Prawase Wasi

During the seven and a half centuries since the Thai peoples migrated from the north they were periodically decimated by cholera, plague and smallpox epidemics following floods in the productive central plain; malaria, yaws, gastroenteritis and intestinal parasites were endemic. Christian missionaries and doctors from the Rockefeller Foundation bringing modern medicine to the kingdom had to overcome superstition among the elite and ignorance among commoners?who drank from the same canals where they bathed and dumped refuse. Thereafter medical schools and clinical practice steadily improved and in the 1930s the new constitutional government regulated markets, abattoirs and crematoria, and instituted standards for licensing and training pharmacists and physicians. The kingdom today has an increasing number of distinguished medical doctors. 

Thailand, however, shares with her South and Southeast Asian neighbors the continuing problem of trained doctors and good hospitals concentrating in the capital and other major cities. Like medical practitioners elsewhere, many doctors tend to treat their profession as a business and even a government-salaried physician assigned upcountry usually attends most readily to his social peers. 

Dr. PRAWASE WASI, in his rise from poor farmer’s son to university professor, has shown that the medical profession offers an opportunity to serve others and one’s country consequentially. Born 50 years ago at Kanchanaburi in the Khwae River Valley near Burma, PRAWASE saw as a boy that the rich could do something about their lives while the poor were helpless, and he vowed to aid them. He worked his way through school and received the gold medal for the highest academic achievement in his class at the government Faculty of Medicine, Siriraj Hospital, University of Medical Sciences, from which he graduated in 1955. After three and a half years of advanced study in hematology at the University of Colorado, and in human genetics at London University, he returned in 1961 to join the Faculty of Medicine, Siriraj Hospital, in the newly named Mahidol University of which he is Vice Rector for Planning and Development. 

Dr. PRAWASE is one of the world’s leading hematologists, most notably identifying the genetic mechanism of alpha thalassemia, a blood disease prevalent among Thais and other Southeast Asian and Mediterranean peoples. He has published more than 100 articles in scientific journals, and scientists come from around the world to work with him. 

Equally public-health oriented, he edited Handbook for Health of the People to which he and 10 prominent physicians, pharmacists and public health doctors contributed practical advice for rural and urban families. His Household Doctor is a compilation of his answers to medical questions published in a popular magazine. He is also editor and publisher of the monthly Folk Doctor magazine. Ever concerned that medical services should meet the needs of all, he campaigned against official plans to build four 1,000-bed hospitals rather than a number of simple clinics within the reach of villagers. He won provision for a hospital in every district in the current five-year national health plan, and helped organize training for village headmen and Buddhist monks in primary health care. 

Withal Dr. PRAWASE’s greatest contribution is his inspired teaching. To his medical students he advocates: “go where the problems of health are most urgent; among the poor mostly in rural villages.” His focus upon community health — along with heightened social awareness among students and concern with rural problems gradually being shown by other teachers — has resulted in an increasing number of medical graduates making careers in the rural areas. 

Gentle in manner and modest in lifestyle, as is his physician wife, he has become the model of the dedicated medical practitioner whose goal is service. 

In electing PRAWASE WASI to receive the 1981 Ramon Magsaysay Award for Government Service, the Board of Trustees recognizes his research contributions to medical science while prompting his profession to make modern health care available to the poor.

The Award is greatly appreciated, not so much for myself, but more for the recognition of the principles shared by my friends in Thailand. There are many good and able people in the Thai Government Service, although the impossible bureaucracy is not so conducive to making those qualities as apparent and valuable as they should have been. We do humbly share the late President Magsaysay?s faith in human values, which, upon being genuinely preserved and promoted, have unlimited power for creativity necessary for humanity to last and prosper. It is the wisdom of this Foundation to create for their beloved President a mechanism to propagate enthusiasm in human value development throughout Asia and, no doubt, beyond. 

A great majority of the people in the world today are still living miserable lives, plagued by poverty, not having enough to eat, poor housing or no housing, lack of proper education, ill health without adequate health care or the ability to help themselves. However, knowledge and technology are already available or will be available, to make health for all possible in the not too distant future if national management and mobilization of human resources are well carried out. 

Thailand has many modern big hospitals staffed by doctors famous in various fields of specialty. But these hospitals are too overcrowded with patients to give good care. After long traveling at great expense and painful waiting, each patient may receive only one or two minutes of a doctor’s time; this cannot be considered good medical service. But the majority of the ill are either too poor or too far away to come to the hospitals. Thus the overall picture is that the majority do not have access to medical care and, for the minority who can make it to the hospitals, the care is of poor quality. This is because the health system, as in many other countries, is upside down. Its emphasis is more on big hospital setups rather than on community-based health care. 

There is an urgent need to expand broad-based community health care. This should consist of primary health care and small health centers or small hospitals located near people’s homes. For primary health care to be successful, all community resources must be mobilized. The people in every house? monks, schoolteachers, workers, etc., must be trained in primary health care. If this is well carried out 90 percent of the health problems will be taken care of, giving the big hospitals an opportunity to improve their medical service. Thus the key to success in health care development in a great majority of countries is to expand primary health care and the small health centers, with the support of more sophisticated levels of medical care, and not build more expensive and inefficient big hospitals. This principle should be appreciated by all concerned with the well-being of the country. 

With hatred toward none and compassion for all, we shall strive together in the endeavor to achieve the noble goal of upgrading the quality of life of the people, as envisioned by the late President Magsaysay as well as by many wise citizens of the world, both before and after him.