POVERTY AND HEALTH Evidence from Poverty Studies in

POVERTY AND HEALTH: Evidence from Poverty Studies in Thailand Sirirat Taneerananon Faculty of Liberal Arts Prince of Songkla University

• • Two studies on poverty Ultra Poor in Thailand 2000 Thailand Research Fund Participatory Poverty Assessment of Thailand • Asian Development Bank 2001 -2002

• Ultra Poor = Quantitative • PPA = Qualitative Focus Groups • Ultra Poor in the South of Thailand: Revisited After A Decade • Quantitative + Qualitative • Nationwide

• Multidimensional Concept of Poverty of United Nations: • Short Life • Illiteracy • Exclusion • Lack of Material Means • Overlap

• SHORT LIFE = GOOD HEALTH • One of the Major Causes of Poverty = ill health , includes chronic and prolonged illness • It causes the inability to earn • Daily earnings to support themselves and families

• Sick = borrow money, consequently work harder and fall into poor health again. • Vicious circle

• • Housing conditions – urban poor Slums Increase propensity to get sick Poor ventilation, lighting, drainage, cleanliness, mosquitos • Garbage

• Stressful life = smoke and drink • Affects their ailing health • Drug addiction to certain drugs used regularly such as pain killers • Diet = not well nourished, irregular meals in certain occupations e. g. taxi drivers, tricycle drivers, hawkers. No breakfasts

• • Occupations= farmers Risk their lives to earn money Spray chemicals to the plants Inhale some chemicals like ink from machines and the like

• Cure themselves instead of taking care to prevent themselves from falling ill • Primary health care = reduction of poverty • Ethnicity and health= certain values regarding diet and hygiene

• Disabled in the family = cause of poverty • Time to care and medical expenses • At least one disabled or chronologically ill in one poor family • Cannot afford time off to see doctors or visit the hospital, so buy drugs and take them without proper knowledge of their illness

• The poor want the government to help the aged first and then the disabled and the sick. They also borrow money for health expenses so it increases poverty. Major expense of the poor family goes to illness • Causes of poverty = old age and poor health

Table 1: No. HH with Chrologically ILL Persons No. ill Nako Satun Patta Phatt rn ni halun g none 38 52 44 52 1 35 25 33 26 2 6 7 3 3 3 1 1 Total 80 85 80 81 Total % 186 119 19 2 326 57. 1 36. 5 5. 8 0. 6 100

Table 2: No. HH with Disabled No. none 1 2 Total Nako Satun Patta Phatt Total % rn ni halun g 71 78 70 72 291 89. 3 7 6 9 9 31 9. 5 2 1 1 4 1. 2 80 85 80 81 326 100

• “For me, poverty is exhausting, no time to rest, have to earn and eat everyday. Some day, it is not enough to eat. Very tired. From the day I was young, since I moved here. ” • ( A man, 72 years old, married with five children, labourer, Kanjanaburi)

• “ Starving, no food to eat” – (A woman, 35, Sakon Nakorn) “ No breakfast. I have to wait to eat at lunch” ( A woman, 59, labourer, Sri Saket) “ It’s hard. No money to buy something to eat. Sometimes I get to eat. Sometimes not” ( A woman, 79, hawker, Phatthalung)

• “ Alcohol? They drink it everyday. Why we are so poor? Both alcohol and cigarettes are consumed as part of our life. That’s why we are so poor” • (A man, 54, Kanjanaburi)

• • Nutrition and diet Chilli paste, salted fish Eggs Fresh food- street food

• Some cases, ill health led to premature death, put burden on the family left behind • AIDS

• • • Unnecessary expenses Prevention than cure = Values Access to health care information is low Health & Hygiene Poverty reduction