The Suandok Hospital, or the Maharaj Nakorn Chiang Mai Hospital, treats patients from all over the North for various heart and brain diseases
Story by PICHAYA SVASTI
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| A patient is treated for a neurological disorder at the Suandok Hospital, in Chiang Mai. |
In a remote hilltribe village, nine-month-pregnant Karen widow Makhin suffered a sharp chest pain before collapsing while working in a field.
The very same day, her ailing father, Thamae, was shocked when he could not lift his left arm, which felt numb. Fortunately, a mobile medical team from Suandok Hospital was visiting the village that day.
Makhin was diagnosed with a valvular heart disease, and her father was diagnosed with a brain disease. Both were rushed to the hospital in time to save their lives.
Founded in 1959, the Suandok Hospital - its official name being Maharaj Nakorn Chiang Mai Hospital - is the medical hub of the North. It serves more than 10 million people in 17 northern provinces, including migrants from neighbouring Laos and Burma.
Many northern people suffer from heart and brain diseases - the second and third major causes of death in Thailand. The hospital has special centres for helping those with heart and brain diseases. However, the centres are short of specialists, hi-tech medical equipment and funding. The doctor-to-patient ratio is one-to-ten. As a result, patients here have to wait a long time to see doctors.
"A very long queue of patients is a common sight, and many of them go home disappointed. Some have to wait so long that they are almost in despair," Asst Prof Dr Siwaporn Chankrachang, chief of the hospital's Northern Neuroscience Centre, said.
The hospital has five brain specialists and eight heart specialists, and serves more than 3,000 brain disorder outpatients and 5,000 heart disease outpatients a year, according to Assoc Prof Dr Niwes Nanthakij, dean of Chiang Mai University's Faculty of Medicine, which is in charge of the hospital.
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| Group therapy for patients and relatives. |
A cooking class for patients and relatives. |
This is why the hospital is raising funds to help patients with heart and brain diseases. Since the allocated state budget covers only 50 to 60 per cent of outpatients and 55 to 75 per cent of inpatients, the hospital has to absorb the rest of the costs.
According to Associate Dean Dr Siwaporn, the hospital is trying to provide better services and make the best use of limited physicians and medical equipment amid a rapidly increasing number of patients.
For example, the hospital's Northern Neuroscience Centre has encouraged its doctors and nurses to collaborate in taking care of patients.
Under the new system, nurses initially interview waiting patients about their symptoms and side effects, sort them by type and do follow-ups.
"It usually takes 45 minutes for each specialist to check and diagnose each patient since most neurological disorder patients have difficulty communicating. Initial interviews by nurses help a lot," Dr Siwaporn said.
After diagnosis, doctors treat their patients and consult specialists in the fields of neurology, psychology and physical therapy. the treatment teams then make follow-ups through analysis and research.
In addition, the centre encourages the patients and their relatives to actively take part in medical care by observing their own conditions, drug allergy and side effects.
It is also organising group therapy and group counselling sessions for patients, relatives, assistants and medical staff to share experiences and self-care approaches.
According to Dr Siwaporn, the details of each patient's development are recorded for future reference. Well-disciplined patients are appointed as leaders of group therapy sessions. The sharing of experiences and feelings has worked wonders to ease other patients' anxieties and fears, she added.
Apart from group therapy, the hospital also runs a Wednesday Clinic that offers non-pharmacological holistic care for patients with neurological disorders. The first Wednesday of every month is for dementia, the second is for multiple sclerosis, the third is for myasthenia gravis and the fourth is for Parkinson's disease.
"On the first Wednesday of each month, we bring together 20 to 25 patients suffering from dementia. Some off-duty nurses volunteer to talk to patients and inform doctors whether the patients regularly take their medications and are encountering any side effects or any other problems," the doctor added.
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| Long queues of patients are a common sight at the hospital. |
According to her, dementia, a chronic and grief-causing disease, is commonly found in people from the North, due to the poverty and poor education in the region. Other neurological disorders include migraines and strokes.
At the Wednesday Clinic, patients participate in group discussions under the guidance of doctors, nurses and patient leaders. People suffering from dementia must be accompanied by a relative since many do not recall their own names. To relax the patients, the clinic organises recreation activities, which include meditation, karaoke and cooking. It also maintains a pleasant waiting area for patients to relax in before seeing their doctors.
Every few months, the clinic provides training by Thai and foreign specialists for the doctors and hospital staff.
The hospital also plans to set up a day centre so patients with neurological disorders and their relatives can congregate to share their experiences once or twice a week.
The last Wednesday of each month is set aside for people suffering from Parkinson's. The exercises they partake in and the sense of community and moral support they feel and receive from one another have positive effects on their health.
A good success story is the case of one male patient in his fifties from Lampang. When he first joined the group, he was stressed because he could not move normally. Now, he regards himself as an old engine that needs lubrication, and can now function with regular exercise and medication.
Many patients are stricken with Myasthenis gravis, a neurological disorder that weakens the limbs,and often causes sagging eye lids and breathing problems. Seriously-ill patients must rely on respirators, and need to frequently lie down and close their eyes.
"During the sessions, they thank us profusely, saying they feel like they have been reborn. Though they do not see our faces while in their beds, they recognise our voices," Dr Siwaporn recalled.
Of all the patients she has treated, the cases of Makhin and her father stuck deeply in her mind. Makhin developed pulmonary edema and suffered heart failure upon her arrival at Maharaj Nakhon Chiang Mai Hospital. The heart surgery saved her life, but not that of her unborn child. Her father, Thamae, was properly treated and prescribed regular medication. Months after being discharged, both returned to the hospital with little presents for their doctors and nurses. Makhin handed a cotton blanket to her heart doctor, Dr Rangsarit Kanchanavanich. It took months for her to embroider it for him.
"In his [Thamae] local dialect, he told me: 'I have nothing but this charcoal grilled fish for you. Do you mind?' Tears welled in my eyes, I was so happy to accept his present," Dr Siwaporn said, with a smile.
Phakamart Thongdee, 45, from Lampang, is another patient whose life was saved. Before treatment, muscle weakness gripped half her body. She felt exhausted, suffered headaches, had breathing problems and could not swallow food and water. She often choked on her own saliva. Her eye lids were so swollen that they covered her eyes. She could not live a normal life, let alone work. Soon she was unable to stand without support.
In addition to traditional medical treatment, Phakamart also now eats more fruits and vegetables and avoids half-cooked foods. She also exercises her neck, back and limbs every day as guided by the hospital.
"Thanks to Suandok Hospital, my health continues to improve. Now, I can do everything from running a small business to farming," she said.
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