Leaving no patient behind

Leaving no patient behind

Sirindhorn Science Home is on a mission to help disabled people infected with Covid-19 get the care they need

SOCIAL & LIFESTYLE
Leaving no patient behind
Authorities developed the Sirindhorn Science Home as the first field hospital for disabled patients. (Photo: National Science and Technology Development Agency)

Recently, a 12-year-old blind child was left alone in his room to quarantine. Not long after, his mother who was a diabetic, died due to Covid-19 and his father was admitted to a field hospital as well. The child was surviving on food given by his neighbour, who made a plea for help on social media earlier this month.

A few days later, officials rushed to the scene and had them tested for Covid-19. The child tested positive. Last week, he and his father were taken to a field hospital for asymptomatic and mild patients with disabilities at the Sirindhorn Science Home inside the Thailand Science Park in Pathum Thani.

The centre provides a learning space for students year-round, however, the outbreak has forced it to suspend camping activities. Three agencies -- the Ministry of Public Health, the Ministry of Higher Education, Science, Research, and Innovation, and the Ministry of Social Development and Human Security -- developed the camp as the first-ever field hospital for disabled patients.

Its command centre is located on the ground floor, with patient rooms on the fifth through 10th floors, with a total of 224 beds fitted with cutting-edge technology. Since June, it has cared for over 70 patients. Amid the third wave of the pandemic, which has left the public health system teetering on the brink of collapse, Life spoke to those who helped set up this field hospital.

A staff member demonstrates the use of oxygen supplies for critical patients with disabilities at the field hospital. Jetjaras Na Ranong

Creating a disability-friendly environment

Dr Bootsakorn Loharjun, deputy director of academic and medical affairs at the Sirindhorn National Medical Rehabilitation Institute, said gymnasiums, schools, and temples have been converted into field hospitals to tackle a shortage of patient beds. However, these buildings are not designed for people with disabilities which range from physical to intellectual impairment. Even hospitals are not suitable as their conditions require more friendly facilities.

"We have created rooms for different types of disabled patients. Telecommunication relay services are provided for those with hearing and/or speech disabilities to help them communicate their health condition. Cameras have also been installed to monitor cases upon approval," she said.

She said staff assess disabled patients and the level of their independence for treatment. They must be able to look after themselves as they are required to report their vital signs and work out at least two times per day in their rooms. Treatment takes 14 days but it can be as short as 10 days in case of bed shortages. The staff will screen their lung condition and administer medication. In case of emergency, they will wear personal protective equipment to help patients upstairs.

"We can't admit less-independent patients because we lack fully-equipped hospital facilities. We forward critical patients to hospitals and help ease the burden of patients we can help. When they are discharged, we send them home by car to ensure their reintegration into communities because they are often stigmatised," she said.

She said treatment of those with hearing disabilities is the most challenging because staff are required to communicate with them via devices that require sign language interpreters to be on hand. They are usually the last group of people who are informed of their status.

"Usually one or two out of 10 patients have never learned sign language but we haven't encountered that so far," she said.

Kullaprapa Navanugraha, vice-president of the National Science and Technology Development Agency, said technology plays a crucial role in minimising personal contact between staff and patients to reduce the risk of infection. New tools were been put to use in hard-hit areas since the first wave of the pandemic but they are now available at this field hospital also.

"When an ambulance is sent to pick up a disabled patient, staff will carry him/her out on a negative pressure isolation stretcher to prevent transmission. Its high-efficiency particulate air filter and UV-C disinfection will ensure the safety of released air," she said.

It also deploys machines for delivering food and medicine to patients and germ sabre robots (UV-C steriliser) to disinfect rooms after they are discharged. Other gadgets include contactless elevator buttons and portable X-Ray machines.

A disabled patient's lungs are monitored in the field hospital at the Sirindhorn Science Home. Jetjaras Na Ranong

Vaccinating the disabled

Besides treatment, the Sirindhorn National Medical Rehabilitation Institute has administered over 1,000 vaccinations to the disabled. Dr Bootsakorn said after they register for jabs with the Department of Empowerment of Persons with Disabilities, they will be put on a list maintained by the Department of Medical Sciences.

"However, those who have recovered from coronavirus should wait at least two months because they develop immunity from natural infection. Their level of immunity is not as high as those of people vaccinated but it is not certain whether they will be at risk if they get shots immediately," she said.

When asked about vaccine brands, she said there have been calls for mRNA vaccines because the first and second shots are spaced out further than those of inactivated vaccines, which reduces the risk of leaving home and becoming exposed to the virus. However, virologists said they should get jabs as soon as possible regardless of type or brand.

"We are using China's Sinovac. The good thing is its management. It is a single dose per vial. On the other hand, the mRNA vaccine is 12-doses per vial. If we are unable to vaccinate exactly 12 people, it will go to waste," she said.

A telehealth platform is used by staff to treat disabled patients at a field hospital at the Sirindhorn Science Home. Jetjaras Na Ranong

Supporting the disabled amid the pandemic

In Thailand, there are 2.09 million registered people with disabilities, making up 3.17% of the entire population. Over one million or nearly 50% of them are physically challenged. However, the total number of infections among the disabled remains unclear due to the lack of statistics.

Saranpat Anumatrajkij, director-general of the Department of Empowerment of Persons with Disabilities, said vaccination priority is being given to disabled seniors and those with seven underlying diseases. Meanwhile, the Rajanukul Institute has inoculated over 15,000 autistic children and the Chulabhorn Royal Academy has allocated the Sinopharm vaccine to the disabled, elderly, and needy.

"Over 800,000 people between the ages of 18-59 are expected to get inoculated but it is up to them. For example, we found that only 270 out of 400 patients at Baan Phrapradaeng had registered to be vaccinated. The rest have not been allowed to get the jab by their relatives," she said.

She said the agency is seeking to ensure the disabled have access to public health services and relief packages during the coronavirus outbreak. After patients are admitted to a field hospital, they will be offered food and advice over the two-week period of treatment. When they return home, they will receive supply bags to ensure their survival for another 10 days. Moreover, the government has introduced relief measures for them.

"Led by Deputy Prime Minister Jurin Laksanawisit, the national committee on empowerment of the disabled extended the renewal of disability identification cards for another six months and the application for interest and surety-free loans until the end of September. It also approved a moratorium until the end of March next year," she said.

A patient is carried on a negative pressure isolation stretcher to prevent coronavirus transmission. National Science and Technology Development Agency

Authorities have developed the Sirindhorn Science Home as the first field hospital for disabled patients. National Science and Technology Development Agency

Staff lead a routine exercise during a video call for disabled patients at the field hospital. Jetjaras Na Ranong

For a video of this story, visit www.bangkokpost.com/vdo.

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