Recently, a friend of mine who owns a pub that I go to a couple of times a week had a major heart attack. This guy is not very old either, he is in his mid 50's and at least in my mind this seems too early for this sort of thing to happen.
I have noticed since i have been here that the expat community tends to be a lot less health conscious than they probably should be or would be if they lived elsewhere in the world. There are a lot of reasons why this is the case but I think I have nailed it down to a few key points that you would do well to keep in mind if you decide to live in Thailand or I presume a number of other places that exist around the world.
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For starters, if you are joining an expat community in Thailand or other places in the world, one of the first things that you are going to notice is that this is a very drink and smoke oriented group of individuals. I know that there are alcoholics all over the world but at least here in Thailand it seems to be for a lot of people, basically the only thing they ever do. Of the people that I know at my local watering holes, I have never seen 90% of the people that go there anywhere except inside of that bar. I never hear about anyone making plans to do anything with anyone else other than meet at this bar or another bar somewhere else at some point in the future. Sometimes, and it is very rare, I will hear about people going on a hike and one day I went on a hike with them. The car that we were riding in was stocked up with beer and the "hike" itself was only about 600 meters to a waterfall where everyone just hung around and drank beer, then we drink drived back home, which I thought was horribly irresponsible.
Also, more people than not are smokers. I think that in most western countries that people have kind of stopped smoking and it is not socially acceptable. Some of the people that I know consider this to ability to smoke basically anywhere you want to be a major reason why they continue to live here. As someone who has rarely smoked in his life and have taken note of the very real and almost guaranteed health problems that smoking brings along with it, I find it particularly stupid that someone would carry on doing this. If you are a smoker, attempting to quit in a country where cigarettes are basically free and you can smoke anywhere you want, Thailand is not a good place for you.
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Healthcare in Thailand is actually extremely good and it is also rather inexpensive. It surprises me that so few of the people that I know and regularly hang out with actually take advantage of this. The few times I have been to a clinic or hospital for something, it was of a much higher standard that I was accustomed in the United States and it also didn't cost thousands of dollars for any ol' thing you can imagine.
So few of the expat community actually take advantage of preventative care and instead, wait until they are on death's door before they even look into where the healthcare facilities actually are.
There can be language barriers at some clinics though and if you encounter this in a healthcare environment in Thailand I think it would be wise to pursue finding a different clinic. In my mind at least, if someone is somehow able to become a medical doctor but never bothered to learn English, I don't see how they could possibly be any good at whatever it is that they are meant to be specializing in as far as medicine is concerned. This is easy enough to circumvent though because there are small clinics all over the damn place no matter where you are in this country.
Even in pharmacies most tiny things that are wrong with you can be at least somewhat diagnosed by the pharmacist, which is something that is likely illegal in my home country because of insurance reasons.
Here is the next part. Health insurance is remarkably affordable here in Thailand. I have "catastrophic coverage" which will only pay for my health care costs if something crazy happens like finding out I have leukemia one day or I get hit by a bus and have 37 broken bones and am in a coma. All other aspects of health care like me having a sore throat I have to pay for by myself. This coverage costs me $150 a YEAR. This all depends a lot on how old you are and since I am under 30 it costs me significantly less than it would if you were a bit older than I am. In my mind, it is just silly to not have this because while health care is not expensive here, the really important stuff like ICU type things and massive surgeries are still expensive. Not bankrupt your entire extended family expensive like it is in the USA, but probably more money than you have on hand.
The next thing that can deteriorate your health in Thailand is the fact that not very many people get a great deal of exercise because it is extremely hot outdoors here. When I lived in Southern USA, I would routinely just go for a jog for the hell of it and to maintain some level of health. Here in Thailand, attempting to do this, even at night, is a miserable experience because you will quickly become drenched in sweat and are probably running a risk of heat exhaustion or stroke.
However, there are health clubs all over the place that are air conditioned and they cost a lot less here than they would in the states.
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The gym I go to near my house is called CNX Gym and it is very nicely equipped, fully air conditioned, and costs about $30 a month. I don't go there every day or anything but it has done loads for me as far as my health is concerned. Normally after work, I will make an attempt to at least go there for a bit. Maybe I exercise a lot, maybe I just do a little. Either way I am doing something and my overall health likely benefits from this.
The bottom line is that I believe after just a few years that it is very easy for an expat to become someone of absolutely horrible health in very little time. If there are people out there that think that just because most Asians are thin that you are somehow going to end up that way just by living here is kidding themselves. Because living irresponsibly is so easy to do and completely legal here, there is nothing standing in the way of everyone just becoming an overweight lazy sack of s**t in just a few years.
To quote Chris Rock: "just because you CAN do something doesn't mean it is to be done." You have all the freedom in the world to do whatever you want here in Thailand, so you are going to need a bit of discipline and dedication to maintain your health here. I don't want to end up like almost all of the people that I see in the pub I visit and unfortunately for them, I think it is actually too late for them to turn it around.