Abstract
The violence in the Southern provinces in Thailand took a toll on physical, psycho-social and spiritual health. Data collection began from March 2004
to March 2007 using questionnaires, face to face interview including group seminars and brainstorming sessions. It was found that the frequency of chaotic events
occured 5,460 times during January 2003 to August 2006. About 1,730 have been
killed and 2,513 injured. These victims included 22 health workers and 31 health
volunteers.
In the prime of the violence, every single hospital has prepared itself to be
ready to cope with those crises. Health workers, for example, suddenly changed
their behaviors substantially such as adjusting their work schedules, not
wearing uniform, taking more precautions, decreasing or avoiding their proactive roles in field works, particularly health promotion and health prevention.
These were remarkable changes in health care roles which would have long term
serious effects on the communitiy health. In addition, security in hospitals has
been tightened while stocks of food became critically necessary. Some local health
offices rearranged their teams by having village health volunteers working closely
with their health officers. These actions could boost their morale and ensure
their safety. Community faith in them and being natives inspired health workers
to remain in their posts.
It was interesting that the number of cases of out-patient and in-patient
departments had not changed much but the number of patients visiting local
health offices clearly decreased. Nevertheless, the number of patients in labor
departments increased and the chronic disease cases increased as well. Besides,
the number of cases with psychosis or having mental problems sharply increased.
Eventhough, the turn over and replacement of health workers became even but
the lack of medical specialists in some areas remained. Number of registered
nurses would become the major concern in the near future if the violence is not
restrained.
The crisis dictates requirements on short-term measures to focus on security, life protection, creating the supporting systems about counseling, referring,
transferring and maintaining the systems. In the long run, measures include
peace restoration, then, create health participatory system of people in communities, self-care system and enhance effectiveness of health system. It should be
concerned about the opportunity to build Muslim medical curriculum and
agenda. Having a specific team work to monitor the situation closely, connecting and communicating with the government and developing the participatory
management of data system and solving the problem may gradually decrease
the violence. In addition, research and development on the consequences of the
health system of the restive southern provinces are required in order to cope
with the drastic change.
