Bamrasnaradura’s Infectious Disease Expertise, Key to Saving Thailand

Kanokchan Patanapichai

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Bamrasnaradura’s Infectious Disease Expertise, Key to Saving Thailand

In normal times, people tend to think of leading private hospitals and those attached to large medical schools when the subject of healthcare services in Thailand crops up. But when the new coronavirus or Covid-19 spread from China and went on to claim so many lives, Bamrasnaradura Infectious Disease Institute (BIDI) came into its own, becoming the light at the end of the tunnel and sparing Thailand the worst of this deadly pandemic.

This medical institute was established to fight against the cholera outbreak at the end of the 1950’s. Its success along with its vast experience in leading the country’s infectious disease control teams and efforts throughout the past seven decades have put BIMI at the centre of all the country’s major decisions. The clear and concise instructions issued by the Emergency Operation Centre reflect the sound strategy of putting the right man on the job.

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Picture: Cholera outbreak at the end of the 1950’s

Back in 1958-1959, Thailand’s public health was at risk from a serious cholera outbreak. With more than 2,000 deaths, the government was looking for a capable person to help it bring the disease under control. 

One name came up: Dr. Long Vejjajiva aka Phra Bamrasnaradura.

A young boy from a fishing family in Rayong, Long Vejjajiva first came to Bangkok to pursue his studies and became a student at Thailand’s first medical school when he was only 14. After graduation, he was sent to Lopburi and later to Ayutthaya to look after patients when the cholera outbreak hit the province.

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Dr. Long Vejjajiva aka Phra Bamrasnaradura

After seeing so many cholera patients being rejected due to insufficient beds in the patient ward, Dr. Long had a new infectious disease ward built. He introduced a new policy under which no patient could be rejected. He also improved treatment standards and brought the spread of cholera in the province to an end. 

Dr. Long or Phra Bamrasnaradura (a royal title similar to Lord in English) retired in the late 50s from his position as Permanent Secretary of the Public Health Ministry. A few years after he retired, cholera hit the country once again and this time spread nationwide. The government named him Public Health Minister and tasked him with fighting cholera.  He travelled all over the country helping local hospitals and medical teams fight the epidemic. A hospital specialising in infectious disease was also established and named Bamrasnaradura in recognition of his efforts. The cholera situation was finally under control.

Sixty years later, the high standards, care, commitment to well-being of patients and people and excellence in infectious disease treatment remain firmly entrenched in the DNA of Bamrasnaradura Infectious Diseases Institute. It has been the center of all the country’s efforts to fight against contagious diseases, including plague, AIDS and more recently SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome) and even Ebola. 

In January 2020, Bamrasnaradura received a call asking the institute to pick up a patient suspected of being infected by Covid-19.  The country’s first case was later confirmed and successfully treated. The patient returned to full health and went back home.

Later, with Thailand’s surveillance and prevention measures raised to the highest level, Bamrasnaradura played a crucial role in treating Covid-19, adopting, where feasible, new treatments including the anti-viral Favipiravir and Remdesivir.

As the centre for controlling the virus, Bamrasnaradura saw its capacity challenged. The institute, which in the early days of the outbreak, was handling up to 300 Covid-19 patients under investigation a day, saw the number of patients top 800 during its peak.

The institute, therefore, had to pool all its resources, equipment and people, as well as professional doctors and medical teams from other medical centres who volunteered to help to make sure that the screening, investigation and treatment processes were efficient and met with infectious disease control standards. A normal patient ward was cleared to make way for Covid-19 patients. 

A nurse at Bamrasnaradura told a local TV news program that she hadn’t gone back home for months. But she didn’t mind because she, and indeed all her colleagues, wanted the patients to get well and go back to their families.  The support from the institute’s management also gave everyone strength and imbued them with a strong spirit to keep going.

Unsurprisingly, the institute’s dedication to fighting Covid-19 has played a key role in making Thailand one of the top countries best prepared for a pandemic. The Global Health Security (GHS) Index presented by the Nuclear Threat Initiative (NTI) and the Johns Hopkins Centre for Health Security (JHU) placed Thailand 6th out of 195 countries and the first in Asia, with a score of 73.5 against the global average of just 40.2.

With Covid-19 still looming in Thailand, Bamrasnaradura will remain on full alert and ready to do its part in combatting the new virus, continuing to work on its core tasks — education, treatment and research into infectious diseases. This DNA will be passed on to the new generation to ensure the nation is always ready for any contagious diseases.

Kanokchan Patanapichai

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