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Health Care in Thailand

Doctors and Hospitals

The quality of health care available in Thailand is very high. Many hospitals in Bangkok have a reputation for providing excellent medical, surgical and nursing care. Nurses and doctors usually speak English, and many have trained in the United States or Europe

There is a distinct difference in the standard of health care between Bangkok and the provinces. In many ways, health care in Bangkok matches the standards of health care in Western cities, at least for those who have enough money. In rural areas, however, health care has to be considered barely adequate on a Western scale.

Health care in Thailand has both private and public institutions. Private institutions generally have higher standards, and one can usually say the more expensive the better.

Luxurious hospitalisation is available at some private hospitals. There, some suite rooms may match luxury hotels in comfort - wall-to-wall carpeting, refrigerator, a reception area, colour TV, telephone, and of course aircon.

It is a custom that when a Thai is hospitalised, family members, friends or a companion stays with the patient most of the time. Rooms in private hospitals usually provide sleeping space for at least one companion per patient. There are usually no set visiting hours and at least in the case of private rooms, there is 24 hour access.

Common opinion is that private hospitals generally require a deposit before admission.

But of course, as provided by law and medical ethics, doctors will attend to any patient in an emergency situation, without asking for money in advance.

Most private hospitals house a number of clinics with medical specialists. On weekdays, clinic hours are usually in the late afternoons and well into the evenings while on Saturdays and Sundays clinic hours are often all day.

Doctor’s fees are not regulated and physicians or hospitals set their own charges. Fees vary widely. In provincial cities, doctor’s fees are lower, and in rural areas, they are about a fourth or less of what is charged in the capital.

Doctor’s fees in hospitals are often not charged by the doctor but by the hospital that employs a physician permanently. This is in pleasant contrast to some other Asian countries (for example the Philippines) where the physician sets the hospital charges the patient only for the facilities used while the doctor's fee.

Emergency rooms often also function as out-patient clinics, with the advantage of immediate attention. Clinics in hospitals have more sophisticated diagnostic equipment and laboratories than doctors’ offices.

Unlike in the West many medications can be bought over the counter. While prescription regulations exist in Thailand for certain drugs, they are often not observed and many drugs requiring a prescription in Western countries are sold freely. There is widespread amphetamine abuse, especially among professional drivers.

Medical drugs sold in Thailand are either manufactured by international companies, which often have local subsidies, or by smaller local companies. Drug patents are not observed very strictly so there are many clones. However, it is generally assumed that the medical drugs of international companies are of a more consistent quality. They are also more expensive.

Most Thai doctors, especially in tourist areas, speak sufficient English to communicate with foreigners.

Health Precaution

The necessity of special health precautions to visit or live in a country like Thailand are sometimes underestimated but most often exaggerated. A journey to or stay in Bangkok is no jungle expedition, and this author has lived in Southeast Asia for more than a decade without falling ill with any tropical disease. Bangkok basically is a modern city - in the tropics, but a modern city nevertheless. To be involved in a road accident or to suffer from vehicle pollution ranks higher on the scale of potential health hazards than do malaria or cholera.

However, common sense recommends a few adjustments to Thailand as a tropical country. Around mid-day one should look for shade. One should be careful with drinking water - an easy task in Thailand as cheap bottled water is available practically everywhere.

It’s advisable to avoid dishes with raw ingredients - vegetables as well as meats and fish. There aren’t many Thai dishes with raw ingredients but where cooking is influenced by Vietnamese traditions, many foods remain uncooked.

A few Thai terms will make it easier for the visitor to distinguish whether a food is raw or cooked: raw - dib; well cooked - sook; raw fish - goy; raw meat - laab. Naem is an uncooked, pickled pork sausage; yam are marinated raw meats or fish.

Of all the diseases that pose a potential danger in a tropical country like Thailand, only malaria is a real tropical disease - the transmitting Anopheles mosquito doesn’t live in cooler climates.

While the danger to be infected with malaria is minimal in Bangkok and other major cities of the country, the risk is real in rural areas especially along the Cambodian border.

Chemoprophylaxis is generally not recommended for persons who stay in urban areas or who have only daytime exposure in rural areas as the Anopheles mosquito feeds only during the night hours.

"Symptoms can begin as early as eight days after infection or as late as several months after departure from a malarial area. Travellers should be cautioned to seek medical attention promptly for any febrile illness and to inform the physician of their itinerary. The wisdom of general protective measures against mosquito bites should also be stressed. Because the vector mosquitoes usually feed at night, it is advisable to diminish exposure between dusk and dawn by remaining in screened areas, using mosquito netting, covering exposed skin with clothing, and using insect repellent. The most effective insect repellents contain N, N-diethyl-m-toluamide (DEET)."

"The mainstay of malaria chemoprophylaxis is chloroquine. Chloroquine phosphate 500 mg (300 mg of chloroquine base) should be taken once weekly beginning one to two weeks prior to travel and continuing during the stay and for six weeks after departure from malarial areas. Minor side effects, taking the drug after meals may alleviate including gastrointestinal disturbances, dizziness, blurred vision, and headache. Serious side effects are rare..."

"For chemoprophylaxis in areas where chloroquine resistant P. falciparum malaria occurs, it was formerly recommended that a single tablet of Fansidar, which contains 500 mg of long-acting sulfadoxine and 25 mg of pyrimethamine, be taken once a week along with chloroquine beginning one to two weeks before arrival in an endemic area and continuing for six weeks after departure from such an area. However, severe mucocutaneous reactions, including erythma multiform, Stevens Johnson syndrome, and toxic epidermal necrolysis, have developed after the use of two or more doses of Fansidar. These reactions have produced fatalities with an incidence of about one in 11,000 to 20,000 among American travellers. Thus, recommendation for chemoprophylaxis have been revised to balance the risk of acquiring CRPF malaria with that of using Fansidar. Any history of adverse reactions to sulfonamides or pyrimethamine should preclude the use of this combination.

Because some strains of P. falciparum and all other Plasmodium species are susceptible to chloroquine, weekly chloroquine administration remains essential in areas where CRPF malaria occurs."

Cholera is not a tropical disease in the sense that it couldn’t occur in cooler climates. But because it’s a disease associated with poor sanitary conditions, and because such conditions are more often found in tropical countries than in countries with moderate climates, it’s often seen as a tropical disease.

While there have been cholera epidemics in Thailand in earlier times, the country is now not seen as a cholera risk area.

As cholera is highly contagious, outbreaks of the disease anywhere around the globe receive much international media attention. The cholera vaccination currently available is considered not very efficient.

Any warm blooded animal around the world can be infected with rabies, including those of the species Homo Sapiens. In general, rabies is much more common in tropical countries than in those with a cooler climate.

A vaccination against the disease which is fatal if unchecked is commonly only undertaken after there is reason to suspect that a person could be infected - usually after being bitten by any warm-blooded animal (though the disease can also be transmitted through the saliva of an infected animal alone).

The rabies vaccination is one of the most elaborate and most expensive one of all vaccinations. Several injections are given subcutaneous over a number of days.

As Thailand is a sexually liberal country, it cannot come as a surprise that it does have its problems with the AIDS disease. A report in the Bangkok Post of April 20, 1991 indicated that at that time there were some 200,000 to 300,000 people in the country infected with the AIDS virus.

From 1986 on, the kingdom had a law banning foreigners infected with AIDS from entering the country. However, the ban was revoked in mid-1991 as it was considered ineffective and detrimental to the reputation of the country.
A Draconian anti-AIDS law was discussed in Thailand at the beginning of 1991. The bill would permit the authorities to compel any prostitute to undergo blood tests; those found positive would be prohibited from continuing to work and confined to one of several rehabilitation centers to be set up.

Hepatitis B is transmitted much in the same ways as AIDS but "much easier to catch than AIDS" and "far more deadly." Hepatitis B is a viral infection of the liver that once contracted may clear up after a few weeks and then leave the person immune. But remaining dormant for years or decades it can result in cancer of the liver or cirrhosis "and early death."

The disease seems to be more deadly for the male.

Hepatitis B is transmitted through an infected person’s body fluids and blood. That means it can be caught by sexual contact or from needles used for drugs, acupuncture and tattoos. Mothers can infect their babies at or after birth... The infection cannot be passed casually but must go into the body through a break in a mucus membrane or a cut in the skin. Yet the hepatitis virus is much more infectious than AIDS. It is far more concentrated, much tougher and more stable."

The first association most people have with poisonous animals are snakes. But while many poisonous snakes are at home in Southeast Asian jungles, they are found in urban areas primarily in zoos.

As poisonous snakes don’t see mammals of the size of humans as potential prey but rather as enemies with whom an encounter will be rather disadvantageous for the snake, the snake will attempt to flee the scene much rather than to attack. Encounters therefore usually happen accidentally.

In general, the danger of poisonous sea animals is taken too lightly when compared to snakes. The most common poisonous sea animal is jelly-fish. However, the most dangerous jelly-fish are not at home in Thai waters. And while some jelly-fish are found in coastal waters, especially during the rainy season, it’s not like on the Southern Chinese or Northern Australian coast - that the authorities would have to warn against swimming in certain bays or during certain times of the year because the sea would be infested with jelly-fish.

On stony or rocky beaches, those not wearing water sandals risk stepping onto sea-urchins. Wounds will usually infect and heal only slowly.

If you tread on a sea-urchin, try to pull out any spines you can and seek medical help. If the latter is not possible, strike the affected part of your foot with a large, smooth pebble or the bottom edge of a bottle. This will break down the offending spines, which the body can then absorb. Many a hardy Pattaya-goer has successfully resorted to this method."

Hospitals in Bangkok

Adventist Hospital
430 Phitsanulok Road
Tel 281-1422, 282-1100, 281-1237
private hospital

Bangkok Christian Hospital
124 Silom Rd
Tel 233-6981 to 9, 233-6907 to 9
235-1000 to 7, Fax 236-2911
private hospital since 1949

Bangkok General Hospital
2 Soi Soonvijai 7 (off New Petchburi Rd)
Tel 318-0066, Fax 318-0066
private hospital with 400 beds

Bumrungrad Hospital
33 Soi 3, Sukhumvit Rd
Tel 253-0250 to 69, 253-5160 to 9
255-0285, 255-0286 to 99, 255-0300 to 4
251-0415 to 6, Fax 255-6622;
priv. hospital

Camillian Hospital
423 Soi 55, Sukhumvit Rd
Tel 391-8786, 391-8311, 391-0136
391-5724, Fax 381-1843;
private hospital

Central Hospital
Luang Rd, Tel 221-6141,
gov. hospital
 

Chulalongkorn University Hospital

Rama IV Road, Tel 252-8131 to 9
government hospital

Deja General Hospital
346 Si Ayutthaya Rd, Tel 246-0137
Tel 246-1685 to 93, 247-2080 to 5
Fax 247-2089;
private hospital

Dental Hospital

88/88 Sukhumvit 49
Tel 260-5000 to 15, Fax 260-5026
private dental hospital

Hua Chiew Hospital

665 Bumrungmuang Rd
Tel 223-1351 to 69, 223-1251
private hospital

Kluanamthai Hospital

80 Soi Rongpyaban 2, Rama IV Road
Tel 381-2006 to 20, Fax Ext 375

Mayo Hospital

2012/5-7 Phahonyothin Rd
Tel 579-3921, 579-1770 to 4
579-1598, 579-9660,
private hospital

Nonthavej Hospital

30/8 Ngarmvongvan Rd
Tel 589-5489 to 91, 589-0102 to 7
589-1794 to 6;
private hospital

Paolo Memorial Hospital

670/1 Phahonyothin Rd
Tel 279-7000 to 9, 279-7040 to 9
271-0227, 279-5240 to 9, 279-3838
Fax 271-4454;
private hospital

Petcharavej Hospital

2469/13 New Petchburi Rd
Tel 318-0080 to 1, 314-2016, 318-1983
319-2083 to 7;
private hospital

Phayathai Hospital 1

364/1 Si Ayutthaya Road
Tel 245-2620 to 1, 245-9621 to 9
245-9610 to 9
private hospital with 300 beds

Phayathai Hospital 2

943 Phahonyothin Rd
Tel 270-0780 to 9, 270-1830 to 9
279-9580 to 90
private hospital, 24 hour service

Police Hospital [584]

Rama I Rd, Tel 252-8111 to 25
government hospital

Prommitr Hospital

12 Soi Prommitr, Sukhumvit Rd
Tel 259-0373 to 8; private hospital

Rajavithi Hospital

Rajavithi Rd, Tel 281-1272; gov. hospital
Ramathibodi University Hospital

Ramkhamhaeng Hospital

2138 Soi 34, Ramkhamhaeng Road
Tel 374-0200 to 16, 374-0197 to 9
374-8198; private hospital

Rutnin Eye Hospital

80/1 Soi Asoke, Sukhumvit 21
Tel 258-0442 to 5
specialise in eye defects and eye care

Saint Louis Hospital

215 Sathorn Tai Rd, Tel 212-0033 to 48
Fax 211-4933
the oldest private hospital in Thailand with 92 years of health services

Samitivej Hospital

133 Soi 49 Sukhumvit Rd
Tel 392-0010 to 9, 392-0119, 397-0067
392-0061 to 5;
private hospital

Siam General Hospital

15/10 Soi Chokechai 4, Ladprao Road
Tel 514-2157 to 9, 514-2273 to 6
specialise in treating brain diseases

Siriraj University Hospital

Prannok Road, Thonburi
Tel 411-0241, 411-3192, 411-4230
government hospital; this hospital has a museum of the Department of Forensic Medicine as well as an anatomical museum (see entries on museums in the chapter Art & Culture)

Sukhumvit Hospital

1411 Sukhumvit Rd, Tel 391-0011
Ms. Dr. Hattaya is their gynecologist and recommended by the Cockatoo staff; lower hospitalisation fees than other private hospitals in the Sukhumvit Road area

Thonburi Hospital

34/1 Soi Sangsuksa School, Issarapharp Rd
Tel 411-4245 to 9, 411-0401 to 7
412-0020 to 7

Vajira Hospital

Samsen Rd, Tel 241-2401
government hospital

Vibhavadi General Hospital

51/3 Ngarmvongvan Rd
Tel 579-9680 to 4, 579-9649 to 53
561-1258 to 67
private hospital with country wide ambulance service

Vichaiyut Hospital

114/4 Setsiri Rd
Tel 271-0125 to 9, 271-4984, 271-3179
271-2585, 271-4996, Fax 278-1017
private hospital