Health care and risks in Thailand

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Many Thai health professionals can speak English.

Despite being a developing country, Thailand is considered relatively safe, hygienic and visitors have few threats to worry about. No vaccinations are needed before coming here, and there are no major viral threats. Although hygiene in some areas, even among posh tourist venues, might be questionable (like polluted, smelly canals), you’re generally safe. Below is a list of the significant health risk topics to be aware of. Thailand’s hospitals and healthcare is extremely professional and good, offering suitable relief if you might fall ill here. A competent effort is also made to deal with seasonal threats.

If you do have to visit a hospital, be aware that they charge considerably more than public ones, overcharging on imported medicines on the assumption that you’re covered by  travel insurance. Often you can get an equally professional service at decent government hospitals, who are more ethical.

Health risks in Thailand

Avian influenza: at the time of writing, there have been a few cases of ‘bird flu’ cropping up from time to time, although a serious outbreak has yet to occur, and the disease has so far not managed to mutate into a form which can pass between humans. To be safe, avoid direct contact with birds wherever possible, e.g. pigeons in the city, birds in captivity in zoos and domesticated pet birds, although you should be safe eating chicken and eggs.

Dengue fever: this disease, which it has similar symptoms to malaria, is spread by mosquitoes mainly occupying urban areas, and hence there is a small risk of contracting this disease while in Thailand. Its prevalence is on the rise in Asia and there are no effective prophylactics, so avoiding mosquitoes is the only prevention. Not all mosquitoes carry the virus and it exists where stagnant water assists in breeding of rare carrier Aedes aegypti. A simply water spray is effectively used across Thailand to reduce this, but avoiding mosquito bites, particular during dusk when they are a problem, is best. Dengue is not usually fatal, but it’s less treatable than malaria. Once caught however, a subsequent bout is often deadly.

Dehydration: during the hot season, from March to June, Thailand can become extremely hot, with temperatures reaching 40°C and beyond. The further south you are the hotter it is, although sea breezes at the coast help mitigate this. Drink plenty of water, and try to escape from the heat as often as you can – if you start to feel overly fatigued, have difficulty breathing or muscle seizures then drink rehydration salts immediately and seek medical attention if the symptoms persist. Special attention should be given to children suffering from this.

Diarrhea: part of the process of adjusting to Thailand and its food often has the side effect of a bout of the runs – particularly if you frequent the roadside food stalls or eat something particularly spicy. Usually the effects will only be mild and should pass in a day. Imodium or similar medication is widely available at pharmacies and will help stop the runs, It’s important to take rehydration salts or electrolyte beverages after a bout of diarrhea to avoid dehydration, which leaves you weak and listless. ‘O-lyte’ is a popular brand found in most pharmacies or 7-Elevens and can be mixed with water. Almost all pharmacists speak English.

Diving dangers: the most common ailment suffered by divers is “the bends”, or decompression sickness, a condition that arises when air bubbles form in the blood due to a rapid decrease in environmental pressure. Symptoms and signs – which usually show up within three hours of a dive – include pain in the joints/limbs, rashes, dizziness, paralysis, shortness of breath, extreme fatigue or falling into unconsciousness. Divers with the bends need to find immediate medical help or call Hyperbaric Services Thailand for assistance. The HST Patong office telephone: (076) 342 518, Koh Tao: (077) 456 572, Gulf of Thailand: (077) 427 427.

Drinking water: in Bangkok, the tap water is apparently drinkable, but across Thailand everyone sticks to bottled water to be safe. Certainly water across Thailand shouldn’t be drunk unless it’s out of a bottle or water purification system, even in national parks streams. Bottled water is widely available, and ice is safe, since reverse-osmosis purified water is supplied all over Thailand to every small village.

Food poisoning: a perennial problem among Westerners who’s digestive system cannot cope with the tropical maladies, not to mention the spicy food. While you’re unlikely to experience the infamous ‘Delhi Belly’ of India, eating at street food stalls or from markets can be hazardous. Diarrhea is a common complaint, usually brought on by overly spicy food, but something as serious as dysentery is rare. Food vendors aren’t subject to regular health checks and some of the foodstuffs, such as coconut-milk based sweets, go off pretty quickly in the tropical heat. Look out for the ‘Good Taste Clean Food’ sign of approval outside restaurants to verify they have passed a hygiene inspection.

Hepatitis: literally means inflammation of the liver, and there are various strains, the most serious being Hepatitis B. Hep B is spread through sexual contact or blood transfusions, so ensure that your vaccination is up to date before travelling and take the usual sexual precautions. The less deadly Hep A is common but symptoms can be mild.

HIV: Thailand seems to be winning the war on the spread of HIV / AIDS; it is comforting to see that condoms are on sale everywhere, and they will be on display right by the front door of every 7-Eleven, rather than coyly stashed behind a chemist’s counter. However, on a global scale the level of infection is still quite high, around 1 per cent of the population. And one of the key reasons for stemming the spread of the disease has been the isolation of one demographic group in which the disease is most prevalent – workers in the sex industry. Therefore, anyone who dabbles in the seedier side of Thailand needs to be especially careful, but condoms should be used at all times no matter who your sexual partner is. Those working in the industry are well informed, the real problem exists with cheap prostitutes frequented by locals who are too ignorant to use a condom.

Hospitals: Thailand boasts an excellent healthcare system, certainly exceeding expectations of a developing country’s hospital infrastructure. The Thai doctors and nurses are extremely professional and competent, and many of the hospitals are well equipped with modern equipment. What’s more they are very affordable. There are world class private hospitals in Bangkok, Chiang Mai, Phuket and Samui and good hospitals in all other major tourist areas, but even government hospitals are usually acceptable and almost all doctors can speak enough English to attend to your needs. For lesser complaints there are numerous clinics across Thailand offering relief, obviously the further you get from a big city the less helpful they will be in an emergency. Ambulance services are generally supplied by the hospitals, full contact details are found here.

Hygiene: Thailand is far cleaner than many other countries in the developing world, yet it is still far from perfect and it is wise to be a bit more vigilant when visiting the Kingdom. The stench which occasionally wafts up from the sewers and toilets is noticeable, while keeping your hands frequently washed is advisable. Popular tourist areas are generally clean but while on day tours you might have to use a squat toilet. Hygiene in food preparation and storage at the basic food stalls is also a problem. Afterall, this a hot tropical country, with plenty of water-borne viruses about.

Malaria: most of Thailand is deemed malaria-free; however, you may be at risk if you are planning a trip down the Mekong River to Laos or other lowland or border areas. Trekkers are genuinely safe and few visitors to Thailand need to take a course of preventions medicine. Symptoms usually show up two weeks after infection, and include fever, vomiting, joint and muscular pain, and acute lethargy (particularly during the recovery stage). Mosquitoes are a widespread irritant across Thailand due to the abundance of water, and like to bite at dusk. Using an anti-mosquito spray, burner or covering yourself with light coloured clothing is recommended. If you suspect symptoms consult a local doctor immediately. Malarial strains here are considered immune to Western prophylactics such as Larium. Soxycycline is recommended as an impromptu preventative medicine.

Rabies: feral street dogs are a particular problem in Thailand. Some do bite, though most are docile. Since they are not generally vaccinated against rabies, anyone bitten is advised to get a anti-rabies injection immediately from a local clinic. It’s not necessary to have one before arriving but keep young children away from these animals, since the infection may be transmitted through saliva. In the advanced stage, dogs affected by rabies show aggressive signs of dementia.

STDs: with its notorious sex industry, Thailand offers the real risk of STDs such as herpes and those that get involved run the risk of picking up something nasty. HIV is a real risk (see separate entry), and condoms should always be used.