Siriraj and Yanhee: A study in contrasts

Statue of Prince Mahidol outside Bangkok's Siriraj Hospital.

Today we had the opportunity to visit two of Bangkok's largest and most important hospitals: Siriraj, a well-established and well-respected public hospital partnered with Mahidol University's Medical School, and Yanhee, a more recently established and rapidly-expanding private hospital specializing in cosmetic enhancements and medical tourism.

Flock of nurses at Siriraj.

Siriaj Hospital was founded by King Rama V to be the hospital for all of (what was then) Siam. It was at Siriraj that Thailand’s first medical school was established. Prince Mahidol was charged with administering both the hospital and the associated medical school, modernizing them and bringing them up to world class standards. Today, the hospital has more than 2 million patient visits each year.

Dean of Siriraj Hospital and personal physician to the King!

We were treated to a series of presentations from doctors at Siriraj and at Thailand's Department of Preventative and Social Medicine. We even got to meet one of the physicians who personally ministers to the Thai Royal Family! The presentations were excellent, filled with information about the country's national health insurance system as well as the myriad challenges, both ethical and logistical, faced by government organizers in public health and medicine here. Thailand has recently passed the threshold faced by many developing countries, suffering more now from non-communicable diseases such as hypertension and cancer than from communicable ones such as measles or diptheria. There was much discussion of Thailand’s unique healthcare system, which provides universal access to all its citizens.

Although the hospital is one of the finest in all of Thailand, you could tell from a simple glance at the packed waiting room and open-air conditions that the government still faces huge obstacles in providing an adequate standard of care to its population. Those with enough money to afford private health insurance, or to pay healthcare costs out-of-pocket will almost universally choose one of these two options rather than be subjected to the long wait times, crowded conditions, sub-par medications, and dismal doctor-to-patient ratios that currently plague Thailand's healthcare system. The strides they have made in recent years, moving from a fully-privatized system like the one China currently employs, to national coverage, are truly laudable, but much work still remains to be done and I do not envy Thai officials the burden they face.

At any rate, after a delicious lunch -- featuring not one but several vegetarian options! -- we piled back on the bus and drove to another part of the city, where Yanhee International Hospital serves quite a different clientele.

The gleaming corridors of Yanhee.

When I tell you that I didn't take any photos of the interior of Siriraj out of concern for the dignity of the cramped patients in such surroundings, perhaps that can offer some sense of the contrast between Yanhee and Siriraj. According to Yanhee's stylish website, the hospital was established in 1984 and has evolved since then into "a world-class health and beauty institution to meet the increasing demands of patients, both Thais and foreigners from all corners of the world. Facilities and medical personnel have been updated and constantly improved. Today, Yanhee International Hospital stands as [a] world-class healthcare facility, and one of the biggest centers in Asia for health and beauty."

Currently, the following medical service centers are available:

* Plastic & Cosmetic Surgery Center
* General Medicine Center
* General Surgery Center
* Obstetric and Gynecology Center
* Pediatric Center
* Bone and Joint Reconstructive Center
* Hair Center
* Permanent Cosmetic Tattoo Center
* Skin Center
* ENT Center
* Varicosity Clinic
* Physical Therapy
* Dental Center
* Psychiatry Center
* Detox Center
* Ophthalmology-Lasik Center
* Weight Control Center
* Sex-change Center

We were served snazzy petit fours and coffee, then treated to a lengthy tour of many of the hospital's clinics and floors, including the detox center and VIP suites and rooftop garden on the top of the building. Currently, Yanhee is undergoing construction to expand the building still further, from ten to fifteen stories, adding about 2oo new beds to the facility.

With one of the staff nurses.
From left to right: me, nurse, Janice.

While there, I simply had to get a picture with one of the nurses. The impression this picture gives is slightly misleading, as my own skirt was rather on the short side today. The nurse here is wearing 3 or 4 inch heels with a miniskirt stretching to mid-thigh. Now, I like miniskirts as much as the next person, but I don't think I'd care to see one on my medical health professional... but who knows; maybe that's just me. In fact, this uniform was actually one of several different kinds I saw there, including a yellow-shirt-hot-pink-miniskirt combo worn by the nurses on rollerblades (yes, you read that correctly).

From left to right: me, administrative staff assistant.

Yanhee also has "administrative support staff" whose job seems to be to operate the elevators and stand around looking tall, thin, and gorgeous. They have no medical qualifications to speak of, though many have had procedures done at Yanhee (eyelid surgery, dimple insertion, etc.) to enhance their own physical appearance. There is a "Miss Yanhee" beauty contest each year used for hiring purposes, to select these employees, some of whom have no education beyond a high school diploma. After leaving the facility, we had a lengthy conversation concerning several bioethical topics relevant to the work that goes on at Yanhee: medical tourism, the commercialization of health and beauty, the objectification of women, the redefinition of "health" and "normalcy," the income gap between rich Thais and foreigners and the afflicted poor we saw at Siriraj, etc. I'm glad we found the time to have this conversation, but I must say I think the images here probably speak more than any philosophical rambling I could offer on today's experiences. Draw your own conclusions... I'd love to hear what you think.