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Thailand | Medical FAQ

▶ Hospitals

Better-off patients are likely to use one of 450 private hospitals. In Bangkok, there are several hospitals with high reputations where most expats go. These include Bangkok General Group – Bumrungrad, Bangkok International and Bangkok Nursing Home. Observers say the group has developed a reputation for top-end treatment, with a pricing structure to match. The concentration of foreign patients in these hospitals is very high. Overall, the private sector has four times the number of beds per patient than the state sector, and much shorter waiting times. Hospital fees are properly structured (unlike in, say, China) and patients should not feel that they are prey to unscrupulous charging. An MRI scan should come in at around £200 – about a third of the UK price. Inpatients are asked to pay in advance. Nursing care is inexpensive, both in terms of professional attention and room hire. Outpatient fees are not usually paid in advance. Consultants' fees can be as low as approximately £20 per appointment. Unusually, though, there is normally an additional £4 charge for use of facilities. According to Bupa International, prices vary widely between hospitals as well as between private and state sectors. Dr Sneh Khemka, the insurer's medical director, said: "Much depends on the hospital. For local nationals using public hospitals, procedures cost roughly a third of what they do in the UK. For expatriates, who use the best private hospitals, procedures cost roughly double that in the UK. For example, an arthroscopy in the UK would cost US$2,500, (£1,690) and in Thailand US$5,000." Despite increasing prosperity, fees in the best hospitals are beyond the reach of most Thais. As is often the case, though, other hospitals offer a broader range of facilities and may be better placed to deal with major emergencies. In such situations, cover with an insurance provider linked to a top-flight assistance company will pay dividends. Assistance companies know where to find the appropriate medical skills. The combination of state and private units sustains a lively health tourism industry.

▶ What to do if you get sick

When you get diarrhea and/or vomiting, the most important thing is to avoid dehydration. Get yourself to a hospital emergency room, I recommend Bumrungrad in the Sukhumvit area or BNH on Soi Convent off Silom (near the Sala Daeng BTS station). Don’t worry about the cost. It shouldn’t be more than 2000 THB for everything including the prescriptions. The usual doctor’s prescription is a drug to stop the symptoms (diarrhea and/or vomiting), an antibiotic to help your body deal with bacteria, and electrolyte beverages to rehydrate. In more severe cases, they will give you an intravenous infusion of fluid. You can also call a doctor in from most hotels. The cost is about 4000 THB for a visit.

Make sure that you take all of the antibiotics that are prescribed to you. Usually you will start to feel better before the treatment is done, but it is important that you finish it because all of the bacteria haven’t been destroyed yet. The small amount of bacteria that are left are usually the toughest ones so if you don’t fight it off you will get a relapse of this tougher strain. When you start eating again you should have bland foods like toast, crackers or rice. Carbohydrates are much easier for your stomach to deal with at this time. Try to avoid fats, proteins and spicy food for at least 1-2 days.

▶ Avoid getting a Food Poisoning

First, let me say, during seven years in Thailand, I've had food poisoning once. Compare this to the three times a year I used to get food poisoning in the US, and I know which country I prefer eating in. However, just like anywhere, food poisoning in Thailand can happen and, if you get it, it can spoil your vacation. Avoiding food poisoning in Thailand is easy. Just follow these tips when you eat or drink anything in the Land of Smiles, and you'll cut your food poisoning risks to a minimum.

Don't Eat Cold Food - A lot of food in Thailand is served lukewarm. Particularly if you eat at some food stalls, the food will have been cooked in the owner's home that morning, but then spends hours sitting outside in the sun with no heating in sight. If you eat at any food stall, street stall, restaurant or cafe, only eat cooked food that's been cooked fresh and arrives piping hot. You really will cut your chances of getting food poisoning down to almost nothing.

Only Eat Unpeeled Fruit - There are tens of thousands of stalls selling cut fruit in plastic bags in Thailand. The only time I had food poisoning was from eating a bag of water melon at one of these stalls. Now, as I have eaten at least one bag of fruit every day from a fruit stall for almost seven years, I would say your chances of getting food poisoning from one of them are slim. But, they're still there. So, if you want to avoid getting food poisoning in Thailand, only eat fruit that still has it's peel on and hasn't been cut. And, make sure you wash it with clean water before you eat it. There are hundreds of thousands of shops in Thailand selling whole fruit for cheap prices, so it won't be difficult to find.

Avoid Ice on the Street - Now, again, I drink iced drinks from the street stalls in Thailand every day and have never gotten sick. However, you might. So, if you really are afraid of getting food poisoning, when you order drinks on the street tell the vendor "No ice" or, in Thai, "Mai ow naam keng". Your drink will be lukewarm, but at least you won't worry about getting sick after you drink it.

Drink Bottled Water - Bangkok actually has some of the safest drinking water coming straight from the tap in the world. I rarely buy bottled water and am never sick but, again, on your vacation you should drink bottled water. Particularly because your immune system may not be able to protect you like mine obviously can. Bottled water is as cheap as 6 baht per bottle (15 cents) and it's everywhere, which means you'll only end up spending $10, if you drink several bottles of it every day of your trip.

Only Buy Ice Cream in Shops and Cafes - You'll see many street vendors selling ice cream in Thailand, but some of them don't keep it correctly refrigerated and it can make you sick. It's highly unlikely it will (in over 1,000 times of eating the stuff I've never become ill) but to completely avoid any ill effects, stick to buying ice cream in ice cream cafes, where it's kept correctly refrigerated or from shops and supermarkets from their freezer section.

Eat Fish and Seafood You Choose While Alive - If you want to prevent food poisoning from seafood or fish, only eat at restaurants where you can choose the fish, lobster etc from the tank while it's still alive. That way you know it was cooked completely fresh. Now, me, I can't eat anything I just saw swimming but, you might feel differently.

Preventing food poisoning in Thailand is relatively easy. Use some common sense about where you buy food, don't drink drinks with ice outside and, if it smells even remotely strange, discard it without eating it and buy something else. A couple of days of bad food poisoning and you may end up wising you'd never come to Thailand and those of us who love the country would hate that.

Wednesday, October 16, 2019