Nan had a motorbike accident when she was 16 years old and was made a paraplegic. Now 26, she spends much of her time bedridden in her house in tambon Khao Mai Kaeo of Sikao district in the southern province of Trang.
Her mother died recently after being in a vegetative state for five years, also a consequence of a motorbike accident.
Family members took care of them, sharing the burden. Nan’s father, Somjai Jansuk, 56, said his daughter tries to do many things by herself despite being immobile from the waist down.
“She never complains and always tries to avoid being stressed,” he said. “I can’t give up. I have to be with my daughter.”
In the same district is Boonaue Suksai, 68, the mother of 45-year-old Sarawut, who has been a paraplegic for five years.
Mr Sarawut had an accident where he fell out of a tree which caused his condition. His mother has to towel him down and turn his body in bed every day.
“I feel exhausted, but I will not leave him. I will stay with him all the time,” she said.
Taking care of people with paraplegia can be both mentally and physically challenging.
Most patients and their families have experienced exhaustion and discouragement. Assistance provided by state agencies can help them get through difficult times.
The Khao Mai Kaeo subdistrict health promotion hospital and the tambon administrative organisation (TAO) of Khao Mai Kaeo decided to subsidise medical equipment in 2013 to aid bedridden patients.
The fund is supported by the National Health Security Office (NHSO) as well as by donations.
The local authorities have contributed seven hospital beds, eight wheelchairs, four medical oxygen tanks, three air mattresses, seven walkers and 10 pairs of crutches. The aim is to assist bedridden patients who cannot stay in hospitals or cannot travel from their homes to see doctors.
In some cases, providing medical equipment is not enough. In Mr Sarawut’s case, the TAO of Khao Mai Kaeo sent workers to build a room connected to his house as the bed provided him was too large to pass through the door.
The room and bed have helped Mr Sarawut live more comfortably, said Peerapon Langmuang, the TAO chief of Khao Mai Kaeo.
Mr Peerapon said some 3,000 people live in tambon Khao Mai Kaeo, of whom 318 are disabled, and 875 are senior citizens.
He said a yearly budget from the Public Health Ministry allocated to local hospitals alone is not sufficient, nor is the TAO’s budget. “What we do is work together and combine budgets so as to best help people in need in our community,” he said.
Sompon Siammai, director of the tambon Khao Mai Kaeo health promotion hospital, said the hospital works with the local authorities and village health volunteers to look after bedridden patients to make sure that they have access to medical services, equipment, public welfare and live in a healthy environment.
“We have a policy to help bedridden patients so they do not have to come to hospital. We take what they need such as equipment and medical services from the hospital to their homes,” Mr Sompon said.
He said teams of medical staff have regular visiting schedules. For example, doctors visit patients monthly while a team of caregivers visits twice a month and village health volunteers make a visit twice per week. He said the NHSO’s Long-Term Care fund has provided patients with some necessities such as air mattresses and nappies, which can be helpful for elderly bedridden patients.
NHSO deputy secretary-general, Dr Atthaporn Limpanyalert, said the number of bedridden patients is growing as Thailand becomes an ageing society.
People cannot just rely on services from hospitals, which may not be sufficient for all bedridden patients, Dr Atthaporn said, adding local authorities also play a key role in taking care of people in a vegetative state at home.
Wilai Pimtong, 50, a caregiving team member in tambon Khao Mai Kaeo, said she has taken care of Nan for more than 11 years. She visits Nan at her house every Friday to change a urinary catheter and provide physiotherapy to ease bed pain.
“I’m happy with my job because my team and I have helped Nan and other patients not to feel left out. We are there for them and also talk to them to give them moral support,” she said.
Mr Somjai, Nan’s father, said the medical team’s visits make him feel relieved that he has support.
“When I first knew that [Nan] could not walk and had to stay in bed, I felt very disheartened. But when the medical and caregiver team comes, I’m relieved and no longer feel exhausted,” he said.