Lack of doctors critical
Hospitals in rural Thailand are suffering from a disease many argue can only be cured by better education and more government funding. They have no doctors.
The Rural Doctors' Society, after a recent phone survey, found that 13 district hospitals had no full-time doctor and 40 per cent were severely understaffed.
Twenty-five 30-bed hospitals had only one doctor who was needed 24 hours a day; 105 10-bed hospitals had one doctor; and 134 30-bed hospitals had two.
Many doctors complained they were often required to work 48 hours without sleep, which society chairman Dr Yongyot Thammawut said was a threat to the well-being of patients.
Under government regulations, medical graduates must work three years in a rural hospital before moving to the city.
But many are opting to pay a 400,000 baht (HK$122,800) fine to forfeit upcountry training, and are being hired by private hospitals.
It seems that under a government policy to decentralise industry away from Bangkok into rural areas, the problem of a lack of doctors is snowballing.
Most graduates are asking to spend their three years rural training in large provinces, causing a disproportionate urban-to-rural spread.
And, ironically, a plan initiated in 1994 to force graduates to spend a year in the city before doing their rural training seems to be backfiring.
The scheme was intended to improve the standard of care, but Dr Yongyot said young doctors were used to working under experienced city doctors and were no longer interested in the rural stint.
The Health Department's Bureau of Health Policy and Planning says the ratio of doctors per person in 1995 varied from 1:940 in Bangkok to 1:10,811 in the northeast.