Good Guys Doing GREAT Things
By day they stand in front of eager, young Thais, imparting their knowledge of their mother tongue, educating Thailand’s leaders of tomorrow. By night, these two middle-aged foreigners linger in a dark Thai soi, waiting for the call that will see them race around the streets of Bangkok at breakneck speed. What they do is dirty, and at times dangerous, but they love it and pursue it with a passion. It’s what drives them and nothing else makes them feel more alive. They are the two white faces in the Ruamkatanyu Foundation’s rescue service.
The Ruamkatanyu Foundation started 60 years ago as a charitable organisation that collected the dead and transported them to the nearest facility. The problem was that sometimes they discovered that the person they had been called to collect didn’t happen to be dead after all! It is from those days that the foundation’s rescue teams and ambulance service was born.
The foundation has 7,000 volunteers nationwide and along with the larger Poh Teck Tung Foundation, is one of the two largest rescue services in the country.
40-year old Kiwi Marko Cunningham is an English teacher by day and a rescue volunteer by night, trading in his pressed shirt and necktie for the rescue workers overalls. Marko has been a resident of Bangkok for more than 10 years and became involved with Ruamkatanyu after accompanying a girlfriend to donate food and clothing for victims of flooding in Saraburi province. He was so impressed with what the foundation was doing that he wanted to get involved. An EMT, an intermediate emergency medical technician, he is studying to be a full-blown paramedic.
Dean James, known to his mates as James, is a 50-year old Scot from a medical family as he describes it and has medical experience back in the UK where he was often the company’s primary first aid officer. A relative newbie to the foundation, he has been with them for 7 months.
Marko and Dean are the only foreign rescue workers with Ruamkatanyu although there are said to be a few other foreigners doing similar work around the country.
The hours can be long and there was a time when Marko, a full-time English teacher, used to work every second night. He would be out with the rescue team until 7 AM at when would dash home, shower, and head straight for the classroom! At the end of his teaching shift he would go home, go straight to bed, sleep, wake up the next morning and so the cycle would repeat itself.
Those days are behind him and like most of the volunteers, he heads home around midnight. This is voluntary work and the volunteers have to report for the regular job the next day.
Rescue vehicles can be seen parked up all over Bangkok. Marko’s team waits in a quiet soi opposite Major at Ekamai, and covers a section of Sukhumvit that runs about a kilometre either side of their position, as well as the sub sois and part of the busy Rama 4 Road.
James, also an English teacher, works with a team across town. His patch is the area from The Mall Bangkapi to Central Lad Prao and over to Rachayothin and all the sois in between, including half of Rachada, some of Rama 9.
With their trucks parked up, the rescue teams monitor the airwaves for accidents and incidents in their patch. They have multiple receivers covering the police channel, the Ruamkatanyu foundation’s channel, other foundations’ channels as well as the network, so called because of the colour of the handsets. The red radio network is a volunteer network with members all over Bangkok who are the eyes and ears of the city. In the case of an accident, a fire or any incident, the red radios are on to it, notifying the relevant authorities. Red radio members include some motorbike taxi riders, rescue foundation members and other community-minded figures.
Rescue workers are almost always the first to the scene of an accident. Marko is famous for being the first rescue worker to attend the scene of the accident when Moo Ham, the young Thai punk who came to infamy for ramming his car into a crowd of people at a bus stop on Sukhumvit Road a couple of years back.
With just 2 days of training, but in some cases many years of experience, the rescue workers aren’t the highly qualified professionals you might expect to arrive if you called the emergency services in the West. And the vehicles that the average rescue worker runs aren’t what you would call ambulances, more makeshift pick up trucks or wagons with limited resources.
But according to Marko the volunteers work extremely hard with the limited resources available to them, all of which they pay for themselves. From their uniforms, to the insignia of the foundation they wear with pride to the vehicles they ride in to the petrol that powers the vehicle, even through to the bandages they apply to the injured, EVERYTHING is financed out of their own pockets!
Marko is the only rescue worker in all of Thailand whose rescue vehicle has a defibrillator, which was kindly purchased by a sponsor at a cost of 80,000 baht.
In addition to the foundation’s volunteers, Ruamkatanyu has 13 ambulances in Bangkok. In a city the size of Bangkok they might be an awfully long way from where they are needed, or even if they are close by, Bangkok’s notorious traffic might prevent them from getting to the accident scene quickly, hence the importance of the rescue services. Unlike the rescue teams, the ambulances are staffed with paid members, doing good work for a mere 6,000 baht a month. Those riding in the ambulances have more resources and more training, having completed a 160-hour training course.
In the case of an emergency in Thailand, where medical assistance is required, you have a number of choices. You could put the sick / injured into the nearest car / taxi and take them to the nearest medical facility. You could call 1669, the Erawan foundation, basically the closest Thailand has to an ambulance service in the West. An ambulance would be dispatched from the nearest hospital. Due to the traffic in Bangkok, it’s a lottery as to when they will turn up. Or you could call or wait for a rescue team to arrive.
In accidents attended by highly trained paramedics in the West, barring critical injuries or an advanced condition, you have a very high chance of survival. In Marko’s native New Zealand, a paramedic might work on a patient at the scene for an hour or more. They have the drugs, equipment and expertise to treat patients and stabilize them before transporting them to hospital. Patients can receive hospital-quality treatment at the scene of the accident.
Here it is more likely that the rescue services will concentrate on stopping any bleeding and hurrying the injured to the nearest medical facility. Fortunately in Bangkok there are hospitals everywhere so even in the cases of serious injury or illness a medical facility shouldn’t be too far away.
Stories abound in expat circles of accident victims being thrown into the back of a tuktuk which speeds away at break neck speed and delivers the injured to the nearest hospital, all with little or no due care taken for the patient who might have, amongst other things, spinal injuries. It’s not quite like that says Marko, explaining that all ambulances and rescue team puck up trucks must have a spine board – a hard stretcher used for those with spinal injuries. A paramedic from New Zealand accompanied him one day and witnessed members of the foundation performing an extrication – where a full spinal suit is applied to the victim and they are removed sideways from a vehicle – and the paramedic from Kiwiland was suitably impressed.
Being injured in a road accident in Thailand is an expat’s worst nightmare, and many times I’ve talked with mates about where we’d like to be taken in a worst case scenario. Most mention the big 4 hospitals – Bumrungrad, Bangkok, BNH and Samitiwej. But Marko explains that these big “farang” hospitals get a relatively small number of trauma patients whereas government hospitals, like Chulalongkorn Hospital, receive trauma patients all day long, every day. As Marko says with a cheeky grin, you might elect to go to Bumrungrad for a face lift, but for trauma, Chulalongkorn is where he would want to be taken. Different hospitals, he explains, are good for different things.
80% of what the rescue teams deal with is motorcycle accidents, and often it is the young punks with their girlfriend riding pillion on the back. And at night-time, 80% of the accidents are alcohol-related.
But it’s not just motorcycle accidents they deal with, but car versus car, sick people, pregnant ladies, collecting dead bodies, poor people in slum communities and so on. They are called out to catch wild animals, including snakes and occasionally crocodiles, and have frequent dealings with rabid dogs. Via the red radio network, they have also helped the boys in brown to catch thieves.
Marko notices that I am staring at the bandage on his wrist and smiles. His team attended a fire where the owner of the building pleaded with them to get the pool table out as he did not have any insurance. The pool table was the man’s livelihood and without it he would have no means to make money. Helping to haul the pool table out of the burning building resulted in him damaging the tendons in his wrist. “You wouldn’t believe how heavy those things are”, he says!
The rescue teams help direct traffics in the city’s snarling traffic jams, assist with broken down vehicles and being based on Sukhumvit, where so many foreigners live, work and play, Marko has provided translation assistance between foreigners who have been the victims of thefts by transsexuals in the Asoke area, something we both agree is on the rise.
Despite being foreigners in a country which is becoming increasingly xenophobic, the work of Marko and James is very well-received by Thais. As James points out, when you have been involved in an accident and require assistance, you don’t really concern yourself too much about who is providing that assistance!
Riding on a bus one day, the conductor started giving Marko funny looks. It turned out that he had attended an accident and helped the conductor – and the conductor refused to accept payment for the bus journey.
Yep despite the amazingly good work they do, there are few fringe benefits. James points out that when he wears the foundation’s overalls, he receive positive gestures and words from Thais, and has also had a number of free bus rides.
Marko’s patch is Sukhumvit, and while he can often be found milling around in the area of Major Ekamai, waiting to attend the next incident, his area actually runs all the way from Sukhumvit soi 1 in the west, to Prakanong in the east. All of the Sukhumvit bar areas popular with foreigners are part of his patch, which includes parts of Rama 4 Road and the many sois off the main Sukhumvit Road.
What is perhaps scary is that while the foundation has 13 fully equipped ambulances in Bangkok, the closest to Marko’s patch is stationed at Wat Hualumpong – where Rama 4 and Phyathai roads meet. That’s quite some distance away, perhaps a 12-minute drive in the middle of the night when there is no traffic but as much as 2 hours at rush hour! The next closest ambulance is down the other end of Pattanakarn Road, out towards the airport!
With the area home to many wealthy Thais, from time to time Mark tends to a patient who despite being in distress wants to practice their English, and in some cases show off their English with the foreign medic!
Home to many of the city’s expats, it’s no surprise that as many as 5% of accidents he attends to involve foreigners. A Westerner he assisted who had been drunk and who he saw was delivered home in one piece happened to the friend of a friend.
So what happens in the case of an accident on the streets of Bangkok? If Ruamkatanyu are first on the scene, as they often are, what can you expect to happen?
If you are in a critical i.e. life-threatening condition, you will be taken to the nearest medical facility. Marko says proudly that while the level of care from the rescue teams might not always be quite what one might expect in the West, things do work well and it is only in the most critical cases where someone might not make it.
If you are not critical and are lucid, you will be assessed as to which medical facility / hospital you will be taken to. If you have insurance and / or a credit card, you will be taken to the hospital of your choice. If you are Thai and eligible to use the 30-baht healthcare scheme, you will be taken to the designated hospital. If you have no insurance and are not covered by medical insurance then you will be taken to either Chulalongkorn Hospital or another government hospital.
Don’t fret too much at the thought of ending up in a government hospital, in Bangkok at least. Marko relays the story of a patient who was delivered to one of the big 4 hospitals where the requisite specialist wasn’t on duty and that patient was subsequently sent to Chulalongkorn Hospital. Being a medical school may have seen the patient seen to by 3 or even 4 doctors, a mix of resident doctors and trainees.
Marko makes every effort to attend the scene of dead foreigners. He knows the protocol on both sides and can help liaise with any foreigners who may be colleagues, friends or family of the deceased. He often finds himself called by family abroad who are keen to understand the situation better.
The work is not without its challenges for the two foreigners. It takes some time to be accepted by members of the team, most of who are just regular Thais from the middle class, or lower. It is the foreigners who have to adapt to the Thai way of doing things. But once you are accepted, you’re family and very much considered one of them.
James relays the story of his team attending the aftermath of a nasty brawl at Songkran. He was treating a guy whose face had been split open and was kneeling down beside the guy on the road when a bunch of hooligans appeared out of nowhere with one idiot launching a brutal kick at the head of the guy he was treating, opening up the wound he had just closed, and missing James’ head by inches. They had to repel the gang, pausing treatment and then get the patient quickly on a stretcher and into the ambulance and out of the area as fast as they could, resuming treatment at high speed in the ambulance!
There are some sois where, despite the life and death urgency to deliver their patient to a medical facility, the rescue team have to turn off the vehicle’s sirens while passing the home of a grumpy senior government official who does not appreciate sirens!
Traffic is the biggest obstacle and Marko admits that his driving has become somewhat Thai. “When in Rome”, he jokes!
His sense of balance has improved immensely, as he has had to get used to working on a patient in the cramped confines of the back of a pick up truck racing through Bangkok traffic, sirens screaming, lights flashing, trying not to waste a single second to get the patient the medical care they desperately need at the nearest medical hospital.
The work is not without danger. Marko’s best friend was attending an accident when a police truck driving past knocked him down, killing him. 3 of his friends have been killed while carrying out work for the foundation over the 10 years in which he has been involved.
Some hospitals in Bangkok pay money to smaller foundations who deliver patients to them, the commissions ranging from 200 to a maximum of 500 baht – and tend to be at the lower end of the scale. Deliver 5 patients in a day and there could make 1,000 baht or so. Peanuts. But for some smaller foundations which appear to have something of a Wild West mentality, every effort is made to be first to the accident scene so they can retrieve the injured, haul them into their pick up and deliver them to the nearest hospital which pays a commission. Some go to extreme lengths to get there first and have even been known to open fire on other rescue teams, with real guns and real bullets! Some smaller foundations have caused major problems with vehicles being rammed, foundation members stabbed and shot. There was an incident not so long ago where the entire side of a Ruamkatanyu foundation vehicle was peppered with bullets from an Uzi by a rival foundation! Turf wars are a problem. Ruamkatanyu does not accept payment for delivering patients to any medical facility.
There are serious consequences for one’s social life. They work every second day, leaving little time for themselves. While the rest of us are out boozing it up or chasing the local lasses, they’re waiting near their pick up trucks for news of an accident, ready to help those in need. I ask about girlfriends and get a frank response. “Most volunteers don’t have girlfriends, or don’t have them for very long!” James adds that the girls can be mightily impressed initially with what you do, but when you’re not there for them on Friday night that attitude soon changes!
They both miss having a girlfriend, but the satisfaction of being in a foreign country and working with the locals doing good things is immensely satisfying. Marko gushes that he is proud to have many Thai male friends from a modest background, people who really care for him because of who he is and what he does, and not because of money.
Speaking with some of the Thai volunteers who have been involved for years, they insist that as bad as things may be, they are much better now than they used to be. They reckon there was a turning point about 5 years ago, when there was increased enforcement of and improved attitudes towards drink driving. It’s still a massive problem, but better now than it used to be. They joke that if petrol continues to rise in price they won’t have to volunteer any more, and all within ear shot burst into sarcastic laughter! And they implore anyone getting on a motorbike, even for the shortest journey, to put on a helmet.
I ask Marko why he does it, why he spends all of his free time and most of his money volunteering. He has no girlfriend and no retirement fund. For many of us, Bangkok is more about our mates and having fun, than about a career, or helping others. So why does he, and why do the volunteers do it? Ever modest, he pushes the spotlight away from himself and answers on behalf of his mates on the team. “They run their pick ups and their ambulances out of love. These people die for what they do. These people are the real heroes of Thailand as far as I am concerned.”
* In the past Marko ran a pick up for the foundation at a personal cost of around 15,000 baht a month – a hell of lot of money for a modestly paid teacher. He has since sold the pick up.
>Marko is keen to buy a fully equipped ambulance that he will run in the Sukhumvit / Ekamai / Rama 4 Road. He is trying to raise 600,000 baht to buy it. You can help! Over the years a lot of readers have offered to donate money to me as gratitude for the enjoyment they have gained from this site. I have always turned these donations down. I would like to say to anyone who would like to donate to this site, please consider instead making a donation to Marko’s ambulance fund. It is totally transparent and all donations will be listed on his website. There are a variety of means of donating including bank transfers to an account in Thailand, a bank account in New Zealand where he has a registered charity or via Pay Pal. For more info, you can check out Marko’s site at bkkfreeambulance.com
Please do consider donating to this most worthy cause!
Check out the original story here.