Unpaid heroes of community medicine

Dr.Amporn

"The public health volunteers are locals who know almost everyone in their neighbourhoods. So, they know about health risks and can intervene efficiently," Dr Amporn Iamsri, director of the unit, said last week.

Rujee Panusatit, a volunteer, said she was looking after 35 people in her hometown.

"They are from eight families. I have all key details about them, their name, address and health problems," she said.

Amporn said the information compiled by the volunteers formed files that health workers could use.

"When we know some people are engaged in health risks, we go out to them and offer useful advice," he said.

Rossukon Chaichana, a licensed nurse at his unit, said a team, comprising a nurse, doctor and pharmacist, went out on house visits every afternoon during the week.

"Each day, our team can cover three cases on average," she said. "We go to each house in turn to follow up on our patients' health or on disease prevention".

The team's mission was also useful to the patients' relatives.

"We've found that the relatives suffer stress from having to take care of the patients round the clock. Our advice and presence helps them," she said.

Another nurse, Lamai Temyingyos, said her team was now paying more attention to Alzheimer's disease, a progressive form of presenile dementia that is quite common among the elderly.

"There are more senior people in our areas," she said.

With more than 35,000 people under its charge, the San Sai Community Medical Unit also has three primary-care units (PCU) to help with its work.

A PCU has smaller facilities and no dentist.

The Kaen Pattana PCU was established last year by Dr Adisak Opastrakul, director of Mae Taeng Hospital, in cooperation with and Muang Kan Pattana municipality.

Kaen Pattana PCU treats about 80 patients a day.

"Thanks to its service, it has eased congestion at Mae Taeng Hospital," Adisak said. "The PCU is also good at taking care of patients who need continuing treatment."

PCU members have also made out calls to patients and people in their neighbourhoods.

"With the visits, tuberculosis patients are more likely to take their medicines as prescribed. They have to take up to 12 pills each day for a period of six months. Failure to follow the prescription strictly will cause drug resistance," Adisak said.

Tiam Udom, a health volunteer, said she regularly reminded 70-year-old Jan Temkuna to take his TB medicine.

"He has followed my instructions perfectly during the past three months. I will keep a close watch on him over the next three months too," she said.

Nam Chaiya, 79, said she was happy to see a medical unit operating close to her home.

"I find it convenient to come for medical appointments. So, I have never failed to show up. Besides, I like the fact that the doctor here is friendly. When I go to big hospitals, things are different," she said.

Dr Wichai Sawasdiwon, secretary-general of the National Health Security Office, said his agency would spend Bt1.1 billion on upgrading health stations to community medical units this year.

Only 158 community medical units are available across the country.

"But actually, we need 6,000 such units," he said. "They attend to minor cases that big hospitals should not be burdened with."