Thailand’s public health system: an introduction

This morning I was introduced to the Thai public healthcare system. Luckily it wasn’t because I had a medical situation on my hands, though my cavalier attitude to consuming street food probably means that a gastro-related disease is only a matter of time. Nope, it was just that I needed to have a medical check-up in order to get my year-long sponsored work permit, one of the many hoops I need to jump. So my post is solely based on my brief and cursory interaction with the health system today. And it was totally fine.

There are a number of hospitals in Chiang Mai but the one in Suan Dok is enormous so it’s probably the main one. Driving the short distance there from work – 5 minutes – and taking about 20 minutes to find a parking spot was reminiscent of my three years of driving 5 minutes to Liverpool Hospital for work. Who would’ve thought that lack of hospital parking was a universal issue?

A workmate accompanied me and guided me through the whole process – I would have been completely lost otherwise, given I can’t speak Thai yet. As soon as we entered the main hospital building she asked, “Compared to Australia, this must seem third-world to you?” Well, I wouldn’t say that exactly – it’s not like hospitals in poorer parts of the world I imagine, though thankfully do not have first hand experience of. A large part of the hospital seemed pretty crowded and old and run-down, though it must have once been new. But it just seemed worn out from over-use that’s all. I actually had the same feeling when passing through LAX last year actually which is one of the world’s busiest airports and in the United States – and looks like it has certainly seen better days.

Compared to the rest of the world, Thailand doesn’t do too badly in terms of healthcare and health outcomes. It has done exceptionally well dealing with issues like HIV and family planning, though lots of other areas need improvement. It also has a public healthcare system that services everyone who pays social security. Many people are clearly left out of this – for example, the many Burmese workers I’ve seen about working on construction sites. The hospital we went to today also indicated that there seems to be a two-tier system – we ended up in a very new part of the hospital which was extremely modern because you can pay to fast track your way through, though it’s really not that expensive, relatively speaking. My boss thinks the public healthcare here is pretty decent and the level of care is exceptional – and given that we’re in the business of international public health, that is high praise indeed.

I was subjected to fairly routine procedures during my visit by nurses who looked like how nurses used to look like in the English-speaking world – fitted two piece outfits, low-heeled white shoes, and starched white caps affixed with bobby pins. They took my blood pressure, weight, height. A doctor also examined me but it only involved him using his stethoscope to check out my heart and lungs, and asking me if I smoked or took medication or had any pre-existing medical conditions. I noticed on the form he ticked that I had not displayed any symptoms of tuberculosis, leprosy or elephantitis – which was reassuring but also disturbing at the same time that these are still diseases people suffer from in the 21st century

The only bit I was slightly nervous about was the drawing of blood from my veins but they used sterile needles and their infection control seemed fine. One thing I noticed which made me think, “only in Asia”, was seeing a nurse carry a plastic container with some vials of blood – and the container had Hello Kitty pictures all over it. Seriously.

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