Supo National High School

Tubo, Abra

Performance Output
In
English for Academic and Professional Purposes
(Sample Mini Concept Paper)

Submitted by: Ruth B. Jueves

Submitted to:
Ma’am Fe Quinio Daguyam

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 CONCEPT PAPER: A Global Health Issue in Thailand

INTRODUCTION
Background Information
“Since the beginning of 2004, southern Thailand had become caught up in the escalating cycle of violence.
In January, Thailand has placed three provinces in the South- Pattani, Yala and Narathiwat under martial law
following a well-coordinated attack on army and police facilities. Subsequent violence, including the
suffocation of around 80 Muslim youth detained in the army trucks in October, 2004 has polarized views about
the ongoing conflict.” [APCSS, 2004]
The trends of attacks have been still ongoing, targeting from police, teacher, monks, and until today, the
trends of attack are randomly by means of anyone can be the victims of any bombing.
Needless to say, how the quality of life of the local people would be effect, which also include the health
personnel as well. With the nature instinct for survival, large population of healthcare personnel begins to move
out of the danger zone. Policy and strategies to emigrate the healthcare staffs have been implemented by
Government and several agencies which concern for the health of the local people, but yet ineffective.
Thus, in this mini-concept paper, I will try to elucidate the local perspective, as well as propose some ideas that
could help ease the pain in the lack of healthcare service for the local population living in the three southern
provinces in the risky danger environment at very this moment.
Before we start, I would like to give some caution on the accessing information

Limitation of the collaborations, information and reference sources

The violent incident remains and continues to occur at this very moment of my writing of this report. Each
day, people are still living in fear, bombing is happening randomly in any possible areas. Lives are still being
lost day and night.
The difficultly in accessing to the information will be much more complicated as this is the on-going situations.
Any leakage of information can put ones at stake. Nevertheless, we must never give-in to the obstacles along
the road to the improvement of the healthcare standard in the three provinces of the Southern Thailand (Pattani,
Yala, and Narathiwat).

My Attempt to encounter the limitation

I have designed the questionnaire for accessing some information from the local healthcare problem.
[Appendix A] The questionnaire has been distributed, among a few police units force in Yala, and to a few
nurses in the local medical units, yet still no responses. So far, as for the time-limitation while developing this
report and the collaboration has been initiated. Further field-collection of data would be required especially
under the circumstance that I am not the local people there. A few local police, forensic scientists, nurses from
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local hospital, and the social organizations have agreed to collaborate. Only one interview in person with the
local police had been done. Two interviews of family-related casualty of death had also have been gained.

Statistics: in the three southern provinces of Thailand.

First priority step in understanding the healthcare problems in the three provinces is to find the statistics. The
key statistics were
1. The statistics the total population in the 3 provinces in the last 10 years, if possible.
2. The ration statistic of religious among the local population.
3. The statistic: Birth rate and Death rate per year
4. The statistic in the causes of death:
4.1 Death from health diseases, and identify the main diseases as cause of death
4.2 Death result as the casualty of violence events.
5. The immigrant of health personnel in and out of the Red zone.
The statistic information in the three provinces is currently unreachable. My attempt to identify the
statistics is using the indirect approaches, by looking at the National Statistic as a whole. Based on: The 2012
Key Statistics of Thailand: provided by the National Statistic Office, which present major statistics regarding
economic, social and environment.
However, it does not reflect upon the significant information that I required for revealing the truth problems
concerning healthcare problems at all. Since the Southern regions in this statistic reference is including all 14
provinces: Nakhon Si Thammarat, Krabi, Phang-nga, Phuket, Surat Thani, Ranong, Chumphon, Songkhla,
Satun, Trang, Phatthalung, Pattani, Yala and Narathiwat.
Still, there may be of potential usage for further analysis with different statistical approach, like comparing
provinces to provinces among 14 provinces to get closer to the real population statistics and main health
problems in the three provinces. Some relevant Tables and Diagrams will be put in the Appendixes. [Appendixe
B –G]

HEALTHCARE PROBLEMS IN THE THREE SOUTHERN PROVINCESOF

THAILAND
PROBLEM 1: Thai population in those three provinces has difficulty in accessing to medical healthcare
service and the standard of healthcare is very poor.
In order to increase the recruitment number of recruit medical personal to those areas, several policies have
been implemented. For instance, the requirement for the nursing examination normally required the examinees
to score above 65 out of 100. The desperate attempt to mobilize more nurses has been substitute with the
scoring of 25 out of100. The efficiency of this proposal may help to increase the number of health personnel,
yet it leads to another problematic issue. From the interview with the local police, he stated that
“If I need to go to hospital, I would rather travel to another province to receive the healthcare, because the
doctor or nurse at the healthcare facility around his house is unqualified”.
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What his answer had indicated is that: Firstly, he has no confident in the healthcare service in the three
provinces. Secondly, he rather takes the risk in traveling a longer distance to get the good healthcare service.
According to him, …He reasoned his non-confidentiality by stating that most sick patients died at the local
healthcare. He rather takes the risk to travel, despite knowing the fact that the longer duration before the sick
patient get to the doctor’s hand may affect the treatment, as well as the hazardous bombing or violence incident
that could occur along the travel route.
From this case scenario, it is obviously that the policy which implemented in order to attract more health
personnel is unsuccessful unless the quality of the health personnel is being developed and maintained along
together. In order to upgrade the quality of life in term of healthcare services, policy to be implemented must
considered both quantity and the quality. Till then, we may yield a better successful rate of development in the
healthcare system for the population living in the war-related zone.
Disease burdens as the consequences of the difficulty in accessing a well-trusted healthcare service. Direct
Determinants and Indirect Determinants
At 1st stage: At the beginning stage of disease may not be out-value the hazard from traveling through the
field bomb to get the health service. From my perspective, only when the individual has the means (cars, secure
channel), as well as when the disease condition is severe to the point that one rather die at home or along the
way to the hospital have made no more different.
Prioritize the most important determinants that should be addressed to fight this problem and justify
your choices.
The most important determinant is definitely to increase the number of qualified healthcare personnel that
are being entrust with full confident by the people in the areas of danger zone.

Evaluating the existing implementation strategies currently addressing this determinant? Please justify
your answer.
Thailand’s instability of political issues has large impact on the implementing and maintaining the health
policy. A series of policies, whether in parallel or contradict, have never reached the phase of productive stage.
Still, Thai governments do realize the emergency of the healthcare problem in the Southern Thailand, the three
provinces, and several attempts have been implemented with different strategies to increase the quality of life in
the healthcare service management.
For the purpose of this report, I shall give a few policies and strategies that have been implemented. Strengths,
weakness, as well as the gaps of the existing implementation strategies currently addressing the main
determinants will be analyzed and addressed.

Problem: Lack of health personnel.

Solution: To increase the health personnel.
Implementation Strategies: Lower the qualification grade for the recruitment of health
personnel in those three provinces.
Strengths: The number of the healthcare personnel increases. (The national statistic is
inaccessible to me at this very moment)

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 Weakness: Lower standards in the professional specialist’s skill and knowledge.
- (secondary consequences) In which leads to the inefficacy to cure the disease, and increased the death rate that
specifically due to the lack of trained/educated knowledge of the health personnel. - (Tertiary consequences)
population has no confident in receiving the health service locally. Stigmatize of the professions.
Lead to relocate health personnel themselves to other area where they may have no pressure from the
stigmatizing has already been culturally distributed. Also, the population have own belief that by travelling to a
non-danger zone, the health service will be much better.
In order to encounter the stigmatized of non-professional health personnel if they are located in the three
provinces. The government has tried to challenge the qualified health personnel with a better benefit if they are
agree to locate themselves in the areas. Some of the attractive offerings are:

Problem: Lack of qualified health personnel., implemented strategies, and the

outcomes
Solution: Increased more qualified of trained healthcare personnel trained from the top-rank university.

Implementation Strategies 1: Offer a better benefit in exchange (Grants,

financially, benefits, etc.)
Strengths: Prior the relocation to the three provinces: May attracted some of the highly qualified medical
personnel.
Justifying: Initially many qualified highly trained and skillful personnel may outweigh the offered benefits over
the risk of danger to life.
After experiences the prices of the offered benefit, protecting and securing one’s own life may override the
original expectation, and thus agreed to lose the benefit in order to relocate back or away from the danger zone.
Weakness: Short-term of health service may leads to the loss of time and expenses, more than that is the loss of
trustworthiness of the local population, the discontinuity in taking care of some diseases that required constant
supervision of the doctors. Cases have to be transferred to the new recruits, the trusted-relationship between
doctor-patients have to be again developed from infancy bonds.
Gaps: This implementation may be abuse its own objective by some group of health personal in order to
receive/gain the benefit in the offering condition.
Problems: Lack of medical equipment.
Solution: Equip the health facility with the modern equipment.

Implementation strategies 2: Not officially, yet there are some attempts to

provide the medical equipment necessary to save human’s life.
Strengths: Availability of the equipment.
Weakness: Just the equipment is not capable to help one’s life, there is a need for the specialist to know how to
handle and utilize the availability of the resources to the maximum outcome. Then here, arise another problem
that entail in the scope of discussion in example of implementation 2.
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Gap: The corrupted government officers can find their way of taking advantages from this type of project in
term of financially. During the process, there are several gaps, that will be and currently ongoing in the Thai’s
governing system. (Simply, the highest bet will be appointed to get the deal, more gap for corrupted parties to
rob the country).
My recommendations to improve strategies to address this determinants and reason.
With respect to the moral code of all health personnel, as the respect to the Human’s Rights and freedom of
choice in protect one’s own life, I will not concentrate on tactic strategies to lure medical healthcare
professional into the danger zone with external benefits. For I believed that the inner urge to put one’s self there
is something much more honorable and we must not try to put prizes on that intention, especially in the age of
capitalism.
My boundaries are clear. In summarized, the human’s right, freedom of choice, capitalism strategies are
excluded from my scope of interest. (Yet, the strategy I am proposing will provide several gaps and weakness,
which will be taken as opportunity from the capitalism definitely. What I am trying to say is that, several gaps
will be detected, and the strategy to encounter and protect the main objective will be taken in maintaining the
nature of the arising concept)

My proposing solution 1: To increase the qualified health personnel.

Educated and trained the local populations of the skill and knowledge that specified to their main health
disease problems in their living areas.
This concept arises from the concept of the (waste water system, which is learned from the trip within this
course), the concept of His Majesty’s “Nature by Nature”
Since we need to respect the human’s right in their freedom of choices, we cannot force any individual to
relocate when it is against their wills, as well as the implemented strategy in offering benefits had proven to be
ineffective.
Nature by Nature, in this context, is to utilize the local resources, for this instance, is the manpower of the local
population who has chosen to live in their origin habitants.
If we cannot transfer helps to them, then we can make them the qualified healthcare autonomy personnel that
are capable of self-health service themselves.
Equipment: As the same strategy as mentioned above, apart from providing the full medical equipment, we
will trained them the necessary knowledge and skills, some medical equipment may be applicable to handle but
the result may be difficult to analyze. The results can be transformed into a digital data or other forms that can
be transferred through
technology to the specialist in any part of Thailand, pr to any part of the World. (Of course to make this
implementation a practical theory, a well-defined system must be carefully planned and monitored, at the
consideration of the ability of the individual at local area at every step of proceeding chain of system as well)
Finally, the fully medical equipment at the strategic location with bomb-shell. However this may also leads to
the overloading of people the wanting to be secure in the bomb-shelter. Thus, this idea is needed to be re-
designed and strategized.

Verification Objective to evaluate the success of my recommendations. Justify your

objective.
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 The ultimate goal is to save lives. Everybody deserves a proper healthcare. Given the limitation of the
circumstances, as well as with the fully respect for individual’s right to secure one’s life. If we cannot transfer
the means to save lives, we could make local become one. It is not too idealistic, if we could identify exact pin-
point of the problem, like what is the most infected diseases there? We should stop over-throwing strategies and
plans and manpower in the dark of truly understand the problem. We should start by the simplest question,
asking “What do you need in the health care service?” or “What do you do when you get sick?”
Get into the foundation of the local people. After all, we are developing strategies to improve their quality of
life, aren’t we? Not a perfect policy with every issue countered but not practical.
“The values of idea lies in the using of it” [Thomas Edison]

References:
1. “The Key Statistics of Thailand2012” National Statistic Office, Ministry of Information and Communication
Technology. 2. APCSS [2004] "Trouble in Thailand’s Muslim South: Separatism, not Global Terrorism “The
Asia-Pacific Center for Security Studies (APCSS) ,Volume 3Number 10, December 2004.