Published online by Cambridge University Press: 28 November 2008
For the last few years an imaginative programme for training Buddhist monks in basic health care has been in operation in Thailand. The scheme, originally based on two wats (temples) in Bangkok, is now being extended to the Northeast where poverty and malnutrition are most acute. The originator of the programme, Dr Prawase Wasi, a distinguished haematologist, has received several awards for his work, which is increasingly recognized as a major landmark in the implementation of health care in developing countries.
I wish to express my gratitude to the Thai National Research Council for permission to conduct this research, and to Dr Prawase Wasi, my advisor on their behalf, for his constant encouragement and inspiration. I am also extremely grateful to the following: Phra Maha Narong Cittasobhano, Dr Somboon Suksamran, Dr Surakiat Achananuparp, Dr W. J. Klausner, Ajan Netnapa Kumtong, Dr Sulak Sivaraksa, Khun Suphot and the Komol Keemthong Foundation, and many others. I am also grateful to the British Academy for their generous award of a grant to fund this research.
1 Wasi, Prawase, ‘The Sangha and Medical Care: An Appreciation’ in Visakha Puja (Buddhist Association of Thailand, BE 2522, 1979), p. 37.Google ScholarBhavabhutanonda, Valaiporn, ‘The Medical Role of the Maw Phra in Bangkok and Rural Communities’, in the Journal of the National Research Council of Thailand, Vol. 12, Pt 2 (1980, Thai).Google Scholar
2 The misuse of drugs in developing countries has been documented by Dianna Melrose in Bitter Pills (Oxfam, 1982). Prices at pre-1984 devaluation rates.
3 Ibid., p. 74–5. Not only is the price higher, but there are blatant discrepancies in information contained in the accompanying leaflets. The Thai versions for both Valium and Mogadon exclude advice given to English readers on ‘tolerance’ and ‘precautions’.
4 According to Jean Mulholland, ‘few modern drugs are sold in Thailand.’ Either she is over-optimistic or there have been considerable changes since her article appeared in 1979. See Mulholland, Jean, ‘Thai Traditional Medicine: Ancient Thought and Practice in a Thai Context’, in the Journal of the Siam Society, Vol. 67, Pt 2 (1979), p. 81.Google Scholar
5 Riley, James N., ‘Western Medicine's Attempt to Become More Scientific: Examples from the United States and Thailand’, in Social Science and Medicine, Vol. 11 (Pergamon Press, 1977), p. 550.Google Scholar
6 Bryant, John, ‘The Health Needs of Rural Thailand: A Challenge to Traditional University Structure and Function’, in the Journal of the Siam Society, Vol. 63, Pt 1 (1970), p. 46.Google Scholar
7 Gosling, David, ‘Perspectives on Thai Buddhist Involvement in Science and Social Development’, in Visakha Puja (Buddhist Association of Thailand, 1979), p. 34Google Scholar; same author, ‘New Directions in Thai Buddhism’, in Modern Asian Studies, Vol. 14, No. 3 (1980), p. 411CrossRefGoogle Scholar; same author, ‘Thai Monks in Rural Development’, in the Southeast Asian Journal of Social Science, Vol. 9, Nos 1–2 (1981), p. 74.CrossRefGoogle Scholar
Heinze, Ruth-Inge, The Role of the Sangha in Modern Thailand (Chinese Association for Folklore, 1977).Google Scholar
Suksamran, Somboon, Political Buddhism in Southeast Asia: The Role of the Sangha in the Modernization of Thailand (C. Hurst, 1977).Google Scholar
Mulder, J. A. N., Monks, Merit and Motivation: Buddhism and National Development in Thailand (Special Report No. 1, 2nd Edn, Centre for South-East Asian Studies, Northern Illinois University, 1973).Google Scholar
8 Tambiah, S. J., Buddhism and the Spirit Cults in North-east Thailand (Cambridge University Press, 1970), p. 67.Google Scholar
9 Ibid., p. 50.
10 Dutt, S., Buddhist Monks and Monasteries of India: Their History and Their Contribution to Indian Culture (George Allen & Unwin, 1962), p. 322.Google Scholar
11 Far Eastern Association of Tropical Medicine, Siam: General and Medical Features (Bangkok Times Press, 1930), p. 49.Google Scholar
12 Tambiah, S. J., World Conqueror and World Renouncer (Cambridge University Press, 1976). pp. 50, 118.CrossRefGoogle Scholar
13 Ibid., pp. 185, 208.
14 Ibid., p. 205; see also Matics, K. I., ‘Medical Arts at the Wat Phra Chetuphon’, in the Journal of the Siam Society, Vol. 65, Pt 2 (1977), p. 145.Google ScholarPubMed
15 It is interesting to compare these illnesses with those encountered by Kaufman in his study of Bangkhuad (which is near Minburi and about 50 km to the South of Nongsua). He lists dysentery and intestinal disorders, haemorrhoids, skin infections, malaria, tuberculosis and trachoma, and also describes prevailing attitudes among the villagers to sanitation. Kaufman, Howard K., Bangkhuad: A Community Study in Thailand, Monographs of the Association for Asian studies, No. 10 (Charles E. Tuttle, 1976), p. 173.Google Scholar
16 The Thai names of medicinal plants were obtained from the monks. Photographs were taken, and both were checked by botanists from Mahidol and Chulalongkorn Universities.
17 Traditional Thai Pharmacy has points of affinity with Chinese and Ayurvedic systems; see Mulholland, , ‘Thai Traditional Medicine’ (see n. 4), p. 104.Google Scholar
18 A sphygmomanometer consists of a stethoscope, inflatable arm strap and pressure gauge, and measures blood pressure.
19 Mass ordinations of young men from the Hill Tribes take place at the Wat Benjamabopitr.
20 Most of the herbs are to be found in Ratdawan Boonratanakornkit and Thanomchit Supawita, Names of Herbs and their Uses (Chulalongkorn University, n.d.).
21 For details of Phra Khru Sakorn's views on Buddhism, see Sakorn Sangvorakij, Phrasong Kap Kaan Patanachumchon: Kaan Patiroop Cheewit Chaaw Baan Tii Yokkrabut (The Monk and Community Development: Reforming the Life of the Villagers at Yokkrabut) (Komol Keemthong Foundation, BE 2520, 1977).
22 Riley, (see n. 5), p. 550.Google Scholar
23 Flexner, A., Medical Education in the United States and Canada, Carnegie Foundation Bulletin No. 4 (New York, 1910), p. 17.Google Scholar
24 Wasi, Prawase, ‘Health Services and Medical Education in Thailand’, Research Report (Mahidol University, 1978)Google Scholar; Bryant, (see n. 6); p. 45.Google Scholar
25 Prawase Wasi, Ibid., p. 15.
26 Bryant, (see n. 6), p. 56.Google Scholar
27 Cunningham, Clark, Some Social Aspects of Rural Medicine in North-Central Thailand (Chiang Mai, 1966 (mimeo)).Google Scholar
28 Boesch, Ernst E., Communication Between Doctors and Patients in Thailand. Part I: Survey of the Problem of Analysis of the Consultations (Socio-Psychological Research Centre on Development Planning, University of the Saar, Saarbrucken, 1972), p. 82.Google Scholar
29 Ibid., p. 17.
30 Jane Bunnag, review of Ernst E. Boesch, Ibid., in the Journal of the Siam Society, Vol. 62, Pt 1 (1974), p. 247.Google Scholar
31 Far Eastern Association of Tropical Medicine (see n. 11), p. 185; Mulholland (see n. 4), p. 84.Google Scholar
32 Matthayat Darot, quoted in Mulholland, ibid., p. 88. A detailed summary of Thai anatomy, physiology and symptoms is contained in the same article.
33 Mulholland Ibid., p. 100.
34 Ibid., p. 101.
35 Ibid., p. 111.
36 Melrose (see n. 2).
37 Wells, Kenneth E., Thai Buddhism: Its Rites and Activities (Suriyabun, 1939, updated 1975), pp. 209, 213.Google Scholar See also Bunnag, Jane, Buddhist Monk, Buddhist Layman (Cambridge University Press, 1973), p. 21 (footnote)CrossRefGoogle Scholar; she refers to ‘merit’ rather than ‘karmic’ balance.
38 Civara Khandhaka, Vinaya Pitaka, Vol. V, 166 (Bangkok, n.d.), pp. 178–80.Google Scholar
39 Kaufman, (see n. 15), p. 180.Google Scholar
40 Tambiah, (see n. 8), pp. 58, 227.Google Scholar
41 Ibid., p. 257; for more details about the khwan, see Rajadhon, P. A., ‘The Khwan and Its Ceremonies’, in the Journal of the Siam Society, Vol. 50, Pt 2 (1962), p. 119.Google Scholar
42 Tongpan fails to get a loan from his landlord to buy medicine for his sick wife, who dies. Luk Isan depicts the exploitation of Northeasterners by Vietnamese merchants selling medicines.
43 Tambiah, (see n. 8), pp. 130, 271.Google Scholar
44 Ibid., p. 136.
45 Kaufman, (see n. 15), pp. 35, 212.Google Scholar
46 Bunnag, , (see n. 37), pp. 59 (footnote), 22, 74, 149.Google Scholar
47 Far Eastern Association of Tropical Medicine (see n. 11), p. 237.Google Scholar
48 Riley, James N. and Sermsri, Santhat, ‘The Variegated Thai Medical System as a Context for Birth Control Services’, Working Paper No. 6 (Mahidol University, Bangkok, 1974).Google Scholar
49 Yoddumnern, Benja, ‘The Role of Thai Traditional Doctors’, Research Report (Institute for Population and Social Research, Mahidol University, Bangkok, 1974).Google Scholar
50 Kaufman, (see n. 15), p. 175.Google Scholar
51 According to Dr Prawase Wasi, ‘traditional medicine being not “officialised” … belongs to the private sector’; Wasi, Prawase (see n. 24), p. 13.Google Scholar
52 Kaufman, (see n. 15), p. 149.Google Scholar
53 It is impossible to generalize as to the usefulness of Ampicillin before promiscuous sex. However, Dr Colin Britton (UK) thought that it would probably prevent some venereal diseases, though the use of condoms was ‘infinitely preferable’. He was also more inclined than some doctors to recommend antibiotics for a wide range of illnesses. His argument was that although antibiotics do not destroy viruses, many viral illnesses induce such a level of weakness (especially in an undernourished person) that a bacterial infection is almost bound to follow.
54 Riley, and Sermsri, (see n. 48), p. 1.Google Scholar
55 Ibid., pp. 43, 13.
56 Ibid., p. 46 (footnote).
57 Ibid., p. 33.
58 Ibid., pp. 16, 24, 37, 52, 53, 54, 58.
59 For clarification of ‘galactic’ and ‘radial’ influences, see Tambiah, (see n. 12), p. 527Google Scholar
60 Ibid., p. 420.
61 For details concerning nammon to cure illness, see Terwiel, B. J., Monks and Magic, Scandinavian Institute of Asian Studies, Monograph Series No. 24, 2nd Rev. Edn (Curzon Press, 1979), p. 251.Google Scholar
62 Tambiah, (see n. 8), p. 133.Google Scholar
63 Ibid., p. 259.
64 Hanks, L. M., ‘Merit and Power in the Thai Social Order’, in the American Anthropologist, Vol. LXIV (1962), p. 1247.Google Scholar
65 Tambiah, (see n. 12), p. 485.Google Scholar
66 Tambiah (see n. 8), ch. 21.
67 Tambiah, (see n. 12), p. 519Google Scholar; see also Gosling, 1980 (see n. 7) p. 430.Google Scholar