They drive on the opposite side of the road here. Their winter temperatures are still extremely hot. There are so many sharp contrasts between the United States and Thailand that it was initially very easy to place these countries into two separate buckets. As my time in Thailand has come to a close, I’d like to reflect on the stark differences but also the foundational similarities between the U.S. and Thailand that I have discovered over the past month.
One of the things that I noticed immediately when arriving in Thailand was how friendly everyone is. I’d like to think that as Maine native who grew up in a small town, I was surrounded by pretty friendly people, however, the treatment I received in Thailand topped most of my Maine experiences. Not only was I greeted by strangers on a regular basis, but people went out of their way to help us and always used respectful titles such as madam. One memory that will always stick with me happened on one of our first nights in Thailand. When we had left a clothing shop and were standing in the street, Casey got her ring caught on the zipper of her purse. A group of ladies who worked at the hair salon across the street saw us struggling to get her ring loose and ran over immediately to help. They brought with them a bottle of lotion to get her ring off and then dragged us into their salon to use pliers to remove the ring from her zipper.
They call this country the land of smiles and I now understand why; I had so many encounters with people that had the most infectious smiles and laughter. Their positive outlook on life was refreshing and brightened my days. I often noticed that instead of saying goodbye when you left a place, they would instead said "see you again soon" or "see you later." Ending your interaction in this way always seemed like the stranger in front of me was more like a friend, instead of someone I had just met moments before.
Another noticeable quality of my interactions with Thai people was that they intently listened to you. Here, they listen to understand, not listen and wait to say what they want to say. I’ve noticed that in the United States we all too often talk just to talk, not respond fully to what another person is saying. Escaping this back and forth way of communicating with people was refreshing and gave me the opportunity to have many meaningful conversations.
Although there are many differences between the practice of pharmacy in Thailand versus in the U.S., I have noticed that the same passion and desire to do good and protect the health of patients is rooted deeply in the pharmacy profession within both countries. Interestingly, in Thailand no prescription is needed for most prescriptions, even antibiotics. Other than certain drugs that we refer to as controlled drugs in the U.S. or are categorized as “dangerous drugs” in Thailand, such as opiates, pharmacists can freely distribute most medications to patients who come into a drug store. These medications include ones to treat high blood pressure, diabetes, high cholesterol, and infections. Even though these pharmacists are able to give these medications, they do not have the role that ambulatory care pharmacists in the U.S. have in managing chronic disease states in their collaboration of patient care with physicians.
Another contrast between the U.S. and Thailand is that in the States, a large majority of pharmacists work in the community setting, but in Thailand a majority work in hospitals. I’ve realized that this is the case because most people receive their healthcare through hospital services and is paid through their national healthcare plan available to all Thai residents, which is a lot different than in the United States where most patients see their primary care physicians for most of their health concerns.
A major similarity in both the United States and Thailand is the growing trend of herbal and natural medicine use and mistrust of modern medicine. A major difference in this issue is that Thai people have been using natural products and have been passing down their knowledge about plants for thousands of years, therefore, it is a part of their culture and history and they do not trust modern treatments. In the United States, the use of herbal medicine is more of a recent fad of people moving away from our country’s foundation of modern medicine and believing natural treatments are better, such as the growing number of people who are against receiving or giving their family members vaccines. This is an issue that we talked about on multiple occasions with pharmacists and pharmacy students in Thailand and it was neat to hear some of their patient stories, such as eating a gecko to cure COPD.
My experience in Thailand is one that I will never forget. My month in this country has opened my eyes to an incredibly rich culture with both many differences and similarities to the United States. After visiting so many healthcare related sites such as a HIV temple community, an orphanage, herbal medicine hospitals, a psychiatric hospital, a large public hospital, extremely fancy private hospitals, a children’s dengue ward, and spending time with students from Thailand, China, and Indonesia at a College of Pharmacy, I have learned to appreciate the diversity in healthcare and not continue to have a black and white, single format template of what healthcare should look like. Thank you to all of our coordinators and teachers who helped provide one of the most unique experiences I have ever had. I am eternally grateful to the University of New England for this opportunity and the growth that I have had because of it.
Warmly,
Natalie Underdown
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