To Help or Not to Help?

[Guest fountainhall]

It is not usual for one Board to continue a discussion from another, unless the original post appears on both Boards (which, in this case, it does not) - and especially when the thread has been closed.

 

http://gaybuttonthai.com/viewtopic.php?f=3&t=4135

 

But one recent thread on this topic drew several comments from posters who are also members on this Board - and the basic point at issue is one which, I believe, deserves further discussion. Hence this post.

 

The subject was a two-year old Thai child from Sattahip who suffered from severe encephalitis. His parents had been told by the public hospital doctors that nothing could be done for the child and they should take him home to die. A small group of expats heard about the case and arranged for the boy to be seen at a private hospital for a second opinion. This sadly confirmed the original diagnosis. Nothing more could be done.

 

I read all the posts carefully and even contributed one. The gist of one post was that some of the time and money spent on a kind of hopeless white knight “falung” escapade would have been better spent on the under-resourced Thai public health system, the more so when the follow-up diagnosis at a private expensive expat hospital only confirmed the diagnosis of the original doctors (I trust this is a reasonable summary of that post).

 

The point I want to make is that the sort of intervention the poster questioned can – and has – saved lives, even though sadly not in that case. 18 months ago Thaivisa and other sites highlighted the plight of a 10-year old Thai boy in Koh Samui who, after years of misdiagnosis by doctors at local hospitals (I refer back to the reasons for this later), had been taken by his father to the Bangkok Heart Hospital – virtually as a last resort. The boy was considerably underweight, suffered from continual breathlessness and sometimes passed out. In Bangkok, he was diagnosed as having a severe heart condition – Ebstein’s Anomaly. The fact is that this is a very rare condition and had never before been diagnosed in Thailand. It was sheer luck that the doctor at the BHH had spent six years studying at the Mayo Clinic in the USA and so had some detailed knowledge of the condition. He announced to the father that unless the child had a major operation, he would not live to see his eleventh birthday.

 

To cut a long story short, the father appealed for the 2 million Baht cost of the operation and immediate post-op care. Many people donated to the campaign, and the BHH agreed to a major reduction in its fee. Not only that, it sent a surgeon to the Mayo Clinic with the child’s records to spend a week studying the delicate open-heart repair operation. This cost was borne entirely by the BHH.

 

With Bt. 750,000 still to raise and time running out, one expat donated the entire amount on a strictly anonymous basis. The child underwent the operation, it was a total success, and this little boy is now finally able to eat normally, to run, play with his friends, ride a bike etc. In short, he has his whole life to look forward to.

 

Equally importantly, thanks to one doctor and to major expat donations and assistance, Thailand now has a greater awareness of what was in this country a previously unknown life-threatening condition. Also, the BHH has a team of surgeons now trained in the delicate surgery necessary to repair future cases of such mal-formed hearts.

 

In this instance, individual interventions did have spectacular results and, I believe, have led to a change in how the public health system will in future regard children who exhibit symptoms similar to those exhibited by the young Samui child. And since many doctors working in private hospitals also spend part of their time at government hospitals, this will have a more specific benefit to the population as a whole. Both the boy and his father want to devote a lot of their time to becoming spokespersons for the illness and so raise greater awareness around the country.

 

So, while the efforts to assist the boy from Sattahip had no positive medical result, other similar efforts have indeed had more success. Those who donate their time and money should, I suggest, be encouraged rather than criticised, no matter what the medical outcome.

[Bob]

So, while the efforts to assist the boy from Sattahip had no positive medical result, other similar efforts have indeed had more success. Those who donate their time and money should, I suggest, be encouraged rather than criticised, no matter what the medical outcome.

 

Ditto. As I noted then (in the thread located elsewhere that you mentioned), nobody is required to applaud the helping falang for his charitable efforts but it was simply classless for the one poster to essentially attempt to demean those efforts.

[Guest thaiworthy]

I don't know what more can be said on this subject. And I hope I am wrong, but the continuation of this topic is an invitation for the critical poster to reassert his claim. Mebbe this is why TJ wanted to close the thread? I hope the moderators are keeping a keen eye.

 

http://www.youtube.com/watch?v=XypVcv77WBU

[Guest fountainhall]

I don't know what more can be said on this subject.

There are two sides to the discussion and both have a right to be aired. After all, this is a subject that will come up again and again with more cases deemed by some as deserving of assistance. Should farang help - even though they may be raising false hopes in doing so?

[Guest]

There are two sides to the discussion and both have a right to be aired. After all, this is a subject that will come up again and again with more cases deemed by some as deserving of assistance. Should farang help - even though they may be raising false hopes in doing so?

 

No side: There are 7 billion people on this planet & I guess over 5 billion may receive either no medical care, or a very limited level of cover. A single middle class farang is unlikely to make any meaningful contribution when sharing his donations widely, fairly & logically. The likes of Bill Gates can of course make a difference with carefully targeted programmes.

One could contribute to charities, but some of these spend so much on marketing & staff, that only a small proportion of the contribution ends up going to the cause.

 

Yes side: If a close friend in Thailand or elsewhere needs some critical medical treatment & the farang can afford it, then why not contribute?

 

Of course our farang needs to take care, as he needs to ensure he has sufficient funds available to pay for his own living costs & medical insurance through retirement. If he's already paying taxes to fund healthcare in his own country & is planning to retire abroad, basically he's spending quite a lot on treatment of other people already.

[Rogie]

Should farang help - even though they may be raising false hopes in doing so?

Ideally yes, they should help, but it is understandable if sometimes they choose not to. Let me explain. I saw the original post from Traveller Jim with the photo of that poor child and earnestly hoped he could be treated successfully. As I do not read that message board every day it was not until Fountainhall started this topic earlier today I was aware that the child's condition was terminal. Thank you Fountainhall for starting this topic on this message board and opening it up for discussion here.

 

Traveller Jim is clearly a very kind and compassionate man, and his friends are to be similarly applauded. However, we cannot all be of the same caliber. After seeing that photo it kept coming back to me at intervals throughout the day, I tried to put it to the back of my mind; it preyed on me. Clearly there was nothing I could do except sympathise and hope the matter had a happy outcome - after all, all I'd done was read a message board and yet here I was all keyed up. I think the reason why I reacted in that way, apart from any normal human reaction most people would feel, is because firstly, the situation was unfolding before us on the Forum in real time, and secondly although I do not know Traveller Jim, I am aware he has an excellent reputation and was acting in the way I would have hope I would, given a similar set of circumstances. I think if you participate (i.e post as well as read) for any length of time in some of the gay message boards you quickly tune in to what makes them tick, and, corny it may sound, to their beating heart.

 

But there is a terrible price to be paid and it isn't necessarily financial - I am thinking of the emotional costs. Not everyone can soldier that burden, the burden of expectation, the burden of hope. I do not know If I would be able to do that, to start the ball rolling not knowing how it will all end. The possibility of disappointment and dashed hopes would quite likely make me pause and, horror of horrors, come up with excuses. Lame excuses, maybe along the lines such as we have heard already, but in a rational world, the world outside, cold reality may win in the battle raging in your mind.

 

Last night I watched an old film from the fifties on DVD, Giant. In it the female lead, Lesley, played by Elizabeth Taylor and married to the boss of a huge cattle farm in Texas played by Rock Hudson, called on the home of one of their Mexican Indian servants. The home was in a sort of shanty town, off limits to the pampered white Americans. The mother was lying in bed, clearly exhausted, her baby crying inconsolably in its cot "the child is sick, my milk is no good" the mother explained. It would have been understandable if Lesley had said she was sorry, made her excuses, and left. Instead, at great personal cost (to her social standing) she managed to persuade their own family doctor to go and visit the child. He did so and the baby lived to grow into a fine young man. Of course the doctor's intervention may have been to no avail, bit at least the effort was made.

 

So, to answer the question, ideally yes, but any situation of this nature needs a thorough assessment before you intervene. If you feel you must, ask yourself if you really can see it through.

_______________________________________________________________

 

Z's post came as I was still writing mine. My comments below:

Of course our farang needs to take care, as he needs to ensure he has sufficient funds available to pay for his own living costs & medical insurance through retirement. If he's already paying taxes to fund healthcare in his own country & is planning to retire abroad, basically he's spending quite a lot on treatment of other people already

 

Yes, that is a good comment, and if unheeded could possibly amount to a bit of a nightmare scenario for most of us. If we choose to get involved in a personal capacity such as the case of the child from Sattahip, it's not going to always be an open and closed case. We know where it starts, but do we know when and how it will end? Can we with any confidence put a price on it? Yes, I would say it is conceivable a well-meaning farang could end up paying more than he could really afford. In this case however, and in the majority I would imagine, it is the time one invests that is the main feature. If the farang is retired and has time all well and good, but if the farang is a working man and he has to take time off from work (as must apply to many parents with sick children the world over) that could be very awkward.

[KhorTose]

I don't know what more can be said on this subject. And I hope I am wrong, but the continuation of this topic is an invitation for the critical poster to reassert his claim. Mebbe this is why TJ wanted to close the thread? I hope the moderators are keeping a keen eye.

 

 

Controversy is welcome on this board. Everyone does not have to be in lockstep. How in the hell can you be afraid of a difference of opinion? While I concur witjh the sentiments so far, I would have given Bkkguy a more constructive response, by pointing out why he is---in my opinion---wrong. However, I am not faulting GB, as the OP asked for the thread to be closed. However, that is not the case here. If you cannot stand to hear opinions that differ from yours, this may not be your board.

[Guest fountainhall]

After seeing that photo it kept coming back to me at intervals throughout the day, I tried to put it to the back of my mind; it preyed on me . . . But there is a terrible price to be paid and it isn't necessarily financial - I am thinking of the emotional costs. Not everyone can soldier that burden, the burden of expectation, the burden of hope. I do not know If I would be able to do that, to start the ball rolling not knowing how it will all end.

That photo preyed on me, too. There is a feeling of helplessness seeing such a young child who is so clearly desperately ill and whose family has been told he will die. Yet, the parents, like all parents would be, were desperate to have somebody do something. The fact that some people appeared and actually did something is, I suspect, hugely important to them, even though it led to no change in the prognosis for their son. And I applaud those who gave their time and money to assist.

 

I speak from having experienced the utter anguish of the parents of the little boy from Samui I cited earlier. I happen to know who the donor is, even though the family does not. Prior to confirmation of the donation, I was asked to meet with the boy and his father. We had a lunch together at a small hotel on Sukhumvit. Throughout, I was hugely impressed by the rock-solid determination of the father to ensure his son would survive, even though he then had only months to live without the operation.

 

His son was equally impressive. At one point, the boy said the hospital had given the operation a 70% chance of success. “I think that’s really good, don’t you?” he said, looking at me with a peaceful smile on his face (he speaks near fluent English). I really doubted if I would have been able to muster that sort of courage.

 

I spent most of that lunch and much of the next few of days hoping against hope that I had not raised that family’s expectations to a level that would eventually not be met. If the donor had decided against the donation, I did not know how I would have faced them. But then the good news arrived. Now the family so much want to meet the farang without whose generosity their son would almost certainly not have seen his 11th birthday. One day they will.

 

So, yes, there is an emotional cost in becoming involved. But that has to be balanced against a host of other emotions. When I saw the boy and his father two weeks ago in Bangkok for his recent check-up, I felt the utter joy this young man feels in now having a life and his excitement in the plans he has for his future, plus his determination to give back to others. You really can’t put a value on that!

 

This goes back to my main point in starting this thread. However small or large one's contribution in cases like this, it can make a difference in a much wider context.

[Guest thaiworthy]

If you cannot stand to hear opinions that differ from yours, this may not be your board.

This sentiment was expressed out of respect for TJ, who is a close personal friend. If you cannot bear to hear sentiments such as this, mebbe you should confine yourself to Baht Stop.

[KhorTose]

This sentiment was expressed out of respect for TJ, who is a close personal friend. If you cannot bear to hear sentiments such as this, mebbe you should confine yourself to Baht Stop.

 

I am really glad you have a close personal friend. TJ does sound like a nice guy. I go to message boards for information, and discussion. Sentiments are fine and I am glad you can feel that way. Nevertheless, please don't let your personal dislike for another opinion pre censor that opinion. I fine it very difficult to believe that TJ--in spite of your claim--would wish to stop all or any discussion on whether or not you should help others and how it makes you feel. By the way I do post on baht stop, and Gay Ting and tong (where I also moderate) and SGT and none of these boards would allow censor shiip of an opinion either. What is "mebbe"?

[Guest thaiworthy]

I am really glad you have a close personal friend. TJ does sound like a nice guy. I go to message boards for information, and discussion. Sentiments are fine and I am glad you can feel that way. Nevertheless, please don't let your personal dislike for another opinion pre censor that opinion. I fine it very difficult to believe that TJ--in spite of your claim--would wish to stop all or any discussion on whether or not you should help others and how it makes you feel. What is "mebbe"?

So long as the discussion is not a continuation of the specific case Traveler Jim was involved in, I have no problem with that. I think controversy is a healthy thing as much as harmony is. The latter seems too rare on these boards, especially when it gets so bitter as is often the case with this specific poster from GB's board. While some may call it merely opinion, I would have argued the manner in which it was said. So it is not opinions I dislike, it is the delivery of that opinion in this case. The circumstances of his statement were ill-timed as well. If he were truly interested in expressing disagreement, he should have started a whole new thread. Which, by the way is just what Fountainhall has done. I just do not want to contribute to anything in any way that will lessen the impact of TJ's motives.

 

So actually, we are in agreement. As you may have discerned by now I am very protective of my friends and will not hesitate to defend them when I feel necessary, even at times when they are wrong. I don't know how we got off on the wrong foot. I wish it would stop. But I will make the effort here by saying you made a valid point. Good on you.

 

From the urban dictionary, which is easily googled.

Mebbe

As in: Mebbe I am too lazy to type maybe.

 

Here's another one you may be more familiar with:

555

 

Both are in common use, especially in chat rooms.

[kokopelli]

"The road to Hell is paved with good intentions" which is what I immediately thought when I read the post by TJ regarding the child. From the photo of the child and prognosis by the local hospitals it seemed clear to me that there was no hope. I did agree with the substance of that contrarian poster however saw no need to have commented. And yes, best that the thread was closed.

[Rogie]

Throughout, I was hugely impressed by the rock-solid determination of the father to ensure his son would survive, even though he then had only months to live without the operation.

 

His son was equally impressive.

 

So, yes, there is an emotional cost in becoming involved. But that has to be balanced against a host of other emotions. When I saw the boy and his father two weeks ago in Bangkok for his recent check-up, I felt the utter joy this young man feels in now having a life and his excitement in the plans he has for his future, plus his determination to give back to others. You really can't put a value on that!

 

Speaking in very general terms now, one thing anyone considering involving himself cannot do is to dither. A short period in which to consider your position is reasonable but after that I feel you must clearly give your wholehearted backing or say sorry, I cannot help. So it is vital anyone deciding to help is fired up with determination. However, quite likely there may be low points to cope with along the way and that is where as Fountainhall has so eloquently written, the determination of the parties involved can make such a difference.

 

And that includes the professsionals too, the doctors. But that's easier said than done, I would imagine. It cannot be easy for a doctor working in a government hospital in Thailand. They must become thick-skinned to all the suffering so that it would seem natural to me they would also suppress their emotions and, unless careful, may come across as distant and, at worst, uncaring. However, I do not wish to dwell on government hospitals as it is probably less likely a farang would be closely involved - I would imagine if the hospital can successfully treat the patient then, whilst still an emotional cost, there are unlikely to be significant financial costs. It is when, such as in Fountainhall's case above, the patient needs medical expertise beyond the capability of a government hospital such that private treatment is needed that the issue of money will arise. Next step, the farang(s) gives the go-ahead.

 

I would argue money opens up vistas unreachable to those without. Fair? No, of course not, but that's how it is. The Private hospital is driven by profit, so if the customer has money, he can start the ball rolling. In fact as long as the money lasts, he knows he, or the person he is sponsoring, will get the best treatment possible for their condition. What a boost that must give you. An automatic high. It may be short-lived, you may be given bad news but at least you will know that news for what it's worth. But assuming the prognosis is a decent one, maybe 70% as in Fountainhall's case he reports above, that gives you (and the person being sponsored and his family in such cases) fair hope to cling to.

[Bob]

The "edge" to this discussion began elsewhere with a poster saying that a falang should never directly intervene in a given case and, instead, should somehow contribute to the general Thai medical system. That advice, in my view, was silly, unrealistic, presumptuous, and unfortunately was given using a few demeaning terms. Absolutely uncalled for and boorish in my view.

 

The individual stories, the one given on the other board and the others given here, involve falang who are adults, intelligent, and financially able to do whatever it is they choose to do. I cannot bring myself to offer any criticism, advice, tips, or whatever you want to call it and cannot fathom how anybody else thinks they could (and, more importantly, should) analyze or critique any of it - especially since the falang involved never asked for that type of input or advice in the first place.

 

And nobody's required to applaud their efforts; regardless, I do.

[Guest thaiworthy]

I cannot bring myself to offer any criticism, advice, tips, or whatever you want to call it and cannot fathom how anybody else thinks they could (and, more importantly, should) analyze or critique any of it - especially since the falang involved never asked for that type of input or advice in the first place.

Exactly. Thank you for that. This is what I have initially been trying to say, or at least meant to. I should have just stuck to my guns. But you did it even better. Well done again, Bob!

[Guest fountainhall]

It cannot be easy for a doctor working in a government hospital in Thailand. They must become thick-skinned to all the suffering so that it would seem natural to me they would also suppress their emotions and, unless careful, may come across as distant and, at worst, uncaring.

I understand your point, but I do doubt that doctors in public hospitals are really any different to those in private ones - other, perhaps, than they have to see more patients in less ideal working conditions.

 

My father, brother, sister, brother-in-law, two uncles and a cousin all are, or were, doctors. All worked exclusively in the UK’s National Health Service. Not once did I hear any of them moan about their working conditions compared to those in private hospitals and clinics (although they did frequently discuss about how badly they felt the NHS was organized!). I do not believe they showed any less care and compassion than private doctors.

 

All doctors enter the profession knowing they will come across a great deal of pain and suffering, along with quite a number of cases where their patient will eventually die. Repeated exposure does not make them immune to it; nor, I suggest, does it make them seem uncaring to patients.

 

So I see no reason why the same is not more or less as true here in Thailand as elsewhere. In any case, most medical students surely realise they will be working in the government health system where there are far more openings than in the private sector. Also, doctors take their Hippocratic oath extremely seriously. One part states –

 

“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”

[KhorTose]

I understand your point, but I do doubt that doctors in public hospitals are really any different to those in private ones - other, perhaps, than they have to see more patients in less ideal working conditions.

I concur. My last 16 years of work was spent in a government hospital. As it was the Veterans Administration many of the patients are treated for free, especially those with drug habits. Yet, we have one of the best programs in the USA, and gave some of the best care to all patients, whether or not they could pay.. Many of the staff had their care at the hospital, in spite of having first class insurance. I think the contributing factor, is time and not whether or not the doctors are different in public or private hospitals. Lets face it doctors try to do their best, but when you see so many patients and have the limited resources to do test, xrays, etc as the doctors do in Thailand's public arena, you may very well miss something that the doctor with more time and better resources can catch. I hardly think it is ever the fault of the doctors, but just the environment they work in. This is were the Farangs ability to move the patient to a less intense, better equiped hospital environment really does make a difference

[KhorTose]

The "edge" to this discussion began elsewhere with a poster saying that a falang should never directly intervene in a given case and, instead, should somehow contribute to the general Thai medical system. That advice, in my view, was silly, unrealistic, presumptuous, and unfortunately was given using a few demeaning terms. Absolutely uncalled for and boorish in my view.

 

 

Exactly Bob, and it is a shame that you were not able to post this on the other board after that man's reply. I know that I could add more and I am sure others could also. I doubt it would have changed his opinion, but at least he will know that many do not think the way he does.

[kokopelli]

There is again a similar post on that other forum regarding the moral responsibilities of a farang toward a Thai. The suggestion was the farang did not do enough to help his bf who was HIV+ and died.

The post is murky in that the relationship between the Thai and farang is not defined nor is the participation of the farang regarding the boy's drug use or HIV infection.

[Guest fountainhall]

I quickly read through that thread. As kokopelli points out, the relationship between the farang and the boy is really not clearly defined.

 

The boy, described as

[KhorTose]

 

Whilst at least some of the assumptions would seem to be true, since the thread is still open, I think it is more appropriate that comments on that particular case be made on GB's board.

 

Sorry, kokopelli, but I could not agree more

 

 

Having been so definite about farang helping in cases like the one cited earlier in this thread, does what I have just written make me a hypocrite?

 

NO

[Rogie]

What the thread does open up for further debate, though, is this: what do you as a farang do if you discover your Thai boyfriend or someone you are seeing is taking drugs and/or is HIV+?

Like Fountainhall, the drug issue would be clear cut in my mind.

 

The HIV positive situation is a real predicament and once again Fountainhall has covered the ground pretty comprehensively. However, there are so many possibilities that generalisations cannot cover all eventualities and in the final analysis you may be unlucky and find yourself tussling with your conscience because the situation is neither black nor white.

 

 

Having been so definite about farang helping in cases like the one cited earlier in this thread, does what I have just written make me a hypocrite?

I would say probably not.

 

Others may disagree but IMO farang helping a Thai person who is a stranger or one he hardly knows to the extent he is landed with both financial and considerable emotional costs should be the exception rather than the rule. I would go so far as to say it should be confined to situations where the medical condition is one that is not easily treatable or where there are serious complicating factors, so that would exclude treatment for HIV under normal circumstances - however if the person in need of HIV care and treatment was for some reason incapable of accessing suitable care (such as may have been the case in the early days in Thailand), perhaps because he is mentally disturbed, some may think that warrants help. To be honest, I really do not know, I am floundering here, these are just a few thoughts - I have no personal experience of helping a Thai person in such circumstances.

[kokopelli]

Whilst at least some of the assumptions would seem to be true, since the thread is still open, I think it is more appropriate that comments on that particular case be made on GB