Thailand Hospitals & A Visit to the Zoo

One of my favorite days of the trip was when we went to Vajira Hospital. We were able to learn about how the hospital is run as well as learn more about what healthcare is like in Thailand. We went around 8:30 am and the hospital was already very busy. There were even some patients on beds in the hallway waiting to be seen. The long wait time in hospitals is a main downside to the free healthcare offered; however, the staff was very nice and worked hard to accommodate the patients. We were also able to tour the hospital and see each unit, including the inpatient and outpatient pharmacies as well as where compounded medications and chemotherapy medications are made. After the hospital, we had some extra time to go visit a nearby zoo. It was similar to an American zoo but there were different animals to see, such as barking deer, sun bears, and water monitors. It was a fun way to end the afternoon and see more of the sights Thailand has to offer!

Thailand - Ramathibodi Hospital Visit

Hello! It's unbelievable that we have been in Thailand for one week! We have enjoyed and appreciate what we have been able to accomplish and see in this time. Most recently, we were given the opportunity to learn about pharmacy and medicinal practices here in Thailand at Ramathibodi Hospital, one of the hospitals with the most developed clinical pharmacy practice. We were welcomed so graciously. We toured the facility and were able to see the many different settings in which their pharmacists practice and teach their students who are interning or on rotation. We were able to learn so much about pharmacy practice in Thailand and also see the differences and similarities with what we have experienced back home in the U.S.

 Our time spent in Thailand is something that will never be forgotten. The amazing students, faculty, and pharmacists we have had the pleasure of meeting and interacting with have shown kindness, humility, and sincerity when serving their patients and hosting our group that will forever have an impact on us as future pharmacists and as individuals.

 Sincerely from Bangkok,

 David Perez, Alejandra Arredondo, and Mariam El-Zein

Every day on this trip is an eventful day, but today seemed even more packed and restless from all the emotions. This morning, we visited two patients and experienced the Home Health Care with the community pharmacist from Wat Pai Tan. It was an eye-opening opportunity and us students left the patient homes feeling heart-throbbed and teary-eyed. The pharmacist was amazing and his passion to help others was clearly evident. He took a holistic approach in caring for his patients and you could just see the patients' attitudes and expressions change for the better after the visit. One even greeted us goodbye in tears while the other wanted to take a picture with us students for good luck. 

That rewarding feeling that people go into the health field seeking was definitely exposed to a whole other level today. I would love for community pharmacists in America to be able to do this as part of their regular duties. It was a lot more effective in keeping up with the patients' disease conditions and accurate in seeing their medications, supplements, meals, and living conditions. It also provided them with an unimaginable amount of support. Afterwards, we visited Osot Sala and got to see one of the biggest community pharmacies. Here, I learned more about the differences in regulations of a pharmacy between our two countries. 

After our site visits, the two Mahidol University students--Pink and Cream-- who guided us for the past two days, hung out with us some more and took us to lunch and a delicious dessert cafe. My group and I had so much fun with them and really had a hard time saying goodbye as it was most likely our last day together. Overall, it was a great day and it's moments like these that make my time here in Thailand all the more memorable.

-Yvonne

All hail the king!

Today, we conducted a home health care visit with patients. We did things like blood pressure screenings, medication reconciliations, and lifestyle assessments. Later in the day we went to the community pharmacy and learned about their smoking cessation programs and the different laws governing Thai pharmacy. We found it interesting that there are minimal regulations on what can be sold without a prescription.

At lunch, we had interesting conversation with the preceptor we were shadowing about the king - King Rama IX. We noticed that around Bangkok there are entire shrines devoted to the king who passed away in October of 2016. In the homes that we visited, there always was a photo of the king and his wife posted on the walls and some people even wore his photo on necklaces. We visited the Grand Palace a few days ago, and there were thousands of people lined up pay their respects - some waiting up to three hours. Thai traditions state that the kings body will be preserved for one year allowing people to mourn. This coming October, his body will be cremated over a 5 day period where people can celebrate his life. He was the worlds longest serving head of state reigning 70 years. His father studied at Harvard, making King Rama IX the only monarch to be born in the United States. Apparently, he was not expecting to become a king and pursued the life of a monk. His brother who was king for a moment, died of a gun shot wound and his dying wish was for his brother to become the next king. From what we can tell, he was really loved by Thai people. 

We are looking forward to visiting the hospital tomorrow and learning more about Thai pharmacy and culture!

Love,
Bradley, Eliane, Joanna, Tiffany and Ian

Lunch from today

Hanging with the Thai students and pharmacists

Shrines of King Rama IX

Thai community pharmacy

Home Visits in Thailand

Hello everyone!

Yesterday we got to go to the homes of some Thai people to review their medicines with them. The medical system is very different here and it was very interesting to see the differences. The people we met yesterday were very kind and really appreciated the help. There was also many duplications in therapy that was corrected during the visits. The visits also showed me how important The pharmacy profession is to keep the people healthy and to prevent medication errors. I'm so excited to do more home visits and to learn more about parmacy in Thailand.

Thanks for reading,
Michael Abrahamson

Evidence Based Medicine vs Cost - A Case on Real Life Risk vs Benefit

Today, we did home visits with patients in the community and I was able to have hands on experience in seeing patients with very advanced gout. The patient said that the doctor told her she had gout but she said she didn't. She also had obvious pitting edema from her congestive heart failure and hypertension yet she only takes her blood pressure meds "when she has symptoms" if she drinks too much water. I taught her to push into her leg to see when her leg was swollen due to leg edema as an indicator of her heart failure so that she can visually see when she has symptoms to remind her to take her medications. I also learned that she was taking simvastatin and that it's very common first line in Thailand because of the price compared to our first line of atorvastatin in the US. It's amazing that although we have evidence based guidelines for superior medications these patients still can not have access to the best available care. Another lady also had osteoporosis and I learned that first line calcium is recommended over a medication like alendronate because of the cost limitations as well.

Lots more photos posted at https://www.facebook.com/media/set/?set=a.10155294126614473.1073741867.635549472&type=1&l=957b5a802b!

Mike

The Trip So Far

Hi everyone!

We are currently on day 5 of our Thailand trip. I will say it's been a great but exhausting trip so far. I love that we've been able to do so much. Even though I've been here in Bangkok before. There has been plenty of sights that I missed during my first trip. The trip to Ayutthaya was was my favorite. It's the capitol of the Kingdom of Siam. The ruines were increadible. I'd highly recommend visiting this site when in Bangkok.

The pharmacy experiences have been my overall favorite so far. We went to Mahidol university, Siriraj hospital, and Chulalongkorn University so far. In these experiences, we learned about the pharmacy curriculum in Thailand and the integration of western and traditional Thai medicine. The integration of the two medicines was interesting to see. I like the idea because Thai traditional medicine allows patients to try non pharmacotherapy treatments first. I think we could learn something from that ideology because not every problem necessarily requires medication.

I also enjoyed my home health visit with the students from Chulalongkorn university. The interview process reminded me a lot of the CSA in patient assessment. I was even able to do a microfillament test on one of our patients! Pharmacists here have some unique problems here in Thailand. The neighborhood we went to for the home health visit had an average income of only 3000-4000 baht ($90-120) a month. For example, most people in this neighborhood didn't have refrigeration. They have to carry a cooler with ice to store the insulin. I feel like they have to be a little more creative when they dispense medications.

Any who I'll write again soon!

Scott

Thai community pharmacy/home health

Hello everyone!

Today we went on our first rotation in a community pharmacy/home health setting. In the community pharmacy, we learned the different screenings that the pharmacists do. This included diabetes, hypertension, dyslipidemia, and smoking cessation. Most of the practices are the same, however we learned that in Thailand, there are no prescriptions for medications. Instead, pharmacists will screen patients and suggest a medication that is appropriate for them based on their signs, symptoms and the standardized Thai pharmacy guidelines. Also, pharmacists are more limited to  certain practices than pharmacists in the US. An example of this is not being able to check HbA1C, blood glucose, or give immunizations. We were also lucky enough to experience a home health visit and witness the pharmacist and pharmacy students perform physical assesments and med recs with two patients. The pharmacist and students also educated one of the patients on his new medication and provided nutrition and exercise education. Overall, it was great to learn and see how pharmacy is practice in the Thai community and we were a little shocked as to how similar it is to the United States.

Alejandra, David, Mariam

Every little detail

Wow! I can't believe our trip is already half way over!! As others have shared we have seen so many beautiful and cool places since we've been in Thailand. It's been really neat to experience the Thai culture. I am eternally grateful that we have people driving us around because the traffic here is insane! (And I thought Phx was bad 🙈). I've really enjoyed getting to go visit all of the temples and palace buildings, as well as the parliament building. They are all so beautiful and covered in intricate designs. I cannot begin to imagine all of the hard work that went into each and every building. When we were at the parliament building there were several art pieces that were only a few feed wide and tall that took 100+ people and over a year to build. So I'd guess these buildings were to the extreme! Even the old ruins are beautiful! Can't wait to see what's next.

Kendall