Health Equity Fellows’ Inspiring Visit to BHCHP
Sometimes, a simple Google search can do wonders for people who are eager to learn and connect with the wider world. That is how Anond Kulthanmanusorn, a general practitioner from Bangkok, Thailand, got introduced to and visited BHCHP while searching for guidance on how to start a medical respite program for people experiencing homelessness in his hometown. Though Anond has over 10 years of experience working as a physician, he began taking care of unhoused patients in Bangkok last summer. The small and dedicated team he established for providing healthcare to Bangkok’s homeless population is called Sookaphawa Roadside. Sookaphawa in Thai means well-being.
We spoke to Anond after his visit to BHCHP—a visit he calls inspiring. Seeing firsthand our high quality and innovative health care, gave him information and ideas to bring back to his Thai team. He says that the key lessons he learned from the visit include BHCHP’s integrated multidisciplinary team-based model of patient care, how throughout our nearly 40 year history, BHCHP has forged important partnerships with public agencies, hospitals, shelters, community organizations, and academic institutions for support and collaboration, BHCHP’s focus on quality measures and evidence-based practices and our ability to adapt our care to the changing needs of our patients.
Once learning about BHCHP online, Anond researched our Barbara McInnis House inpatient 104- bed medical respite facility, the first of its kind in the country. He knew that he needed to see our program in-person and he reached out to us. In June, we invited him and his cohort of fellows from Southeast Asia and China at The Equity Initiative, to an informational tour and program of our flagship facility at 780 Albany Street and engaged in conversation with BHCHP’s senior leadership including our CEO Stephanie Sullivan, PhD and Chief Medical Officer, Dr. Denise de las Nueces, among others. Once the formal tour and program ended, we were able to speak with Anond to learn more about the homelessness crisis facing Bangkok and the lessons he gleaned from his visit to our program.
It was during the pandemic that Anond came to interact more with Bangkok’s homeless population through his volunteer work taking care of Covid-19 patients. According to the Thai government’s latest survey from last year, Thailand’s homeless population is approximately 2500 people, with Bangkok accounting for 50% of that number. Like most homeless census data, Anond believes that this is an underestimation of the crisis in his country. Although Thailand’s universal health system covers the general population, he realized that impoverished people and those experiencing homelessness faced additional barriers to accessing quality health care services. While organizations existed to provide housing, employment, and food support, none provided health care services to this marginalized population. This prompted the idea behind Sukaphawa Roadside; Anond and his team presently care for homeless patients at their mobile clinic, through street outreach, and basic respite services.
Says Anond,“I think homelessness is a multidimensional problem. There are many causes to homelessness but the key reason in Thailand is unemployment.” Anond remarks that the rise in unemployment, especially as a direct result of the pandemic’s societal disruption, dramatically increased the homeless population in Bangkok. With limited safety net programs, Anond explained, it is easy for a person who lives from paycheck to paycheck to lose their home once they are not able to pay rent. In addition to unemployment, family discord and mental health challenges make it more likely for a person to begin living on the streets. A large number of people experiencing homelessness in Thailand are elderly who suffer from higher rates of chronic and infectious diseases such as HIV, TB, diabetes, and hypertension. Anond notes that addiction and mental health issues represent a minor facet of the health conditions impairing this population and his small team are faced with the challenge of how to best support the health needs of their patients. He says, “Health equity means that everyone has equal opportunity to have a healthy life. I try to provide an opportunity for homeless people to get access to health care.” As simple as that statement may sound, building an actual program that is continually innovating and evolving to meet the pressing demands of homeless medicine is extremely challenging.
We are grateful to Anond and his team for taking the time to visit our program and learn about our best practices. As a thought leader at the intersection of homelessness and health care for nearly 40 years, BHCHP is honored to share our knowledge to deliver on our mission of ensuring unconditionally equitable and dignified access to the highest quality health care for all those experiencing homelessness. Reflecting on the visit, Dr. Denise de las Nueces comments, “It was delightful to welcome the Health Equity Fellows to BHCHP! While we appreciated their curiosity about our program, it was incredibly inspiring to learn more about each Fellow’s work in their home country addressing issues of homelessness, poverty, lack of access to health care, and women’s health.” We encourage Anond and others like him in their work and to continue to keep in touch with us here in Boston. His kind words inspire us as well!
“Your story can inspire our team very much. What I learned from here – I know where I’m going next.”
