Health in Chiang Mai isn’t a high-risk problem, plus the healthcare system in Thailand is pretty good where tourists are concerned. There are a number of tropical diseases around, but incidences of infection aren’t alarming. Similarly, personal safety in Thailand is relatively good, as Thai people are generally passive and violence or theft is only a minor risk. Incidences of petty theft are naturally greater in tourist areas, although Chiang Mai is safer than most popular spots. Effective Tourist Police are usually on duty – Tel: 1155.
Risks to consider for your health in Chiang Mai include: reckless driving, irresponsibility towards risky activities, dengue fever, poor hygiene during food preparation, and sexually transmitted diseases. So far the Thai police have done a commendable job in minimising the risk of terrorist activity. Although there is sectarian violence in the south, this is limited to three provinces that attract little tourism anyway. If you do have to visit a hospital, be aware that they charge considerably more than public ones, overcharging on imported medicines on the assumption that you’re covered by travel insurance. Often you can get an equally professional service at decent government hospitals, who are more ethical.
Health risks in Chiang Mai
Avian Flu: is no longer a threat and was always most dangerous when receiving adverse negative hype in the press (which particularly affected the tourism industry). Although a few new cases were reported in mid-2004, they are isolated and chicken products across Thailand are considered safe to eat. The only reported human cases have been from farms where the infected were in close contact with livestock, and since there have been hardly any reports.
Dehydration: During March, April and May, Thailand becomes extremely hot, with temperatures reaching 40°C/105°F. Those who are not used to such temperatures will certainly feel uncomfortable and should drink plenty of water to avoid dehydration, especially if out in the direct sun and engaging in activity. If you’re suffering the runs from spicy food you should also rehydrate. Symptoms include: dizziness, fatigue, breathing difficulty, very yellow urine and a dry mouth. Rehydration salts/drinks, or a trip to the nearest hospital, is recommended. Ask for ‘O-lyte’ or DeChamp in any convenience store/pharmacy.
Dengue Fever: has similar symptoms to malaria and is spread by mosquitoes occupying stagnant pools of water in urban areas. Dengue fever is certainly on the rise in Asia as climate change brings more water. Risk is highest between July and October. There is no medical prevention available yet and if untreated the hemorrhagic form of the disease can sometimes be fatal. Symptoms start with a cold sweat fever for a few days, followed by fatigue, dizziness, bleeding gums, rashes, lack of concentration and constant headaches. After contracting and recovering from dengue fever, the risk of fatality becomes higher during a subsequent bout and a visit to the doctor is a must for blood tests (during and after). Within two weeks the body recovers by itself.
Drinking Water: tap water is apparently drinkable, but everyone favours bottled water (including Thais), which is widely available and cheap. Be aware that mountain streams also may be contaminated as discharging waste into waterways is common in Thailand. Reverse-osmosis water purification systems are generally used, therefore ice and free water offered in restaurants is safe for drinking.
Diarrhoea: is common among non-Asians and a mild bout of the infamous ‘Bangkok belly’ at least once during your trip is common. This usually results from poor hygiene preparation in the kitchen (roadside noodle shops can be bad), too much chilli in your food, contaminated water or unfamiliar spices and herbs.
Anti-diarrhoea medication is widely available in Thailand (ask for Imodium, loperamide, disento or charcoal). The runs usually pass within 24 hours; be sure to keep well rested and rehydrated. If you have been vomiting or suffer a severe case, then report immediately to the hospital.
Hepatitis: exists in a variety of strains that all affect the liver – although symptoms may be similar, they differ in method of transmission and seriousness. Hep’ A is spread through contaminated food and drink, resulting in fever, chills, headaches and fatigue. The best remedy is simply resting and eating properly and waiting for the symptoms to pass. Hep’ B is far more serious and often results in ‘yellowing’ of the skin and leads to long-term liver problems. It is spread through contaminated blood or sexual activity. Hep’ C, D and E are less common but can be lethal and there is no vaccination against these.
H1N1 (Swine Flu): has not spared Thailand, which was among the top 10 countries in the world for fatalities. However, this only numbered about 10 in 2009, and the initial scare has subsided as most infections turned out to be mild symptoms. It remains a worldwide threat and although has faded in risk, check current media for the latest on this high-alert health risk.
HIV: Thailand has generally been very successful in its campaign to limit the spread of HIV / AIDS in a country that has a reputation for its sex industry. Realistic estimates put the infection level at roughly three per cent of the population. However, those mingling in the go-go scene are obviously among a higher risk group – condom usage is essential and widely practised here. Other methods of transmission are deemed to be low-risk in Thailand, with the exception of sharing syringe needles.
Malaria: Chiang Mai is apparently malaria-free; in fact, most of northern Thailand is too high in altitude for the virus to thrive. Despite this we have heard of isolated cases during recent rainy seasons. You will certainly be at risk if you are planning a trip down the Mekong River to Laos or other lowland areas. Mosquitoes are a widespread irritant across Thailand due to the abundance of water.
The malarial strains here are considered immune to western prophylactics such as Larium. Soxycycline is recommended as an impromptu preventative medicine, but visitors to most tourist destinations in Thailand need not worry about anti-malaria medicine. There is a malaria centre alongside the outer western flank of the moat (near Chiang Mai Ram Hospital). Symptoms start with cold sweats every 6-8 hours for several days, but this might likely be dengue fever, which is more common here.
Pesticides: are still unfortunately widely used by ignorant farmers who are desperate to scratch a living by whatever means boosts their crop success. Vegetables are generally sprayed with toxic insect repellents and products are also often enhanced in appearance using dyes.
Few cases of poisoning are ever noted and organic vegetables are available in selected modern supermarkets, at a premium price. Most respectable eating establishments will endeavour to source healthy vegetables.
Rabies: There are many ‘soi dogs’ in Thailand and travellers complain of bites fairly regularly. A rabies vaccine is now available; if you have not had this treatment before coming to Thailand and are subsequently bitten it is advisable to report to a hospital for injections – five of them. The rabies infection can be fatal and is carried in the saliva, so even a dog licking an open wound can be dangerous. Immediately clean the wound with iodine if you are worried. Dogs infected with rabies usually display symptoms of dementia (madness), acting very aggressively and foaming at the mouth in the late stages.
Venereal Disease: There are higher incidences of diseases, such as syphilis, herpes and gonorrhoea, among prostitutes and their clients; however, the high publicity of AIDS has encouraged many people to use condoms, thus reducing the spread of venereal diseases in general.