Top: Arunrat Rukthin checks the temperature of her neighbor in Nong Khai. Photo: Arunrat Rukthin / Courtesy
BANGKOK — As soon as a woman in her rural community registered a high fever, Auntie Arun alerted the local hospital doctors, who soon arrived in at least three cars, prepped to transport a COVID-19 patient.
Fortunately enough, the woman did not have the coronavirus, and the Moo 11 village in Nong Khai province remains free of the pandemic. Auntie Arun, or Arunrat Rukthin, 60, said she plans to keep it that way.
Arun is not a doctor, but a member of the nationwide Village Health Volunteers, known by their Thai acronym Aor Sor Mor – the unsung heroes on the frontline to monitor and protect residents from the coronavirus. They are also credited as one of the reasons why COVID-19 figures in Thailand stayed relatively low.
“We’re very ready, every village, subdistrict, district. We know everyone, who’s living where. We knock on doors, ask where people travelled to, and give our numbers to them so they can call. We distribute pamphlets about COVID and washing hands, and stick them up on doors,” Auntie Arun said.
The volunteers act as middlemen between rural residents and health officials, conveying medical facts and doctors’ orders to neighbors they’ve known all their lives. Their job is to knock on doors to check temperatures, as well as educating locals about hand-washing and social distancing.
“Some people are scared at home, so they call us, and ask us to come check their temperatures,” Auntie Arun said.
During a recent news conference, government coronavirus taskforce spokesman Taweesin Visanuyothin also thanked the volunteers for quickly reporting a new case of infection in Chiang Mai province.
“It is the ability of Aor Sor Mor volunteers in the area who took the man to test for COVID-19,” Taweesain said on Thursday. “This shows how important local personnel are.”
What is Aor Sor Mor?
It is possible to watch some Thai news channels all day and miss out on the roles of these aunties and uncles taking up their civic duties in the countryside, since much of the mainstream coverage is occupied by doctors, experts, and other Bangkok-based officials.
But the volunteers have not entirely gone unnoticed. Back in April, the World Health Organization gave a shout out in a Tweet and congratulated them for their work.
The Village Health Volunteer network was set up in 1977, after the Thai Ministry of Health partnered with the Japanese government to develop a primary health care system in all regions nationwide.
The concept was also an embodiment of Thailand’s pragmatism. In a column, former deputy PM Wiraphong Ramangkun said the Aor Sor Mor was inspired by the Thai Communist Party’s local version of the rural “barefoot doctors” in mainland China – despite the widespread anti-Communism sentiment in Cold War Thailand.
Each of the 1.04 million Aor Sor Mor volunteers is expected to provide basic health information to local residents, and coordinate doctors’ visits to 15 to 25 households.
The project’s foot soldiers are ordinary senior citizens in rural communities, like Pompaeng Phaholtap, 60, a volunteer in charge of 15 households in her village in Nong Bua Lamphu province. She has been working for the program since 2001.
Since the pandemic broke out in January, Pompaeng has been delivering prescription medicines from doctors to the elderly in her neighborhood so both parties can practice social distancing.
“Some people call us to visit their house because they want us to give them more information about COVID, even if they already heard it before. They want to hear us say it,” Pompaeng said. “We’re the ones taking care of everyone, from newborns to the elderly.”
The People’s War
While they are not trained to operate like professional doctors and nurses, the volunteers play a crucial support role in the country’s public healthcare system by doing their best to prevent people from falling sick in the first place.
“We are only doctor’s helpers,” volunteer Phannarath Phanpong said. “We don’t do things beyond our reach. We keep people away from diseases and help reduce the workload of hospitals.”
The government agency that oversees the network said the volunteers also helped in protecting local residents from bogus medicines and supplements, and providing mental services to their neighbors.
“Their role is to be a bridge between people and health care institutions,” Health Service Support department chief Thares Krassanairawiwong said. “We have relatively good health records because of Aor Sor Mor volunteers, who are crucial in strengthening public participation in the public health system.”
Like many fellow volunteers, Phannarath Phanpong, 65, has only completed basic education. But after her village committee in Satun nominated her for the role, Phannarath received training on how to perform basic medical procedures, promote healthy practices, prevent common diseases, and use telemedicine technology.
She said Aor Sor Mor is ideal for retirees and the elderly who want something to do and help their communities at the same time.
“It’s an enjoyable experience for me. I got to help people out, got to see those who are less fortunate than myself. I feel fulfilled helping people who are in need,” Phannarath said.
Village volunteers also help bring people to hospitals in small-town areas where residents are still “too scared to go to the hospital or having no idea what to do,” said Chutima Lahnui, a volunteer in Narathiwat, who recalled having to send drug addicts to rehab at midnight.
Many volunteers, especially the elderly, conduct their duty with personal risk to life and limb.
Prapot Ariyabunditkul, 68, a volunteer in Pathum Thani, recently fainted from extreme fatigue from work and drove off a road into a khlong, resulting in injuries.
Boonsong Manaowaan, a 72-year-old volunteer in Suphan Buri, also died in a motorbike accident while delivering face masks and sanitizing gel on April 22. He had been a volunteer for 34 years.
Prime Minister Gen. Prayut Chan-o-cha himself posted a message of condolences after his death.
“Grandpa Boonsong died while on duty…as one of the million Aor Sor Mor volunteers nationwide who are sacrificing for his country. He is one of the reasons why the COVID-19 situation is improving,” Prayut wrote in his Facebook post.
The volunteers’ invaluable role of tracking and containing local outbreaks of the coronavirus can be seen in Narathiwat, the first province in the southern region to register a COVID-19 case. Officials said the virus crossed over the border from Malaysia. One person has died since then, and 38 have been infected so far.
Chutima Lahnui, 50, works as a volunteer in Su-ngai Kolok district, right on the Thai-Malaysian border. She and 97 other volunteers in five villages organized a response immediately after the news broke.
They took temperatures and interviewed people crossing the border back from Malaysia, trading off in morning, afternoon, and night shifts that start as early at 6am.
“At first some people wouldn’t turn themselves in to get checkups, but after the death, everyone became paranoid,” Chutima said. “Some people were supposed to go into state quarantine but didn’t because they were afraid everyone would treat them like a pariah if they did.”
She recalls an incident when one of her fellow volunteers was harshly berated by residents after she reported a person illegally crossing the border to authorities so he could be put into state quarantine.
“It was a huge affair. The relatives took grudges against us, and the woman in charge cried a lot and couldn’t sleep and eat,” Chutima said. “We had to educate them that it’s not right to run away like that. We volunteers are really on the front line and are affected the most, because we will have to work with these people for our entire lives.”
Volunteers in the southern province of Satun also acted fast after locals started to return from overseas. Phannarath shifted from the routine elderly care to coronavirus prevent, working in a 12-hour shift to check on those held in state-run quarantine and making visits to returnees who self-isolated at home.
She went on about her duty despite a shortage of equipment, having turned raincoats into a makeshift full-body protective gear.
“I was concerned about getting the virus, but after following the doctor’s instructions and having no symptoms, I began to feel relief,” she said.
Satun reported no local transmissions so far, though 18 people returning from Malaysia and Indonesia were found to contract the virus during their stays at quarantine facilities.
Similar vigilance is observed on the Thai-Laos border in Nong Khai province, where Auntie Arun’s screens people arriving in her subdistrict and asks where they have been. She then fills out forms for the local health office, so they can trace the virus if an outbreak takes place.
For anyone who comes from at-risk areas such as Bangkok or overseas, she arranges their stay at a state or home quarantine. Doctors are alerted immediately if she spots any coronavirus-like symptoms.
Before the pandemic, her responsibilities, like most volunteers, were checking up on the elderly and bed-bound in her community to recommend their diet, exercise, and physical therapy.
If anyone was pregnant or diabetic she would also advise them to go to the hospital to get appropriate shots and vaccines. She would report her findings at a monthly meeting with other volunteers.
“It’s a lot of work, especially during mosquito season where we have to check for dengue and make sure houses don’t have open water containers and spray repellant,” she said.
Although some government initiatives are doomed to fail due to their poor funding, the volunteer network is immune to such failure, because its success doesn’t rely on money – but on volunteers’ sacrifice and personal connections.
No one signed up for the program expecting a big paycheck. Volunteers get a compensation fee of 1,000 baht per month, increased from 600 from just a few years ago. Many volunteers said there was no compensation at all in the past.
“That’s not even enough to cover the cost of gas from driving to people’s houses,” said Chutima, who has been a volunteer since 1999. “Some people do the job with soul, and just keep doing it for years. …I have knowledge and don’t want to keep it to myself.”
Phannarath from Satun said she’s unfazed by the responsibility, even though her team has only 17 volunteers for the 1,555 households, or around a couple of thousand people.
“It can be exhausting sometimes, but we managed to get through it,” she said. “Our job is also easier since the volunteers know their people well and they listen to us.”
Back in Nong Khai, Auntie Arun’s folksy, down-to-earth manner and genuine care for her fellow neighbor is her driving impetus.
“I know how many people live under each roof. I’m responsible for them from birth until death,” Auntie Arun said.
She’s been a volunteer since 1991, and knows every single person in the 20 households in Moo 11 that she is solely responsible for. Her sub-district, Tha Bo, has about 300 volunteers altogether, with 22 in Moo 11.
“I do it because I love it. I want to help my neighbors. Of course I don’t hope to get anything back from it during this time of COVID. But I love my family and neighbors and don’t want them to catch anything,” she said. “I also like going out to chat to people, check up on them, and learn new things as a health volunteer.”
Additional reporting Tappanai Boonbandit