Farewell Dinner

Tonight we celebrate our final dinner together in Thailand. It has been an amazing experience with amazing people. We have all had many laughs and great times; and we learned a lot as well! I'm sure it will be an experience that none of us will ever forget. 

94 degrees and not a cloud in the sky

Paradise is quickly coming to an end but we are enjoying the humidity and the sunshine. A bunch of us enjoyed a banana boat ride this afternoon while others biked the island. The temperature is at a record high of 94 with a uv index of 7 today which is unheard of for this time of year. Below is a picture of the ocean side pool.

Weekend Getaway

As we are quickly approaching the end of our time in Thailand we are spending the weekend at Sai Kaew Beach Resort.The sand is white and water is very blue. 

Thanksgiving in Bangkok!

We all enjoyed a wonderful thanksgiving feast at the Westin Hotel in Bangkok. Great food with great company! 

Naresuan University Hospital Internal Medicine

A small group of us visited the internal medicine unit of Naresuan University Hospital. Their hospital system is much different than systems in the United States. All of the patients in this unit were placed in one large room with 28 hospital beds with the nurses station located so that all beds could be observed at all times. It was interesting to see the similarities and differences between this University hospital to one in the US. Although I was not allowed to take photos of the unit I was able to photograph some of the emergency medical supplies that they keep in stock on the internal medicine floor. 

Crash cart 

Loi Krathong

After a busy day of classes we participated in Loi Krathong. We made floral and leaf arrangements in class this afternoon that we would light at a ceremony this evening as well as lanterns. The ceremony held thousands of people and had many street vendors selling the arrangements as well as traditional Thai food and treats. 

Our amazing Thai Tradtional Medicine staff with the WNEC AND UNE students 

Tonight's restaurant location. It was directly over the water and we had a great view of the full moon!

Thailand APPE group dinner 

 

Dr. Krebs and Am(the amazing APPE coordinator) participating in the light ceremony.

Bonnie and Vananh letting their lantern float into the sky

The entrance to the festival on the river. Happy Loi Krathong

A local street vendor with a variety of deep fried bugs to include crickets, bullfrogs and maggots

Emily, Gabby and myself have been contemplating eating a bug since our arrival in Thailand. In celebration of our last didactic day we said why not. The crickets were very crunchy and didn't have much flavor but we officially can now say we ate a bug!!!!!! 

Pharmacy Operations

One of the more interesting things I have learned in the various hospitals and pharmacies in Thailand is their methods for making pharmacy practice easier.

The facility we visited today, Naresuan University Hospital, on an average day fills 2,600 prescriptions. In order for a facility of this magnitude to operate smoothly, certain work arounds need to be developed.

The pharmacy staff tags all incoming medications with a color coded sticker. The color system helps pharmacy staff quickly and easily identify expired medication thereby minimizing errors and increasing inventory rotation efficiency.

Naresuan University Hospital Ambulatory Care

The Naresuan University Hospital is a 320 bed hospital that sees about 950 patients per day. The faculty pharmacist KP who specializes in oncology gave a few students a tour of her ward. The newest addition to the hospital is the oncology unit which has 10 beds and there were six patients receiving infusions. The process for ordering oncology medicine is very similar to that of the United States as there is an order set from the doctor of standard chemo regimens. A major difference was that the order sets at NU are hand written and all the patients medical records are kept in a book opposed to electronic storage. The chemo regimens are very similar to that of the USA as well as the length of therapy. NU hospital has 27 pharmacists and 34 pharmacy technicians between the four wards of the facility. (The first picture is of KP with Silpa Bonnie Alissa and Emily) (The second picture is of the hospitals hypersensitivity kit in case of an adverse drug event with the chemo)

Naresuan University Hospital ICU

Student group #1 visited the ICU at the Naresuan University Hospital. Many of us seemed to agree that this experience was suprisingly similar to that of our ICU experiences in the United States.

Though many of the practices and procedures were similar, many of their communicable diseases were much different than that which we typically encounter.

Naresuan University

Yesterday we visited Naresuan University where we participated in a lecture about traditional Chinese medicine. We learned about accupuncture and moxibustion. We all learned a lot and a few of us were lucky to try both of these medical methods. 

Ryan getting acupuncture therapy in his ears 

Alissa and Van getting acupuncture therapy in their hands to help with shoulder/back pain. (And our amazing guide Am observing the technique). 

Nikolay receiving moxibustion therapy

Introduction to Buddhachnaraj Hospital

After introductions of the exceptional staff at the hospital Apple, one of the pharmacists gave us a brief overview of the facility. Buddhachnaraj Phittsnulok Hospital is the biggest hospital in the Northern region of Thailand. The facility has 1063 beds of which 70% of their patients are enrolled in the UC program and 13.4% pay cash. The mission of the hospital is to provide health services in all aspects and healthcare at all levels. They work within a joint development and production initiative to educate and train all medical personnels for public health. Buddhachnaraj Hospital is a teaching hospital that works with fourth fifth and sixth year medical and pharmacy students. The facility currently has 53 pharmacists, 946 nurses, 228 physicians, 24 dentists and 1356 other employees. With a staff this large the hospital sees 900,000 outpatients per year and 70,000 inpatients yearly. On a daily basis 3100 patients are seen by the different practices within the hospital. Apple went on to explain that the number one reason for an outpatient visit in 2014 was hypertension which attributed to 75000 cases and that the number one inpatient visit was for senile cataracts at 2195 patients. The hospital has 52 wards and 7 pharmacy dispensing rooms. We were lucky enough to tour a portion of the facility to include inpatient and outpatient pharmacy dispensing and the surgery dispensing unit. 

Family Style lunch was delicious!

Lunch was delicious!

Buddhachinaraj Phitsanulok Hospital - Manufacturing

Today we visited the Buddhachinaraj Phitsanulok Hospital. One of our site visits took us to their pharmaceutical manufacturing laboratory. Due to the enormous cost of some commercially compounded medications, the facility chooses to do much of this work in house.

One such example is the balm (similar to Tiger Balm) that is given to patients who take their medications as prescribed. We received a free sample as a take home gift!

Phitsanulok Exploration

In our free time, some of the guys got together to do some exploring. Unlike Chiang Mai or Bangkok, we require a taxi to get most places here. We found a restaurant called Woodstock that featured live music and a huge portion of Americana. The establishment had everything from Ford Motor Company signs to Shell gasoline pumps.

We also stumped upon the night market which had a wide variety of vendors.

Sukothai Historical Park

Today we visited Sukothai Historical Park.  The park contains the ruins of the original city of Sukothai from the 13th and 14th century. We rode bicycles throughout the grounds of the park on a beautiful Sunday morning in Thailand!

Myself, Emily, Analesa and Alissa on the bikes. 

Elephants!

We had a great time at the Thai Elephant Conservation Center this morning. We watched the elephants being bathed, the elephant show and then got to ride them for half an hour! 

Our elephant "driver"

Gabby and Alissa

Analesa and Dr. Krebs

Vicki, myself, Van and Bonnie

The elephants were always ready for a picture 

Fruit night market

It just so happens that I found out there was a night market specifically for produce in Chiang Mai the last night we were there. I had to go to this thing to check it out; needless to say, I was not dissapointed. The streets were lined with flower and fruit vendors and on top of that it was all the cheapest I had seen in Thailand. I picked out 3 kilos of mangos, 3 pineapples and some durian. Everything was delicious. 

A beautiful mound of durian.

A good old fashion mini with a roll cage. Im in love