Hospitals, Health and Medical Care on Koh Chang

Common Holiday Illnesses and Accidents 

Firstly, if you do get sick or have an accident on holiday on Koh Chang then it’s useful to know where you can get medical help. 

Hospitals and Clinics

Every resort on the island has at least one female member of staff who will dish out overly sweet green tea, sympathy and a handful of Tylenol to anyone who stays out in the sun too long or falls off their rented scooter.  

But if your medical needs require more specialised help then you can head to the International Clinic, run by the Bangkok Hospital group, up the hill at the far southern end of White Sand Beach.  It’s open 24 hours for emergencies & and takes credit cards.  

Expect to pay a small fortune to see a doctor, who speaks your language and get a prescription, so maybe it’s not the best place to go if you need cream for a mozzie bite.   It’s the place to go if you have medical insurance and so don’t care how much the final bill will be.  As a guide, expect to pay 4,000 Baht just to see a doctor.  ( It costs 400 Baht to see the same doctor at Bangkok Hospital’s Trat hospital on the mainland. )

Also in emergencies they can arrange for evacuation by boat or helicopter 24 hours a day to one of their hospitals on the mainland.  Patients are usually taken to Trat first and then to Pattaya or Bangkok for the most serious cases

Fortunately, there are cheaper options. You could visit Koh Chang’s Government hospital on the east of the island.  This is located in Dan Mai village, 15 minutes drive south of the ferry piers.  A couple of doctors speak a bit of English. As with all government hospitals expect a long wait alongside an assortment of other patients who will be dripping blood, wailing or coughing up heir lungs in your vicinity.  On the plus side, it is cheap.  

Instead of heading around the other side of the island, you can get a fairly accurate diagnoses of common ailments at most pharmacies.  These are located on all the west coast beaches.  If you can point to the problem or give a simple description then you’ll be able to get remedies for ailments such as  bites, stings, wounds, obvious food poisoning etc.

Another budget option for medical treatment are the local clinics in each village on the island ( Klong Son, Dan Mai, Salakphet, Jek Bae, Klong Prao and Bang Bao all have small clinics that are permanently staffed by nurses. ) As with pharmacies, these are good for simple, obvious problems that don’t require any details explanation of symptoms.  They’re the place to go if you fall off your scooter and need wounds cleaning and bandaging.  Take your passport with you as you’ll need to show it as ID.

However, if you need to explain your symptoms then it’s better not to take too many shortcuts in order to save a few Baht.

The best alternative to the International Clinic are a couple of private clinics.   There are a couple of clinics with English speaking doctors and nurses. One good option with an English speaking female nurse is ‘KP Clinic’ opposite the gasoline station in Klong Prao village. There is also another clinic in the shophouses opposite grand Cabana Resort at the south end of Klong Prao beach.  Whilst a third private clinic can be found 100 metres from Bhu Tarn Resort in the centre of Klong Prao beach.

More information:

International Clinic website (contact details but nothing else of interest at all)

Koh Chang Public Hospital (in Thai language only)

Dentist

There is only one dentist on the island, ‘Baan More Fun’ – which is how the Thai words for ‘Dentist’s office’ get translated into English letters.  

This is also in Klong Prao just south of The Splash resort and on the opposite side of the main road.  It’s a modern office and the dentist has a very good reputation for doing quality work at very reasonable prices.  In High Season you have to book an appointment a week or two in advance for any treatment that isn’t an emergency.  An increasing number of people combine their holiday with dental treatment and there are a lot of repeat patients. 

I’ve been there to have a tooth removed and whilst it wasn’t enjoyable, the dentist did a very efficient, almost painless job.  He took an X-ray to show the problem and explain why the tooth couldn’t be filled.  Then I was into the chair where you have an overhead TV to watch to distract you.  10 minutes later the tooth was out.  Under an hour from leaving the house to arriving back home with my tooth in a small ziplock bag and a supply of painkillers.

See Koh Chang Dental Clinic on Facebook for more information.

What are the Health Risks on Koh Chang?

Malaria

Will you catch malaria and die an agonising death if you visit Koh Chang?  Or will you be one of the lucky ones and survive two weeks on a beach?

Judging from the emails I receive and from speaking to guests who stay at our place, most people are a bit worried about the chances of catching malaria here. It’s the most common health related concern.

If you Google ‘Malaria’ and ‘Koh Chang’ and you’ll find plenty of websites which have Thailand’s borders with Cambodia and Burma plus Koh Chang coloured in a foreboding red. 

However, in reality, there’s only a chance of catching malaria if you plan on spending a few weeks camping out deep in the jungle during the rainy season. And then the chance of getting it is so slim that you’re far more likely to win the lottery.  Koh Chang isn’t free of Malaria entirely, but the only cases I occasionally hear about involve Cambodians who go off hunting in the jungle.  Not people lazing on a sunlounger by a pool.  

So, rather than panicking or stocking up on expensive Malarone before you leave home, just take the obvious precautions against being bitten.  Wear long sleeved shirts and light trousers in the evening.  Use a good mosquito repellent, something with a high percentage of DEET in it as mozzies can sometimes be a nuisance.

Natural, citronella based repellents, may make you feel as though you’re saving the ozone layer, but when it comes to deterring mozzies; coating yourself with DEET or, any Agent Orange derivative, is the best option.

But don’t take my word for it. 

The Hospital for Tropical Diseases at Mahidol University, Bangkok and the Thai Red Cross recommends against taking anti-malarial drugs for several reasons including:  

• Ineffective prevention of an infection allowing for a sub-symptomatic infection that delays diagnosis and treatment. Treatment during the early first stages of malaria is very effective, but it gets more difficult as the infection and life cycle of the parasite progresses.
• Contribution to the development of resistance pools to anti-malarials that are also used for treatment
• Side effects from the anti-malarials. Rather, they recommend that you use bite prevention and if you have the slightest doubt that you might be infected, report to the nearest clinic or mosquito control office (there’s one in every small town in Thailand) for a diagnostic test, followed by immediate treatment on the one in a million chance that you have actually contracted malaria.

But if you feel that the leading authorities in Thailand are still a bit too ‘third world’ to be a reliable source of accurate information, then feel free to contact the American Center for Disease Control. If you’ve ever met Americans when they’re travelling you’ll know how paranoid many of them are about catching any foreign bugs, so you should feel pretty confident that the CDC’s advice errs on the side of caution.

This is their reply to my email asking about the chances of catching malaria on Koh Chang. (Note the use of the word ‘should’ to avoid any possible law suits resulting from following their advice):

The malaria-risk areas of Thailand are its borders with Cambodia, Laos, and Burma. Koh Chang should not have malaria transmission. No antimalarial drug should be required, although you should wear insect repellent with DEET if you are out of doors between dusk and dawn for a little extra protection.

Thank you for your inquiry. Please call or write if you have further questions.

Sincerely,

National Center for Infectious Diseases
Centers for Disease Control and Prevention
[email protected]
770-488-7788 (Malaria Hotline, 8am-4:30pm, eastern)
770-488-4206 (fax)

And finally, especially if you’re from the UK, you’ll find that your doctor will almost always recommend that you take anti-malarial medication whenever you visit an area of a country your GP hasn’t already visited personally. Safety first . . . but the fact that some anti-malarials cost a small fortune and the profits on sales must be quite high may also be a factor.  

Doctors in most European countries tend not to advise visitors to Thailand to take anti-malarial drugs. 

Dengue Fever

If you re going to worry about a mosquito-borne tropical disease then Dengue should be the one, not Malaria.  

Anyone who has lived in Thailand or anywhere in this part of the world for a period of time will have either had it or will know someone who has.  It’s prevalent across the region.  Not just in the countryside and in the jungle but in modern cities such as Singapore that had over 30,000 cases in 2016.  Until 2016 there wasn’t any vaccine for it and there’s no cure or way to treat it other than rest and paracetamol.  There’s also a more deadly version of it that attacks weaker patients, mainly young children and the elderly, Dengue Hemorrhagic Fever.  You end up bleeding to death internally.  That’s not a good way to die.

I’ve had it twice.  Once, back in 2001 when I lived in the centre of Bangkok and once, in 2012, here on Koh Chang.  

The initial symptoms are that you become very lethargic, usually get a high fever and severe migraine behind your eyes.  Plus you can have all your joints seize up so that making even the smallest movement is painful.  As though you have arthritis.  After a few days there will also sometimes be a red rash across your chest.    

But wait, there’s more . . . .  just to compound things your platelet and white blood cell count will drop way down.  This isn’t a good thing.  Your body needs fuel but you don’t feel like eating or drinking at all, so the options are to either force yourself to eat and drink or end up in a hospital bed on a drip.  I don’t like hospitals so I just made myself drink and eat small amounts of food at regular intervals.  Mind over matter.

In all, it usually lasts about a week.  But you’re left drained of energy and it takes much longer to get back tonormal.  Personally, about a month or so to get my energy levels up and feel ‘normal’ again. 

In 2016 a vaccine ‘Dengvaxia‘ was made available to the public.  However, it isn’t intended for tourists and the efficacy of the vaccine is only 65%.   The World Health Organization (WHO) only recommends dengue vaccine in people age 9-45 years old who live in a dengue endemic area.  

Ironically, for the vaccine to work well, you must have already been exposed to the Dengue virus via mosquito bites.  Which is why there is no recommendation for travelers and any expats who want to take it should have lived in a Dengue endemic area for at least 9 years. This is also why it isn’t suited to young children.  As they haven’t had time to get bitten by enough mozzies to have had a good chance of being exposed to it already.

However, if you really are worried and want the vaccine then Bangkok Hospital will sell it to you for around 10,000 Baht for the three required injections which must be administered over a 12 month period.

Chikungunya Virus

In addition to carrying dengue fever, mosquitoes are also capable of spreading Chikungunya virus. This isnt as dangerous as Denge Fever for adults.  Children are at most risk as the disease can affect the liver, kidneys and heart.

Chikungunya spread by mosquito in both urbanized and rural areas. Mosquitoes that carry the disease often venture out to feed during the daytime during the rainy season. Meaning that children who enjoy playing outside are most at risk of contracting the disease.  Pregnant women who contract Chikungunya are at risk of passing the disease onto their unborn child.

Symptoms of Chikungunya are very similar to Dengue fever with patients getting a high fever that lasts for a couple of days, a shorter period than with Dengue fever.   There can also be joint and muscle pain, similar to Dengue fever.

There’s no drugs or vaccines that target Chikungunya. Doctors can only treat the symptoms.  Eg by prescribing fever drugs and pain relief medication.  Followed by encouraging the patient to get lots of rest , drinking plenty of water and having a healthy diet 

Zika Virus

Zika Virus is another mosquito borne virus that is found in most tropical regions of the world.  And for the vast majority of people it doesn’t pose any risk.  Most people who get it don’t have any symptoms. So don’t realise they have it. 

It’s not something that makes the news here in Thailand.  There are only occasional headlines about babies born with birth defects.  But it is the fact that expectant mothers can become infected, without realising it, and pass it on to their unborn child is the most worrying aspect of the virus.  Especially for pregnant women visiting Thailand.

The good news is that the chances of getting Zika virus anywhere in Thailand is extremely slim.  The bad news is that there isn’t a vaccination against it.  All you can do is take the usual precautions against being bitten by mosquitoes.  

There’s a good infographic on pregnancy, travel and Zika Virus here https://www.iamat.org/ 

 

Common Medical Problems For Tourists in Thailand

Assuming you don’t get Malaria or Dengue, then the following are probably the biggest risks to your health whilst on holiday on Koh Chang, or anywhere in Thailand for that matter:

Dehydration  

Dehydration is very common, but also very easy to avoid.  It’s often mistaken for food poisoning as often the symptoms are similar – vomiting, diarrhoea and a fever.   

If you’re just drinking a couple of bottles of water a day, that isn’t enough.  Think closer to a bottle every couple of hours. Or if not water then some other liquids eg soft drink or fruit shake.  It’s often very humid here so you will find yourself sweating when you are standing still.  And if you don’t replace that fluid regularly, you’ll get sick.  

Bear in mind, you also need to replace the salts that you lose.  The cheapest and easiest way to do this is buy sachets of ‘Oreda’ oral rehydration powder from any pharmacy.  (See the photo above.) These cost about 10 Baht and work wonders.  Put one sachet in a 500cc bottle of water and drink it slowly, make it last an hour, so the salts have time to be absorbed into your body.  It’s orange flavour so ideal for kids too.  Keep drinking like that to replenish fluids and essential minerals. You’ll feel a lot better within 24 hours. 

Food Poisoning

Also common, especially in the first week of a holiday when your stomach is just getting used to a whole new set of bacteria.  

It’s not necessarily that you’ve got food poisoning, just that your stomach is taking time to adapt to new strains of bacteria it hasn’t encountered before.  The places to avoid are small, quiet restaurants that don’t have a high turnover of customers and buffets.  Especially at hotels where lukewarm food is left out in the evening for a few hours.  If you are buying streetfood, make sure it;s cooked in front of you.  Some stalls will often cook their BBQ ‘meats on sticks’ in the afternoon, leave them sitting on a tray for a few hours and then just warm them up on a grill for buyers in the evening.  

You’re going to have a rough 24 – 48 hours if you get food poisoning, but it’s unlikely to be longer than that.  During that time, you won’t want to travel more than 30 seconds from the nearest toilet.  Again make sure you drink water with re-hydration salts.  

And if you want to eat anything, try ‘Khao Tom’, a type of rice soup that contains ginger but isn’t spicy and won’t upset your stomach.  That’s what Thais eat if they get a bad stomach.   Any restaurant will make it even if it isn’t on the menu.  It’s also good hangover food. 

Jellyfish

There have been cases of people being badly stung by potentially deadly Box Jellyfish off Koh Mak and Koh Kood.  But so far no confirmed reports of any being sighted off Koh Chang’s beaches. And for most of the year it’s unlikely you’ll come across any jellyfish when you are swimming.

However, at certain times of year, especially at the end of the rainy season there can be huge numbers of small jellyfish in the sea.  These are washed along on currents and so can be in one location one day and then disappear the next.  On the mainland coat going towards Cambodia swarms a kilometre long are sometimes seen just metres from the shore.  

Taking a tour by small boat to see the sea of jellyfish is an increasingly popular day out for locals in Trat.  Fishermen will try to track the swarms and call them in when they see them, visitors then have to get to the nearest village where they can hire a small boat to take them out to sea.  We went a few years ago and it is an amazing sight.  These jellyfish do sting, but it feels more like a stinging nettle or insect bite.  It’s just annoying not life threatening, unless you happen to react badly to their stings. 

Sandflies

More very annoying that actually harmful.  Sandflies like quieter stretches of beach.  They lay their eggs in the sand, so if a beach is raked every day or there are lots of people walking on it daily there won;t be many sandflies around.  But if you find a quiet stretch of sand, then you can expect some sandflies.  They are small, only a millimetre or two in size and look like a speck of dirt. So are hard to notice even when they are on you.

Many people don’t have any adverse reaction to their bites or simply aren’t bitten at all.  It’s often the case that in a family there is often one person who is the bait.  Everyone goes to the beach together and when they come back, one person has been bitten to pieces and the others are fine.  ( They bite me and I notice when they do, but I never get any spots or adverse reaction to the bites.)

Go to any pharmacy and get some extra strength Hydrocortisone cream, that will stop the itching quickly.  The pharmacist will know what the problem is as soon as they see the bites.  For older bites tablets are given.   Yellow Oil, a Thai miracle herbal cure, can also be used to help stop the itching. Give it a try if modern medicine fails.

There isn’t anything that people agree will stop sandflies from biting.  They tend to ignore mozzie spray.  Coconut Oil often works as they’ll avoid landing on you if your skin is sticky and oily.  But you have to keep applying it regularly.

Scooter Accidents

These are another regular cause of injuries; occasionally very expensive medical bills and sometimes deaths.  

In High Season it’s common to see the telltale signs of bandaged elbows and knees on tourists hobbling along the roadside.  They’re the lucky ones as sadly,  it’s also now common to see someone has set up a GoFundMe page for a friend or family member who has had a serious motorbike accident somewhere in South East Asia and who has discovered that their medical insurance doesn’t cover it.  

Unless you are licensed to ride a scooter in your own country and have an International Driving License, your travel insurance won’t cover you if you have a scooter accident and neither will the bike insurance.  That will be just the most basic Third Party insurance that is required by law.  No insurance companies will give First Class, fully comprehensive insurance to a scooter rider in Thailand – as they’d go bankrupt quickly.  

The narrow, hilly roads on Koh Chang aren’t the ideal place to learn to ride a scooter. And when it rains the hills often become super slippery.  You also have to be aware of your fellow road users, especially at night.  Pretty much everyone driving late night will have had a few beers, as drink driving is common here, so even if you are sober, the guy driving his pick up truck towards you on the wrong side of the road probably isn’t.  Leave the bike at home at night, it’s no fun.  Take a pick-up truck taxi instead. ( My guide to renting a scooter. ) 

Stray Dogs

Their bark is worse than their bite.  There are a lot of stray dogs on the roadside and also on the beach.  But if you leave them alone then they will leave you alone.  They won’t bite without provocation.  And, although they might appear friendly and come up to you , if a child starts teasing them with food, it’s not surprising that the dog will try to bite it out of their hand.  

That’s happened before and made the newspapers.  The real story wasn’t the dog biting a 6 year old girl.  It was the child teasing the dog and the parents allowing her to do it whilst they were having dinner.  

If a stray dog does bite you then you’re going to need to get a Rabies injection as soon as possible.  Statistically, the chances are very high that the dog doesn’t have Rabies, especially on Koh Chang. As there is always far less chance of getting it on an island than on the mainland.  But nonetheless, a doctor is going to insist you get not just one jab, but a series of them.  Four doses of Rabies vaccine are required.  One as soon as possible after the bite.  The further  doses on the 3rd, 7th, and 14th days.  

Rabies injections are around 1,200 – 1,500 Baht and up, depending on where you get them.  This might sound expensive, but it’s a lot cheaper than they cost in the US or Europe. 

If you want to help feed the stray dogs on the island, contact Happy Dogs Koh Chang – they’ll welcome a donation of dog food or money. 

Sunburn

It’s always fun to have new guests arrive from Bangkok where they have had a couple of days wandering around the temples and Grand Palace.  And usually without getting sunburned.  As one of the benefits of staying in Bangkok is that the pollution blocks out a lot of UV rays.  

Usually, it’s straight to the beach for  a couple of hours and the end result is a lobster red ‘tan’.   You’ll burn quickly here under a pollution-free sky.  Get hold of some Factor 50 sunblock.  You’ll find it in 7-elevens, supermarkets and pharmacies on the island.  However, it’s also important to remember that brand name sun-lotion ( eg Nivea, Banana Boat ) in Thailand costs a lot more than in Europe, as it’s imported and shops know tourists need it.  So ideally bring a few bottles with you from home.  Don’t forget the aftersun either.  And some lip balm especially if you plan on being out on the sea or riding a scooter as warm wind will chap and dry your lips quickly.

Remember, you’ll burn without realising it when you’re riding a scooter, as the wind will keep you cool.  It’s only after you get off the bike you’ll notice the tan lines on your feet and red knuckles.  

If you’re planning on taking  snorkelling trip, it’s best to wear a rashguard or just an old t-shirt.  The water magnifies the suns rays and you’ll end up roasted if you aren’t careful.  Remember to apply sun lotion to often overlooked areas ,such as the back of your ankles, neck and ears. 

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Recommended Vaccinations for Tourists Visiting Thailand

There aren’t any mandatory vaccinations for visitors  to Thailand (Aside from a Yellow Fever vaccination certificate for visitors who arrive from a country with risk of Yellow Fever transmission, i.e. most African and South American countries.)

But there are some vaccinations that doctors recommend, especially if you are planning on staying in the country long-term or staying in remote places.  You’ll need to plan in advance if you want to get them, as some jabs need a couple of doses which have to be done anywhere form a few weeks to a few months apart.

The good news is that despite what you may read on random travel sites, according to Tropical Medical Bureau , there area really only three vaccinations that visitors to Thailand should have:  Tetanus, Hepatitis A, and Typhoid.

Tetanus

Tetanus is an absolute must-have for all travelers. Over 1 million people a year get it worldwide.  For many people, Tetanus is associated with cutting yourself on rusty metal. But is spread by bacteria in soil, dust and dirt which gets into the body through scratches or puncture wounds.

(Years ago I managed to impale my foot on a rusty nail sticking out of a piece of wood.  Three things I learnt from that : a) Flip-flops don’t offer much protection against nails. b) Having a nurse stick a chopstick wrapped in gauze into a hole in your foot hurts quite a bit c) Tetanus jabs are very cheap in Thailand. )

Hepatitis A

Hepatitis A affects the liver and can vary in severity from being a mild annoyance to a lifelong illness.  It’s common across South East Asia and in pretty much every developing country on the planet.  It is spread through contact with faeces or through contaminated food and water.   So, if you see restaurant staff leaving the toilet without washing their hands properly – it might be better to elsewhere.  

Typhoid

Typhoid fever is also spread by contaminated food and water. And is also common across southeast Asia. It is another reason to eat at restaurants and foodstalls that are clean. Symptoms include lasting high fevers,  stomach pains, headache, and loss of appetite.  The bad news is that even if you have the vaccine it’s only 50% to 80% effective.