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THE ILL HEALTHOF PUBLIC HEALTHREFORMImproving Thai well-being requires a holistic, bottom-up approach that involves the participation of government, civil society and the private sector, says Professor Prawase WasiFifty years ago, when medicine was less advanced than now, a newly graduated medic joined a public health unit testing for thalassaemia in rural villages. Apart from the anaemia, diabetes or hypertension that were prevalent, he realized health was not only a matter of diseases but had roots in many social factors including financial status.“I could tell that we get sick more easily if we are poor,” the young medic, now professor, Prawase Wasi, told Elite+. “The poorer the people, the higher the chance they have of developing anaemia. Let’s say if we test medical students’ blood, we’ll scarcely find any of them developing blood diseases because most come from well-to-do families. On the other hand, if these tests are done on indigent villagers, we’ll find more than 90% are unknowingly facing anaemia. It is obvious that illness directly relates to poverty.”Khon-kai [p“atient] derives from two words,The doctor believes impoverished people suffer from illness out of proportion to their ages. Diseases might be diagnosed, but once patients leave the hospital or mobile health units, sickness continues. Without adequate financial support, it is impossible to solve such health issues. Prof Prawase is an activist who has long suggested that the term “health” should be redefined.which are ‘human’and ‘disease’. Presently doctors are simply concerned with the latter component, disease, and neglect the component referring“Health is associated with more than one dimension. Khon-kai [patient] derives from two words, which are ‘human’ and ‘disease’. Presently doctors are simply concerned with the latter component, disease, and neglect the component referring to aspects of humanity. Medical treatment focuses on symptoms such as blood glucose concentration or blood-pressure level and medications to apply to these. Yet a patient carries many dimensions, including emotions and societal and economic conditions. These have no one-size-fits-all solution. That’s why I’ve become interested in the health service system, figuring out how to promote public health effectively, which is not usually a doctor’s concern.”+ Elite 5to aspects ”of humanity