A VISIT TO A HOSPITAL IN BANGKOK IN THE ERA OF COVID-19

COVID-19 Test Hall at Ramathibodi Hospital (24/05/2020)

I am 72, a regular visitor at Ramathibodi Hospital in Bangkok. As a two-year bladder cancer survivor with a few other health issues common to an elderly person I find my hospital visit a norm of life. That is until the arrival of the Novel Corona Virus Diseases in 2019. I have happily retired from a long, exciting, active, and fulfilling public life as a political scientist, television journalist, documentary producer, a drafter of the 1997 constitution, and a one-term senator. During the two years following my bladder cancer operation in 2018 I am required to undergo update check-ups every 3 to 4 months. These involve blood and urine tests, ultrasound, x-ray, and cystoscopy. I also have prostatitis  which requires regular administration of a drug called Uroflo. My hernia inflammation now needs an operation. Not to be outdone, in 2015 I met with a deadly car accident where I came out with all kinds of broken bones and one full year of convalescence. All these medical issues combined make my visit to the hospital in the era of COVID-19 all the more challenging. 

Ramathibodi Hospital of Mahidol University is among Thailand's most advanced and well-equipped hospitals. It is a public hospital which means it costs less than private hospitals but the healthcare facilities are of high quality as required by the world standard of medical science. Yes, it's a bit crowded because of its quality and relatively low cost. In fact, most hospitals in Thailand are of world standard because of adequate funding and doctors with world-class education and training. Medical science education is heavily subsidised by government funding and scholarships within the countries and abroad. Young Thai best medical minds can go to Harvard, Johns Hopkins, and Oxford, with full government scholarships. Freshly graduated Doctors are required to practice in the rural area for a couple of years before moving on into public hospital of their choices or enter private practice. Doctors in public hospitals are allowed to hold parallel jobs with private hospitals where they enjoy additional and higher pays. Provincial hospitals may be smaller and limited in equipments and resources but the expertise of doctors, nurses, and healthcare workers are of the same high standard as in any big-city hospitals.

As for cancer treatment, Ramathibodi Hospital (or 'Rama' in short) is my hospital of  choice.

I told my doctor that I prepare myself exhaustively by reading many American and British books and websites on cancer and follow advices I have read from
Johns Hopkins' Sidney Kimmel Comprehensive Cancer Center ,
American Cancer Society, The National Cancer Institute, And Bladder Cancer Advocacy Network (BCAN).
My Thai doctor replied: "Don't worry, we at Rama are up to date with the world of medical science. Whatever is available and being practiced in the US we have it here at Rama."

Thai doctors go by the books of science and I know I am in good hands at Rama at a fraction of the cost in the US.

During this chaotic COVID-19 era Thailand has been very successful in coping with the pandemic. Temperature checking, infected person-tracing by mobile phone application, and hygienic measures are everywhere with full cooperation from the citizens, both in Bangkok and the provinces. The minute I enter the hospital door the fever temperature machine with a line of smiling nurses await me. I only have to look up at the distance camera on the machine to have my temperature read and then given an OK sticker on my shirt sleeve. People sitting or walking around the hallways and at fronts of the doctor rooms are advised to keep a social (or physical) distance the best way possible. But on a busy day a two-three-meter physical distance is a real challenge. And I always move to the best further-away seating possible. Everyone wears facial mask as a norm even long before the COVID-19 pandemic. Facial masks became a new normal since the particulate matter 'PM 2.5' air pollution had made big scary news in many big cities a year before the Novel Corona Virus Diseases of 2019.

Thanks to efficient management of the Ministry of Public Health, anyone can get a COVID-19 test if needed. I never had a COVID-19 symptom so I don't need a test. I only come to the hospital on regular appointments and get to observe and absorb the atmosphere in the hospital every few months. Now that I have scheduled for a hernia operation on this coming Monday 25th May the doctor will give me free bonus of COVID-19 test the day before the operation. This is the normal practice of the hospital to administer COVID-19 test to pre-operation patients regardless of the symptom. So I got my very first COVID-19 test on Sunday morning of May 24th and the result came in the afternoon the same day. The testing was done in a tightly-closed room with glass window partition separating doctor and patient. The doctor put out her hands through two rubber holes in the window and instructed me to assist her (as earlier seen on the video in the waiting room). I was required to help the doctor going through the whole 5 minutes process - putting on PPE gloves for her, handing her the swab, letting her insert the flexible swab into my nostril, put the swab back into the tube container, closing the swab tube and put it into a zip-locked plastic bag. After thanking the doctor I came out of the test room and handed the test-kit to the nurse for immediate lab analysis. Rama Hospital informed me by phone in the afternoon that I tested negative.

My son lives in Los Angeles. He suspected a COVID-19 symptom of loosing sense of taste and smell but he could not get a COVID-19 test anywhere for the past two months. He just quarantines himself in his apartment, alone with all his music-composition equipments to keep him from going crazy. He is a film music composer temporary devoid of work opportunity in the era of COVID-19 in 2020. A Magna Cum Laude graduate of Berklee College of Music, but being an Asian immigrant in the US during Donald Trump's era is worse than contracting COVID-19 or any disease, I sense. It seems like the American COVID-19 is racist and should be renamed "COVID-F" (Corona Virus Immigration Diseases-Forever - "F-Virus" for short).

Medical science and public healthcare in Thailand are trusted and admired by developing countries around the world. Political leaders, king and queen, and ordinary citizens from neighbouring countries routinely come for medical treatment in Thailand. Migrant workers also are given the same healthcare privilege as any Thai citizen. The late King Bhumibol of Thailand, himself was born at Mount Auburn Hospital in Massachusetts, preferred medical service from Siriraj Hospital to any other hospital abroad till his final days. Medical tourism ranks Thailand among the world's top destinations.

I am lucky to live in Thailand with world-class healthcare, especially in time of public health crisis.
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As of 9 December 2020 Thailand recorded a total of 4,151 COVID-19 cases,  25 more from the previous day. 3,880 cases were remedied, 211 still hospitalised, and 60 sadly died. With some minor precautions,Thailand is ready to open the country and live with the new normal disciplinary precaution starting Monday 15 June 2020. Only travellers from abroad will be routinely tested, given hotel rooms to stay in quarantine for 14 days with full bedding and lodging services, tested, treated, and traced after leaving the state quarantines.

The race for COVID-19 vaccines is on in full force around the world and in Thailand. Leading universities, research institutes, scientists, a private biotech company in Thailand including Chulalongkorn University, Mahidol University, National Research Council of Thailand, National Vaccine Institute, and BioNet-Asia, in close cooperation with the University of Pennsylvania, my alma mater, have been hard at work together to find and then produce the best COVID-19 vaccine possible, probably within the next one to two years. With safety and efficacy as the ultimate goal, COVID-19 vaccine from Thailand and other countries will surely help save millions of lives and stop this deadly pandemic.

Somkiat Onwimon
24 June 2020

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