-3 months.... We knew that she could not afford the medicine, so we gave her free... absolutely free for everything....

It was almost noon time, I can remember... She was there in the hall while I was strolling down to the hospital canteen.... With my curiosity, I sat by her and asked her some questions....

I: Yay, why didn't you come to see us last month? Were you sick or something?
Yay: I was alright....
I: You're not quite alright.... We give you free medicines, right? Are you afraid to pay?
Yay: No, it's not that... I don't have a 10-baht bus fee from the village to the hospital....

Before that time, I was thinking that my governmental salary was too low (it was less than 8000/month).... After that conversation, I gave up that idea, and my attitude has changed ever since...

More details of this reflection will be further narrated in the next blog.... I think I've come to a point where I would like to start...

What do you think?

Best regards,

Create Date : 02 มีนาคม 2549
Last Update : 2 มีนาคม 2549 12:49:58 น. 37 comments
Counter : 383 Pageviews.

I still and used to be one of the people living in the countryside. I get what you are telling about them.

โดย: IP: วันที่: 3 มีนาคม 2549 เวลา:22:14:13 น.  

Actually, 30-baht-cure-all program is not so effective.

The government gave the fixed amount of budget to the hospital which is around 1,500 baht/case. Many of the case is chronic and complicated, so we have to spend much more money than that fixed rate. I can't imagine how the hospital could be survived. Recently, Thamasat university's hospital has walked out from this program, and it's loss around 105 million bath...(from the newspaper na krub)

About the cost of living, US is, apparently, higher salary. So the life there can't be cheap. The doctors and paramedics earn a lot of money. Where is those money came from, Insurance company, Social welfare or from the patient themselves? This makes the cost of medical fee so expensive.

Anyway, I guess you already knew. :-D

โดย: IP: วันที่: 4 มีนาคม 2549 เวลา:11:49:44 น.  


โดย: dont wanna no IP: วันที่: 4 มีนาคม 2549 เวลา:12:33:54 น.  

I always think that healthcare system in the US. is a big failure. It's so expensive a lot of people can't afford it. They made us believe this is "THE WAY", when it fact, it shouldn't be. Many countries in this world have better, more effective , yet affordable healthcare. You're so right -> "America has the best medicine in the world. But it may be worthless if its people cannot afford it." That is very sad, indeed.

โดย: Fah IP: วันที่: 5 มีนาคม 2549 เวลา:1:31:48 น.  

Your blog is very impressive. I am working in medical field. And I have been working for many years. In my opinion The Universal Coverage 30 Baht cure for all is a good campaign in theroretical, but the policy makers are not in medical profession so they may not know the root causes of medical problems in Thailand. I am very glad to see poor people access medical service without fearing how much money do they have to pay for. But on the other hand medical professions work harder so how could us give the proper service to everybody? And right now we are working with feeling fear or suing. I think itmust be great if we promote this campaign and educate people how to promote their health simultaneausly as universal coverage campaign is not for cure all diseases, but some diseases due to nature of them. My english writing skill is not well but I try to express my feeling. I am getting bored now. Don't know why do I have to work hard for patients who are not realised what me and medical professions have done for them. But I understand that it's because of their perception about us is not right, anyway I am quite tired working hard for nothing. I hope to overcome this feeling very soon.

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amatuer translator
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Note: My life has been intertwined with works and many others. New responsibility has emerged, resulting less and less time for my ordinary life. Although, a love to write is still intact... But having less time is related to having less imagination.... Therefore, I could not come up with new writings for quite some times.

It might be a good time for me to leave this forum for moment.... Please take it as Mr. A.T. is having a sabbactatical leave or something like that....

As noted above, my love to write is still the same... and will not be changed. Sometimes somehow, I hope I could come back and give some thoughts in this blog once more.

Mr. A.T.
June 6th, 2008



My pen-name in Pantip is amatuer translator. Actually, I'm a lousy translator with lame translation. My pen-name is somewhat misleading, I have no background in linguistics what-so-ever. Anyway I love to read, write and communicate with people...

Reading is my most favorite hobby. I read everything from shopping bags to articles in theoretical physics. I do research and teaching for my living. So, reading, writing, thinking and doing research works are my everyday routine.

I would like to define myself as a person who is accepting new ideas and adopting those into my way of life.

I believe in power of knowledge/education. I think every society can be a better society with knowledge. Ignorance can be dispelled by it. Humanity can live sustainably and harmoniously with each other along with its biosphere with understandings in the nature surrounding it.

Apart from my philosophical thoughts reflecting who I am, I can tell you something I like or love in particular;

I love dogs.... Particularly, labradore retrievers.... One day, I would like to spend my time and life with them as a big part of my family.

Zhuge Liang is my hero. With his wisdom and faithfulness, he led a tiny army to a mighty and formidable kingdom. He left his humble residence with a hope to come back. But, sadly, he had never returned and died far far away from home in a horse carriage in a battle field. If I could choose where I would, I would say where-ever my lovely wife was nearby.

I value happiness and my family as my first priority. My profession and my philosophy come in the second. Pursuit in wealth has never been in my desire.

I'm glad to be your friend, and look forward to seeing you around krub.

Best wishes,
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