Real life in Thailand...

I say real life because honestly it is amazing what is going on in the lives of people living right next door to the tourist resorts here. It is not that I blame the tourists at all. If it weren't for them the whole area would be in crisis still. But I want people to know that behind every fancy swimming pool and expensive restaurant real life is playing out and it is not pretty.

Almost a week and a half ago now my team located 2 of our cases in Kuraburi. A 7 year old girl and her 2 year old sister. They found the 22 (!) year old mother and her newborn baby with tuberculosis. The baby couldn't breath, couldn't open her eyes, without coughing and coughing. The family couldn't get much help at their local hospital because they are Burmese and don't speak any Thai. This is a huge problem here and prevents many Burmese people from getting medical attention. They also fall into the category of illegal migrants and so are generally scared of formal institutions like hospitals for fear of deportation. (It is not supposed to happen but sometimes hospitals will call the police and have people deported when they can't pay a medical bill.)

Anyway, being the good Samaritans that they are, my team found transportation for the woman and her children to a hospital closer to our office where MSF (Doctors without borders) has Burmese translators working. They could not drive the family in our team car because there are checkpoints in Thailand and if you are found to be driving someone without legal documentation you can be arrested for human trafficking. Good to know, good to know. I would have surely popped them all in my car and driven off so thankfully I was not with the team that day!

I was there the day that they checked into the hospital here in Takuapa and let me say that it was a sad sight. If I could have transferred my Thai Gold Standard insurance coverage over to them and taken them to the Phuket hospital I would have. Instead we shuffled around the Takuapa public hospital for no less than 8 hours before they were finally given a room. The mother with TB, coughing and coughing into a rag. The baby (turns out has pneumonia also) choking and choking barely able to breath being carried by the mother. No offer of a wheelchair at all. Mother so weak she can hardly stand trying to also watch her other girls. It was a pathetic standard of care. The hospital staff just kept demanding to know who would pay the bill. And that is ridiculous since Thai law mandates that TB patients receive free treatment since it is a public health risk. Of course, absolutely no one seemed to be in charge at the hospital to discuss this with. After hours and hours of the same-moving from the lab, to the x-rays, to the chairs, to the exam room, to the interpreters, and back again you just get in the zone and go with it. It is so difficult to fight any system here and get anything done quickly or efficiently. I had to demand that the hospital test the 2 older children for TB-they weren't going to do it! And it turns out they have it!

Finally we left the little family in the most disgusting room imagineable. Tiny-2 wooden beds with thin plastic mattresses. Broken fan. Dirty walls. The nurses dropped the baby on the bed and she was laying in a pool of her own urine until I had to point it out to them. It is as if being Burmese makes them animals in some people's eyes.

The story does not end there. The family is HIV positive. The hospital called later in the week to tell us they wanted them all out because they didn't want the TB to spread to other patients. It was a long week of looking for options, rounding up some money, and trying to convince the hospital to at least keep the baby until she is well. They agreed but only if we could find a woman to come and take care of her-they refuse to feed or change her. Can you BELIEVE that?!
Father has shown up and they are all living in a temporary shelter for Burmese migrants run by a local NGO now. It is grim but not as bad as the hospital.

In a side story to demonstrate the severity of the problems between the Thai and Burmese here, we literally ran into a woman sitting outside the baby rooms on a bench as we were dealing with this other case. She was hand expressing milk into a cup for her baby and crying and crying. My Burmese translator stopped to talk to her and her story is heartbreaking. She and her husband brought their sick newborn to the hospital all the way from Kuraburi (2 hours north) because they knew there were Burmese translators here. The father got stopped at a checkpoint near the hospital and was deported back to Burma for being illegal! The mother has no money, the hospital staff wouldn't tell her how her baby was doing or when she could leave, they were demanding money or they would deport her. Meanwhile the other children in the family were living with a neighbor back in Kuraburi. If both parents were deported the children would all be abandoned and never know what happened. It was such a sad story and the woman obviously felt so hopeless. End of story is that we are helping to sort things out-despite the fact that the case is not in our records. Just considering it preventive care...

I had to ask Save the Children for an emergency response fund to help with situations like these. You cannot just turn your back and what happens when we don't have money is that my staff start paying out of their pockets. They cannot afford this and it isn't ideal case management. We needs funding to actually DO things. It is so frustrating at times.

In a final note, yesterday we met some friends from California here and spent the day at their hotel which is the nicest in the whole area. I couldn't help myself and on the way into town for dinner I took them by the Burmese temporary shelter to drop off some things for the family there. They stayed in the car so they certainly didn't see much but I know that what they did see was a shock. I don't think they imagined that just a few kilometers down the road from their hotel the same sunset passes over rows of concrete shacks filled with HIV and TB patients and others in desperate need of a safe place. I feel a little guilty because I could have run that errand at a different time but I wanted them to see. They were really quiet afterwards.

Restrictions on the Burmese tighten daily. Now in Phuket province they are not allowed to congregate in groups of 5 or more, they cannot use cell phones or drive cars, and they must be indoors after 8pm. It is becoming a human rights violation. These people escaped the military regime of Burma, many of them are heroes (like my staff members) who put their lives at risk to stand up against the government. But they find themselves being forced to run and hide like animals here.

From Bang Niang.