One Health, One Home

Us with Dr. Nisit and Pi Peter

Hey, Baylor Family! It’s Catherine!

A beautiful sunrise and a hearty breakfast helped us continue our journey out of the fog that jet lag creates on our minds and bodies. Today, our brains were jumped into action when Dr. Nisit Wattanatachariya, a family physician who teaches at Chiang Mai University, gave us a lecture on the Thai health care and health issues. One of the many interesting things Dr. Nisit talked about during his lecture was the Thai health care and health insurance systems. Thailand is divided into tambons or villages which then add up to a district, and several districts create a province.

Similar to the United States, the health care system is divided into regional hospital and community hospitals, but in Thailand, the regional hospital is at the province level, the community hospital at district level, health center at tambon level, and village primary health care (PHC) center for villages. Regional hospital in Thailand are very similar to that in America where they house several specialists as well as numerous beds. Community hospitals in the U.S. are like a miniature version of a regional hospital, while in Thailand they don’t have the specialists but they house dentists and pharmacists as well as doctors and nurses. Health centers at the tambon and village levels provide basic medical and emergency care but also have the main function of health prevention and promotion. Unique to Thailand is their institution of the Village Health Volunteer. These volunteers train for 15 days to perform many different PHC activities for their community like health education, basic treatment of common diseases, etc. This definitely helps the population of these villages who have a physician-to-patient ratio of around 1: 1,985. Since the United States has a ratio of 1: 628, this institution wouldn’t be as necessary as in Thailand, but hospital volunteers are just as helpful in the States to maintain efficiency in the hospitals.

Health insurance in Thailand is broken down into 3 programs: Civil Servant Medical Benefit Scheme (CSMBS), Social Security, and Universal Coverage (UC). CSMBS is for anyone that receives a salary from the government and their families and provides coverage for 10% of the population. Social Security works very similarly as that in the U.S. expect that citizens can receive Social Security earlier than retirement. UC is for the remaining 75% of the people that don’t fit into the first two programs. Under each program, everything is paid for (or mostly paid for) by the government with a few exceptions: cosmetic surgery, prescription lenses, and the Dengue vaccine. Although everyone is covered under one of the three programs, people aren’t able to choose the hospital they want to go to as is possible depending on the medical plan in the U.S.

FUN FACT! All prescription-strength medications, except for opiates, can be obtained without a prescription in Thailand at pharmacist shops. Due to this, however, antibacterial resistance is very high in Thailand.

Sawatdi Khrap!  (Hello!)  It’s John! 

After taking some time to rest after the lecture with Dr. Nisit, we listened to Dr. Muehlenbein speak on some of the main topics of study for this month.  Dr. M began by comparing the definition of “Global Health” to the definition of “One Health.”  He explained that Global Health refers to broad concepts such as the equal consideration of the health needs of all humans, the impact of globalization on health, and studying health issues beyond national borders, socioeconomic class, ethnicity, and culture.  More specifically, One Health considers the health of the environment and non-human animals and their correlation to the health of humans.  Rather than focusing only on factors that affect human health, the One Health perspective employs a range of physical and social science disciplines to analyze how certain health factors of different species are connected. 

Dr. Muehlenbein also touched on the topics of travel medicine and ecotourism, subjects in which he had done some research himself.  Travel medicine looks at specific health characteristics and behaviors of international travelers.  A lack of knowledge of the causes of diseases can lead to complications for tourists, so the travel medicine field seeks to educate and fully prepare people for their experiences abroad.  Additionally, ecotourism is a type of vacationing that focuses on engagement with nature with the intent to contribute positively to the biodiversity of the environment and focuses on respecting and benefiting local cultural heritage.