All the fun we had in Thailand!

This post is a little after the fact, but I felt I should post it. It's a little long and I'm going to come back to add photos to the sections:

Ah, all the extracurricular activities!

We visited several neat places!

We went elephant riding! We also visited and elephant zoo where we saw the elephants put on a show, afterwards the elephants would give hugs and we fed them. Walking out we got to have some fun with a baby elephant and Ashley found out how strong they are. It grabbed her hand in its trunk and tried running off towards its mom.

We visited the Grand Palace and found out about the history of the Monarchy and various historical events. Then later that day we went to the Vimanmek Palace (Teakwood Mansion). This one was very nice, it had Victorian style architecture with grounds and a lake. It was naturally presented in a linear museum that you walked through, but it was nice seeing.

One night we took the BTS Skytrain to Sathorn Pier (Yes it was the site where a grenade went off) and caught a riverboat up the Chao Phraya River to the Azeatique pier area. We had a nice dinner with Miew! She is a Thai pharmacist that is learning at the University of Arizona. She later joined us for some of our professional work days too.

As a group we visited some really good Wats as well, my favorite was Wat Arun, the downside is that it was under reconstruction so we couldn’t explore all of it. There was another Wat that was really good that had motifs of demon/monkey statues holding up the pillars. This place also had a really cool scale model of Wat Arun carved in stone.

Our trip to Ayuthaya went pretty well. Later that night, we all got dressed for a night on the town. We first visited the rooftop bar known as the Moon Bar, it was packed and nowhere for us to sit. So we went to the Sirrocco Skybar at the Lebua instead! This bar is known from Hangover 2, the view was amazing from both sites of the Bangkok Skyline.

The night before we went to Pattaya, we checked out The Onyx. It was a bar/dance club. I went inside and danced. It was pretty cool as we met a girl there who knew the DJ and got us some free drinks. We got home pretty late and slept a couple hours before our trip to Pattaya.

Pattaya was pretty fun. We checked out the beach first. It was pretty awesome as we rented some chairs under a cabana to lounge under. The ocean was pretty good too, the water was shallow for quite a distance and we made it pretty far from the beach before actually having to swim. When we were done we grabbed some food at the nearby mall. I tried the McDonald’s menu finally and got the Red Hot Spicy Chicken with Rice and Egg. It was delicious! After the day’s events, we went to the Alcaraz Cabaret Show. It’s a show where all the performers are men or ladyboys and they lip sync songs from many different countries like France, Russia, Thailand, China, etc. and they dance or perform to them. My favorite parts was one performance where a man is singing, it went dark then a woman sings and it alternates. Then there was a scene where there are golden and silver statues on stage. I highly recommend this show and I won’t spoil how it ends.

On the group’s last day in Thailand it was a free day so the group had lunch together at a Japanese restaurant. Then about half the group went to the Bangkok Convention Center to check out the Thailand Research Expo. We were given VIP status and shown around the various booths. A lot of it was based on agriculture. We were shown some of the pharmaceutical and healthcare research. Most of the research shown here were already done in other countries, but this research focused on developing it within Thailand to lower healthcare costs while maintaining effectiveness. The reason they do this is due to the National Healthcare provided by the government, they need to keep costs down to maintain the program.

We went to The White Flower Restaurant at Siam Square One for a farewell dinner to Thailand. The food was very delicious. It was during this dinner that we learned about the bombing at Ratchaprasong Junction just 0.4 miles away from us. We stayed where we were and just enjoyed the dinner while Dr. Katz checked in with the University of Arizona. It was very sobering to think that I had spent my free day walking through that intersection multiple times and had even passed through it not that much time before the bomb went off.

After dinner everyone just went to their hotel rooms until the flight. I got up with the group to say goodbye to them (my flight wasn’t until the next day), and went back to bed.

For our last day in Thailand, Supranee and I went out to the countryside to visit some food markets. Lots of delicious food to be had! We even visited the Train market where all the stalls are right on the tracks and they’ll quickly pull it all in as the train rolls through, although it didn’t happen while we were there.

Despite the events that went on in Thailand, I highly recommend coming back or visiting the first time. There is plenty of stuff to see and many things to do.

Homey's in the Back!

Don't worry about the title, it's a motto by Daniel and I when we got in the van/bus.

We started our official University of Arizona trip by letting everyone sleep and get over the jet lag.

We went to Ramathibodi and were given a tour. We later went to Siriraj hospital where we were given a tour of the grounds, private pay and public pay sections. The hospital was really cool as it had a built in park/botanical gardens that people could walk around in. There was a museum we visited and got to see some history about the museum as well as some exhibits with the human body. No photo!

The next day we visited a community pharmacy where we learned some of the problems faced by community pharmacies, but also some of their opportunities. The government will pay pharmacists to visit a patients home to perform medication reconciliation and referral. The downside is that not a lot of pharmacists can do this due to a shortage. The pharmacist said that students in Thailand are attracted towards industry and hospital as that is the main focus of Universities.

Visiting Chulalangkorn University we talked with some students about their program and presented what life is like as a student at the University of Arizona. We were shown the herbal museum by some students we made late to class (Sorry!). Then we broke off into groups to see some hospital wards where we asked questions of students on rotation. One interesting thing I noticed about hospitals in Thailand is the lack of private or semi-private rooms. Every bed for patients was in a ward of 20 or more beds.

At Huachiew Chalermprakiet University the faculty showed us a presentation explaining how pharmacy is taught in Thailand, the differences between private and public universities and the teacher/student dynamic. One interesting thing that the faculty expressed was the lack of student confidence in questioning or even doing things on their own. It was explained that culturally, students don't question teachers or the teacher may become offended. As compared to the US where it is encouraged so that the student may learn. The faculty had more questions for us than we did them. They wanted to know how to make their students more active in their education and how to westernize their attitudes and curriculum.

On our last day of professional work we met up with some University of Kentucky residents and sixth year Thailand students on rotations at the community pharmacy. We went out with the residents and the students into the community to provide home health visits. There we observed/assisted the students as they asked patients questions, took blood pressure, blood glucose, etc. It was very different from what is taught at University of Arizona. Some of the students had a hard time with performing the screenings as they had only 1 hour of being taught how to do these tests earlier in their education, as compared to the UofA where we are given multiple opportunities to practice these skills before rotation.

I have to say that all the Thai students, faculty, and pharmacists that have hosted us have been very nice and made this trip a lot of fun so far. I will post again about all the extracurricular activities!

Khob Khun Kha (Thank You) Thailand!

 

I’d like to take this opportunity to thank Dr. Katz for organizing this educational trip which had exposed us to various pharmacy settings. Traveling to Thailand with a diverse group of students has helped me grow professionally and intellectually. Also, I am greatly thankful for all the Thai pharmacists, faculties, and students who took the time from their busy schedules to teach us about pharmacy practice in Thailand and their health care system.  The difference in practice and disease states in the communities makes hospitals and clinics in Thailand good learning environment for pharmacy students.

During our visit to one of the pharmacy schools in Bangkok.

Our learning experience extended beyond pharmacy and clinical practice. Our tour guide was very knowledgeable in Thai history and culture. We visited many historic sites, and attended cultural shows, walked through neighborhoods and streets in Bangkok. Additionally, we had the chance to meet and network with many great Thai pharmacists and students.

 

 

In our last night in Bangkok, we were saddened by the tragic terror attack that happened in Central Bangkok. Our hearts go out to those who lost their loved ones and may everyone live in peace.

One of the beautiful streets in Bangkok.

 

As a Japanese with fantastic Americans in Thailand

Our adventure in Thailand is about to end. 

Spending time with American students in Thailand allowed me to learn culturally, socially and professionally about both the US and Thailand and rethink of Japan as well. 

1. Professionally,
Pharmacy practice 

Impressed with how pharmacy students and pharmacists practice comparing we do in japan. 

Especially their English, since they use medical words in english and use english text books, is great. I suspect that the fact we don't use English at all is the one of the reasons of Galapagosization of Japanese medical care which we warred about right now.  

speaking about Home visit, one of MTM class that students visit patients' house by themselves, bring benefits to both students and patients. What students do is ask patients basic questions, check compliance, take blood pressure and blood glucose and answer patients questions. pretty much what pharmacists clinically do. Patients, on the other hand, can get this help for free, they can prevent spending time in hospital, they can know their condition. Surprisingly patients who has diabetes check blood glucose only when they go to see a doctor which is around once every three months because they can't afford for checking kit. therefore pharmacy students are great help for them.

Hospital 

We visited two of the best hospitals in Thailand, Siriraj hospital and Ramathibodi hospital.
One looks like a huge department store that has many cafes and entertainment stage, and the other looks like a luxury hotel that has calm wide lobby and a beautiful garden.

They also have pharmacogenomics department of pathology which is very early even in the US according to American students. 

They have fantastic facilities and beautiful buildings, but the problem is that it takes a loooooooong time to get everything done. At least 1-2hours to get medicine ready. 

In addition you have to stay in front of the pharmacy since you never know when is your turn. 

2. Culturally

Low self-esteem

One thai teacher asked Dr. Katz how to make thai students more active and confidence like american ones are. We, asian people both in Thailand and Japan, tend to suffer from low self-esteem. 

Being confidence, like having questions and asking a lot and speaking in public, is very attractive for us and wish we were like that. 

On the other hand, we are afraid of society that doesn't allow us to be "unique" traditionally.
feeling comfortable with being yourself is a key point to solve low self-esteem no matter what kind of person you are.

"You need to speak softer. "
That's the word I heard when I learned Thai words. Actually thai people, not only women but also men, speak very soft and kind. That's "normal" in Thailand (of course there's always exception). 

In Japan, we also learn to be feminine as a girl, humble and polite. That's what we call "normal".
We have a hard time when own personality is different the ideal model.

I am also the one who struggled with this especially after a year of my life in the US that let me find and be who I am. Low self-esteem comes from evaluations saying "you better change". 

But I believe that there's no right answer to what kind of person is better. 

Asians might not active enough to tell own opinion in front of people, but they are good at coorparating. 

We need to find own good points and how to use it instead of trying to change it. 

And the most important thing I found from my experience is to see both if the way you are fits the environment you are in and if you feel comfortable with the way you are.

We are all different but have wonderful smiles in common!

Buddhism 

I'm surprised that Buddhism in Thailand is very different from one in Japan at the point of how to pray, what to wear, or even how Buddha looks like. 

Also many thai people strongly believe their religion. Monks are so respectful that people pray when monks pass by. 

Here in Thailand, You see monks on the street walking through and in a temple studying. 

In Japan, you rarely see monks even at temples. We Japanese face to the problem of low birth rate and low monk rate! 

3. Socially, 

Big gap in standard of living 

Basically everything is amazingly cheap in Thailand, $1-2 for a meal, $6 for a dress, $2 for a T-shirt, less than $1 for a bottle of water. On the contrary, there are shopping malls filled with high brands like Dior and CHANEL.

Also there are luxury hospitals like ones I mentioned early, but the reality is that many local hospitals don't have air-conditioning. In addition, you don't see pharmacists in most of the pharmacy, but you can get medicines.
I saw many people sleeping and asking money on the street.
That makes me think of a lot of things.

Finally, I'm very thankful to everyone I have met during this trip, especially Arizona students who always help me a lot with english and entertain me all the time, and Dr. Katz who gave me such a wonderful opportunity, care of us and spend great times with us. 

I couldn't make this trip one of the best in my life without them. 

Our adventure in Thailand has ended. 

But our journey is continued...

See you guys next January in Tucson!HA 

-Mai

Home visits and MTM services

In addition to roles of community pharmacies in patient care, as explained by my fellow student Rick in his post, community pharmacists and senior pharmacy students provide MTM services through home visits.  An MTM service is adopted by different pharmacy schools and community pharmacies. Dr. Katha Bunditanukul at Ruen Ya Drug Store spoke with passion about the potential of community pharmacists to expand health access and provide affordable and convenient services to patients with uncontrolled chronic conditions.

MTM service in Thailand is provided through home visits.  We had the opportunity to shadow pharmacy students on rotation. According to one of the students, patients are referred by a community leader. The community leader is any individual who is knowledgeable about the residents in certain areas and their health & economic condition.

Pharmacy students are reconciling this patients' medications during their first home visit.
**Patient and students consented to taking and publishing this picture.

During the visit, students conduct a comprehensive interview about life style, medication use, herbal product use, nutrition, and any other chief complaints the patients might have. In addition, students perform assessment tests such as blood pressure, glucose, and foot exam. Depending on the patients’ conditions, students can provide recommendations, schedule future visits, or refer patients to the hospital.

I asked one of the patients we visited about her experience with pharmacy services, and she said she’s satisfied and very grateful for the students.

During our visit to the pharmacy, Dr. Katha Bunditanukul explained the role of community pharmacists in providing smoking cessation. Lung cancer is one of the most prevalent types of cancer and men are mostly affected by it. Dr. Katha Bunditanukul mentions that patients are most likely to seek help with quitting from a pharmacist than from the psychiatry unit where smoking cessation programs are commonly provided.

Sobering Final Night

Shortly after we arrived at the White Flower Factory restaurant for our final dinner in Bangkok, there was a large explosion about a block from the area in central Bangkok. I'm not sure how we did anything before we had the internet, but within a few minutes we knew the location of the explosion and possible cause.  The place we were in seemed safe, so I decided that rather than being out on the streets to get back to our hotel, we would continue the dinner and see how the situation unfolded. The dinner, with some of our Thai friends was great and despite some anxiety all had a good time.

It appears that at least 27 people were killed.  The thoughts of the University of Arizona and our Thailand 2015 team are with the families of those killed, with those who were injured, and with all our Thai friends and colleagues. It is hard for rational people to understand what motivates people to harm others in the name of politics, religion or whatever other excuse people have. One thing I have learned in my international work and that we all, despite differences in culture, language, religion, politics or what color shirt we wear (Thai political reference for those who don't follow) are pretty much the same.  Peace, everyone.

Last Day in Beautiful Thailand

Today is our last day in Bangkok and I'm not ready to go back to the states. I wish we had more time to travel to countries nearby, but I guess this just means we'll have to start planning for our next big trip! I'm going to miss all of the street food for $1-$2/meal, the friendly locals, Thai tea, all of the students and pharmacists we have met, the amazing shopping centers, and the countless activities available. There's always something new and exciting to try in Thailand. This trip has definitely motivated me to visit more Asian countries (hopefully Japan with Mai!). This trip has also triggered ideas on how to work internationally in the future; maybe I'll go into academia, global medical affairs/drug development, or something I haven't even thought of or encountered yet.

I highly recommend that people travel internationally when the opportunity presents its self. Everyone on this trip has grown to become so close, and we have all experienced adventures on this trip that will always maintain a bond between all of us. Plus, we have learned so much culturally (i.e. how Thailand compares to America and even Japan, both socially and professionally). No education compares to what you can learn when you travel, and I'm so thankful for being able to go on a trip like this.

Thanks for coordinating this exciting trip Dr. Katz!