Health

 

A healthy lifestyle can be achieved anywhere in the world as long as you are aware of the special concerns in your particular area.  Thailand has a tropical climate and with this comes exposure to certain germs, insects, plants and animal life that you may have never previously encountered.  To combat this, Pattaya has a full range of medical services available, and the major hospitals have the latest equipment and technology for diagnosis and treatment.  As you are in a foreign country, if you feel uncertain concerning a diagnosis or treatment it is always good to get a second opinion, either from another local doctor or your doctor in your home country.  This chapter will endeavour to inform the newcomer of how to adapt to your new environment and avoid common health problems.  It also lists hospitals and other medical facilities should you be in need of medical attention.

 

PRIOR TO YOUR ARRIVAL

It is advisable for you and your family to have a complete medical examination before departure.  Most companies can arrange this for you.  Be sure to bring a supply of any medication you take with you along with a copy of medical records containing pertinent information.  Most medications are available here but often have different names, so it is better to have a supply until you know where to get what you need here.  Visit your dentist before you leave your country and bring along your eyeglasses prescription.  Also bring a list of vaccinations that you have been given, especially for children.

Health Insurance

If you have come to Thailand independently, or the company for which you work does not provide health insurance benefits, you should obtain good coverage.  If retiring, there are several policies for those over 65 years of age.  Getting coverage can be done in your own home country before you leave, or in Pattaya.  Check the policies being offered and choose what you think you will need.  Be aware of what your policies cover.  Some policies do not cover emergency room treatment.  This can be obtained separately and is a wise decision considering the driving habits of the local population.  Some policies are valid for services only in Thailand, while others are valid anywhere in the world.  Benefits, while adequate in Thailand, may not be sufficient where health costs are higher.

Immunization

There are no compulsory immunizations required for adults in Thailand.  Medical opinions vary as to which immunizations are advisable.  However, children must be immunized and proof must be furnished.  The incidents of some diseases such as tuberculosis, toxoplasmosis (no vaccine), rubella and measles are increasing.  These, as well as some others like Japanese ‘B’ encephalitis and typhoid, do present a real danger in Thailand.  The Thai National Health Schedule recommends a standard immunization programme.  Two new vaccines have been added to this list, HIB (Haemophilus Influenza Type B Meningitis) and Hepatitis A.

 
ADVISABLE VACCINATIONS

The following vaccines are generally recommended for most adults living in Thailand.  As with any medical treatment, if you are pregnant, please consult a physician before receiving vaccines.

 

·                    Diphtheria

·                    Pertussis (Whooping cough)

·                    Tetanus(up to date)

·                    Polio (up to date)

·                    Typhoid (oral vaccine after 4 years of age)

·                    Hepatitis A (Havrix)

·                    Hepatitis B (Engerix, HB Vax II)

·                    Influenza (yearly)

·                    Japanese B Encephalitis (readily available at any hospital in Pattaya, but possibly not in your country)

The very cautious may also wish to have Pre-exposure Rabies vaccine.  Have your vaccine records detailed on an International Vaccine Card.  If you are not able to complete a course of vaccinations before departure, consider bringing the vaccine with you.  Keep it with you in the plane and ask the steward to refrigerate it.  Note that the chicken pox vaccination is now available in Thailand.

The Thai National Health Schedule recommends the following immunization programme for children. 

 

In Nursery

·                    BCG vaccine (Tuberculosis).  Given at birth in the hospitals in Thailand, and recommended for children under 6 yrs if never vaccinated.

·                    HB vaccine (Hepatitis B). First dose.

 

One month

·                    Physical check up, advise of any feeding problems.

·                    HB vaccine.  Second dose.

 

Two months

·                    DPT (Diphtheria and Tetanus toxoids combined with Pertussis vaccine).  First dose.

·                    OPV (Trivalent Oral Polio vaccine).  First dose.

·                    HIB (HIB Meningitis).   First dose.* 

 

Four months

·                    DPT and OPV.  Second dose.

·                    HIB.*   Second dose.*

 

Six months

·                    DPT and OPV.  Third dose.

·                    HB vaccine.  Third dose.

·                    HIB.*   Third dose.*

 

Nine months

·                    Measles vaccine.**

·                    Tuberculin test (if negative reaction repeat BCG).

 

Twelve months

·                    Japanese B Encephalitis vaccine.  Two doses 1-2 weeks apart.*

 

Fifteen months

·                    MMR 9 measles (Measles, Mumps and Rubella vaccine).**

 

Eighteen months

·                    DPT and OPV.  First Booster.

 

Two years

·                    Japanese B Encephalitis vaccine.  Booster.*

·                    HA Vaccine (Hepatitis A).  Two doses 6-12 months apart.*

 

Four to Seven years

·                    DPT and OPV.  Second Booster (Pre-school). 

·                    Typhoid vaccine.  Two courses, three years apart.

·                    MMR booster.  At age five.

 

Ten to Twelve years

·                    Rubella vaccine.  Pre-puberty girl who has never received rubella vaccine. 

·                    DPT, OPV and HA booster.

·                    HB booster every ten years.

 

*          Hepatitis A and HIB Meningitis vaccinations are recommended by private hospitals as well as the Thai National Health Schedule.  Japanese B Encephalitis is recommended in endemic areas.

 

**        MMR can also be given by starting at nine months with measles only.  Then complete MMR at 15 months.  This is usually recommended in areas where measles is considered endemic.  Check with your doctor.

  

 

ACCLIMATIZATION

Regardless of where you come from, adjusting to a new area and a new climate takes time, possibly from a few weeks to several months.  The newcomer can lessen the degree of discomfort and shorten the length of acclimatization time by heeding a few suggestions.

  • Wear loose fitting natural fibre clothing and open shoes/sandals, which give good skin ventilation.  sweat and dampness can cause bacterial and fungal growth, which causes itching and rash development. 
  • Increase fluid intake to prevent dehydration.  Water and diluted fruit juices are best.  Alcohol, coffee and tea have a diuretic effect and should not be considered part of your ‘increased fluid’, if you do consume them, drink equal amounts of water to compensate.  It is very easy to become dehydrated in this tropical climate so always have water with you if possible.  Bottled water is also readily available in most places.
  • Introduce your stomach gradually to new hot and spicy foods.  Thai food is delicious but has all sorts of spices and ingredients you most likely have never eaten before.  Most newcomers experience some ‘travellers diarrhoea’ due to the change in their diet.  If you have a sensitive stomach, do not hesitate to use an intestinal pack for the first few days.  This may alleviate the pain.
  • Increase physical activity gradually until you become accustomed to the heat and humidity.  Limit outdoor activity to early morning or late afternoon and evening when possible.  Again, always have drinking water available when exercising.
  • After bathing, dry thoroughly and apply powder.  Be careful as certian ‘cool’ powders used by Thais can irritate the skin.
  • Use a fan to circulate air, instead of air-conditioning, as much as possible.  This will greatly speed up the acclimatization process.
  • The sun is very strong.  Gradually increase your exposure to it and always use sunscreen, on yourself and your children.  It not only prevents sunburn but skin cancer as well.  Hats and umbrellas are useful also.
EVERYDAY LIVING

The body has a natural way of building up immunity to new germs and bugs, but this takes time.  With sensible precautions, you should not have any serious health concerns.  If for some reason you do become ill, do not hesitate to consult a doctor.  General medical care is affordable here, and a quick visit to the doctor could save you or your family many days of discomfort.  It may be a good idea to visit one of the hospitals in the area soon after you arrive.  This will allow you to assess the facility, know its location and perhaps choose a general doctor before any emergencies arise.

Air-Conditioning

Be aware that many germs are transported by air.  Air-conditioners are breeding places for germs.  Ensure filters are cleaned regularly in your unit, at least once every three months, if you use it constantly.  Air-conditioning dries the air and can increase the risk of respiratory infection, particularly in children.  Avoid leaving it on too long.  Try to let as much fresh air into your home as possible.

Food and Hygiene

Cleanliness in food preparation and personal hygiene is more important when living in a warm climate.  Some expats are incredibly cautious and still get ill occasionally, while others take no precautions and eat vegetables rinsed in tap water and food from street vendors and never get sick.  Common sense prevails in most cases, but the following reminders are worth noting:

  • Wash your hands, not only when you prepare food or after going to the toilet, but also when you return from a street visit.
  • Wash fruit and salads thoroughly with bottled water.  If eating fruit on the street, peel it.  Many supermarkets carry vegetable washes and Kpermanganate to rinse off pesticide residue.
  • If buying from a food stall, buy only cooked food.  Do not eat uncooked or partially cooked food.
  • Shellfish should be avoided if it comes from polluted waters, but again many expats experience no ill effects.  Prawns/shrimps in Thailand are raised in fresh water and are therefore safe to eat.
  • Thoroughly reheat leftovers.  Be aware that when using the microwave to cook food, all bacteria may not be killed.  Eat leftovers within 2-3 days and throw them out if the power has been off for more than 4 hours.
  • Make sure all garbage is sealed in a plastic bag and placed outside.
  • The Thais are not immune from food poisoning.  So, if you enjoy eating Thai food from street vendors and small restaurants, visit places where you see many Thai people eating.
  • Every year, newspapers report a series of deaths that occur after consumption of horseshoe crabs or Maeng Da Talay.  Thai people like the eggs of the crabs.  Only the stools are poisonous, so the crab needs to be cleaned thoroughly.  We advise you to avoid it if at all doubtful.
  • It is a good idea to eat all seafood as soon as it has been cooked.  Be wary of leftover shellfish that has been in the fridge for a few days.

 

Pregnancy

Managing a pregnancy in Thailand differs little from the experience you would have in your own country.  Most of the specific tests required during pregnancy are available here such as antenatal tests, ultrasound scans, amniocentesis and special blood tests.  Expat women have been having babies in Pattaya for years.  There are some very good doctors available.  It is best to ask a friend or contact one of the mothers groups in the area to see which doctor would best suit your needs.  Consult your obstetrician for special birthing requests.  There are limited resources for premature births in the Pattaya area, however there are some excellent hospitals in Bangkok.  Caesarean births are common in Thailand, so if your doctor here suggests a caesarean make sure it is for the right reasons.

A healthy lifestyle during pregnancy is the best way to make sure you will have a healthy baby.  Smoking and excessive alcohol are harmful to your baby.  Do not take any medication without consulting your gynaecologist.  In Thailand, avoid eating green papaya.  Research shows that papaya contains an enzyme, papain, which interacts with progesterone and can be powerful enough to cause a miscarriage (Bangkok Post).  Pregnant women should remember that most miscarriages occur during the first three months, so activity and travel should be limited during this time.

Women in the last months should avoid unnecessary medication, but vaccinations and anti-malarial drugs should be taken where needed, under doctors advice.  Pregnant mothers should take extra care in the Thai heat.  It is easy to get dehydrated in this climate, so be sure to drink lots of water throughout the day.  It is also much more uncomfortable and tiring coping with a pregnancy in the fierce climate.  Be sure to get enough rest, avoid the mid-afternoon heat and don’t do too much strenuous activity of any kind.

Breast-feeding is well proven to be the best way of feeding your baby.  However, if you choose to bottle feed, there are powdered milks available, which can be mixed with boiled bottled water.  A comprehensive baby care book would be extremely useful.

 

Medicines

When visiting a doctor here, you may be surprised at the amount of medication prescribed for ailments.  Do not forget to use common sense and all the knowledge you have obtained from visiting your physicians at home.  Many medicines can be purchased over the counter here that would only be available by prescription at home.  Ask your physician the name and purpose of each of the medicines prescribed.  Get the pharmacist to write the generic and brand name in English (the hospital label is often stuck over the original label, therefore making it impossible to read instructions and warnings).  Keep a record of all medicines used.  Warn your maid, nanny and school staff not to give medicines to your child without first consulting you.  You will also need to stress to them the need to keep medicines well out of your child’s reach.

 

Water

Tap water comes from various sources.  Pattaya City water passes through a treatment plant.  However, there are no guarantees as to its purity when it reaches your home.  It can become contaminated in damaged pipes.  Water can be delivered by tanker, but the source of the water is unknown.  Do not drink tap water.  Use bottled water to brush your teeth (some expats use tap water without ill effects, but it cannot be recommended).  Train young children not to drink the bath water!  If you must use tap water, boil it vigorously for at least 10 minutes to sterilize it.  For babies up to 12 months old, you may wish to boil bottled water for drinking.

Drinking water can be bought in individual bottles.  These are convenient, easily obtainable and inexpensive.  Water can be purchased in any supermarket in various sizes.  Most restaurants will also bring bottled water sealed to your table when requested.  For your home, large bottles of water may be delivered for everyday use.  Many times the condominium complex will have a water delivery service, allowing you to get your water directly from your complex.  Remember that bottled water is not fluoridated, so young children will need fluoride tablets.  See a pediatrician for the recommended dosage which is based on age.

When making ice cubes at home do not use tap water.  Ice cubes that are served in drinks at established restaurants are not a problem, as they are usually prepared from boiled water.  Be wary of crushed ice, as it may be frozen tap water.

Swimming in the sea in Pattaya is not recommended.  The city is currently making a great effort to clean up its beaches and waters but there is still much work to be done.  However, some expats swim at Jomtien Beach and Naklua Beach, the choice is yours.  Most condos, homes and hotels have beautiful pools that more than make up for the disappointment of not swimming in the sea.  There are also several islands very nearby with clear, clean water.  Usually, fresh running clear water is considered safe.  If visiting northern Thailand where there are waterfalls, it is very tempting to bathe.  Many books warn of the presence of a small worm, which causes Bilharzia (schisto).  It is usually found in stagnant water and is not life threatening, but it can cause many unpleasant symptoms as the parasite moves about the body.  Despite this, many expats have enjoyed swimming in the waterfalls in the north.  Again, use your own judgement.  The best guideline is to make sure the water is flowing.

 

POTENTIAL HEALTH PROBLEMS

It is not possible to cover every illness or danger to health that an expat might encounter.  We will discuss some of the common problems and illnesses faced by expats.  Where possible, causes, symptoms and treatment will be discussed.  Similarly, other dangers involving plants, insects and animals will be covered.  After reading this section it may seem that staying healthy in Thailand seems impossible, but most of these ailments can be avoided with some common sense.  You should be much more concerned about being on the roads in Pattaya!

 

COMMON AILMENTS

Many of the problems encountered by expats are minor and would not cause much concern in their own countries.  However, it needs to be said that a small problem here can quickly grow into a bigger problem because of the heat and humidity.  Always wash and sterilize the smallest cut immediately, especially if caused by coral or objects in the sea.  Do not wait too long if you think you need treatment.

Cystitis / Urinary Tract Infection

Cystitis is an infection of the bladder.  The symptoms are the frequent need to empty the bladder and a burning sensation after urinating.  Drink plenty of fluids, water, etc.  If the symptoms persist, see a physician who should do a urine test and will be able to prescribe the correct treatment.  Do not self treat as other illnesses can cause similar symptoms.

Dehydration

Dehydration can be recognised by signs such as infrequent urination, sunken eyes, increased thirst and dizziness.  Dehydration can become a serious problem if you don’t drink enough fluids, if you overexert yourself, exercise in the heat or have continuous diarrhoea or vomiting.  This loss of fluids and salts need to be replaced.  The best prevention is to drink plenty of water every day.  If you do feel you are suffering from dehydration, get out of the heat, relax and drink some fluids.  It is a good idea to have some electrolyte beverage powder at home for such instances.  These are available at all pharmacies.  Or you can make your own by using one litre of sterilized water, four heaped teaspoons of sugar and half a teaspoon of salt.  A little extra salt may be needed depending on your diet.  Bottled electrolyte drinks, or sport drinks, are readily available at most food stores now.

Traveller’s Diarrhoea

Traveller’s diarrhoea is caused by such things as a change in diet, local water and spicy food.  After frequent exposure, however, a degree of immunity should develop.  Give your body time to adjust to the Thai food and drink only bottled water.  Traveller’s diarrhoea normally resolves on it’s own, however do see a doctor for fever, persistent abdominal pain or blood in the stools.

Children’s Diarrhoea

Diarrhoea in babies and young children is potentially dangerous in any environment.  Because babies have a small body mass, it takes a very short time to become dehydrated.  Problems like diarrhoea and dehydration can escalate very quickly in this climate.  See your physician if the baby is under 6 months or has abdominal pain, fever, vomiting or diarrhoea.

It is not unusual for doctors here to recommend that your child stay in the hospital for one or two days.  If dehydration is suspected, your child will be put on an intravenous drip.  If your child is suffering from diarrhoea avoid milk, fruit, raw vegetables or fruit juices.  Bananas, rice, applesauce and oatmeal are recommended.  Your doctor may prescribe antibiotics and milk formula.

Food Poisoning

Food Poisoning is more serious and along with diarrhoea is usually accompanied by vomiting.  Should you get a persistent case of diarrhoea, remember to drink lots of fluids (non-alcoholic) to avoid possible dehydration.  Try to stay out of the heat and avoid strenuous exertion.  If symptoms persist after two days, seek medical advice.  You should contact a physician anytime you pass blood or have violent diarrhoea or vomiting, as these can be symptomatic of amoebic dysentery and haemorrhagic fevers like cholera or yellow fever and thus are life threatening.

MICROBIAL / VIRAL INFECTIONS

This group probably afflicts the greatest number of people, mainly from intestinal infections, resulting in mild diarrhoea. More serious are viral infections like hepatitis, haemorrhagic fevers, or HIV.  Travellers coming from or going to rural areas need to beware of mosquito borne viruses like malaria, dengue fever and Japanese Encephalitis.

Otitis Externa (Outer ear infection)

The outer ear canal can be an excellent breeding ground for microbes, which thrive in moist, warm places.  The best prevention is to thoroughly dry ears after bathing or swimming.  You can use a hair dryer to really dry them well.  Cotton tipped swabs are not recommended, as they may force water and ear wax further into the ear.  Remember this is different from Middle ear infection.

Fungal Infections

These can occur in any part of the body where skin surfaces rub together and remain warm and moist.  Likely places are between the toes, under the breast, armpits and genital area.  Always dry these areas carefully.  Antifungal creams are available here (Mycospor, Canestan and Lamisil).

Cuts and Abrasions

The tropical climate may promote infection in even minor cuts.  Wash the wound thoroughly with soap and bottled water initially.  The wound should be cleaned thoroughly before applying Betadine or antibiotic cream.  Always cover the wound with a firm (not tight) cotton bandage.  If the wound becomes infected, repeat the cleaning procedure.  If it does not improve after a few days, see a doctor.  If you are using Betadine, use it exclusively and sparingly.

Prickly Heat

This is a common tropical skin condition, which produces tiny water blisters.  These are caused by sweat trapped beneath the skin of the face, neck, chest, arms or legs.  A cool shower and an air-conditioned room will relieve the symptoms.  You can also use prickly heat powders or camomile lotion.

Sunburn

Ultraviolet rays causing sunburn are intense in Pattaya.  Excessive exposure to the sun can cause not only painful burns, but will hasten the aging process of the skin and may induce skin cancers.  For best protection, use products containing Para-Aminobenzoic Acid (PABA) with a sun protection factor (SPF) of 12 to 50.  Use a minimum of 15 SPF for children.  Avoid taking babies and young children out at the hottest time of the day (10am to 3pm) and use a sun hat and loose cotton shirt, even for swimming.

Discomfort caused by sunburn can be eased by using Kamillosan cream, Aloe Vera gel or soaking in a cool bath with baking soda.  A physician should evaluate severe sunburn accompanied by fever.

Vaginal Infections

Vaginal itching and discharge can be caused by a variety of fungal and bacterial infections, which thrive in this tropical climate.  Try frequent showers without soap and loose cotton undergarments.  Persistent infections should be evaluated by a physician, especially if accompanied by foul odour and/or greenish color.

Worm Infestations

This is not a common ailment here, but worms are common in Thailand and are contracted by eating contaminated food, walking barefoot or sitting in a wet bathing suit on beaches.  Children especially should not walk barefoot outdoors and put their hands in their mouths.

There are several different varieties of worms including hookworm, roundworm, beef and pork tapeworms, hydatid cysts and angiostrongylus cantonensis, which is contracted by stroking dogs.  For hydatid cysts there is no reliable drug treatment.  They must be surgically excised from the liver where they most often occur.  For the other worms, drug treatment is available.

Make certain your food is well cooked, particularly beef and pork.  Always wash salad well.  Lightly cooked or raw fish is the primary source of the Chinese Liver Fluke.  Worms live in their hosts for years and left untreated can cause anaemia.  In some cases, heavy infections can lead to cardiac arrest.  Although a frightening thought, infestation by worms is in fact very rare.

Typhus

All four varieties of typhus cause fever, headache and skin rash, but intensity of symptoms vary according to type.  Effective treatment is available if started early enough in the illness.  Vaccine is available for typhoid fever.

Japanese Encephalitis

This is also a viral illness spread by mosquitoes to animals, then from animals, particularly pigs, to humans and causes fever and confusion.  It has been reported in Pattaya and Bangkok in the past six years, and vaccination is recommended.

MOSQUITO BORNE DISEASES

Malaria

Mosquitoes can carry diseases, the best known being malaria.  Malaria is a parasite spread by the female of the Anopheles mosquito.  Remember these diseases are mostly found in rural areas.  Bangkok and most other popular tourist centres in Thailand are considered relatively risk free.  There should not be a problem unless you are staying in forested rural areas.  Other high-risk areas include some of the islands like Koh Samet, Koh Chang, Koh Pha-ngan and Koh Tao, which present a high risk to the traveller.  The Cambodian border is reputed to be a high-risk area as well, as is trekking in Chiang Mai.  In such high-risk areas, some of the mosquitoes are becoming resistant to most drugs.

To protect against mosquito bites you can use mosquito repellent containing DEET.  You may also use sprays for yourself as well as your living area.  A mosquito net is also an option, especially with small children and babies.  Mosquitoes are most active at dusk and in the evening.  The mosquito carrying the dengue fever, however, is a daytime creature and should be protected against (balms) and not be ignored.  In the dusk hours wear long sleeve shirts and trousers to cover up exposed areas of skin.  Burn mosquito coils for added protection.  Consult the Thai Red Cross Society or your physician or Embassy for currently recommended secondary prevention methods (medications).  Also be aware that some anti-malaria medicines can make you ill.  There is no current vaccine.

Dengue Fever

This is a mosquito borne viral disease causing flu-like symptoms.  Symptoms include high fever, headache, joint and muscle pains.  The mosquito responsible is active in the daytime.  There is no vaccine, and the only prevention is mosquito repellent.  Dengue is not uncommon and almost never fatal to young people in good health.  It is a threat for older people or those with chronic illnesses.  Paracetamol or Tylenol, not aspirin or ibuprofen, should be taken to relieve symptoms.

CONTACT DISEASES

AIDS

The AIDS virus, called HIV (Human Immuno-Deficiency Virus) is prevalent in Thailand.  The best way to avoid contracting either STD (Sexually Transmitted Diseases) or AIDS is to avoid sex with strangers.  The correct use of latex condoms from a reputable manufacturer reduces the risk with a casual partner.  Certainly, risk does not arise from prostitutes alone.  Engaging in unsafe sexual practices with any partner is risky.  AIDS (Acquired Immuno Deficiency Syndrome) describes the spectrum of diseases caused by the HIV virus.  From the initial contact, it may take up to six months for HIV antibodies to become apparent from a blood test.  AIDS is the first universally fatal form of venereal disease.  In the absence of a vaccine or cure, only preventative and educational measures will halt the spread of HIV.

For AIDS/HIV advice, contact the Bangkok Nursing Home Tel: 02-233-2610-9 or locally Father Giovanni Contarin at the Camillian Social Center Tel: 038-685-480.

Hepatitis

Hepatitis is a viral disease of the liver.  Different forms of hepatitis exist.  The most common are ‘A’, ‘B’,  ‘C’ and ‘D’, but recently new forms have been discovered ‘E’ and others (yet unnamed).

Hepatitis A

Hepatitis A is an infectious disease spread through food and water contamination, undercooked or raw shellfish and seafood, along with raw vegetables.  Once infected, a person becomes immune to future infection, this can be detected by a blood test.  Symptoms develop about one month after exposure to the virus.  Immunization is available and recommended.

Hepatitis B

Hepatitis B can be much more serious than Hepatitis A, possibly resulting in chronic liver disease.  It is spread through blood and body fluids and contaminated needles.  Sexual intercourse, IV drug use, tattoos and contaminated needles, syringes or razor blades are risks for infection.  The incidence rate in Thailand is high.  Immunization and regular boosters are highly advisable.

Tuberculosis

All Thai children are vaccinated against tuberculosis at birth.  It is recommended that any staff you employ are tested for the disease.  It is a treatable disease, but it can leave after-effects for life or even in a few cases be fatal.  Different forms of tuberculosis exist.  With the increasing incidence of AIDS, such diseases as TB are re-emerging.  It is an airborne disease, so coughs and sneezes are contagious and can cause it to spread rapidly.  BCG vaccine might not provide 100% protection, but it will prevent you from being affected with complications of tuberculosis such as Tuberculous Meningitis.  It is a good idea to have an annual tuberculin test or chest x-ray to detect infection.

Typhoid

Typhoid is not a real threat in Thailand, but because of the seriousness of the disease everyone should be vaccinated.  The best prevention is good food hygiene.

WILDLIFE DANGERS

Much of the natural life encountered in and around Pattaya will be different from your own country.  The tropical climate brings about new problems to watch for, but these should not be a problem if yu are aware of the hazards.

Plant Life

Plants can be toxic and the newcomer may not be familiar with the dazzling display in Thailand.  Handling or ingesting any of the following plants may cause adverse reactions:  Poinsettia, Oleander, Allamanda, Dieffenbachia and leaves from Mango, Papaya and Frangipane trees.  If you like to have plants in your home, it may be worth buying a book on poisonous plants.

Rabies

Rabies immunization for animals is not compulsory in Thailand.  There are over two million stray dogs in Thailand, and even animals known to have been vaccinated are not 100% protected.  The principal risk here is rabies from dog bites.  However, rabies can be spread by any fur-bearing mammal, including cats and monkeys.  In addition, insects pose a threat as well.  Avoid petting or picking up stray animals.  Teach your children to stay away from all unknown animals.  If you are bitten, scratched or licked on any broken skin by any animal, immediately cleanse the wound with soap and water only and proceed to the nearest hospital.  It is advisable, especially for children, to receive pre-exposure rabies vaccine.  This does not preclude the necessity for post-exposure treatment.  It helps to delay the action of the virus, but you should not hesitate to contact the hospital as soon as possible.  The Merieux vaccine is available at all private hospitals.

Sea Life

The sea life on the islands around Pattaya and in other parts of Thailand is wonderful.  If you are scuba diving you should be aware that a great number of life forms in the sea are poisonous.  The stone fish is exceedingly so and can be lethal.  Do not attempt to play with or even to touch coral dwellers.  Swimming and snorkelling are safe in unpolluted waters, but wear shoes to protect yourself from sea urchin spines and coral cuts, which can easily become infected.  Beware of jellyfish during the rainy season, vinegar can help calm the sting.  Visit the aquarium at Bang Saen, in the Marine Science Museum of Burapha University, where you can see the dangerous fish in the waters of Thailand.

Snakes

Thailand has many venomous snakes.  Most snakes are shy and will retreat to avoid an encounter.  Unprovoked attacks are rare.

  • Avoid creating homes for snakes by keeping your garden clear of leaves, compost heaps, etc.
  • Walk on clear paths whenever possible and avoid long grass or bushes.
  • If you go trekking, wear rubber boots and long trousers.  Always be very careful where you put your hands if climbing or even if playing golf.
  • Do not allow your children to go barefoot or wear flip-flops in questionable areas.
  • If you do see a snake, do not try to capture or handle it.
  • If you are out at night, carry a flashlight and take extra care.  Snakes are more of a danger at night, especially after heavy rains.
  • Learn about the dangerous types of snakes by visiting a Snake Farm.

A lethal dose of venom can have it’s effect within 30 minutes.  If you are bitten, remain calm and proceed immediately to the hospital.

If bitten by a snake, wash the wound with soap and water and immobilize the bitten limb as much as possible.  Avoid harmful first aid measures like commercially available snakebite kits; these often do more harm than good.  Proceed to the nearest hospital; all of the international hospitals in this area are equipped to deal with snake bites.

You may not be given the serum immediately if it is unclear which snake is responsible for the bite.  The medical staff will observe the symptoms until there is a definite indication for the correct serum.  If possible, kill the snake and take it with you to the hospital.

Lizards

Thailand is full of geckos and lizards of all shapes and sizes.  The small lizards are harmless and help reduce the numbers of insects around your home.  The larger lizards are aggressive when cornered and will bite.  If you are bitten, you will need medical attention to check for signs of tetanus and diphtheria.  Tell your children to look at the lizards but not to touch or chase them.

Scorpions

Some species of scorpions in Thailand are dangerous.  They are usually shy but will react if they feel threatened.  If you are stung, remain calm, immobilize the affected area and get to a physician as quickly as possible.

Wasps

About one person in 200 is severely allergic to bee or wasp venom.  In such cases a bee sting can be fatal.  If a bee stings you, scrape the stinger out with a knife or fingernail and avoid grasping the pouch, as this will inject more venom.  People who are severely allergic should carry an identifying tag, in case they are found unconscious, and should always carry equipment for self-administration of epinephrine, which will relieve symptoms.  They should see a doctor as soon as possible.

 

MEDICAL SERVICES

Pattaya and Sri Racha have several private and public hospitals.  These hospitals have good facilities, and the majority of the staff speak English.  They have excellent snakebite facilities.  Each of the private hospitals has its own ambulance service and 24-hour emergency facilities.  Hospitals offer services of most medical specialities, dentistry and physical therapy.  Cardiac patients will often be referred to Bangkok.  All hospitals operate their own pharmacies, full-range laboratories and diagnostic X-ray facilities.  General practitioners, dentists, opticians, physical therapists and pharmacies are also plentiful.  If you are unsure about whom to see, it is best to seek the advice of friends or ask your company.

Ambulance

Emergency ambulance service differs from that found in most Western countries.  All the hospitals have ambulances, but they are mainly used for transferring patients, though this is changing.  Emergency numbers (except hospitals) are only useful if you can speak Thai.

In the event of a car accident, an ambulance is not called as standard practice.  If somebody travelling with you calls the hospital direct, they will most likely ask them for details of the injured party and yourself and then send an ambulance.  Most times the patient is ‘picked up’ by a helpful motorist, rather than waiting for the formalities needed for ambulance services.

HOSPITALS

Bangkok Pattaya Hospital
On the west side of Sukhumvit Road, about 1 km north of intersection with North Pattaya Road.
Tel:  038-427-751-5
Fax:  038-427-755
24-Hour Emergency:  038-427-777
A full range of general and specialist medical services is available.  A well equipped, recently renovated modern hospital including a trauma centre and cardiac care unit with the very latest technology for diagnosis and treatment.  Hotel and home call available as well as transportation for wound care and appointments.  Offers a drug treatment program.  An International Department can assist with insurance; translators for numerous languages are available as well as insurance.  Coffee shop, restaurant and meeting rooms also inside.  Reasonable medical costs and good hours for outpatient appointments.

Pattaya International Hospital
On the south side of Soi 4, between Beach Road and Pattaya Second Road.
Tel:  038-428-374
Fax:  038-422-773
A well equipped, modern hospital.  A full range of general and specialist medical services is available.  An International Department can assist with insurance; translators for numerous languages are available as well as insurance.  Reasonable medical costs.

Pattaya Memorial Hospital
Sign on south side of Central Pattaya Road, just east of Pattaya Second Road intersection.  Hospital is located at the back of a row of shop houses.
Tel:  038-429-422-4, 038-422-741-2
Fax:  038-422-740
Smaller hospital with limited staff and facilities.  No snake bite treatment.

Banglamung Hospital (public)
Take Sukhumvit heading north from Pattaya.  After the footbridge in Naklua, turn west onto Sawang Fa Road.  Turn left at the sign.
Tel:  038-429-245
Fax:  038-428-464

Laem Chabang Memorial Hospital
Opposite Laem Chabang Industrial Estate, on Sukhumvit Road near Km 127.
Tel:  038-491-888
Fax:  038-491-878
This facility includes a Japanese Medical Centre.  Ambulance service available.

Phyathai Sri Racha General Hospital
On Nakorn 3 Road, north of Pacific Park Mall.
Tel:  038-770-200-8
Fax:  038-770-209
Well equipped with the latest technology (laparoscopic surgery, computerized tomography).  The hospital runs a day care centre on the fifth floor.  Nurse aides welcome healthy babies from birth up to one-year old.  Mon-Fri 0730-1630.  Please call for more information.

Samitivej Sri Racha Hospital
North Sri Racha, on Soi Laemket, north of Jermjompol Road.
Tel:  038-324-100-20
Fax:  038-312-961-3
Now affiliated with Bangkok-Pattaya Hospital.  Well equipped modern 100 bed hospital.  Many specialist doctors available covering all ranges of illness.  Good lab and radiology services, anything that cannot be dealt with is referred to their sister hospital in Bangkok.  Reasonably priced with excellent accommodation, all rooms with a view of the sea.  Japanese and English translators available.  Checkup packages for a good price.  Small snack bar inside.  Can accept most international insurances.

Somdet Sri Racha Memorial Hospital (public)
South-west corner of Jermjompol Road, signposted on Sukhumvit Road as the Queen Sawangwattana Hospital.
Tel:  038-325-590-8, 038-322-157-9
Fax:  038-311-008
Many of the doctors here also work at the nearby private hospitals.  Also known as The Red Cross Hospital.

DOCTORS / DENTISTS

If you have a medical problem in Thailand, it is normal practice to visit a hospital.  However, there are a few independent practitioners.  Good dentists with high standards of hygiene can be found in private hospitals.  Similarly, eye specialists often work from private hospitals.  Call or visit before you actually have a problem so you are comfortable with the doctor and know the hours (which often change without notice).

PHARMACIES / CHEMISTS

There is an abundance of pharmacies (chemists, drug stores) in Pattaya.  Be aware that drugs sold only through a doctor’s prescription in your home country may be sold over the counter in Thailand.  Beware, some drugs are sold in different strengths and dosages than what you are used to in your home country.  It’s best to buy from a large pharmacy to be sure your medication is pure and not a ‘copy’, and generally these pharmacists speak good English.

OPTICIANS

There are many optical shops in the area.  As with doctors, it is useful to get a recommendation from a friend if you are unsure of where to go.

MASSAGE / BEAUTY SERVICES

You will see massage establishments everywhere.  Once you find a place you are comfortable with, getting a massage can be a very enjoyable benefit to living in Thailand.  Usually ‘Traditional Massage’ designates an establishment offering straight-forward massage.  If you are unsure the place you want to visit is a reputable establishment, ask a friend first.  Expats often use private masseurs at home or massage services at certain establishments.  Most of the major hotels have massage facilities, but they tend to be more expensive.  Most of the full service salons offer a variety of massages as well.  Be cautious, as Thai massage can be very physical.  Do not hesitate to stop the massseur if you feel uncomfortable.

Getting beauty services can also be an enjoyable part of living in Thailand.  Take care in choosing a place that is clean and sterilizes their equipment, particularly for manicures/pedicures, or bring your own manicure set.  Avoid these services on the beaches/islands because they do not use sterile instruments.

There have been several instances of severe allergic reaction occurring to the dye used for ‘tattoos’ on the beaches around Thailand.  ♥