|
Thailand HEALTH AND WELFARE
By Asian standards, the level of public health in Thailand
was relatively good. In 1986 the life expectancy for men was 61
years; for women it was 65 years. In 1960 for both sexes life
expectancy had been only 51 years. In 1984 deaths among children
under age 4 averaged 4 per 1,000, while infant mortality for the
same year was 47.7 per 1,000. The crude death rate for the
population as a whole declined fairly consistently between 1920
and 1984, from 31.3 to 7.7 per 1,000. Much of the decline was a
reflection of the successful struggle against malaria, which once
had been the single greatest cause of illness and death. The
expansion of the public health system in general, however, was
also an undeniable factor in the improved health picture.
Health and related social welfare services received an
allocation of 10.3 percent of the total 1984 budget. Of this
amount, about 50 percent was assigned to public health
activities; the remainder went to social security and welfare,
housing, and community services. Although a disproportionate
number of health care facilities were concentrated in the Bangkok
area, Western-style medical treatment was provided throughout the
country by a network of hospitals, regional health centers, and
other clinics. In 1981 there were 359 hospitals, with 1 bed per
734 people and 1 physician per 6,951 people. In the same year,
the nation registered 1,142 dentists and more than 50,000 nurses
and midwives.
Despite progress in lengthening life expectancy, combating
disease, and building public health facilities, Thailand in the
late 1980s faced a bleak public health situation. One of the most
critical national health problems was the water supply. In the
mid-1970s, little more than 20 percent of the population, most of
that portion being urban dwellers, was reported to have access to
safe water. Even in Bangkok, where the proportion with such
access was highest, only about 60 percent of the population had
access to potable public water. In the countryside, inhabitants
depended on shallow wells, roof drainage, rivers, and canals.
Throughout Thailand, but especially in Bangkok, the
traditional skyline with its Buddhist temples was becoming
overshadowed by Western-style buildings and skyscrapers.
Construction was done mostly by laborers who usually lived on
site with their families. In 1980 there were more than 373,000
construction workers (79 percent of whom had once been farmers)
living in temporary housing, which typically measured only 3 to 4
meters square and had a door but no windows. Workers'
compensation and paid sick leave were almost nonexistent, and
illness and inadequate sanitation were common in these
shantytowns. Although public and private agencies were becoming
aware of the seriousness of the problem from both a health and a
legal point of view, the transient nature of the burgeoning
construction community made this population difficult to serve.
In the urban areas, modern development and outward prosperity
often masked deficiencies in basic infrastructure that arose from
rapid and unplanned growth. Urban planners were confronted with
traffic congestion, housing shortages, and air, water, and noise
pollution.
The development of an international consumer economy brought
new challenges and Western diseases, particularly for urban
dwellers. Prostitution and narcotics use, which had been part of
Thai culture for centuries, took on new dimensions as health
hazards. With the worldwide spread of acquired immune deficiency
syndrome (AIDS) and new strains of venereal diseases, Thailand
became concerned about the welfare of its female citizens and the
effects on tourism. By mid-1987 eleven people in Thailand were
reported to have AIDS and about another eighty to be AIDS
carriers. The government had begun to take such action as testing
homosexuals and drug addicts for AIDS, testing donated blood
supplies, sponsoring public information campaigns, and funding
the development of an inexpensive AIDS testing kit by Mahidol
University.
In the mid-nineteenth century, narcotics were seen as a
domestic problem, but one limited mostly to the Chinese. By the
1960s, drug use was considered a security or a foreign affairs
issue. Only by the late 1970s did Thailand recognize drugs as a
growing domestic problem. By that time, in addition to organic
narcotic production, there was a dramatic rise in the production
and use of synthetic drugs. Narcotics-related crimes ranked third
among all types of criminal activity in 1983. In that year, there
were 28,992 convictions for drug offenses nationally and 11,777
in Bangkok, which resulted in the overcrowding of prisons and
detention centers. To combat the problem, the government
instituted both public information campaigns and drug treatment
centers. The national media began to make daily announcements
about the social effects of drug use, and even in small
provincial cities billboards were used to carry the message. Some
traditional social systems were also employed in an innovative
fashion. For example, Wat Tam Krabok, in Sara Buri Province,
became one of the most important centers for the treatment of
opiate addiction. Moreover, the government responded to the
increase in health-related problems by placing new emphasis on
meeting basic social needs in its economic and social development
planning.
Data as of September 1987
|
