Planning your elective--Thailand

Mark Wilson tells you what you need to know

Situated between the Indian and Pacific Oceans, Thailand is well known for its beautiful beaches and has become a well travelled backpacker route. However, it has a great deal more to offer the travelling medic. In the capital, Bangkok, there are several well equipped private hospitals. But in the north there are many remote and under-resourced centres dealing with both Thai hill tribes and those who have crossed the border to escape the political troubles of Burma.

This month James Harper reports on his elective at one of the largest and most famous of these centres, "Dr Cynthia's Clinic" in Mae Sot. Dr Cynthia Maung was originally from Karen in Burma but fled with the student uprising in 1988. The clinic she set up and now runs provides education as well as aid to many of the "refugees." A word of warning, however, if you are thinking of going to the border. In recent years several stations have been attacked and there have been cases of kidnapping. For this reason most visitors to Mae Sot now stay in the town (No 4 Guest House comes recommended) rather than the clinic itself. The town has a lively atmosphere, a bustling gem trade, and there are usually several workers from Médicins sans Frontières (MSF) and Shoklo Malaria Research Unit (SMRU).

At the other extreme, there are several busy medical schools and specialist hospitals. Thailand's main medical problems are infectious diseases--malaria, tuberculosis, and typhoid in rural areas (especially the north) and HIV in the cities. Eighty per cent of prostitutes are thought to be HIV positive. Western diseases, such as diabetes and cardiovascular disorders, have been increasing for several years.

A visa is required to enter Thailand for more than 15 days. Contact the Royal Thai Embassy, 29-30 Queen's Gate, London SW7 5JB (tel 020 7589 2944; fax 020 7823 9695; email dx42@cityscape.co.uk; web http://thaidip.mfa.go.th/london

Remember Thailand is extremely harsh on drug traffickers. Do not under any circumstances get involved, and lock your bags before you get to the airport.

Your health

Immunisation against typhoid and hepatitis A is recommended. Immunisations against diptheria, rabies, and Jap B encephalitis are sometimes recommended depending on where you are going. Obviously you should have had a BCG (?) and hepatitis B vaccine. Remember that there is a very high incidence of malaria in the north (and HIV especially in Bangkok)

Finally

There is loads to do in Thailand, but I must make a personal recommendation: there are several British prisoners in the main prison in Bangkok and you may find notices in Bangkok youth hostels that say "so and so" would like to be visited. This may seem very alien and frightening, but they really appreciate visits (you have to go on specific days) and it is an amazing insight to Thai prison life.

Medical schools

In Bangkok:
Chulalongkorn University, Faculty of Medicine, Rajdamri Road, Bangkok 10500, Thailand http://md2.md.chula.ac.th
Mahidol University, Faculty of Medicine, Siriraj Hospital, 2 Pharnnok Road, Bangkok 10700 (For tropical medicine contact: Wellcome-Mahidol University, 420/6 Rajvithi Road, Bangkok 104000, Thailand (tel 2 2460832; fax 22467795)

In Chang Mai:
Chiang Mai University, 110 Intawaroros Road, Muang Districtm Chang Mai 02000, Thailand (tel 053 221122; fax 053 217144; website http://www.medicine.cmu.ac.th)

In Mae Sot:
Dr Cynthia’s Clinic: PO Box 67, Mae Sot, Tak 63110, Thailand (tel 55 533 644; fax 55 544 655; email win7@loxinfo.co.th). Please remember that Dr Cynthia’s clinic is extremely busy and run by donations so do not expect an instant reply and send an international reply coupon is writing.
There are several other camps along the border?for example, in Maela?run by larger agencies. Contact Médicins sans Frontières for more details.
Shoklo Malaria Research Unit: PO Box 46, Mae Sot, Tak Province, 63110, Thailand (tel 55 531531; fax: 55 544442). Run by a group of international scientists and doctors, this group researches into resistant strains of malaria.

Private hospitals
Bumrungrad Hospital, 33 Suhhumvit Soi 3, Klong Toey, Bankok 10110, Thailand (tel (00 662) 6671000; fax (00 662) 6672525). This is recommended as Bangkok's finest private hospital. It has excellent teaching, resources, and health care. It is centrally located and because of it international reputation many there speak English.
The Thonburi Hospital Public Co Ltd, 34/1 Issaraphap Road, Soi 44, Bangkok-Noi Bangkok 10700 (tel (02) 412 0022; fax (02) 412 6005; website http://www.thonburi-hosp.com) For more rural and private hospitals in Thailand and hospitals in other countries check out The Medic’s Guide to Work and Electives Around the World (Arnold 2000, ISBN 0 340 76098 2) or visit http://www.medicstravel.com)

Mark Wilson, senior house officer in intensive care medicine, University College Hospital, London and author of The Medics Guide to Work and Electives around the World
Email: mark@medicstravel.com


studentBMJ 2001;09:399-442 November ISSN 0966-6494