Trip to the Emergency Department

We were just telling the OMF Medical Adviser last week that our family has been in pretty good health for the last 4 years.  We hadn’t been to a Thai hospital for an emergency since our second son fell from the tree house in Lampang about 2 metres onto concrete, knocking himself unconscious. We still think it is a miracle that he didn’t suffering any brain damage from that fall.

Then a couple of nights ago, our youngest son was sliding down the stair railing when he slipped and fell from the second floor stairs to the bottom of stairs, head first opening up a deep and nasty gash on his forehead which needed a trip to emergency.  Again, we are thankful to God for sparing us a major head or neck injury.

In Chiang Mai there are a numerous hospital options, especially for those who can speak Thai (like us).  For those who can’t speak Thai, the two main options are Chiang Mai RAM and Bangkok Hospitals.  They cater for foreigners and are the quickest to get seen but they are the most expensive hospitals.We ended up going to one of the these two hospitals (I won’t say which one), because it was the closest hospital to us and it was peak hour traffic so we didn’t want to be stuck in traffic.

We weren’t impressed on entering the emergency department as there was no one in the reception area.  It was a few minutes before we could get the attention of some of the staff inside the door of the treatment area so that we could get our son seen.  After my wife carried my son into the treatment area led on by a nurse, I went back to my car which was idling outside the doors of the emergency department to find a parking spot.  When I returned to emergency, again there was no one at the emergency reception area so I just walked into the treatment area.  I was surprised that the doors just opened and I could just walk in start searching the cubicles to try to find my wife and son.  You wouldn’t see that in any major hospital in Australia. 

Generally, we received excellent care in the hospital.  We were seen by the nurse initially and then the emergency doctor within 15 minutes or so.  We waited another 15 or so minutes before a surgeon came and started to suture my son’s head wound.  All up we were there for an hour and half or so. What I wasn’t impressed with though was the emergency doctor recommending that our son get a head CT.  Initially we agreed, but I started having doubts almost immediately.  Having been a physio and worked in a hospital for a year, I thought that it was a bit over the top recommend a CT when there were no neurological signs and he didn’t lose consciousness when he had the accident. He wasn’t even complaining of that much of a headache and was pretty normal apart from the deep cut on his head.

I rang the OMF medical adviser and asked for his advice whether a head CT was necessary in this case.  He agreed that if there was no neurological symptoms such as vomiting or decreased consciousness that a CT was not warranted.  That was all I needed and I told the nurse that we didn’t want a head CT anymore.  She had a sign a waiver stating that we declined the medical advice to get a CT.

Another issue was the doctor prescribing antibiotics.  It was a pretty clean wound and I doubted whether my son needed antibiotics.  So I consulted with the OMF medical adviser and he confirmed that no antibiotics were needed.  By that stage the medical bill had already been printed and the hospital pharmacist had put stickers with my son’s name on the antibiotics so I couldn’t really cancel them.  

It is pretty common to order test and give medicines that you don’t necessarily need in these hospital catering for foreigners.  We’ve experienced it many times before but I was surprised especially about the CT as they aren’t cheap even in Thailand.  

We were given appointment cards to come to the emergency department to have the bandages changed everyday and also see the surgeon for a followup appointment and appointment to remove the stitches.  We haven’t gone to these apart from the final appointment which we will go to to get the stitches removed.  I figured that I could change the bandages without too much trouble and save the extra fee from the hospital.  

The total bill was over 8,000 Baht (AU$320).  Not too expensive if you had the same procedure done in Australia but almost half our monthly rent in Thailand so it was pretty steep.  

A Very Different Neighbourhood Reception

Our house warming party

I have been surprised by the difference in the reception we have received by our Thai neighbours between our old neighborhood and our new one.  In our previous neighbourhood we weren’t able to really get to know any of our Thai neighbours at all.  We tried to great them whenever we saw them but apart from a polite greeting, they did not really want to engage with us at all.  However, in our new neighbourhood, our Thai neighbours have been much more friendly and we know more about them in our first month of living here than we did in 8 months of living in our previous home.

What could explain the difference in reception.  Perhaps one reason could be that in our previous neighbourhood we lived in there was a large number of missionaries or expats renting and in our small street, half the house would have been missionaries or expats.  Due to the transitory nature of the work missionaries and expats are involved in, there is a lot of moving in and out of these houses.  The Thai neighbours who live there may have experience this and are not willing to engage with the foreigners who they know will not stay long term.  That is understandable.

In our new neighbourhood we don’t have any missionary or expat families living in our surround streets (except for one man with a Thai wife).  The family who had lived in our house had been in it for 10 years.  So they are have not experienced the same amount of change in foreign families moving in and out.

Also, we made the effort to have a house warming party and personally go and invite all our neighbours.  Although only 3 households actually came and stayed at the house warming party, many came with gifts and an apology of not being able to make it. 

So although being close to so many other missionary families had it benefits in terms of friendship for our kids, it had a detrimental effect on our relationship with our Thai neighbours.  We feel so much more connected in our new neighbourhood and look forward to getting to develop our relationship with our neighbours.

Coaching Course

Coaching Course

One of the advantages of living in Chiang Mai is that many courses and conferences are held in this city.  Living Chiang Mai means that I can attend the course or conference during the day and still be at home at night making it less of a strain on the family.

This week I attend a 3 day coaching course run by our organisation but attended by others as well.  I was surprised at how applicable this course was in my current regional leader role. This course had been available from time to time over the last 5-6 years but I didn't think was important enough to sacrifice to time and effort to go.  How wrong could I have been.  But perhaps it is even more useful in my current role than in previous roles.

I had seen the importance of mentoring but I had no idea of the difference between mentoring and coaching.  I thought that were pretty similar.  However, they are quite different in that with mentoring you as the mentor are using your experience to guide the person you are mentoring.  In coaching you are not trying to direct the coachee in making a decision or action you think is best but trying to help the coachee come to their own decisions and action steps by asking open ended questions.  

I had heard before that people are much more likely to do something when they have ownership of the decisions rather than being told what to do.  I didn't really know how to enable this to happen but now I have the basis to do it.  

There are many models of coaching.  The one we were taught was a Christian coaching model developed by Keith Webb (https://keithwebb.com/coach-model).  I'm looking forward to seeing the difference in my leadership as a result of this coaching course.

Finding a Rental House in Chiang Mai

Renting a house in Chiang Mai is definitely easier than renting a house outside of a major city like Chiang Mai, such as in Lampang or Chiang Dao where we have worked previously.  At least in Chiang Mai there are a fair few real estate agents who have houses advertised on websites which you can look through and they can organise for you to look at.  That said, it is still not an easy process as we have experienced in the last couple of weeks. 

Firstly, even though there are hundreds of houses to search through in websites such as http://www.ddproperty.com/ we found that most of the houses we were interested in, when we inquired with the real estate agent, they were no longer available.  So I would have a short-list of 10 houses which were listed on the website, but when I called the real estate agent only 1 or 2 at most would still be available.  A lot of time was wasted considering houses which weren’t available in the first place. I think they leave houses on the website to entice people to make contact with the real estate agent. 

Secondly, although many landlords in Chiang Mai are using the services of real estate agents, a lot of houses still are advertised privately, by a “for rent” sign outside the house.  If you just relied on websites and real estate agents you would miss out on a lot of houses for rent.  Knowing that I spent a few days just driving through neighbourhoods street by street looking out for “for rent” signs. 

Red "For Rent" sign in front of a house (not our one but one of the many we went past)

Thirdly, we have a big family of 4 kids which is amazes most Thai and the majority of houses are built with only 3 bedrooms and small living areas which suits most people.  But we were looking for at least 4 bedrooms and a large living area, close to the kid’s school, close to a shopping centre, without a spirit house if possible, able to have a dog and which didn’t have too much furniture (majority of houses for rent in Chiang Mai are partially or fully furnished).

In the end, we had looked at over 20 houses with real estate agents and on our own for several weeks and had found a few places which we could live in but nothing which we felt was just right.  In the end, we gave ourselves just one more day to find a house and if nothing turned up we were going to take a house which was o.k, but was fully furnished and a smaller living area than we wanted.  On the last day, I was at immigration and met another missionary and he told me about two neighbourhoods they looked at when they were searching for houses.

After I had finished at immigration I went to these two neighbours and drove up and down every street looking for “for rent” signs.  Finally I found a sign and rang the owner and organised a time later that afternoon to see the house.  Once I went into the house, I realised that this could be “the house” and I quickly rang my wife and organise to pick her up and get her to see it while the landlord waited. 

The house fit with almost everything we were looking for and the landlord was more engaged and helpful than any other landlord we’ve dealt with.  They didn’t advertise their house on real estate websites because they wanted to be very selective about who rented their house and they had rejected a lot of previous people who had wanted to rent their house.  They immediately dropped the rent by 2,000 baht per month and when we told them that we liked the house but as Christians we wanted to pray about it overnight and get back to them the next day, they dropped the rent by another 500 baht per month because we were involved in helping religion. 

We are really thankful to God for the provision of this new house.

Trying to get settled

Even though we’ve back over a month already, we are not yet fully settled, even though we were able to move back into our old house.  One of the first major tasks we embarked on was trying to find a new house closer to the two older boys new school and a bit bigger than our current house.  However, after looking at a few houses we decided to put off looking for a new house to rent after we worked out how the traffic was around the school.  Some areas, even though a lot closer to the school, because of traffic can take just as long to get to the school as from our house 15km away.  There is a school van service but it costs 3,000baht per child per month which is a little expensive.  Also, it would mean getting up earlier for the kids (being picked up at 6:30am rather than leaving at 6:50am as we are doing now).  We also like the area we are living in now and the children have friends who they are playing with regularly.  Moving to a new area always has risks that it won’t be as good as the area we left.

The second major task was selling our van (as we no longer need to be transport students) and replacing it with a second hand car.  At first I put a deposit on a pick up truck (Ford Ranger 2010) which had low mileage and a good price.  However, during the week I had to think about it, I realised that it wasn’t the right car for us.  I didn’t like the colour (Black – which would heat up a lot more in Thailand’s hot sun) but also it would require around 60,000baht to put a carryboy on the back with air-conditioning and seats.  

I decided that a much smaller car, the Toyota Avanza would be a better option for us at the moment, especially when trying to find a park near the boy’s school and navigation narrow streets.  There are lots of Toyota Avanza’s on the second hand market.  I think it is the car of choice for missionaries in Chiang Mai as it can seat 7 and is reasonably cheap.  I ended up going with Toyota Sure because they would trade-in the van.  Although, I’m sure I would have got more for the van if I sold it privately and bought another Avanza cheaper somewhere else, doing it myself would take time and effort which I didn’t want to spend right now.

Normally, my passport and work permit are enough for the transfer of ownership of the car, but because the address in my work permit is Bangkok (and I’m buying the car in Chiang Mai), the transport office require me to get a Certificate of Residency.  Then I found out that Immigration are not supplying the Certificate of Residency for a couple of weeks while they do a software upgrade?

The third major task was getting a dog.  We have not been able to have a dog for the last 10 years in Thailand as we have moved around a lot.  However, since we hope to be in Chiang Mai for the next 5 years and don’t plan on any long periods overseas, we could finally get a dog.  In the end, my wife and kids picked out a 4 month old beagle.  We’ve begun the toilet training process and dog proofing the front gates and watching youtube videos on how to look after dogs. 

All of this takes times and a lot longer than it does back home.  So today, I lodged my application for a Certificate of Residency.  It is free to get it but it can take up to 3-4 weeks for the free option.  I paid a man in a store at immigration 500 baht for each certificate (I need 2) to get it the next day.  I don’t know how this works exactly, but I’m not asking questions.  This afternoon, I’ll try to dog proof the front gate with the plastic fencing I bought from Home Pro yesterday which I will attach with cable ties.

Once, the boys who are going to school start their after school activities and we have a better idea of how many trips back and forth we need to make to school each afternoon, then we can tackle the last major job of moving house.  That is the hardest and most time consuming task of all.  Then we can start feeling settled.