I fell down Mo Paeng accidentally. Given the experience we've had at the local hospital over the past week and a half I wanted to offer a few suggestions for dealing with foreign hospitals.
This unofficial advice is just to tell our story. Maybe it will help you too.
Look after your own issues
They never asked if I was taking the antibiotics, and when mine ran out we had to ask for more. If we hadn't asked, there would have been a lapse in my regimen which renders the medicine useless.
The nurses are often not meeting the hygenic standards expected in the west. In the course of a week we saw them do the following while treating my open, infected wound:
- Snip the ends off their gloves and continue on as if it were nothing.
- Answer their cell phones after putting gloves on.
- Pick at their own ear, hair, or clothing after putting gloves on.
- Pick things up after they fell on the floor.
- Use surfaces immediately after another sick patient vacated them.
- Ignore my clearly infected wound and just send us off without blinking.
If stuff like this happens and you're uncomfortable with the risk, don't hesitate to politely ask them to discard something.
Trust your own judgement
We went in and I got five stitches the first visit. It was pretty efficient and cheap compared to US or even German standards. We had high confidence in the staff after the initial visit.
Then, the wound cleanings became faster and faster, with little attention being paid to the state of my leg. The first two days we just chalked it up to being low priority. But my leg was swollen. We didn't like how it looked and started getting nervous. Finally on the fifth day an older, more experienced nurse looked at my leg and asked how long it was like this, we said since day two. She said it's very infected and we need to do something.
The doctor immediately had them pull stitches out and let my leg drain. It had an abscess. If we'd trusted our instincts and asked for a doctor sooner, the doctor would have started treating the infection sooner.
Now, I have some sympathy. No other westerners we saw ended up visiting more than three times total. They're all idiots who fell off their motorbikes, earning their so-called "Thailand tattoos" in the process. My wound was not superficial. We are on day 10 and still have a ways to go. Due to our longer-term treatment, sometimes the staff seem like they're tired of seeing us.
So if you feel like there's a problem, be polite but assertive, and ask to see a doctor. Even the doctor might be apathetic so if you feel like your care isn't adequate and it's feasible for you to move cities, consider moving where you can get better care.
Beware of visa issues
Our problem caused us to stay past our original 30-day VOA. We only thought of and dealt with it a few days before the visa expired, and that caused us stress.
Thailand has immigration offices in Mae Hong Son, Chiang Mai, and Bangkok. We luckily went to Mae Hong Son which is waaaay out on the border of Thailand and Myanmar. From Pai, it's about the same distance to Chiang Mai, but due to its remoteness it's also completely empty (it also has a magnificent view being on top of a mountain). A trip to immigration could very well take you more than a day if there are long lines, so plan accordingly.
When you go, bring the following:
- Yourself. Ironically, the policy is that extensions must be made in person. I have no idea what happens if you're so ill that you cannot make the trip.
- Visa extension request from a doctor at the hospital. It should have a stamp from the hospital on it, but it's otherwise a pretty informal document.
- Copy of your passport. We showed up without a copy, just the real thing. They sighed and charged us for copies.
- Departure card that you received upon entry to Thailand. Most important is the number under the barcode in the upper right.
- Passport photo. We carry around extra copies with our passports, you should do this as a matter of habit.
- 1900 baht per person for the extension itself.
The doctor requested 10 days on our document but immigration gave us 30. If you are travelling with a partner, the immigration folks have no problem issuing your partner an extension too. I'm not sure about bigger groups, but the policy indicates that one person can remain to accompany the person needing treatment.
Donate a bit of money
Aside from the initial cost of stitches which was something like $27, the follow-up care we received cost literally $3 per day. Medicine was mere pennies.
I don't know how these facilities work financially, but many other Thai people were using the donation boxes at the payment counter. I decided to start putting money in too as we paid each day and the people were genuinely appreciative, thanking us many times.
Given the low impact it has on your wallet, consider helping others and dropping your change into the donation box.
Be polite and calm, and have a sense of humor
Thai people seem to truly value a polite, friendly demeanor. Greet people with respect. Never lose your cool. Never raise your voice. This wasn't a problem for us, but we saw other westerners losing it and it felt very out of place.
Thai custom is to address people the reverse of western custom: family-first, given-last. So every day we go in, and wait for my name to come over the loud speaker:
It's become something that brings a smile to my face, even if our situation isn't the greatest. Laugh it off, and always remember that it's part of the journey.