Monday, February 27, 2017

Boomerrang Day - Back up in the country

I barely spent 24 hours in the big mango when I had to go back upcountry for a medical emergency. One of B's first cousins was in the hospital in critical condition.  She had a serious case of ovarian bleeding due to an infection and was at the local hospital.  The cousin is the only daughter of B's father's closest sister and we were asked to go back to provide morale and financial support.  She was at the local government hospital where poor citizens can be treated for only 30 baht.  The problem is that the hospital is only staffed with a pharmacist and no MD was present.  She was in danger of going into shock unless she saw a medical doctor fast.

I had committed to the Charity BBQ on Saturday and B had to get some things to bring back so we left the Mango at around 6:30 pm and was at the hospital by 10:00 pm.  During our trip upcountry, we arranged for a private doctor to come to the hospital to treat B's cousin.  Told him we would pay for his trip and fees from the main hospital in town to our local hospital.  We told him if she needed surgery, he should release her and we would pay for an ambulance to take her over to the main hospital for surgery if needed.  

As it turned out, the doctor said she was in serious condition, but he did not recommend surgery at this point as her infection had to be dealt with first and her condition had to improve.  He put her on a vigorous course of antibiotics, IV, and close monitoring in a private room.  When we got there she looked very pale and fragile, but she was stable.  We stayed a couple of hours and finally went back to the resort exhausted after a long day.  The doctor had already left and we were to meet him the next day.

Our visit to her yesterday was a lot better.  She was actually able to sit up on her bed and her fever was gone.  From what I could understand, she will be kept there for another 5 days for observation and treatment.  We are now looking for doctor that is a specialist in women's health to check her out in a couple of days, again on a private basis.

One thing I have learned and confirmed for sure is that public medicine can be a nightmare.  You can build the hospitals and equip them with beds and equipment, but one cannot create doctors out of thin air.  The best doctors are going into private practice and large hospitals where they can make a lot more money. Government hospitals suffer from both a shortage of doctors and doctors in many specialties. In our case, the hospital had a lot of space and beds, but no doctors at night.  I counted 10 new looking ambulances sitting idle,  with no drivers available.  Such a waste of resources and I hope the US will never go down the same path.  

During last night's visit to the hospital, patients were in beds in the outside waiting area in queue for the doctor, including a boy of about 5 years old who was crying. The doctor wasn't due in until the morning.  There is terrible injustice in the system, but I'm not smart enough or rich enough or powerful enough to do a whole lot about it.  As they say, life is hard and then you die.  And in the poor countries of the world, you get an up close view of how cheap a life really is.  A few thousand baht can be a good night out on the town in the big mango for some, but for a poor family in the rural northeast, it could mean life or death.

Health care is a major issue not just for the US, but the entire world.  Unless we change it drastically and make sure the incentives for those that treat patients, regardless of financial capability, are some how equalized, it won't matter what we want to call it by name.  

A slightly depressed Sevenwinds....exiting stage left


  1. now you know sorry about your relative.
    this is the problem i'v been fighting with my friend
    no money no care.
    there are some good doctors but too few of them
    the 30 baht system does not work to well
    this is the ultimate goal of obam care to destroy health care

  2. In retrospect, I think the only way to make some headway is to force all doctors to work at the public hospitals at least 1/3 of their time or they will not be certified to practice that year. Unfortunately, that will likely create an underground network of doctors or force doctors to leave the country for brighter opportunities elsewhere. No easy answers to a very complicated problem. In the meantime, many will die in the halls waiting their turn to see doctors...what a frickin waste.


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