THE RURAL DOCTOR
Aphotograph in an elegant frame, a welcoming card with a shining golden rim, an exquisite outfit — the presents for newborn babies can be very exciting. But if a baby is born in Ubolratana Hospital in Khon Kaen, the gifts will be something different. Parents may be given trees or plants from hospital director Apisit Thamrongwaranggoon.
In the next five years, they will grow enough to give something back to the child.
If they are banana plants, most of their parts — such as fruit, leaves, flowers and stem fibres — will pay for the child’s education.
If they are hardwood trees, the child will have materials for building a house when he or she reaches adulthood.
If they are Dipterocarpus alatus, or Yang Na, his or her family will earn a decent income from the essential oil extracted from the tropical forest tree.
Planting trees for the good fortune of newborns is not an idea that just came out of Dr Apisit’s head. It was mainly inspired by King Bhumibol Adulyadej’s sufficiency philosophy. “The philosophy is a practice that allows anyone — farmers, consumers or even patients — to achieve what they intend to do,” he said. “Those who try get better day by day.”
Now 57, Dr Apisit was a young rural doctor in 1984 when he joined a Khon Kaen hospital. Two years later, he moved to Ubolratana Hospital, where he tried different methods to solve the hospital’s problems, including packed wards and poor finances, until he had a feeling of being stuck in a blind alley.
The silver lining appeared in 1993 when he met local scholars who had adopted the King’s sufficiency philosophy in their livelihoods and become respected by the people.
Learning from scholars encouraged Dr Apisit to adapt the sufficiency philosophy’s “three loops and two conditions” in hospital management. The three loops refer to living and working in moderation, rationalisation and good self-immunisation for changes. The two conditions refer to management with knowledge and virtue.
Dr Apisit then analysed the potential qualities of Ubolratana district that would lead to success via the three loops. He found the area had high rainfall, strong sunshine and good air quality, and they were all free.
Trees and available land would allow the hospital to make the most of these advantages. He planted many trees that soon yielded herbs, food and income while increasing non-monetary capital for the hospital to survive even in years of national economic hardship.
Trees and plants were given to patients including parents of babies. A few months after receiving the gifts, they had enough food to eat.
When trees yield more products, they have more food left to share with others, meaning they build good relationships. They have some more to sell, meaning an improvement in the household economy. People have no need to strive for a hard life. They have more time to exercise. They have good mental and physical health.
Some patients, including an alcoholic and cancer sufferers, were reported to have improved their health after planting trees.
According to the hospital’s survey of local households who have more than 1,000 trees with a mixture of at least 20 species, families were saving 60-300 baht a day. A banana plant offers income of 20 baht a day. Large trees, such as rubber, have an economic value of about 3,000 baht. The more it grows, the more its value increases.
Many households can repay their debts within five years by growing trees, which is like a non-monetary pension that can turn into money in the long term.
“Our survey found that growing trees is equivalent to saving money with 10% interest,” Dr Apisit said, compared to bank savings accounts offering less than 1%. “Every Thai can have 10 million baht in their hands.”
The two conditions of the sufficiency philosophy — management with knowledge and virtue — were adopted by empowerment of hospital staff and local people to run activities such as health promotion and a disease prevention programme.
They are allowed to have a voice in the hospital’s development. One example is the building of 20 special units that are due to open in the next two months.
Funded by donations, the units will end the practice of patients being forced to wait in corridors for rooms — a common scene in community hospitals across the nation.
Dr Apisit has a dream to establish a social enterprise in Ubolratana district to invest in trees that can yield produce and help the environment. A bigger dream is to see the whole country start growing trees on any available land.
“It would haven taken us a long time to develop these strategies, but the King’s initiative and teachings led us to see the light,” he said.
The King’s reign with “love without reward” inspired Dr Apisit to continue working for the people without despondency. Changes don’t come quickly. However, Ubolratana Hospital has become a dream place for many young rural doctors who want to contribute to society.