Reflections from Thailand: Thoughts, Memoirs, and Anecdotes
- Charles Chen, MPH
- Nov 18
- 13 min read
Written by: Charles Chen, MPH
American University of the Caribbean Global Health Elective Dates: February 12 – April 4, 2023
Pre-Departure Reflection
Date: February 12, 2025
The Prequel
I write this reflection as a prequel in suspense of what is to come in Thailand. The unknowns: language, culture, food, people, environment. No amount of research can properly prepare you for what you will come across in-person. Plans are bound to change, activities might not occur on time, and being in a new environment means that you will have to adapt. I earnestly believe that real life experiences are the truest form of knowledge. Textbooks can only teach part of the story. Experiences like this can be life-changing and bring about new perspectives and untapped compassion and empathy.
With that being said, I need to consciously keep an open mind and do my best as to not impose my preconceptions I may have had about the country. If I don’t, I know I can fall victim to ethnocentrism, which oftentimes prevents people from fully immersing and understanding other cultures. Thailand offers a unique opportunity for me to grow both personally and professionally. Being a Taiwanese American who was fortunate enough to return to my homeland several times in my childhood has given me a glimpse into what may come. Both Taiwan and Thailand are largely Buddhist countries that share many similar values and rituals. Both Thailand and Taiwan have universal healthcare and offer unique insights into perhaps a much more efficient healthcare system.
Nonetheless, I get to see how healthcare is run in another country. I have been fortunate to be able to experience or practice healthcare in various locations including Panama, Guatemala, the Dominican Republic, and Taiwan, but never in a developing nation in Asia such as Thailand. I welcome the experience with open eyes, ears, body, and mind. I cannot wait!
Written Reflection #1
Date: February 21, 2025
Traditional Thai and Chinese Medicine in Practice
Yesterday, we had the opportunity to follow and shadow a few people from the Chinese Medicine and Thai Medicine department of Sichon Hospital. A notable aspect of my experience in Thailand was the integration, and in some cases, the coexistence, of Western medicine with traditional Thai and Chinese medicine. In both rural clinics and urban hospitals, patients are prescribed herbal remedies, acupuncture, cupping, and other traditional therapies either as standalone treatments or in conjunction with allopathic care. This integrative approach is often met with respect by Thai physicians, who are generally open to discussing and accommodating patients’ preferences as long as safety is maintained.
Coming from a predominantly Western medical background, this was eye-opening. In the United States, this type of medicine is called complementary and alternative medicine (CAM). It is often viewed with skepticism, and although it seems to be gaining more acceptance, it remains largely outside the mainstream medical framework. The medical culture in the United States tends to prioritize evidence-based Western medicine as the standard of care, often to the exclusion of traditional or complementary therapies. Notably, I realize that this can lead to a gap in communication and trust between provider and patient.
In Thailand, however, the lines between modern and traditional medicine seem to be more fluid, much more harmonious. Many patients view health holistically, blending spiritual, physical, and herbal practices with biomedicine. This culturally grounded approach provided me with a different understanding, and as such, highlights the value of listening carefully to patients’ beliefs and finding common ground, especially in a multicultural or global setting. It is not uncommon for a patient to receive treatment at a government hospital while also seeking out a local herbalist or visiting a temple for spiritual healing. There is an underlying cultural belief that health is not merely the absence of disease, but a balance between physical, mental, and spiritual well-being. This holistic approach is deeply rooted in Buddhist philosophy and centuries of Thai and Chinese healing traditions. I was impressed by the openness with which Thai physicians engaged with these traditions.
This dual-framework approach taught me an important lesson about humility and cultural competence in medicine. In the U.S., we often rely heavily on pharmaceuticals and advanced diagnostics, sometimes at the expense of appreciating lower-tech, culturally resonant approaches to healing. While Thailand’s system may not have the same level of medical technology or resources as the U.S., there is a palpable sense of patient-centeredness and cultural alignment in how care is delivered—especially in rural and community settings.
Written Reflection #2
Date: February 28, 2025
US Healthcare System versus Thailand Healthcare System
I distinctly remember Dr. Ekarat giving our team an overview regarding the Thai healthcare system during our introductions to the global health elective at Sichon Hospital. It got me thinking, ”What are some of the differences between the healthcare system in the United States compared to Thailand?” So, let’s dive in. Traveling to Thailand has given me the opportunity to observe a healthcare system markedly different from that of the United States.
Thailand’s healthcare system is often celebrated for its commitment to universal health coverage (UHC), which has been in place since 2002. Through the Universal Coverage Scheme (UCS), the Thai government provides basic health services to the vast majority of its population, including those in rural and underserved areas. During my rotation, I witnessed how this policy translated into real-world care: patients presenting to government hospitals were rarely turned away due to inability to pay, and services such as preventative care, maternal health, and chronic disease management were widely accessible.
In contrast, the healthcare system in the United States is more fragmented, with access to care often mediated by insurance status and socioeconomic factors. While the U.S. boasts cutting-edge medical technologies and some of the most advanced subspecialty care in the world, the lack of universal coverage continues to pose a barrier to equitable access, especially among underserved, uninsured, and marginalized populations. The Thai system’s emphasis on access and primary care served as a powerful reminder that high-tech interventions are only one part of a functional healthcare system—equity, access, and prevention are just as critical. Thailand’s commitment to UHC ensures that even those in remote regions have access to basic care. I saw firsthand how community health volunteers, rural clinics, and primary care networks work together to keep populations healthy. What is the point of having the technology when there is little to no access to them?
As I reflect on this experience, I find myself rethinking what it means to provide comprehensive, compassionate care. This experience reminds me that medicine is as much about understanding people as it is about treating disease, and with that, honoring traditional beliefs can play a vital role in that process.
Written Reflection #3
Date: March 7, 2025
Primary Care Units in Sichon
As part of our rotation with Sichon Hospital, one of the most memorable recent experiences was our visit to a rural Primary Care Unit (PCU) nestled deep within the fertile hills of the Nakhon Si Thammarat province. The morning began as the sun was breaking dawn, the sky painted in soft hues of lavender and gold as we boarded a van in the parking lot of Sichon Hospital. The ride was quiet at first, punctuated only by the rustling of leaves and the occasional call of a bird in the canopy overhead. As we wound our way through narrow mountain roads, I found myself captivated by the scenery: rubber tree plantations stretched in tidy rows across the hills, palm trees swayed gently in the breeze, and mist hovered over the distant mountain range like a silk veil suspended between worlds.
Arriving at the PCU felt like entering another world—slower, quieter, yet deeply connected. As soon as the doctors and nurses arrived though, it was as if a switch was turned, the rush began. Upwards of fifty to sixty patients needed to be seen before 12:30pm after which the healthcare were to report back to Sichon Hospital to continue working. The building was modest, a single-story structure with open-air corridors and the faint scent of jasmine floating through the breeze. Despite the simplicity of the facility, the staff greeted us with warmth and pride. Their commitment to serving the health needs of the local population, often with limited resources, was inspiring.
Throughout the day, I had the opportunity to meet with patients who traveled long distances, sometimes on motorbikes or even by foot, just to be seen at this clinic. One elderly woman arrived cradling a plastic bag of her medications and a medical pamphlet (their physical medical record) with her blood pressure readings and vitals from all her previous visits meticulously written in Thai script. She smiled as she spoke of her grandchildren and asked thoughtful questions about how to better control her diabetes. There was a sense of resilience in their stories, a quiet dignity that stayed with me long after we returned to Sichon.
What struck me most was the seamless integration of medicine, culture, and community. Although busy, there were moments when the healthcare team took time to explain things to me. And it was in those moments that served as a beautiful reminder to me that medicine is not just about diagnosis and treatment—it’s about connection, respect, and understanding the world through someone else’s eyes.
As we drove back to Sichon, the afternoon shown brightly with amber rays of the sun beaming strongly. Children in school uniforms waved from the roadside and cows grazed lazily in fields. I watched it all pass by with a quiet sense of gratitude. This experience challenged me to think more deeply about what it means to serve as a physician—not just in the context of urban hospitals, but in the broader, global community of humanity. It reminded me of the privilege we hold in medicine, and the responsibility we carry to ensure that care is not just effective, but also equitable, compassionate, and rooted in the places people call home.
Written Reflection #4
Date: March 14, 2025
Home Care Visits in Thailand
Our group had the opportunity to follow a medical team that was conducting home visits for patients that may have recently been discharged or are simply being followed for long-term care. As the van rumbled down the winding roads of rural Sichon, Thailand, I sat pressed against the window, watching the landscape shift in hues of green and brown. Coconut palms stood like sentinels across the rice paddies, and the occasional rooster darted across the dirt roads. The sun cast long shadows as we moved from home to home, bringing care, conversation, and compassion to those whose lives had become defined by illness. This was medicine far removed from the fluorescent lights and polished linoleum of American hospitals — this was personal, intimate, and deeply human.
Our home care team was a tight-knit unit: two doctors, two nurses, two physiotherapists, and Meha, Zainab, and myself, a group of visiting medical students hoping to understand what it means to provide care where resources are limited but the commitment is boundless. The team brought a small duffel bag stuffed to the brim with gauzes and other medical supplies, and we set off down small, narrow roads, our destination a list of patients printed in careful Thai script.
One distinct case that remains vivid was a 74-year-old female status post right-sided craniotomy due to subdural hemorrhage from a motor vehicle accident. This patient had a past medical history of diabetes mellitus and dyslipidemia. Of note, patient was on tracheostomy and required an orogastric tube placement. As we arrived at her home — a small, dilapidated townhome— her daughter met us outside, her eyes both grateful and anxious. The woman laid on her bed just inside the sliding door entrance, the most easily accessible area for the patient. The scar from her surgery arced across her scalp, and her body remained weakened, her speech indiscernible. The team worked together — the physiotherapists gently encouraging movement, the doctors adjusting her medications, the nurses teaching the family how to prevent pressure sores. I stood with the girls at the foot of the bed, humbled by the strength it took to heal in silence, but moved at how many family members were present to provide their constant support.
That same day brought us to a man recovering from a stroke due to a right MCA infarct. His bed had been moved to the back of the house so he could feel the breeze beyond the trees and away from the main road. The team provided more than just medications and physical therapy — they brought relief, dignity, and presence. I learned that sometimes, in palliative care, the most powerful intervention is simply being there, bearing witness to someone’s final chapter with open eyes and an open heart.
This experience taught me that healing can happen in the most humbling and unpretentious places — on bamboo mats, in tin-roofed homes, under the warm gaze of a family’s devotion. It showed me that medicine is not confined by institutions or technology, but rooted in relationships, in resilience, and in respect. I know that in the future, I will carry with me the quiet strength of those patients and families, the determination of the Sichon care team, and the wisdom found in listening deeply and caring fully — no matter the setting.
Written Reflection #5
Date: March 21, 2025
Nopphitham and Medical Students
We were able to work alongside second-year medical students from Walailak University. Their energy was infectious—eager, curious, and deeply engaged in their public health project. Despite being early in their medical training, their sense of purpose was unmistakable. I was struck by the pride they took in their work, and I quickly came to admire the way they seamlessly bridged their formal education with the cultural nuances of their own communities.
That morning, we were picked up by the university vehicle, winding our way from Sichon to the Noppitham subdistrict. The air was thick with humidity as we walked the narrow red-dirt paths that connected one stilted home to another, roosters crowed in the distance and the elderly looked curiously from the front porches, occasionally waving or flashing a bright, curious smile.
The students were conducting a comprehensive public health survey, asking local villagers questions about chronic diseases, healthcare access, and basic demographics. Watching them in action was both humbling and inspiring. They approached each household with a deep sense of respect—bowing gently with their palms pressed together in the traditional Thai wai, removing their shoes before stepping into homes, and always beginning with small talk to establish trust.
Inside the homes, often open to the breeze, we sat on plastic chairs, and even an elevated bamboo surface at one of the homes. The villagers spoke candidly about their lives—about a mother with hypertension who only visits the hospital when her symptoms worsen, or an elderly man who walks for over an hour to reach the nearest clinic. One proud grandfather shared how his sons had left for the cities, one living in Sweden and another living in Bangkok, leaving them in hopes of a more prosperous life. Others proudly pointed to certificates of education hung on the wall, evidence of the next generation’s progress. I was especially moved by one elderly woman who offered us fruits after our interview, saying, “We may not have much, but we always share.”
The data we collected—on noncommunicable diseases, frequency of hospital visits, and education levels—was invaluable. But it was the stories behind the statistics that resonated most deeply with me. I learned that understanding public health isn't just about numbers and charts—it's about context, culture, and connection.
Written Reflection #6
Date: March 28, 2025
Realization and Gratitude
It is a very bittersweet moment knowing that our time in Thailand is coming to an end. A rush of emotions fills my heart as I think about all the people I have met, places I have encountered, and things I have experienced.
As we drove between homes, villages, and the bustling city, I often found myself lost in thought. The countryside blurred past, and I reflected on the contrasts: between the limitations of rural medicine and the expansiveness of its compassion; between the language barriers and the universality of human empathy. I thought about how the doctors spoke not only with words, but with touch and tone. I watched how the nurses crouched beside family members, offering both instruction and emotional support. And I marveled at the physiotherapists, whose work breathed hope into limbs that had nearly forgotten movement.
My days were divided between the quiet, rural rhythms of Sichon Hospital and the bustling academic corridors of Walailak University Hospital. In Sichon, surrounded by lush, soaring palm tree and the hum of motorbikes winding along narrow roads, medicine felt raw and intimate. The resources were sufficient, but the care was profound. I remember one afternoon vividly: a woman in her 80s was being followed up by the medical team for a home care visit, stated she had been feeling short of breath for weeks. The family medicine doctor gently examined her, his stethoscope the only tool between them, confirmed the patient’s worsening congestive heart failure. We arranged for an ambulance to the ER because the medicine that was given to her was not enough to quell her symptoms any longer. With the medical team waiting alongside the woman’s granddaughter, the only other family member present at the time, we offered comfort in a moment of quiet vulnerability.
At Walailak University Hospital, the pace was faster, the technology more advanced, yet the heart of care remained the same. I rotated mainly with the anesthesiology team and even scrubbed in with a cardiothoracic surgery team. There, I witnessed a female patient undergo a mitral valve repair. The surgical team moved like clockwork, led by a meticulous and kind-hearted cardiothoracic surgeon who took the time to explain each step, even as the tension in the room thickened. Post-operatively, the anesthesia team monitored him with care that bordered on reverence—adjusting ventilator settings, calculating drips, and always watching. There was a quiet pride in their work, a reverence for life that permeated every corner of the ICU.
There is nothing that will ever replace with memories of my clinical and personal experience in Thailand and I could not imagine having better mentors and classmates to share them with. Absolutely sensational. Thailand has truly taken a piece of my heart with it and I am eager for my return to the beautiful country whenever the opportunity presents itself.
Post-Departure Reflection
Date: April 4, 2025
Return to the US
As I look back on my six-week global health elective in Thailand, I find myself both humbled and inspired. Immersed in a world so different from my own, I was given the rare opportunity to learn medicine in a setting that challenged not only my clinical skills, but also my assumptions, priorities, and perspective on what it truly means to be a healer.
The physicians, nurses, and allied health professionals I worked with were as generous with their time as they were with their hearts. The family medicine physicians took me into rural communities, where we visited patients at home—elders whose ailments were treated with a blend of modern medicine and traditional Thai remedies. The internal medicine residents invited me to join them for lunch under the shade of mango trees, sharing not only food but their stories. And the anesthesia team, whom I shadowed for several cases, greeted each day with laughter, Thai iced tea, and an unwavering calm that I came to admire deeply.
Outside the hospital walls, I was embraced by a culture that radiates warmth and generosity. The people of Thailand live with a quiet joy that is both contagious and comforting. I was welcomed into homes, invited to local festivals, and guided through bustling night markets with the same kindness I saw in the hospital. I shared meals of fragrant tom yum, green curry, and fresh mangoes, always served with a smile. In Thailand, sharing food is an expression of love, and I felt that love in every meal, every conversation, every nod of understanding.
The Thai concept of “jai dee”—a good heart—came to define my experience. Whether in the OR or on a dirt road in a farming village, I encountered jai dee in every corner. It reminded me that while medicine may be a science, healing is an art—one painted with compassion, patience, and humility.
This elective has changed me. I return home with a renewed sense of purpose, carrying with me not only medical knowledge but the deep, enduring lessons of kindness and cultural humility. The faces of my patients, the words of my mentors, and the rhythms of life in Sichon will stay with me as I move forward in my career—guiding me to be not just a better doctor, but a more thoughtful and open-hearted human being.
