In the rural border area where KRCH is located, the care of tuberculosis patients throughout their period of mediation presents a number of significant challenges. Patients must take their medication each day for the full period – a minimum of 6 months – or risk developing drug resistant tuberculosis, however, the patients may have travelled significant distances to reach the hospital, they may be migrant workers with no permanent residence, the surrounding hilly terrain makes travel to receive medication difficult, particularly in the rainy season, and patients speak a variety of different languages.
In this challenging context, the hospital provides a comprehensive tuberculosis program:
- An On-Site TB Clinic run by the hospital's Public Health Unit, which provides screening and check-up services to approximately 70 people per month.
- A Mobile TB Clinic run by the hospital's Public Health Unit once a month at Three Pagodas Pass, the nearest border crossing point between Thailand and Burma, which provides screening and check-up services, including to patients who cross the border to attend the clinic.
- A Tuberculosis Ward with isolation rooms, where patients spend the first two weeks of treatment.
- Directly Observed Treatment (DOT). A team of 6 motorcycle drivers travel each day from the hospital to the homes of approximately 30 patients. The DOT drivers, who are trained in tuberculosis treatment and able to speak the local languages, find the patient, supply the medication and directly observe the patients taking it. The drivers also serve as a link between the patient and the Public Health Unit to solve any problems with the medication, and they are able to recommended that any of the patient's friends or relative with suspicious symptoms are tested for tuberculosis.
- 'Sala' Residential Treatment. Migrant patients from remote areas beyond the reach of the DOT drivers can stay on-site in the 'Sala' – the hospital's housing for TB patients which has 20 rooms, cooking and toilet facilities and easy access to the hospital. In the Sala, the patients receive observed drug treatment, regular health check-ups and charitably funded food allocations. Patients stay for the duration of their treatment – a minimum of 6 months – and are often accompanied by family members.
- The Sala Handicraft Project provides Sala residents with the opportunity to learn new craft skills that they could continue to use after returning home, and provides the opportunity for KRCH staff and volunteers to spend time with the resident and express God’s love in a personal way. Examples of the crafts produced include handmade bead jewellery, braided macramé jewellery and crocheted bags. All funds raised from selling the handicrafts go directly back to the Sala TB Handicraft project – through wages to the patients, purchasing craft resources and improving Sala facilities.
TB medication costs for Thai citizens are funded through the Royal Thai Government's national TB Control Program. TB treatment for migrants is funded by Global Fund, through World Vision Foundation of Thailand.