Wednesday, 2 February 2005
I’m well into my fourth week at Fang Hospital – time is really flying. The last few weeks have been jam-packed with activity. I’ve had some amazing experiences here at Fang Hospital, and some very memorable trips around the area.
I’ve finally managed to post some of my pictures on the Web. I’ll try to keep adding albums as I go. There are presently FIVE albums on the web, visit the website below for access. You do need to sign up, but it is very easy. Also visit my Blog for updates.
www.yorkphoto.com/share/p=772291106997308381/l=41400905/cobrandOid=1002
www.adventureswithhamish.blogspot.com
This coming week I’ll be seeing lots more hospital action, going on a jungle trek, visiting some more hill-tribe villages before finally saying my good-byes and packing to come home. But first here goes for another update (I apologise in advance for the length and morbid content).
Thailand’s Health
Health in Thailand is a paradox. On one hand Thailand is definitely a ‘Developing’ country, with high child mortality and loads of preventable disease. On the other hand, Thailand has embraced development with vigor, resulting in a remarkably high number of doctors. Here are a few of my personal experiences with some of Thailand’s top current health concerns.
Roadkill
Last weekend I witnessed the worst results of road accident I’ve ever seen. The incident involved 2 motorbikes, 5 young male passengers, 0 helmets and an unknown quantity of alcohol. The first to guys were brought into ER in pretty bad shape. One had a deep leg laceration and nasty head wound – but was conscious and stable. The other was unconscious and barely breathing. His face was an absolute mess, with watery blood running from his nose and mouth and left leg broken in at least two places. He was intubated, stabilised and transferred to a neurosurgeon in Chiang Mai (3 hours south).
I met the remaining three victims at the morgue – their lifeless bodies displayed unceremoniously on stainless steel trolleys for the doctor to examine. The fluorescent light overhead gave their skin an eerie, unreal appearance and their fingers were stained blue from fingerprinting ink. Family members were ushered in to identify the dead. I cannot describe the look of loss, pain and total disbelief on their faces. As I joined the doctor to identify and record the injuries my mind spun as I tried to make sense of what I was seeing.
I’ve mentioned Thailand’s shocking ‘road-kill’ statistics, but this brought it home in a very real and personal way. Here is an excerpt from The Nation – an independent Bangkok newspaper:
EDITORIAL: ’Tis the season of carnage on the road (Jan 02, 2005)
http://www.nationmultimedia.com/2005/01/02/opinion/index.php?news=opinion_15948534.html
One is more likely to die in a road accident than from any other cause in Thailand… With 36 road deaths a day, Thailand ranks sixth in the world in relation to total population, according to the World Health Organisation.
With the high proportion of motorcycles on Thailand’s streets, 80 per cent of fatalities from road accidents involve these two-wheeled vehicles. But that’s not the end of the story… a percentage of these drivers will be under the influence of either alcohol, amphetamines, or perhaps even both.
It’s time the government and police started getting tougher on bad drivers, particularly drunken drivers, those who fail to put on their seat-belts and motorcyclists who decline to wear helmets… Irresponsible motorists must be treated like the potential killers that they actually are.
HIV/AIDS
As the biggest single health issue facing the world, HIV/AIDS gets a decent chunk of teaching time at Monash University. But it is here in Thailand that I have really seen the results of this indiscriminate killer for the first time. At present there are half a dozen patients with AIDS-related illness on the ward, and a large proportion of general patients have asymptomatic HIV infection.
I think of one girl in her mid twenties, suffering from Pneumocystis carinii pneumonia – a severe lung infection only seen in advanced AIDS. She lay before me, her wasted body buried in a pile of blankets. As her sunken eyes met mine I wished I could communicate with her – but what would I say? She is dying a slow and ugly death, I cannot begin to understand what she is going through. Another 25yo man is here with cerebral toxoplasmosis – an AIDS-associated brain infection. He has repetative muscle twitches and intermittent convulsions. He has improved somewhat and is due for discharge today – but he’ll be back, it’s just a matter of time. Another young woman presented with CMV retinitis – an AIDS-associated eye infection. She still somehow manages to look after her family and work, but is slowly going blind.
Here is an excerpt from an international AIDS charity on the present situation in Thailand:
AVERT - http://www.avert.org/aidsthai.htm
There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale, but Thailand is an exception. Its well funded, politically supported and comprehensive prevention programmes have saved millions of lives, reducing the number of new HIV infections from 140,000 in 1991 to 21,000 in 2003. None the less, one-in-100 Thais in this country of 65 million people is infected with HIV, and AIDS has become the leading cause of death.
The first case of AIDS was reported in Thailand in 1984, and it is believed that widespread transmission began in the late 1980s. In 1988-89 in the first major wave of the epidemic, HIV infection exploded among injecting drug-users, rising from almost nil to 40% in a single year. At almost the same time, a second wave of infection spread among sex workers. The rising infection level among sex workers launched subsequent waves of the epidemic in the male clients of sex workers, their wives and partners, and their children.
It has been estimated that each year, up until the end of 2006, over 50,000 Thais will die from AIDS-related causes. Over 90% of these deaths will occur in people aged 20-44, the most productive sector of the workforce.
The campaign against AIDS involved: massive funding; a huge public information campaign; and the ‘100 percent condom program’ aimed at commercial sex establishments. This has had great success in reducing sexually transmitted HIV – the HIV infection rates in sex workers dropped from 50% in 1991 to 20% in 2001. However it has done little to reduce HIV in injecting drug users – with infection rates of 40-50%. HIV infection is rising among young people, presently at around 17%. Evidently, the problem will remain for some time yet.
Women’s Health
One of the most personally distressing cases I have witnessed here was a girl coming in after a ‘backyard abortion’. Like many other desperate women, she had illegally obtained a drug to prematurely empty her uterus. Now she was had presented to ER with bleeding, sepsis and emotionally shattered. She would need surgery to clear up the physical mess, antibiotics to stop infection, and would hopefully avoid being rendered infertile for life. As I saw the physical and mental torture this girl was going through, it really brought home why abortion must be legalized.
In Thailand legal abortion is restricted to cases of incest, rape or threat to the mother’s life. Yet, like anywhere else, abortions continue. These illegal abortions involve medical or physical evacuation of the uterus, with shocking physical and emotional consequences. In Thailand, one quarter of maternal deaths are due to complications of backyard abortions. In Burma, the stats are tenfold higher.
With these facts, I see no room for moral superiority in the debate on abortion legalisation. The focus must return to supporting a vulnerable and desperate woman as she makes one of the most difficult and distressing decisions of her life. Abortions will always occur, but society can choose whether to protect or persecute the women involved. It’s well and truly time that respect was returned to these women, allowing them to make the best moral decision for their individual circumstance.
Additional Highlights
Pandas – During a weekend visit to Chiang Mai I checked out the local zoo, including its key attraction – two beautiful Pandas. I still have a Panda teddy my Grandma made (which takes pride of place on my pillow), so it was great to see a live, breathing and bigger version in real life. Don’t worry, I didn’t try to cuddle it.
Wat Phrathat Doi Suthep – Overlooking Chiang Mai city is a magnificent Buddhist temple. During my religious exploration here I came across a Chinese fortune box of chopsticks. The chopstick I got was #9 (my favourite number), and I eagerly looked up its message- “The 9th number tells that you should not go away”. My next stop was a Meditation centre which advertised a 3 week short course for foreigners – the exact amount of time I had left at Fang! My excitement was quenched when I read the rules: no eating after noon, no ‘chatting’, no music and no reading!
Golden Triangle – A day trip to the Golden Triangle (of drug trade infamy) gave me the chance to visit 3 countries in one day: Thailand, Burma and Laos. I had lots of interesting experiences here, which were almost overshadowed by a scare with immigration. As a foreigner I was held up at the border to fill out paperwork. As I waited in line I realised that I was holding three bags full of my Thai friends ‘shopping’’ though I didn’t really now what was inside. It hit me that this would be the perfect way for my friend to smuggle in drugs. My imagination went nuts, especially as my friend had conveniently lost herself in the shops. I was honestly figuring out how best to spend my time in a Bangkok prison – would they allow books, music, writing letters? I knew my legal defense was pretty weak. I reached the official with beads of sweat on my forehead, looking anything but relaxed and innocent. But, I’m not writing this from my prison cell, so I evidently got through unscathed.
Conclusions
That’s it from me. I hope you have enjoyed another update. You can view them all online at www.hamishthailand.blogspot.com (and add comments too). Feel free to pass this on to others who are interested.
In love.
Hamish
Email: hamish_hammer_graham@hotmail.com
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