​What kinds of symptoms do patients experience before receiving treatment?

The symptoms of appendicitis include pain in the upper abdomen or around the navel. In addition to this, patients will commonly have a distended abdomen, pain in the lower right side of the abdomen, nausea, vomiting, a lack of appetite, constipation, or diarrhea.

​What is the impact on patients’ lives of living with these conditions?

The patients’ quality of life will be low. They will experience a sudden pain that begins on the right side of the lower abdomen or around the navel, that will become increasingly severe. They will be uncomfortable due to a slight fever, constipation, diarrhea or indigestion. They will be unable to work, go to school or do any other chores or activities. Most importantly, untreated appendicitis can lead to a ruptured appendix and/or an abscess which are both life threatening. An untreated abscess can spread and damage other organs, while a ruptured appendix can spread bacteria which may lead to a serious infection.

What cultural or regional factors affect the treatment of these conditions?

Often times, patients tend to seek medical attention when their symptoms have become severe or when they have exhausted all local and affordable options. Further adding to this, is that many patients are just treated for their symptoms and are not diagnosed properly. In Thailand, undocumented migrant patients will sometimes put off going to the hospital due to a fear of being arrested by the police. Meanwhile in Burma, appendectomy surgery is only available in larger towns and cities, which is difficult and expensive for patients residing in remote areas and villages to access.

What does the treatment process look like?

At first, the patient will receive general anesthesia. During the surgery, a surgeon makes one incision in the lower right side of the abdomen. The appendix is removed and the wound is closed with stiches. This procedure also allows the doctor to clean the abdominal cavity if the appendix has burst.

What is the impact of this treatment on the patient’s life?

After the procedure, the patient will no longer experience abdominal pain, nor nausea or vomiting. The patient's appetite will return and they will be able to resume their daily tasks.

What potential side effects or risks come with this treatment?

The potential risks of undergoing an appendectomy include bleeding, wound infection, injury to nearby organs and a blocked bowel. However, these post operative complications are rare.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Surgery is only available in a hospital in larger cities in Thailand, which is expensive and unaffordable for most migrants and refugees in Thailand. In Thailand, only Thai citizens have access to a public healthcare system, and all non-citizens must pay full treatment costs. At the same time, in Burma most patients live in remote areas, where subsistence and semi-subsistence lifestyles are still common. Although some patients, especially in towns, earn an income, they do not earn enough to cover the cost of their treatment. Many patients turn to acquaintances for help navigating the healthcare system in Burma and Thailand. Once they arrive at a clinic or local hospital, they are referred to a larger hospital, before being referred to BCMF for financial support of their treatment.

What are the alternatives to this treatment?

The alternative treatments that exist for appendicitis is to drain the abscess with a needle or during surgery followed by a course of antibiotics. Additionally a less invasive procedure to remove the appendix involves a laparoscopic appendectomy if the appendix has not yet burst. However, at Mae Sariang Hospital, most patients undergo an open appendectomy.