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Thailand's Improving Health Care

Thailand's Improving Health Care

Dr Boonruang Triruangworarat of the Ministry of Public Health strives to cement the Kingdom as an international medical hub while focusing on preventive measures and extending access to all facets of Thai society


Then he was young, Boonruang Triruangworarat, now director-general of the Department of Health Support Services, Ministry of Public Health, and certified by Johns Hopkins University, never wanted to be a medical doctor, despite the prestige of the profession in Thai society.


“I always wanted to study engineering, because I love the idea of building something and creating a system,” Dr Boonruang said, in an interview with Elite+. “Yet my parents weren’t convinced. In my day, engineering was associated with reckless vocational students, and my parents wanted me to get a prestigious and secure job like becoming a doctor.”


As it turned out, he enjoyed medical school and university life at Khon Kaen University. In his free time he participated in development camps, giving him the opportunity to learn more about the health problems of poor people. This was an eye-opener for young Boonruang, who came out of his cosy shield at Assumption College, the prestigious boys’ school in Bangkok.


The ideals of public service and utilitarianism have been embedded in him ever since. Although he became a high-ranking official at the Ministry of Public Health, Dr Boonruang never hesitates to visit local communities, no matter how inconvenient or dangerous. When he worked as a ministry inspector in 2009 and 2010 in the dangerous provinces of Yala, Songkhla, Pattani and Narathiwat, he regularly visited areas where bombs had gone off.


Dr Boonruang had opportunities to earn more money and work comfortably. Over three decades ago he was wooed by private hospitals. He turned them down. “The salary at the ministry was much less. But working in public health helped me realize my dream of helping poor people.”


“Helping” for medical doctors mostly involves providing treatment, performing surgery or prescribing drugs. But Dr Boonruang prefers to focus on people’s health before they get ill.


“The best medicine is having good health. Most in the medical field know that the best way to fight disease is eating right and exercising regularly. So if the country wants to improve the state of public health, it should invest in proactive measures. In reality, 95% of the public health budget is used for building hospitals in cities and buying technology and expensive equipment. Very little has been spent on preventive campaigns that educate people on how to eat right and stay healthy so they don’t have to come to hospital.”


Investment in infrastructure often misses the real culprit, the doctor says. “The myth of cancer as the number one killer has driven the Public Health Ministry and medical profession to invest in more technology to cure cancer patients.”


In reality, taking more lives than cancer are non-communicable diseases (NCDs) such as high blood pressure, heart disease and diabetes that result from unhealthy lifestyles. Most NCDs can be overcome by eating right and exercising regularly. Very little budget is allocated for this although 65% of illness in Thailand comes from NCDs. Instead, 70% of the ministry budget is used to treat problems such as stroke or kidney disease, which might have been prevented had patients been better educated on healthy living.


“NCDs come from materialistic society and globalized lifestyle. People eat junk food because the consumption looks modern, without knowing that the ingredients are bad for health. The ministry needs to provide more programmes to educate society about unhealthy consumption.”


The backbone of the Thai medical industry is being solid and trustworthy, Dr Boonruang says. Currently 44 private hospitals have Joint Commission International (JCI) accreditation, considered the gold standard in global health care. Choice is widening, since respected public hospitals such as Chulalongkorn University Hospital and Siriraj Hospital have started opening special clinics that offer faster and more convenient services, while still charging less than private hospitals.


“The quality in both is equal because most doctors at JCI-approved private hospitals also work and teach at state hospitals,” he said. “The difference is convenience, time, décor and attentive service. If people have financial means, they can go to private hospitals.”


Although part of Dr Boonruang’s job at the ministry is to improve Thailand’s position as a medical hub, he never forgets the underprivileged. His focus as a doctor has always been how to create a better system for preventing problems before they start.


Given a chance to reengineer Thailland’s public health system, Dr Boonruang would invest more in medical schools to enable more doctors and nurses to work in remote areas. “The cost of medical education for one doctor is around 1 million baht. The budget can create more doctors to work in remote hospitals, so that poor people do not have to travel across provinces just to see a doctor.”