There is both good and bad news with regard to healthcare issues in Thailand. The good news is we did not experience any major disease outbreak in 2012, nor were visited by a new disease or virus.
And while there were important medical breakthroughs to ease our lives, it turned out that difficult health-related situations have become more consumer-orientated. More products readily available in the market and popular among consumers, both edible and inedible, were found to bring about adverse health effects, some even life-threatening.
Thailand's Food and Drug Administration (FDA), the governing body, therefore had to closely monitor the situation throughout the year to prevent harmful goods from leaking onto market shelves.
But like it or not, we have to admit the FDA's task is a mission impossible. In the end it is down to consumers: they should be more careful about their health and keep themselves up to date with certain goods or practices that could potentially put them at risk.
So here are top health-related news and issues in 2012.
Needle phobia no more
This year Thailand celebrated one of its most important medical breakthroughs: it introduced a painless route to influenza jabs via a technique called micro-injection, or intradermal injection.
Even though Thais are familiar with influenza and most are aware there is a vaccine that can prevent its spreading, many still refuse to take it for fear of its side effects including soreness, redness and swelling at the point of inoculation, and a fever that may last a few days after the shot is given. They may also suffer from needle phobia.
As a matter of fact, the micro-injection technique was developed to fix drawbacks in the old vaccination approach.
The old approach required jabs deep into the muscle, while the new technique involves disposable syringe shorter than those previously available.
The syringe comes with a 1.5mm needle, which is able to deliver the vaccine precisely under the skin.
Intradermal injections have proven a more effective technique than the intramuscular method as the skin layer contains more immune cells than the muscle layer, enabling the body to better produce immunity against influenza, especially among the elderly.
So no more needle phobia. The new tiny needle causes very little pain.
What's in a name?
Seafood connoisseurs found themselves in a spin, apparently confused by the names of fish _ the expensive John Dory, Pangasius Dory or just plain Dory (or even Dolly). These names circulated on the social media and raised numerous questions, especially as to which one was the real John Dory.
And prices were an issue, too. While fine dining restaurants charge several hundred baht apiece for the real John Dory, a fish with a similar name is also available at streetside stalls and sold at around 100 baht per kilogramme.
The FDA was quick to take action and fix the confusion. The director of its Bureau of Food, Dr Tipvon Parinyasiri, explained the controversy over different Dory versions readily available in the market involved two different fish families _ Zeidae and Pangasiidae.
The famous and pricey John Dory is a marine fish in the Zeidae family. This white-fleshed sea fish is found in deep European waters, hence it is very expensive and usually sold in high-end restaurants at over 300 to 400 baht a piece.
But the so-called Dory fish commonly available at hotpot franchises as well as streetside eateries is not the John Dory. Rather, it is a species of freshwater fish in the Pangasiidae family, much smaller in size than the posher John Dory and much cheaper too.
And Dory is a generic name leading to confusion among consumers and restaurant operators alike.
To solve the problem, the FDA asked fish importers and restaurants to add the word Pangasius to the label. From now on, if the product is tagged Pangasius Dory, you know it is the freshwater fish and not the real John Dory.
Battle of the bulge
Obesity in is a serious problem. According to the Ministry of Public Health, 17 million Thais are grossly overweight and their number is expected to increase by 4 million annually, costing the government 100 billion baht each year in medical bills.
Childhood obesity in particular has become even more critical, as reflected by the number of Thai teens who are morbidly overweight and need to undergo weight loss surgery.
Watpong Sansuksai, an 11-year-old boy, is a recent case in point. He requires surgery but unfortunately is not a good candidate for the procedure as he's too young. A native of Phitsanulok, Watpong weighs 175kg, suffers from sleep apnea, high blood pressure and asthma, and needs his aunt's support when going about his daily chores.
His weight loss programme includes a balanced diet and exercise under the watchful eyes of healthcare experts. With their help, Watpong has lost 25kg in three months.
Children who are obese face serious health problems including diabetes, hypertension and cardiovascular disease from a young age, and as a result fail to reach or develop to their full potential.
In Watpong's case, for instance, he is unable to go to school on a regular basis.
Unhealthy eating habits are to be blamed for obesity, while the lack of exercise and being stuck in front of a television or computer for long hours also contributes to its development.
Traditionally, obesity signifies wealth and opulence in Thai society. While an overweight baby is often viewed as cute, an obese child is seen as coming from a wealthy family. However, obesity is today considered a real threat caused by health and social problems.
Disease blights school
Although it afflicts children every year, hand, foot and mouth disease seemed to wield a wider impact this year than before.
A large number of children were infected by the disease from early this year until July. In Bangkok alone more than 2,000 were affected, more than 80% of whom were below the age of four. Fortunately, no deaths were reported.
More than 50 schools were affected, and because the disease is highly contagious, the Bangkok Metropolitan Administration, advised by its Communicable Disease Control Division, decided to temporarily close more than 30 schools in the city so children could stay home and not spread the virus.
But the disease did not just attack the capital. Children in the provinces were also affected. The government had to close more than 100 schools nationwide to prevent a major outbreak.
Schools were asked to keep an eye on the infection. They were allowed to stop classes for seven days in case more than five of their students got infected by the virus. Some institutes that had to close as a result had their premises fumigated before resuming classes.
Free HPV jabs?
The fight against cervical cancer, in which the Ministry of Public Health plans to seek cabinet approval for free HPV vaccinations for all prathom or Grade 6 girls, has become a subject of heated debate due to the high cost it would entail (500 baht per shot, 1,500 baht for a series of three shots) and concern among parents about its safety.
Dr Yot Teerawattananon, director of the ministry's Health Intervention and Technology Assessment Programme (HITAP), said the price of the vaccine shouldn't exceed 190 baht per shot, citing a HITAP study. He also noted that in some African countries it costs only 150 baht per shot. In his opinion, screening tests that include a Pap smear and visual inspection with acetic solution is the most effective way to detect cervical cancer.
Secretary of the Women's Health Advocacy Foundation, Nattaya Boonpakdee, backs the vaccine so women could benefit from advances in medicine and protect themselves, but she doesn't support the ministry's plan for adding the HPV vaccine to the national programme.
She urged the government to strengthen screening tests and use it as the main tool in dealing with the problem. This can be achieved through the expansion of obstetrical and gynaecological services to all parts of the country, and improving standards of service and facilities. Serious campaigns on the subject and on the importance of pelvic examinations and screening tests should be launched to raise awareness among women. Nattaya stressed the HPV vaccine is not high on the foundation's agenda and its proposed price should be reviewed and brought down to a level that is reasonable.
While parents are worried about its side effects in the long term, they have called for the setting up of an HPV vaccine information centre to provide correct and clear facts, as well as updates on the vaccine.
Prof Harald zur Hausen, who won a Nobel Prize and dealt a crucial blow against cervical cancer that led to the development of the HPV vaccine, was in Bangkok last month. He said the vaccine doesn't contain any genetic material and there was no risk of long-lasting adverse effects, the only exception being allergic reactions, but with a remote chance of only one in 100,000 cases.
He cited a study carried out in Australia which found that side effects were reported by only 25 of the 300,000 young girls who received the vaccine over a period of 1.7 years. And when these 25 cases were examined, only three were found to have had a genuine adverse reaction to the vaccine; the rest were judged to have merely had an allergic reaction to a protein in the vaccine.
He concluded by saying that the incidence of side effects is extremely low compared to vaccines that are given to small children.
Nearly 530,000 women worldwide are diagnosed with cervical cancer annually, according to the World Health Organisation, and an average of 275,000 fatalities from the disease occur every year, the vast majority in developing countries where it is the most common form of cancer in women.
Cervical cancer is the second most common form of cancer among women in Thailand, according to the National Cancer Institute. It's estimated that there are about 10,000 new cases each year and almost 14 of them die from it each day.
Pretty is pricey
The concept of beauty among Thai women has changed dramatically. In today's speak it goes well beyond the high-bridge, sharp nose typical of Caucasians. What is most beautiful is fairer skin, bigger eyes and a slimmer facial structure, the so-called ''V'' shape.
Thai women's obsession with being white is reflected in the launch of a product that claims to help their intimate areas look fairer.
To lighten their complexion, they choose whitening creams and glutathione skin-whitening pills and injections. Some also take advantage of the technological advancement in aesthetic treatment with botox and filler injections as well as thread lifts.
But this beauty trend has been associated with health risks because long exposure to skin whitening products can pose serious side effects, including discolouration of the skin, skin cancer and organ disease. Many of these products are illegal and the number of women with botched cosmetic jobs is on increase, according to the Dermatological Society of Thailand.
The most talked-about victim of a botched cosmetic surgery was a product presenter. The woman was unable to breathe and lost consciousness minutes after getting a filler injection into her buttocks by a doctor who then turned himself in to the police. She went into a coma and was on life support for two weeks before she died. Experts said her death was caused by swelling of the brain brought on by the lack of oxygen, which in turn resulted in organ failure.
The presenter's case was not the first and is unlikely to be the last as long as the craze for beauty, associated with opportunity and success, lasts.
Carcinogens all around
Consumers in Thailand were alarmed by reports appearing in the media throughout the year with regard to the detection of carcinogens in many of their favourite foods including tapioca balls in pearl milk tea and, more recently, the controversy over Korean instant noodles.
The FDA collected several samples of popular Korean noodle packs from market shelves in Bangkok and sent them for thorough analysis.
Consumers were alarmed by the word ''carcinogens'', mentioned more often this year. The furore raised a lot of questions among the public as to whether they should completely avoid cancer-causing foods and whether their consumption is life-threatening.
Actually, carcinogens are everywhere, and they are very much part of the people's changing lifestyle and eating habits. Insecticides found in fruits and vegetables abound with carcinogens. But their fears were perhaps fuelled by a killer that had sneaked up on them _ like eating too much junk food that contains high levels of fat and carbohydrates which can also increase the risk of developing cancers, especially of the breast, colon and prostate.
Processed foods stand a greater chance of containing carcinogens than fresh foods while grilled meat is known to contain benzo(a)pyrene, a type of carcinogen which is a product of so-called ''incomplete combustion''.
And non-food products such as plastic containers or even strong sunlight are considered carcinogens too.
So living in a world awash with carcinogens, it is highly unlikely we can avoid them altogether. The option then is to eat more fresh food than processed food and readily cooked food than instant food. It would keep you safe from cancer-causing agents _ at least to some extent.
Preserving fertility
The hot new trend among modern Thai women may not be the latest collection of Louis Vuitton handbags, but preserving fertility and having the chance to conceive later in life or at a time more appropriate to them. Most women reach peak fertility in their early 20s, after which it slows down as they enter their late 20s. At the age of 35, fertility declines and by 38 it is in rapid slide. And a women's chance of conceiving each month by the age of 40 is about 5% and drops to 1% by the time she turns 45.
However, many modern women in their 30s are devoted to climbing up their career ladder rather than getting married and having a baby. As a result, having their eggs frozen before their quality decline for future use can be a good option for women who plan to conceive in the future.
The process starts with a visit to a fertility specialist who counsels and evaluates the need for the procedure. If the woman is a good candidate, she is required to have a blood test to asses her fertility. She will be then given fertility medication for nine to 12 days to stimulate the ovaries in order to produce mature follicles _ fluid filled sacs containing eggs. After that, eggs are extracted using an ultrasound guided needle which is inserted through the vagina while the woman is under mild sedation. The eggs are immediately frozen using the latest snap freeze technology called vitrification. The collected eggs are kept in liquid nitrogen at -196C.
When a woman decides to conceive, the egg will be thawed and fertilised with a sperm and implanted into her uterus. If the procedure is successful, she becomes pregnant.
About 95% of eggs preserved using the snap freezing process survive the thawing process.
Blood bank shrinks
Last month the blood stockpile at the Thai Red Cross Society's National Blood Centre shrank drastically, affecting its ability to respond to requests from hospitals countrywide.
Every day, under normal circumstances, the centre releases from its stock enough blood to meet the demand of some 1,500 to 1,600 patients in hospitals across the country needing blood transfusion, which means it needs to replenish the amount it has released, and it does that by inviting the public to donate blood on daily basis.
But last month the number of daily donors dropped to around 1,200 to 1,300 for reasons unknown, and while demand remained the same, it created a shortage.
It forced the centre to dig into its reserve. Normally the centre tries to maintain a stock that is good enough to meet the needs of at least 3,000 patients. Yet, such was the daily shortfall that by the end of the month the stock was down to a few thousand litres.
The shortage prompted the centre to rein in the media, which has been encouraging people to go out and donate blood. The situation has somewhat recovered since, but now the centre wants the people to make blood donation a habit, urging them to come forward and provide for those in need this ''red fluid of life'' every three or four months, rather than wait for special public occasions to make this sacrifice. After all, the sick can't be kept waiting.
