1st trip to the local mooban emergency room

[misskit]

The local "bufallo" hospitals do pretty good patch up work and if they are the closest to your house, is the best bet for emergency, I think. They do tend to be understaffed but not poorly trained.

I've found them to be good about sending me on to another hospital or specialist if they don't have the ability to diagnose or treat a problem.

At least in this area, there is an ambulance waiting to take you to a better equipped hospital if the case calls for it.

[Brown Sugar]

Good advice from both Eliminator and Rickscoppers. However treatment varies considerably from one local hospital to another I am lucky where I live there is a small local clinic with visiting doctors which serves all the community well for general things. 20 klms. away there is a larger regional hospital which I personally have used on about three occasions over the last seven years (eg. Surgical removal of three annoying cysts on the neck collar line all no problem in and out in about 1 hour cost including 'antibiotic' cover only 620 BHT sutures removed later by our local village clinic free ). However they do admit their limitations and if a condition is out of their field of expertise they will recommend a visit to an appropriate hospital in Nakhon Sawan. However I have noticed that when a person visits our local "doctors" private practice the treatment appears to be identical for what ever the ailment - an injection of what I am told is 'paracetamol',
paracetamol or similar tablets, anti-depressants (ie valium given out like sweats) about three other ill-defined remedies and a standard charge of 300 THB. Also absolutely no attempt at hand cleaning ect between patients.

[Brown Sugar]

Having worked and lived in the Far East since the early 1980's I forgot to mention one thing in my last post - WATER. I have found that this plus raw salads are the biggest cause of digestive tract infections. At the top of my list is ICE - never have ice in your drinks (including beer) and also do not use local stall vendors who pour your coke into a plastic bag and add ice. If the bar or eating place get their ice from the local ice factory there is no saying where the ice factory water comes from (could be direct from the local river) even if a bar makes it's own ice with it's own machine the water that feeds this machine is from the local town or village water supply. Personally I will drink my local village supply which I have tested (in the UK) at intervals and it is excellent but when I go anywhere else for my own safety and piece of mind I will only drink water from a SEALED bottle. I may have been lucky but in all this time (including my last seven years in Thailand) I have never had the misfortune to suffer any abdominal upsets what so ever. As for Thai food the ones that I like and ones that I wish to try I will only eat if I know how and where it has been prepared and it has got to be fresh not stood in trays or dishes with flies doing their business all over it. If one is sensible eating out in Thailand is great with all the variety of flavours and foods available.

[Mid]

here's some advise for you Brian ...........

paragraphs , much easier to read than a wall of text .

[chassamui]

Personally I will drink my local village supply which I have tested (in the UK) at intervals

I only drink virgins water.

If you live up country it's probably wise to only drink water you have passed yourself.

[Iceman123]

Here is another tip Brian - if the ice is tubes with a hole straight through the centre it is perfectly safe to drink - it has been manufactured with purified and filtered water from a very expensive ice maker - preferable and cheaper than bottled water.

I know look at my handle!

[rickschoppers]

Brian, good advice and the washed salad has caught me out on several occasions. I like green salads, but have stepped away from them in Thailand. I drink cold beer with no ice and only use it to cool the beer.

Be aware of anything that is washed with local water and not cooked.

[wasabi]

So what are the chances of catching cholera in Thailand. Cholera is sewage leaking into drinking water.

[rickschoppers]

Cholera vaccine is not generally recommended, though cholera is reported, because most travelers are at low risk for infection. Two oral vaccines have recently been developed: Orochol (Mutacol), licensed in Canada and Australia, and Dukoral, licensed in Canada, Australia, and the European Union. These vaccines, where available, are recommended only for high-risk individuals, such as relief workers, health professionals, and those traveling to remote areas where cholera epidemics are occurring and there is limited access to medical care. The only cholera vaccine approved for use in the United States is no longer manufactured or sold, due to low efficacy and frequent side-effects.

More about recommended immunizations at this link.

MD Travel Health - Thailand - vaccinations, malaria, safety, and other medical advice

[beazalbob69]

It's Ok Brian I am happy for the info in whatever writing style it is in. As far as the water thing you are probably right. I have gotten diarrhea before from having too much local water.

Never a problem with the ice at our shop it's delivered every morning by the ice dude and like iceman says it has the hole through the middle, but I am unsure about the crushed ice from the markets might have been the culprit more than once.

[JayZee]

Only been to a Thai public hospital once (Rangsit) - broke me tailbone. Sat down quietly (and carefully) with the rather agitated (Thai) missus and told her to wait patiently (sorry, no pun intended). Receptionist came over to see me, and I was whisked away for an X-ray immediately. 20 minute wait and went to see doctor who spoke excellent English. Told me what was what and prescribed some pain killers. Collected those on the way out - total time about 45 min, total cost 650baht

[rickschoppers]

I really hate to say it, but the healthcare in Thailand is probably better than most western countries, including the US. I am not talking about cutting edge medicine that exists, but the run of the mill emergency medicine and treatment of general ailments.

The cost of treatment in Thailand is also one of the better "deals" you will find. Many westerners come to Thailand to have procedures that their health insurance will not pay for at a fraction of the cost they would pay in their homeland. Yes, the facilities may not always be the best, but if you are able to find a good physician, it can save you a lot of time and money.

Having worked in US hospitals for over 30 years, I am embarrassed at the current state of healthcare in my homeland. The insurance companies pretty much run things now and how physicians practice is pretty much a side affect of defensive medicine and making sure what they do is "covered."

The last hospital I worked at I wouldn't even take my dog to. Such an inefficient and regulatory culture, I have never seen before. More time was spent worrying about the next regulatory agency than how to take care of the patients. I would never allow myself to be admitted or be seen by the ER staff unless I had no other choice.

If I ever do need any medical treatment, I hope it is in Thailand.

[Brown Sugar]

So what are the chances of catching cholera in Thailand. Cholera is sewage leaking into drinking water.

Amazingly it does not appear to be endemic in Thailand of late, but this is surprising as our local "toilet soakaway emptier" simply pumps his raw waste from his mobile 'tank' into public irrigation ditches (I have seen him at it) then in turn this water is pumped onto agricultural fields.I suppose through ground filtration this possible contaminant could find it's way into the drinking water system.

[terry57]

If I ever do need any medical treatment, I hope it is in Thailand.

One things for sure in this life mate, That is you will need to be admitted to hospital at some point.

Just make sure you have insurance or plenty of the folding stuff to pay for it.

[rickschoppers]

Terry, I actually have Medicare insurance along with a Medigap policy that will cover instances internationally. If I have a serious problem that can not be handled by the Thais, I will then head back home.

For the minor injuries and illnesses, I would rather spend a short time in the Thai hospital than wait 6-8 hours to be seen by a US physician in an emergency room.

[Brown Sugar]

Terry, I actually have Medicare insurance along with a Medigap policy that will cover instances internationally. If I have a serious problem that can not be handled by the Thais, I will then head back home.

For the minor injuries and illnesses, I would rather spend a short time in the Thai hospital than wait 6-8 hours to be seen by a US physician in an emergency room.

At 75 I find it is impossible to get health insurance at any price. Until I was 68 no real problem but after that even my current company at the time would not extend my cover. I had never made a claim against them in many years but their policy was unbending.
Regarding Thai hospitals I fractured my right neck of femur (hip) in Changmai six years ago. As the fracture was not displaced they did not recommend pinning (due to possible introduction of infection). Spent 5 weeks in total bed rest in local hospital, absolutely no complaints re treatment received once one had sussed out the Thai system where one hires ones own nurse or uses family for what I term 'hotel and personal toilet items'. Total cost was UK£1,260:00 (THB 79,380:00 at the time) including nurse hire, doctors fees, xrays, medications and a private room they even modified their food supply within reason to suit my western tastes. I returned to the UK for a couple of weeks about three months later while there had the 'injury' checked over by "orthopods" in the NHS everything fine.

[Yasojack]

We took a trip to our local clinic yesterday after five days of what i thought was a urine infection, decided it was best to make sure, i not really like taking medicine.

Got there had my height,weight and blood pressure taken and then went to see the nurse, asked a few questions, expecting him to ask me to drop my trousers nope just gave me Norfloxacin.

Thank god i never had a dose.

[Brown Sugar]

We took a trip to our local clinic yesterday after five days of what i thought was a urine infection, decided it was best to make sure, i not really like taking medicine.

Got there had my height,weight and blood pressure taken and then went to see the nurse, asked a few questions, expecting him to ask me to drop my trousers nope just gave me Norfloxacin.

Thank god i never had a dose.

A little scarey had this turned out to be anything really serious there appears to be no apparent attempt at a 'culture' to find out which 'bug' was causing the problem and which type of antibiotic was actually suitable for the treatment of same.

[rickschoppers]

^
This probably would have been the exact same treatment in the US. Physician asks some questions in the ER and if it sounds like a UTI, Norflox or Cipro would be given. If you do not have major pain and blood in the urine associated with a high fever, they will not admit you to the hospital.

I still think Thailand has very good healthcare compared to all western countries and they are reasonably priced.

[Yasojack]

cost nothing they have a box, i dropped 100 baht, for a 5 day course

[pompeysbroke]

Personally I will drink my local village supply which I have tested (in the UK) at intervals

I only drink virgins water.

If you live up country it's probably wise to only drink water you have passed yourself.

that's twice you've made me laugh tonight...ta!

[Brown Sugar]

We are all banging on about safe drinking water and ice (me included) in Thailand but a not very charitable thought passed my mind yesterday. One assumes licenses or permits are required in Thailand to bottle and sell 'safe drinking water' to the public. Knowing how easy it is to obtain licenses and permits for other items through the back door is it just as easy with a "drinking water' license.

If this is the case how many rogue traders are bottling and selling drinking water which is not fit for purpose and in fact could be positively dangerous to consume.

If we take just 1% of water sold comes under this heading just how many thousands of bottles are sold daily through out the kingdom.
Where I live two guys with a pick up truck sell drinking water in sealed plastic bottles for just 3 THB a bottle and on replacement orders they will give you 1 THB for every one of their plastic 1 litre bottle returned. Like every thing elese if it looks too good to be true it probably is.

I am sure that bottles water purchased from large supermarkets, seven elevens stores and the larger pappa and mamma stores is fine but I am not so sure about water sold by some small vendors and such like.

[Mid]

water comes out of a tap .

[Yasojack]

just buy a water filter.and your own ice machine

[Brown Sugar]

just buy a water filter.and your own ice machine

Warning re water filters as sold by retailers and hawkers.
They are only good for filtering out organic matter such as minerals and salts etc. they are absolutely no defence against water born diseases such as Cholera (Bacterium Vibrio Cholerea) no matter what is says on the 'tin'.
In fact the filter material used in these units combined with the latent temperature in tropical countries and the damp conditions with in the filter is an ideal breeding ground for such bacteria to multiply. You are probably safer using straight unfiltered tap water if the supply is good.

The only type of filter which will remove bacterial contamination is an evaporator filter such as Meco manufacture (they actually produce distilled water) and these cost many thousands of dollars to buy and run and require an engineers constant attention on service and maintenance. These are really only suitable for ships (usually used as desalination plants) or very large hotels etc.

The only reasonably safe way to produce potable water is to boil it for at least five minutes prior to use (can be left to cool) or use sterilising tablets (YUK) even then it is not 100% guaranteed to be absolutely free of bacterial infection.
Or may be stick to alcohol (no ice)!!