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Journals from Traditional and Modern Healthcare in SE Asia

2014-02-04 Umphang District Hospital

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On the left is part of the adult in-patient ward. On the right is the pediatrics in-patient ward.

Monday, 1/20/2014

We visited the Umphang District Hospital. Normally, because of the healthcare programs, Thai citizens pay 30 baht (about USD $1) per visit to the hospital while non-Thai citizens have to pay a higher price. This hospital, though, is sponsored by an Umphang foundation, so anyone can come and be treated for free, regardless of citizenship, which is fantastic. They don't turn any patients away. Additionally, if a patient needs to be taken to a better hospital in Mae Sot, this hospital will pay for the care they get over there. This hospital has five doctors and 150 beds total. The waiting time is less than an hour to be seen for appointments and less than 4 minutes for the emergency department.

The hospital is located near the border between Thailand and Burma, so language is a big barrier for communicating with patients. There is one interpreter for the whole hospital, and a few of the nurses can speak multiple languages. There are two Karen tribes in the area which speak Karen, a Hmong tribe which speaks Thai and Hmong, and thousands of Burmese refugees that speak Burmese. The Karen have been in Thailand for 200 years, but since they mainly keep themselves culturally distinguished from the Thai (they generally don't speak or write Thai and don't get an education), there is no way for them to get Thai citizenship. However, the Thai government allows them to remain in Thailand instead of evicting them. The Burmese refugees are fleeing their country because there is a war occurring over there, so wounds from landmines are frequently treated, as well as malaria.

We had an in-depth conversation with two nurses and learned about the difference between nurses in Thailand and the United States. To become a nurse in Thailand, one attends nursing school at a university for four years. Students are allowed four attempts to pass the nursing exam for certification. New graduates are guaranteed a job for two years after they finish nursing school, but they cannot choose their work location. The government places them in a location to train and get experience. After the two years, they can go to another hospital. Most will move to private hospitals or to Singapore, where they can earn a higher salary. The salary for new nurses at Umphang District Hospital is typically 15,000 baht (USD $450) a month. A new nurse in Bangkok could make 18,000 baht (USD $540) a month. There are 12 levels in nursing, and to be promoted one needs to do more schooling and pass an exam. To keep a license, nurses must complete 50 credits of continuing education every five years, which are earned by going to conferences and seminars. All people, except lawyers, are required to retire at sixty This includes nurses.

At the Umphang District Hospital, the nurses work incredibly hard, often doing double or triple shifts and getting only 3 hours of sleep each night because the hospital is understaffed. Although the government places new nurses here to work, after the mandatory two years, most will leave to go to private hospitals to get a bigger salary. This is a common reason why general hospitals and clinics are understaffed.

I have so much respect for the nurses and doctors because they are passionate about helping others. They continue working at Umphang District Hospital for lower pay and longer hours even though they could go elsewhere. They love their jobs and are dedicated to their patients. 

Kristin Jung

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