The past four weeks have completely flown by; each day has been packed with so many cultural and educational experiences that it's crazy to believe how many things we were able to fit in. I can say without a doubt in my mind that this rotation has taught me so many things that I will carry with my through my future career as a pharmacist.
I am not sure what exactly I was expecting when I came go Thailand but I can say this experience was more that I could have ever imagined. So much of what I learned and saw is difficult to put into words. One of the things I was most surprised about it how urbanized Thailand is. Bangkok has many modern skyscrapers with gorgeous hotels and name brand only shopping malls. Yes, on occassion there were a few less updated toilets that required squatting over a toilet bowl in the ground and flushings by pouring buckets of water into the toilet; but these experiences were fairly infrequent compared to what many of my colleagues have told me in the past. Thailand is very much in a transition period between a mostly rural to urbanized developing country.
One of the most heart warming things to witness throughout Thailand was though they are becoming more drastically modern (more similar to the United States) they have not left behind their culture and ever present hospitality. I will never forget the very first night that I arrived in Bangkok. Feeling exhausted from countless hours of traveling, fatigued from the heat and humidity, and overwhelmed by a drastically different country with a strange language, my colleagues and I were still determined to go and explore this new city. As we exited a small shop off of a narrow side street I managed to get my ring caught in the zipper of my bag (how this happened I will never undedstand)! As I struggled to free myself from my bag and my ring I was suddenly surrounded by 5 Thai women who dragged my into their hair salon to doors down. Grabbing lotion and a set of pliers the women worked together to finally extract my ring from the zipper and reattach the piece to my bag. These women did not speak English and never once asked me for money, but came to my rescue out of the kindness of their hearts. It was such a heart warming moment, and I would continue to receive these kind gestures throughout the duration of my stay in Thailand.
The second thing that truly surprised me was how much the healthcare workers in Thailand do for their patients each day with much more limited options. Thailand spends only 4% of their annual GDP on healthcare, significantly less than that spent in the United States. In the states we focus so much on safety, safe practices, safe drugs, etc. In Thailand, their number one focus is always on accessibility. Because there are many patients who struggle to receive the care they need so when a patient does get seen by a healthcare provider they focus on creating one stop services and stress the importance of patient education. It seems that the Thai pharmacists really engage with their patients and spend an equal amount of time during their conversation listening to the patient as well as educating them. I has the opportunity to witness interactions like this in various settings including in and outpatient hospital, community pharmacies, and home visits. It was amazing to watch because although I didnt understand the language on what was being said the patients body language and engagement in conversation really seemed to empower the patients and make them feel like a valuable part in their healthcare team.
One particular comment was stated my many of the healthcare providers we met and it always struck me as being so odd. Many times they would say, "we do the best with the resources that we have, but we are always striving to be more similar to healthcare in the United States." Sometimes it almost seemed as if they were apologizing for not being as advanced as they see the US being. Each time this statement was made I immediately felt that I had to remind the Thai of all the incredible work they are doing now. I personally was so impressed that they manage to do so much for their patients without spending a lot of money. There are many aspects of healthcare that I personally feel the Thai do better, specifically patient education. I think that it's important to not just strive to move forward but also recognize all of the accomplishments that have already been made. As the Thai move forward into a more advanced system of healthcare, implementing computerized patient records and other technology into their work flow I truly hope that they do not lose that incredible connection with their patients. Once that connection is lost or jeopardized such as it has been in the states it is much harder to regrow that bond.
I am still in awe that both patients and providers were so welcoming to us as foreign students to allow us to learn. I think in the states we are so focused on privacy surrounding patient healthcare and hold a culture of distrust in medical as students that we dont always have such a welcoming opportunity to engage in these learning experiences. But in Thailand we were welcomed into patient rooms, actively reading through their charts and able to talk to patients about their own experiences in the health are system. While it is important to notice these differences it is also vital to remember that neither our system nor theirs is better or worse than the other, rather just providing lessons on how we can improve our own healthcare system through mutual learning.
I would say my favorite activity of all the educational things we did was our class meeting with other international pharmacy as students from Thailand, China, and Indonesia. It was amazing to have the opportunity to learn from these other students. During our discussions we found that all 4 of our countries struggle with similar healthcare issues (for example antibiotic resistance and misuse, though the reasons for these issues were all different. It was so amazing to discuss with these other students ideas on how to address these health disparities, as well as have an open conversation on the benefits and challenges of these ideas. Having so many different students in one room really created such a diverse discussion that added a whole new dimension to conversations that are had regularly in our own countries. After that class not only did we gain significant insight in healthcare topics but we made some pretty cool friends.
Thailand is a country inhabited by welcoming people and a culture filled with incredible flavors, colorful temples, and kindness unlike any other. I learned so many more things than I every could have imagined, especially that mango and coconut do not belong together in desserts or smoothies. There are so many things that I will miss about Thailand upon returning to the states including the friendliness of the people, the street vendors lining the roads with food and souvenirs, the incredible flavors, and most importantly the thai tea and coconut ice cream! Though there are two things that I will not miss: 1. The heat and humidity, 2. The pungent smells especially in Bangkok that can be inhaled while walking through the streets. But nevertheless I would embrace these two downsides any day to come back to visit Thailand.
I can't thank everyone enough for the amazing opportunity to learn from our Thai friends. I know I can speak for all of the UNE students here when I say that we are incredibly grateful that everyone took time from their work schedules to meet with us. I know that it can be a major interruption to the daily work flow to not only meet with us but also show us around the facilities. We really appreciate the generosity of all the people who added to this incredible learning experience.
The most important thank you, though, belongs to Noi for guiding us throughout this journey. She dedicated so much time to helping us and giving us an incredible experience. Words can not thank her enough for everything that she did for us! Noi, we thank you and love you for all of your hard work and for putting up with us for 4 weeks! We will miss you.
Also thank you so much to Nu, our driver, as well as our three amazing UNE preceptors: Dr. Jim Krebs, Dr. Hailey Choi, and Dr. Ryan Warren. We could not have done it without you. Thank you all for dedicating your time to help us learn. You're hard work and kindness did not go unnoticed. Thank you for making this an incredible learning experience!
Lastly, I would like to thank UNE CoP for this incredible opportunity and everyone who took the time to read through this blog. We hope you enjoyed our posts and were able to follow us on our journey through Thailand. Please enjoy these last photos from our journey.
Best wishes to all,
Casey
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