Remembering a pioneer of modern Thai healthcare
Forty-one years ago this month Dr Yawarat Porapakkham welcomed me to Thailand. I was a newly appointed fellow at the Mahidol University's Centre for Population and Social Research. Pi Yaw, as I came to know her, was a professor of biostatistics at the Fac
Our trips to collect data for our study acquainted me with provincial towns and rural areas throughout Thailand. The trips also occasioned lessons on proper Thai manners. Yawarat was among the first to point out that the correct way to eat was with a folk and spoon, not a knife and fork. Once, early in my stay, we had lunch together and I cleaned my plate. She looked at me with disapproval and asked, “What are you doing?” I said, “My grandmother told me to always clean my plate.” She replied, “My grandmother always told me to leave a little bit so it’s clear you had enough to eat.” This was just one lesson in Yawarat’s course on how to be a guest.
This instruction continued over the years. I learn tactics for keeping my head in the correct position when passing a superior, and the theory of kreang jai – a reluctance to impose upon others. If all Yawarat did was improve my manners, I would be grateful, but she would not merit being remembered beyond her family and friends.
Yawarat did far more than help socialise an awkward young farang. She embodied traditional Thai values – which is why she wanted me to learn correct behaviour – and modern science. It was this melding of traditional mores and contemporary health science that make her life and career noteworthy. She was both a consummate Thai and a scientific internationalist.
She was an accomplished professional, a well-regarded teacher and researcher who published numerous influential papers on public health in Thailand. Her range was broad and included studies of contraceptive practice, HIV, diabetes, and obesity. She was a consultant for the World Health Organisation. Later in her career, she was director of the Asean Institute for Health Development at Mahidol University.
Yawarat and others like her were modernisers who helped transform Thai society. Yawarat’s calling was medicine and public health. She was a physician, a woman in science with a degree from an American university and an international reputation for her research. She valued science and evidence-based public policy that improved Thailand’s healthcare system. More than 10 years have been added to life expectancy since Yawarat started her career. Not all of that was due to better preventive and medical care, but much was. Yawarat recognised the value of collaboration and encouraged a wide range of cooperative research projects with both Thai and foreign specialists. She strengthened Mahidol’s public health faculty, and was a valued teacher and mentor for the current generation of academic leaders.
Yawarat had a stroke in December 2009, after which it was impossible to tell what she remembered, understood or knew. She was hospitalised in August and died in mid-October. As befits a teacher, Yawarat’s career provides a final lesson: Respect the people who have helped transform our world and in the process showed us the proper way to behave.
Peter J Donaldson is president of the Population Council.
