Special Olympics Thailand is making sure children with intellectual disabilities across the country have access to health resources
Statistics from the Department of Mental Health show that out of 600,000 people with intellectual disabilities in Thailand, only 40,171 of them, or 6.25%, seek medical care from public hospitals. Children form a large part of this group and this poses a national healthcare concern -- the big question being, how does Thailand increase the rate of medical treatment and consultation for the young with mental disabilities?
Since July, Special Olympics Thailand, a 28-year-old organisation best known for empowering children with intellectual disabilities through sports, began the final year of "Special Olympics Thailand's Healthy Communities", a health screening project for children with intellectual disabilities.
The three-year project was put into effect after Thailand became just one of seven members of the Special Olympics selected by the Clinton Global Initiative in 2013, to spin off its comprehensive health screening programme, "Special Olympics Healthy Athletes", the screening programme that has been adopted for its athletes since 2005, to cover non-athlete children who barely receive public healthcare. As part of the Thailand project, an overall physical check-up by certified medical practitioners is provided in six schools for mentally-challenged students in six provinces.
According to Dr Arpaporn Puengyod, a project volunteer, the problem is not because public healthcare is not accessible to these children, but because they are not introduced to healthcare. She thinks that the children's inability to articulate their health conditions is one of the main factors that cause parents to take their illnesses for granted.
"As adults we can voice our opinions, but with these children it's different," Dr Arpaporn said. "If their guardians don't notice anything different, they won't see anything. Communication is a major problem. Sometimes parents and teachers don't understand this."
However, Rachaniwan Bulakul, director of Special Olympics Thailand, also believes that the public healthcare system doesn't strive to encourage these parents or guardians to seek medical services.
Rachaniwan recounted the story of a Chumphon adolescent from the Special Olympics Thailand team who was suffering from cataracts and was in need of immediate treatment. His father took him on a night bus to a public hospital in Bangkok. They arrived at 5am but had to wait until 3pm to see a doctor. By the time they met with the doctor, the boy was having tantrums and the doctor didn't have enough time to deal with him. Finally, father and son had to return home without receiving treatment.
"This is the real situation of patients with intellectual disabilities and their families accompanying them to get treated," Rachaniwan said. "If we don't do anything to facilitate them, such problems will only continue.
"So, aside from raising awareness among the public on the importance of seeing doctors on a regular basis, we should also raise awareness among medical professionals about the importance of understanding people with intellectual disabilities. Surely there are still misunderstandings among the care providers themselves when it comes to handling this kind of patient."
Rachaniwan, therefore, pins her hope on the heath screening project to make a difference by setting a good example for government related agencies to follow.
"We are killing two birds with one stone. Because by having those medical volunteers coming to help us, we are not only giving the children the opportunity to have their health screened, but we are also letting them learn how to take care of these children so that they will be able to do or share what they have learned with others in the future.
In 2013, the first challenge for Special Olympics Thailand was to liaise with the Ministry of Public Health and Ministry of Education.
"Nowadays, we all know that each agency is not very good at working with each other," Rachaniwan said. "There are so many layers and complications, and that doesn't bring any good to the community. But we are working towards breaking down that barrier.
The organisation reached out to Panyanukul schools, special state schools for children with intellectual disabilities, as well as provincial health offices for recruiting medical volunteers, including doctors, dentists, nurses and physical therapists. All of them are trained by doctors from Rajanukul Institute, a governmental agency under the Department of Mental Health.
The model previously used for athletes was adjusted to better fit new targets. The project was then piloted at three Panyanukul schools in Lop Buri, Phuket and Ubon Ratchathani.
In 2014, the organisation went on to cover more schools, including Suphan Buri, Chiang Mai and Bangkok with Unicef Thailand joining the bandwagon as financial sponsor.
A total of 142 volunteers from all of the participating provinces were trained. Many returned to work this year.
Apart from medical volunteers, there are also those with no medical background. Phismai Sukajarone, a 70-year-old pensioner who has been working with a Tambon Health Promoting Hospital as an unofficial spokeswoman who promotes health in her community, joined last year. She is responsible for taking blood pressure.
"I'm proud to be able help society," Phismai said. "I'm glad that I spend my free time doing something good. I don't have any obligations so it's better than wasting time doing nothing."
On screening day, the children go through different checkpoints for height and weight, body temperature, blood pressure, dental health and eye health, as well as other physical examinations. Some are specially designed for them such as an examination on visual acuity, where pictures are put on the table for them to non-verbally match, as some of them can't read. Once they have gone through all the checkpoints, they are then assessed by a doctor, who will determine if they need further treatment. Data is collected in personal logbooks as well as on a computer. Parents are later told of their children's health through classroom teachers.
"We are trying to make the system as smooth as possible so that the families don't have excuses not to bring them to see doctors," Rachaniwan said. "Then we try to spoon-feed them with a lot of information like, 'Your child has severe tooth decay and you have to see a dentist otherwise it will affect his or her roots'. Some parents can be like, 'My child doesn't look sick at all so what's the point of bringing him or her to see a doctor?'."
A total of 1,359 children received the screening last year. The check-up found 226 children to be overweight, while 105 were underweight; 288 children had vision problems; 550 children had tooth decay; and 273 had gum inflammations. Sixteen needed to seek immediate medical treatment and 240 needed to see a dentist immediately.
Twelve out of 182 children with Down's syndrome had heart disease. An eight-year-old boy with Down's syndrome from Surin was diagnosed with Cyanotic heart disease, which meant that he must have suffered from breathing difficulties from the low oxygen levels in his blood that results from a defective heart valve without his parents being aware of it. He received treatment at a hospital in Ubon Ratchathani.
After the project was completed last year, the Department of Mental Health was motivated to expand the project to cover 14 more Panyanukul schools around the country. For that, it is hoped 5,000 more children with intellectual disabilities will receive screenings this year. The department hopes to add more provinces onto the list. Each participating province is, however, expected to carry on by itself after the project comes to a close this year.
"The ultimate goal of the project is to let each province continue without the presence of Special Olympics," Rachaniwan said. "They need to be on their own. We can't do everything for everyone. Eventually, the community itself owns the project. That is the key."
STORY : DUANGPHAT SITTHIPAT
link : http://www.bangkokpost.com/lifestyle/social-and-lifestyle/676264/