An elderly gentleman coughs blood with every desperate breath, as a voice says surgery is too great a risk for the lung cancer patient during the COVID-19 pandemic.
“Let him go,” the unseen doctor tells his wife.
With local treatment options closed, he considers a different option.
“Thailand? Are you sure?” the patient asks sceptically. “I’ve never heard that there were good hospitals and great doctors in Thailand.”
He ends up travelling to Thailand, having an operation and his pain presumably relieved. “Thank you, Thailand, and thank you doctor. For me, this is now one of the safest places in the world”.
The video clip was inspired by a true story of a foreign patient at Bumrungrad International Hospital who was transferred to Bangkok amid the global coronavirus pandemic to receive treatment. The clip, tagged #LocalHERO and #MiracleofBumrungrad, has gone viral with over six million views since being posted in early September.
Receiving and processing patients for medical service can be trying at the best of times. Amid the pandemic, the logistical challenges and risks have become even more complicated.
Dr. Thassanawut Dhearapanya, Division Director, Business Development – International & Medical Transport, Bumrungrad International Hospital, said the challenges and plot portrayed in the clip were accurate.
Dr. Thassanawut Dhearapanya
“The difficulties in the film were all real, including how he could not go to the local hospital, how we were initially rejected by the flight, and even the pouring rain when the patient arrived,” Dr. Thassanawut said.
“We really put in a great effort so that he could receive treatment and we went through discussion after discussion about the patient’s condition and the COVID-19 situation in the two countries.”
Bumrungrad launched the Transport Unit a decade ago to facilitate the transfer of patients both from within Thailand and abroad.
Dr. Thassanawut said transfers typically involve both air and ground transport, and if warranted, medical escorts.
The team taps into the wide breadth of expertise available within Bumrungrad, including nurses trained in advanced CPR, specialists in aviation medicine or pediatric care and even cardiologists specialising in ECMO (Extracorporeal Membrane Oxygenation), a technique of providing cardiac and respiratory support for patients whose lungs and heart are functioning poorly.
COVID-19
The COVID-19 pandemic has brought an entirely new set of challenges for the hospital’s Transport Unit, from the global disruption in air travel to the safety challenges involved in ensuring patients as well as staff involved in a transfer remain safe.
Bumrungrad is highly committed to adaptability in light of the crisis, imposing various strict measures for utmost safety for patients and everyone in the hospital.
Bumrungrad began resuming admissions of overseas patients in May, after several months of discussions with the Ministry of Foreign Affairs and the Ministry of Public Health on proper protocols involving testing and quarantine practices.
In mid-July, Thai authorities launched the Alternative Hospital Quarantine program to facilitate arrivals of foreign nationals coming to the country for medical care.
Dr. Thassanawut said the safety of patients as well as staff was the top priority for the hospital.
“Before, a patient could simply contact us and catch the next flight to Bangkok. Now, it usually takes around seven days to finish the entire process,” he said.
The Medical Transport Unit manages not only travel logistics and the communication of the medical information, but also fit-to-fly documentation and COVID-19 testing documentation. Patients must test negative for the COVID-19 virus prior to travel to Thailand under the Alternative Hospital Quarantine program.
“We have to go through the procedure with a great number of related parties, including informing the Ministry of Public Health to approve the patient list, calculating logistics, coordinating with the checkpoints, contacting aircraft operators, arranging for an air ambulance, exchanging information with Thai embassies abroad and foreign embassies in Thailand, and even discussing details with insurance companies,” Dr. Thassanawut said, adding that the process typically takes seven days.
During the transfer, Dr. Thassanawut said the process was managed as a closed system to minimize possible exposure. Drivers are outfitted with masks, face shields and protective suits, and upon arrival at Bumrungrad, patients go directly into a negative pressure room for diagnosis, separated from normal patients. Transport within the hospital is also carefully planned to minimize interaction with other patients, with everything along the route disinfected by cleaning teams after use.
Implementation of safety measures against COVID-19 in preparation for AHQ programme participation of Bumrungrad
Dr. Thassanawut said that in one case, a doctor who was with the transfer staff to pick up the patient placed himself in self-quarantine as a precautionary measure to eliminate any risk.
“Such extra-safe practices help build trust among patients and protect our staff as well,” he said.
Going Forward
Working amid the pandemic over the past several months has highlighted the importance for flexibility and agility for the Medical Transport Unit.
“The situation is changing so rapidly that we sometimes jokingly said to each other that the new work process is like a new semester at school with a whole new set of issues,” Dr. Thassanawut said.
He said as one example, the hospital learned quickly that the mandatory quarantine period proved particularly stressful for patients used to regular exercise. The hospital eventually learned that elliptical trainers were better suited for the hospital than treadmills due to their quieter operations.
“This is the learning curve. We don’t know when we will reach the plateau, we can only commit to adapting to this new normal, which, in a way, has already become the only normal,” Dr. Thassanawut said.
Bumrungrad alone currently handles nearly a quarter of international patients seeking medical treatment in Thailand, giving the hospital a huge database of information and front-line experience in the handling of patients.
“We continue to make the best use of all this data, information and details to streamline the processes and prepare for a constantly increasing number of requests for our services. The situation will only intensify once commercial flights start to resume,”
Dr. Thassanawut said.
“Meanwhile, we can communicate our insights learned from our experience after several months of backbreaking work to help the larger effort [by other hospitals] in providing treatment under these unusual conditions.”
Dr. Thassanawut said he was proud of the achievements made by Bumrungrad’s Medical Transport Unit with the excellent collaboration of many departments and of the country’s health care sector as a whole.
“Our public health sector is internationally recognized as one of the best in tackling the coronavirus, with zero local transmission for consecutive weeks,” he said.
“After treatment, patients can wear a mask, walk out of the hospital with minimal worry, and enjoy our country’s renowned hospitality. Plus, the medical bill is reasonable, offering great value compared with other countries at the same world-class medical standard.”
He repeated a line from the Local HERO video: “Thailand not only has good beaches and great food but also people who try to do their job the best way possible, regardless of any obstacles.”
Watch the Local HERO video at https://www.youtube.com/watch?v=cQpyqxejjqY.
If you are interested in the services provided by the hospital’s Medical Transport Unit or would like to have a teleconsultation, Bumrungrad International Hospital offers a 24-hour service at 0 2011 3333, email: MedicalTransport@bumrungrad.com or contact one of the 65 referral offices in 38 countries worldwide for more information.