The recent floods have made life miserable for many people in the provinces, particularly patients with kidney disease who have been left scrabbling to find hygienic areas to perform peritoneal dialysis on themselves using portable, lightweight equipment.
Lalita Chanthasae, 39, prepares a dialysis kit and performs the procedure on herself at a shelter in Warin Chamrap district of Ubon Ratchathani. Onnucha Hutasingh
But joint efforts and efficient management by various parties has helped ease the plight of patients suffering from failed kidneys.
When floods hit Ban Hat Suan Ya in Ubon Ratchathani's Warin Chamrap district last month, Lalita Chanthasae, a 39-year-old kidney disease patient, rushed to minimise the damage.
First, Ms Lalita, along with her husband, daughter and her parents, had to move to safe ground on the side of Warin Chamrap-Ubon road, where they now live in a makeshift shelter. This is becoming more commonplace during the rainy season.
''But this year was different because of my kidney disease. I had to make sure the place was clean enough for me to do the dialysis,'' she said.
She managed to set aside a small space in the shelter partitioned with plastic sheets for the procedure. Like many patients, she has to perform a 30-minute dialysis four times a day -- for the rest of her life.
Dialysis requires that strict hygiene conditions be met -- the equipment must be sterile, whether conducted at home, in a hospital or in the makeshift shelter by the roadside -- to prevent the risk of infection.
"If infections worsen the condition and you can no longer treat yourself, then you'll have to go to hospital for a hemodialysis, which is more difficult and more expensive,'' Ms Lalita said.
In the face of floods, finding a sterile place to store the cleansing fluid for dialysis is also important. Moreover, used fluid must be safely discarded to stop the infection from spreading to the public.
Fortunately for Ms Lalita and other patients in the province with failing kidneys, they no longer have to deal with such medical scares alone.
A network of patients was recently established to collaborate with Warin Chamrap Hospital and provide aid.
The hospital and network have devised plans to help out before the onset of this rainy season. They know where patients plan to relocate to in order to escape the floods, and how they plan to create temporary "safe zones" where dialysis can conducted.
When floods occur, patients will contact the hospital via the popular messaging app Line. Hospital personnel will then be sent to examine them and provide any assistance.
Siriporn Burasee, who works at the hospital, said nurses like her have to look after at least two patients with failing kidneys. Some 97 patients now require regular dialysis there.
She said it's important to stay in regular contact with patients during floods.
"Floods may make it hard to travel, but it doesn't prevent communication between hospital staff and patients. However, difficulties may arise when it comes to storing the cleansing fluid and getting rid of used fluid,'' she said.
When a deluge strikes, the hospital stocks a month's supply of cleansing fluids as one patient needs four packets of fluid every day. Most of these fluids are kept at a community health unit known as a tambon health promotion hospital.
If this is also flooded, the cleansing fluids are moved to one of patient's houses and made available to others in the area. They may also be stored at local temples, Ms Siriporn said.
She advised against throwing used fluids in public waterways to prevent contamination. They should be thrown in toilets or kept in plastic bags so hospital staff can dispose of them later, she added.
The National Health Security Office made an agreement in 2011 with Thailand Post and the Government Pharmaceutical Organisation to provide a service to deliver cleansing fluids to patients at home, she said.
Postmen also play an important role in easing the plight of kidney patients in Bang Hat Suan Ya during the annual floods, officials said.
If certain areas become inaccessible due to high water levels, they can use boats to help ferry medical supplies to patients and provide sterilised supplies.
Niyaporn Noiwong, who works at Thailand Post Distribution Co's Ubon Ratchathani branch, said the workers feel duty-bound to deliver cleansing fluids to patients regardless of the dangers involved.
"If we deliver to those destinations it means we can help save the lives of patients. That's an important mission,'' Ms Niyaporn said.
