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Father of rural healthcare

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As Dr. Sem Pringpuangkaew turns 100, a review of his life reveals a history of rural medicine in Thailand during the 20th century.

Dr Sem

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Father of rural health care, Dr Sem Pringpuangkaew, 100, is a true medical pioneer by Sukhumaporn Laiyok

Dr. SemLiving to be a 100 is truly remarkable. But for Dr Sem Pringpuangkaew, who celebrated his 100th birthday in May, public recognition is not only for his age, but also for his work that benefits public health.

It is not easy to describe the contributions to Thailand's public health development made by Dr Sem during his working life, which spans over 70 years.

He was a pioneer in rural health care and as time passed by, he laid a strong foundation for Thailand's medical and health care development and reform. Dr Sem, who is also recognised as a dedicated mentor and educator, is currently in Rajavithi Hospital due to old age

A graduate of medicine from Chulalongkorn University, Dr Sem began his career as an intern in the public health department under the Ministry of Interior. At the age of 24, he was stationed in Amphawa, Samut Songkhram in 1935, when cholera hit the province. He was located in a local temple and provided the simple treatment of saline solution to villagers suffering from cholera. When the saline solution ran short, Dr Sem created a saline substitute by applying a local white liquor apparatus to purify water and added salt and sugar. His quick thinking and innovation saved many lives.

After the epidemic, Dr Sem returned to Bangkok and worked at Vajira Hospital, where he gained experience in several medical skills, including performing a Caesarean and other surgery, and a bit of dentistry, from his peers. His newly acquired skills came in handy when he returned to the rural areas.

In 1936, he was appointed head of the Chiang Rai Provincial Hospital, which is now the Chiang Rai Prachanukroh Hospital that currently serves a population of about 800,000. There he struggled with a shortage of medical facilities and personnel. However, Dr Sem made a great effort to deal with problems at hand.

During World War II when medical supplies were short, Dr Sem used a local herb, vitex peduncularis (ton ka sam peak), to replace quinine to treat soldiers and patients with malaria. When the war was over, soldiers and people who joined the army were honoured, but the young doctor became an unsung hero, whose efforts went unnoticed.

Dr Sem has been known for his strong commitment and hard work. "I have stayed with my patients until their last breath and have closed their eyes when they died. That's a beautiful death," he said in an article written when he was 96.

With complete professional responsibilities, he has also proven to be a complete family man.

In 1937, he married Chalam Piyakesin, a nurse, and the couple have five children, three boys and two girls.

Dr Sem's wife mused: "He's a devoted doctor, who lives for his patients. When he delivered our child, he told me that his job was done and that he would take a nap, because the next day he will have to take care of his patients.

To ensure that their children were well taken care of, Dr Sem asked his wife to quit her job and become a homemaker after she delivered their second child.

In addition to the role of rural doctor and good father and husband, Dr Sem is a pioneer and creator. He has been instrumental in fostering medical and public health administration that paved the way for the country's further development. He pushed for several public health development projects, including the establishment of provincial hospitals nationwide and nursing schools, aimed at producing nurses to work in the rural areas.

One of his outstanding masterpieces is the rollout of a blood bank initiative in 1950, a mark of the level of acceptance and respect that he engendered among peers and people.

Apart from medical and health care practice, he conducted his medical research activity examining why villagers in Chiang Kam died after eating wild boar; goiter studies at Mae Chan; and gallstone studies at Kwan Phayao, as well as studying herbs and plants for medical treatment.

In 1951, Dr Sem was appointed director of the Children's Hospital, which is today known as Rajavithi Hospital, in order to serve the Plaek Pibulsonggram government's policy of decreasing the mortality rate in mothers and infants. He eventually resigned from the post, in 1962, eight years before retirement, and opened his own practice called the "Bangkapi Osoth" on Sukhumvit Road.

When Prof Sanya Dhammasakdi formed a government in 1973, Dr Sem was named deputy health minister and stayed in the position until 1975.

He was public health minister from 1980 to 1983, and was a pivotal force behind the national health care reform of integrated illness prevention and treatment services, in which the health care structure is still being used today.

He was involved in supporting a new paradigm of national health service development or primary health care that concentrates on health care equity through development of health care network among village health volunteers in accordance with WHO's Health for All by 2000 agenda.

His remarkable portfolio also includes a declaration of "National List of Essential Drugs" that provides a starting point for using medicine in reasonable and economical manners.

In his eighties, Dr Sem played an active role in providing guidelines as advisor to several non-profit organisations and agencies, including the Rural Medical Foundation, Folk Doctor Foundation and Thai Medicine Development Foundation, to name but a few. He has been involved in nurturing the Children Foundation to help children with nutrition deficiency in remote and rural communities.

Former prime minister Anand Panyarachun praises Dr Sem. "He is a good, righteous and caring man, who's passionate about life and encourages everyone around him to achieve their very best. He's also a great director who can make decisive decisions at difficult times."

"We love him for his strength and courage. He never gives up to do the right thing and never concedes to any power and dominion that may undermine justice and the public benefit. He deserves monuments in recognition of his efforts and services," he said.

Dr Prawase Wasi said Dr Sem has made wonderful contributions through his life' work. "His work is greatly valued. He's a great rural doctor, friend, colleague and mentor and is warmly loved by many people. For those close to him and the hundreds of people he has served, he is like a father."


Among the well-wishers who turned up at an event to honour Dr Sem Pringpuangkaew last May were Prajeen and Buri Leesin, conjoined twins who were separated by the doctor 51 years ago. The brothers were among the five pairs of Siamese twins the doctor operated on. The twins, who shared a liver and umbilical cord, were born at a hospital in Prachin Buri. They had to travel from their home province in Sakaeo, with their mother, to take part in the celebration - an event they heard about from a newspaper.

Jinda Leesin, the twins' mother, said she was told that her children were conjoined soon after delivery. "It was an easy, short labour. It surprised me," she said. "It was Dr Sem who took the twins from a hospital in Prachin Buri province to the Children's Hospital in Bangkok and helped separate them.

"I'm thankful that Dr Sem helped to operate a surgery to separate us that give us a new life," Buri said.

"I was grateful of what the doctor did for us. But we couldn't find a perfect time to show our gratitude to him before this 100th anniversary event," Prajeen said.

(Source: Bangkok Post, Father of rural health care, Dr Sem Pringpuangkaew, 100, is a true medical pioneer, 17/06/2011, Sukhumaporn Laiyok, link

Medical Vocabulary

(noun) - the treatment of diseases, injuries and other medical problems by doctors and nurses (See Wikipedia)
(adjective) - having to do with medicine and the treatment of diseases

pioneer - be the first one to do something
medical pioneer - a doctor, nurse (or other health care professional) who creates some new effective medical treatment

medical practice - the use of medical knowledge by doctors, nurses and other healthcare professionals to treat diseases and other medical conditions
medical research - research aimed at improving the treatment of diseases and other medical conditions (See Wikipedia)

facilities - the buildings and equipment for an activity สถานที่และสิ่งอำนวยความสะดวก
medical facilities - hospitals and clinics (buildings with special equipment to diagnose and treat diseases)
medical supplies - all the things that doctors and nurses need to diagnose and treat diseases

patient - a person receiving health care for some health problem
treatment - the process of providing medical care การรักษา

nurse - a person specially trained to look after sick people and assist in the delivery of medical treatment to sick people in hospitals and at home (See Wikipedia)

health care professional - the many highly-skilled healthcare workers providing health care besides nurses and doctors (See Wikipedia and allied health care professionals)
intern - a medical student at the end of their education, being given practical on-the-job training under the supervision of practicing doctors 

primary - first and most important
primary health care - the first treatment a person receives for a medical problem they have (See Wikipedia #1 and #2
primary health care provider - the first place (clinic, hospital, doctor, nurse, health volunteer) that a sick person goes for medical treatment

- being fair and reasonable, treating everyone equally
health care equity - being fair in who receives health care (for example: poor rural people getting medical treatment even if they do not have enough money to pay for it)

- a large system of connected parts, organisations, people, etc. เครือข่าย
health care network - all the hospitals and clinics in an area working to provide healthcare to the population of an area (as well as health care professionals: doctors, nurses, volunteers)

- people working without (for a good cause, helping people)
Village Health Volunteer (VHF) - an innovative network of local volunteers in rural Thailand that help remote rural communities with their primary health care needs (See short description, whole ebook and a longer description)

Health for All - a public health idea popularized starting in the 1970s by the World Health Organization (WHO) (See Wikipedia)
agenda - list of goals to achieve in the future กำหนดการ

- in the countryside (farms, forests), not the city ชนบท บ้านนอก
healthcare - all the activities of diagnosing and treating health problems by doctors, nurses physical therapists, etc in clinics and hospitals
rural healthcare -
the treatment of health problems in the countryside (where healtca
father of rural healthcare - the person responsible for the real beginning of modern "rural healthcare" health care 

development - the gradual growth and formation of something
public health - the study of how diseases can be prevented, health promoted and life prolonged through education and other activities  in communities (example: vaccines) (See Wikipedia)
economic development - the gradual process of a poorer country improving its economy over time to become a modern industrialized economy (with richer citizens and a higher quality of life) (See Wikipedia)
public health development -
gradual improvements to the health of a large population of people
public health administration 
public health minister - the highest level government official for public health in the country (reports to the Prime Minister)

blood bank - blood from blood donations gathered together for use in emergency "blood tranfusions" (See Wikipedia)
blood transfusion - the process of receiving blood from other people into one's own body in medical emergencies (See Wikipedia)

rate - the percentage of people who die (here: women in childbirth and babies being born)

national health care reform
integrated - combining things of different types in one effective system ที่รวมเข้าด้วยกัน
prevention - the act of preventing something, or things that people do in order to prevent something
integrated illness prevention

malaria - a serious disease with recurring periods of high fever carried by mosquitoes which bite humans (See Wikipedia)
quinine - a chemical for treating malaria that comes from the bark of the cinchona tree (See Wikipedia)
cholera - a disease that can kill people by heavy diarrhea and dehydration unless the patient is rehydrated quickly (See Wikipedia)

saline solution - a liquid containing salt (See Wikipedia)
suffering - physical or mental pain or problems ความทุกข์ทรมาน

(adjective) - clean and not containing any harmful substances
purify (verb) - to make pure
purify water -
clean water and remove anything harmful that could cause sickness if people drink it
innovation - a new way of doing something นวัตกรรม

epidemic - a large number of cases of a particular disease happening at the same time in a particular community โรคระบาด
surgery - medical treatment in which a doctor cuts open someone's body การทำศัลยกรรม การผ่าตัด

herb - a plant normally used as a medicine or for adding flavour to food สมุนไพร

vitex peduncularis (ton ka sam peak) - a herb in Thai herbal medicine (See #1 and #2)

delivered their second child - when a doctor, midwife or nurse helps a woman give birth to a baby

goiter - a swollen neck, a disease of the thyroid gland (See Wikipedia)
gallstone -
a hard painful stone in the gall bladder (See Wikipedia)
herbs and plants for medical treatment -

pivotal force - the central or most important thing or person in a situation

- providing the materials necessary to your body so it can grow and be healthy, many common health problems can be prevented or alleviated with good nutrition (See Wikipedia)
nutrition deficiency - when a person does get the right chemicals for their body in the food they eat (nutrients) 

conjoined twins - identical twins born with their bodies joined together (See Wikipedia)
Siamese twins - same as "conjoined twins"
twin - two babies born on the same day from the same mother ฝาแฝด
identical twins - genetically identical twins with the same sex (both boy or both girl) (See Wikipedia)
umbilical cord - the cord of tubes connecting a baby to the plancenta and mother and providing nutrients while the baby is inside their mother (See Wikipedia)

labour -
the process of a woman giving birth to a child that takes place over many hours (See Wikipedia)
an easy, short labour
- not taking a long time to give birth to a baby (and no problems or difficulties)

General Vocabulary

remarkable - unusual or special and therefore surprising and worth mentioning ไม่ธรรมดา
celebrate - do something special fun on a special occasion such as a birthday or anniversary ฉลอง

recognition - be known for something
benefits - goods things that can happen from an activity ผลประโยชน์

contributions - something that you do or give to help make something successful การช่วยเหลือ
contributions - the amount given by each member to the shared fund
span over 70 years - exist over the period of 70 years

foundation - a strong base or supporting structure (for example, the foundation of a building beneath the building that supports it and prevents it from falling) รากฐาน
laid a strong foundation - create a strong base and support (to hold something up and prevent it from falling)

reform - improvements to a system; changes to correct a situation that is wrong or unfair การแก้ไข การปฏิรูป
dedicated - believing that something is very important and giving a lot of time and energy to it ซึ่งอุทิศตัวเพื่อ

mentor - a person who acts as a teacher in on-the-job training giving help and practical advice
career - a job that a person does for much of their life (See Wikipedia)

stationed - when a soldier or government worker is officially sent to a place to work there

- in or related to the area that you live, or to the particular area that you are talking about ท้องถิ่น
simple - easy to understand; not complicated ง่าย,ไม่ยุ่งยาก, ไม่ซับซ้อน

substitute - a person or thing that is used instead of another person or thing คนหรือสิ่งที่เข้าแทน

peers - people with the same age, job, or status as you เพื่อนร่ีวมสาขาอาชีพ

- a type of work or task requiring special training and knowledge ทักษะ ความสามารถเฉพาะทาง
learn a new skill - go through the study necessary to do some skilled take correctly and proficiently
newly acquired skills - skills that a person learned recently, skillls newly learned

come in handy -
be useful (example: This flashlight will come in handy, if the electricity in the building goes out.)
appointed - officially given a certain position in an organization (example: He was appointed director of the organization.)
population - alll the people who live in an area

shortage - when there is not enough of something การขาดแคลน
personnel - people who work for a company or organisation

effort - an attempt to do something ความพยายาม the energy and enthusiasm that people put into an activity
make an effort - try hard to do something (to achieve some goal)
problems at hand - the current problems that have to be dealt with and solved

replace X with Y - to get rid of one thing Y and to put a new thing X in their place หาคนมาแทน

honour - to treat someone with great respect and admiration, look up to someone 
hero -
someone who does something brave, new and good and is thus admired by people
unsung hero -
a person who has done heroic acts but is not yet recognized as a hero (has not received the praise it deserves)

efforts - the work done towards achieving some goal ความพยายาม
efforts went unnoticed - no person saw or appreciated what he was doing

commitment - 1. willing to give your time and energy to something that you believe in; 2. a promise or firm decision to do something การมอบความไว้วางใจ, ข้อสัญญา
responsibilities - things that you must do as part of your job or position

(noun) - a job requiring special training, skills and following high standards (such as a doctor, architect, lawyer, accountant, etc ... however any job can be essentially be turned into a "profession" with an attention to detail and quality of services provided)
professional (noun) - a person who is a member of a profession
professional (adjective) - following high standards as in a profession
professional responsibilities - all the tasks that a "professional"  

proven to be - shown to be (by the things he did)
family man - a man who spends a lot of time with his family (taking care of them and making sure their needs are taken care of)
couple - two people who are married or are involved in a romantic relationship คุ่รัก

muse -
think about something (and say what you are thinking at the same time)
nap - a short rest or sleep or rest (usually during the day, not the main sleep at night)
take a nap - have a rest or short sleep in the middle of the day

- to make certain that something happens or is done รับรอง ให้ความมั่นใจ ให้การยืนยัน 
homemaker - a woman who spends a lot of time and effort taking care of her home and family

role - the position, function or purpose that someone or something has in a situation, organisation, society or relationship บทบาท
instrumental - involved in an important way in making something happen
foster - help something grow and develop

X paved the way for Y - X helped Y happen (created the situation needed to make Y happen)
nationwide - throughout a whole country ทั่วทั้งประเทศ

outstanding - clearly very much better than what is usual ยอดเยี่ยม, ดีเด่น'
masterpiece - a great work of art (the best that an artist has done, the best work in some art) (example: Beethhoven's ninth symphony is truly a masterpiece.)
rollout - the official start of a new service or product

initiative - a new plan for dealing with a problem or achieving some goal ความคิดริเริ่ม
mark - to show that something is happening เป็นการเริ่มต้น, เป็นเครืองแสดง
respect - admiration, considering someone as great and special (because of who they are or because of some achievement) นับถือ
X engendered Y - X created Y, X led to Y (example: His hard work engendered respect.)
peer -
people in the same job or profession as you 

boar - a wild pig living in the jungle
policy - a plan of action to guide decisions and achieveoutcomes (See Wikipedia) นโยบาย
infant -
eventually - at the end of a period of time or at the end of a process ในที่สุด

resign - formally quitting a job or leaving a job
retirement - the time when you stop working, especially because of old age เกษียณอายุ

portfolio - the collection of the high quality work that a person has done (example: The job candidate displayed the most impressive pieces of his design portfolio at his job interview.)
remarkable - unusual and surprising, deserving attention and praise, great 
remarkable portfolio - a collection of work that has been done by a person (that is different, unusual and special, praiseworthy)
declaration - an official announcement that something is true or is happening การประกาศ
economical - careful about spending money ประหยัด

active - working, operating, doing its job
played an active role - got involved in some activity (helping it achieve its goals)
provide - to give someone something that they want or need
guidelines - rules to help guide action แนวทาง นโยบาย
non-profit organisations - organizations that do not work for a profit like companies do (often providing community services such as education or health care)
nurturing - helping something to grow and develop, same meaning: "fostering"
remote - far away from cities, difficult to get toไกล ที่ห่างไกลจากความเจริญ (ของเมือง)

decisive decision - making the final result of a situation completely certain แน่วแน่
concede - give in and not resist anymore

monument -
a large stone sculpture or object made to remind people of a famous and important person อนุสาวรีย์
recognize X for Y -
when an organization shows its appreciation for the work some person has done by giving them an award
monuments in recognition of his efforts and services - a large object or sculpture built to show appreciation for a person and their work

- to make weak and less effective ทำให้อ่อนลง,ทำลายทีละน้อย,ทำลายอย่างลับ บ่อนทำลาย
justice - when people are treated fairly and equally (See Wikipedia) ความยุติธรรม
undermine justice - make justice weak (decrease fairness in the way laws are applied)

benefit - to get help or an advantage from something ผลประโยชน์
public benefit - when all people get some advantage or good thing from a project
colleague - someone who works in the same organisation or department as you do เพื่อนร่วมงาน

celebration -
having a party and doing something fun on an important day such as birthday, anniversary, moving into a new home ...
well-wishers -
friends and other people who like you and want to "wish you well" in your new life

turned up at an event -
went to an event (and were seen there) when they were not expected there
honour - to do what you promised to do ทำตามสัญญา'

grateful (adjective) - a feeling that you want thank someone because they have given you something or done something for you สำนึกบุญคุณ
gratitude (noun) - wishing to show appreciation and thanks for things that others have done for you ความรู้สึกขอบคุณ

anniversary - a date when you celebrate something that happened in a previous year that is important to you วันครบรอบ


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