SHALOM PEACE – Itapon Foundation Sangkhlaburi Branch

by Dr. Phil McDaniel

Construction progressing on the “new” Kwai River Christian Hospital in Huay Malai, approximately 1983-1985. These photos were taken from the water tower of the mission compound.

“What if we built something ‘bambooish’ to start with?” I remember Dr. Lois Visscher saying something like this around 1982 during one of our discussions about the uncertain future of the Kwai River Christian Hospital.

The Electrical Generating Authority of Thailand was in the process of constructing a dam that would result in flooding of the valley of the Khwae Noi River (often called the Kwai River in English). Detailed surveying by EGAT had shown that the Kwai River Christian Hospital at its original site would be flooded out along with several villages. Time was running out for us. The reservoir would start filling in June, 1984. We had to decide whether to rebuild or close down.

Front entrance of the original hospital building, probably mid to late 1970’s. The hospital site was only about one kilometer from the bed of the long abandoned “Death Railway”. The objects in the foreground are railway wheels which Dr. John Freeman hired elephants to drag in as a memorial to the thousands of Asian coolies and Allied POW’s who died laboring on that infamous railway project.

The Kwai River Christian Hospital as it appeared about 1980. At this point the building had served the community over 15 years. It was doomed to be swallowed up by the reservoir in 5 more. The front entrance to the hospital is on our right behind the coconut trees; the operating room and delivery room are at the near end of the hospital.

Map of the Sangkhlaburi and Thongphaphum areas of western Thailand depicting roughly the area flooded by the reservoir that backed up behind the Vajiralongkorn Dam, also known as the Khao Laem Dam. The note at the bottom of the page about travel times by car or boat was true in 1984 but no longer apply. There is now a paved road all the way from south of the dam to the new town of Sangklaburi. That distance can be covered in about an hour.

Map of original location of the Kwai River Christian Mission. This was drawn up by “Uncle Billy” roughly around 1982. Please disregard the circled numbers. The buildings have now been labeled directly on the map. [Left click once on the map to enlarge it.]

The mobile clinic team was able to travel by boat to some of the villages on the circuit. Here Olivia, who headed up the mobile clinic program, secures the cargo. The original Kwai River Christian Hospital was built near the bank of the Ranti River, one of the tributaries of the River Kwai. The mission boat landing was in front of the doctor’s house.

When roads became impassable in the rainy season, patients were still able to get to the hospital at the original site [Lainam] by boat.

By “bambooish”, Dr. Visscher meant a structure that used inexpensive, locally available building materials such as bamboo. Dr. Visscher had been a missionary in India for about 40 years before she aged out according to the rules of her mission board. She then came to help at the Kwai River Christian Hospital! She was used to economizing from her days in India.

But why rebuild the Kwai River Christian Hospital with cheap materials? It’s because some were asking, “Why rebuild the Kwai River Christian Hospital at all?” The KRCH had been in operation since 1963 (and had operated as a small clinic in a wooden shed for a year or two before that). In those twenty years of operation, the hospital had served thousands of patients, but there had been frequent problems staffing the hospital, especially with doctors and nurses. Twice the hospital had closed for lack of staff. Some said, “Maybe it would be better to just close the hospital, and eliminate these headaches!”

Another force dampening enthusiasm for building a new hospital, robust from end to end, was uncertainty as to whether the villagers would actually move to the relocation sites assigned to them: “What if the hospital moves to its assigned relocation site but the villagers don’t move to theirs? The hospital might end up serving a very sparse population.”

The Electrical Generating Authority of Thailand did provide some compensation for villagers and institutions. However, the compensation for the hospital was not sufficient to rebuild the hospital with all new robust materials from one end to the other. We decided to build one end of the hospital robust and the other end “bambooish”, with the intent of gradually upgrading the cheaply built end if the hospital was well utilized. The service and support area of the hospital (operating room, delivery room, x-ray, pharmacy, and central supply) was built robustly. This allowed medicines and equipment to be stored in locked rooms.  The inpatient and outpatient areas of the hospital had a concrete floor but woven bamboo walls.

Jit Yawan (far left) was Ben Dickerson’s foreman during relocation. Here he poses with his bride-to-be, Jan Vertigan, his parents, and her parents. Jit’s Dad was village head man of Nithe Village during the 1950’s when missionaries were exploring the area. He was in favor of the missionaries setting up a hospital and school. Ultimately, a plot of land just west of Nithe was granted (in the Lainam jurisdiction, where Kamnan Thun Sa was headman). At the time this photograph was taken, Jan was head nurse at the Kwai River Christian Hospital. This not only carried the usual responsibilities of head nurse but many additional duties related to relocation as well.

Loes deVos, missionary pharmacist from Australia, was responsible for packing up the medicines and supplies for the move to Huay Malai. At one point, the operating room and the delivery room at the “new” hospital were not available for operations and deliveries because they were filled with medicines and supplies. This, because they were the only rooms at that point that could be locked.

Woven bamboo walls divided examining rooms in the outpatient department.

Patient, nurse, and relatives in the large open ward on the “bambooish” end of the hospital. Note the bamboo latticework for a wall behind the patient: one of many measures taken to try to keep construction costs down in the “bambooish” end of the hospital.

Missionary nurse Lea Lindero checks on a patient in the open ward of the “new” hospital in Huay Malai. Note the woven bamboo “walls”. When it became clear that the hospital would be well utilized, the bamboo was gradually replaced with concrete blocks. Also the large open ward was partitioned into two medium sized wards and two semi-private rooms. The man on the left is Don Cross, volunteer electrician from Australia, who helped with the wiring of the new building.

Dr. Edwin McDaniel standing in front of the Khao Laem Dam while still under construction, about 1983. This is the dam that flooded out several villages and the Kwai River Christian Hospital.

The shell of the original Kwai River Christian Hospital building: forlorn but still standing. Note that the roofing, door frames, window frames, glass louvers, shelves, and cupboards had all been salvaged for use in the “new” hospital in Huay Malai about 10 miles away. Even the trusses that held up the roof of the original building were re-used. For that reason the “new” hospital had to be built the same width as the original. This photo was taken shortly before the reservoir filled: probably about 1984.

Two man sawpit: The builders hired to move the mission compound (hospital, school, boarding house, workers’ houses, and more) salvaged as much wood as they could from the buildings at the old site, but there was still a need for more. This was due in part to some of the old wood being dry rotted, termite-eaten, or otherwise unusable. The demand for new wood was also driven by the increased number of buildings at the new site.

Watch your toes! Many large trees stood on the old mission compound. They were going to be flooded out if not harvested first. It made no sense to buy wood on the outside when we could hire sawyers to saw the wood on the old compound into planks that could be used on the new. The endurance and skill of these men was impressive. This is dangerous work!

Driver applies chains to one of the back wheels of the “six wheel” truck bought for the relocation project. During relocation, trucks carrying building materials salvaged from the old site to the new site sometimes had to use mud chains to make it through. Muddy conditions prevailed during each rainy season, about June through September.

This is what the road looked like in front of the hospital in the rainy season about 1984.

Original site of the Kwai River Christian Hospital, now covered by the waters of the reservoir. Note the coconut trees at “half mast”, the water level having crept half-way up their trunks. About 1985.

Visiting all that remained of the duplex housing for single missionary ladies at the old site (about 1985). Flooring, siding, roofing, windows, and doors had all been transported to the relocation site for use in buildings there. Note the rising waters of the reservoir in the background. To our left is the boatman hired for this trip. In the center with back to camera is Linette McDaniel. On the right, pointing to the “ruins”, is Jan Stretton, missionary nurse, who used to live in this building.

As a cost saving measure, long slices of bamboo were used in place of steel reinforcing rods. This was not my idea, but I did not oppose it. I wish I had. The workmen used wooden stakes to hold the latticework of bamboo off of the dirt surface below before pouring the cement. Later, we had a big termite problem!

Pouring cement floor for what was to become the large open inpatient ward. Note the bamboo “reinforcing bars” underneath.

This wooden guest house, moved from the original hospital site, was used as temporary pharmacy, lab, outpatient examining room, and operating room while the new hospital building (behind us) was being built at the Huay Malai site. Note the outhouse in the background.

Morning worship. Same building as on left but from the inside looking out. Staff members have left their shoes at the entrance in order to keep the floor clean. In the background is the Huey Malai hospital under construction. Note the two colors of roofing. The darker colored roofing was salvaged from the old hospital building; the light colored roofing was bought new.

Same building, here being used for the Under 5’s clinic, a health maintenance program for young children.

Same building as in the photos above and left, but a year or two later. At this point in the building’s history it was back to being used as a guest house for patients’ relatives and for long term patients, the way it had been used at the original site. Note the laundry hanging out to dry!

New hospital in Huey Malai under construction about 1984. Note use of woven bamboo for the wall on the near end of the building and, in the background, the use of old roofing salvaged from the original hospital building.

Brick and mortar section of the hospital under construction even as patients check in and check out.

Inpatients and outpatients receive care even as the hospital is being built around them.

Same area as above but 1-2 years later

The land in front of the “new” Huay Malai hospital before it was cleared by a bulldozer.

Same building. This was taken shortly after the land in front of the hospital had been leveled by a bulldozer.

The “new” hospital in Huay Malai turned out to be well utilized, serving two refugee camps along the Thai-Myanmar border as well as the villages near Huay Malai, the new town of Sangklaburi and points beyond. The “bambooish” end of the hospital was upgraded by degrees, until it began to look like a real hospital. At no time did patient care cease. It was available either at the old site or the new and for a brief time at both. To bring this about was a bit of a challenge as a major amount of construction material was being salvaged from the old hospital to use in the construction of the new. After the carpenters removed the roofing and support structures from half of the hospital at the old site, there was nothing to keep the rain from falling into the unroofed hallway and making its way to the part of the hospital which still had a roof. We had to chisel a small diversion channel so that the rainwater would run out the side of the hospital rather than continuing into the pharmacy and x-ray area.

KRCH (Huey Malai) at time of completion of main building. L to R: Front entrance of the Kwai River Christian Hospital; banana plantation in the hospital compound, water buffaloes grazing outside the hospital fence, road to Sangklaburi. In the background is the village of Huay Malai. Probably mid to late 1980’s.

We are standing in the front entrance of the Kwai River Christian Hospital looking out, Huay Malai, about 2000.

In 19– a new wing was added to the Huay Malai hospital. In the 1980’s and 1990’s the Kwai River Christian Hospital and the Armed Forces Research Institute for Medical Sciences (US division) collaborated on several research projects.

Front entrance to KRCH. Huay Malai about 1990’s.

Front entrance to KRCH, probably on an “Under-5’s Day” in the 1980’s

Nurse Sabaithip at hospital entrance, 1980’s or early 1990’s

The changing face of KRCH, Huay Malai

Over the years it has become more and more difficult to meet the building codes of the Ministry of Public Heath at the Huay Malai facility. The parts of the Huay Malai structure that were salvaged from the original (1963) building are now 55 years old. Construction is already underway for relocating the hospital once again.  With financial assistance from Overbrook Hospital in Chiang Rai, USAID, and Church World Service, this new building will be up to date and ample in size. The building is going up in Sangklaburi Christian Center in the town of Sangklaburi, the transportation hub for the district of Sangklaburi.

Over the years a great deal of time, effort and money has gone into building, relocating, upgrading and remodeling. When the new building (at Sangklaburi Christian Center) is complete, the Kwai River Christian Hospital will be able to move into the largest and best equipped facility in its history. However, the most important asset of the hospital will still be its staff. My hope and prayer is that the doctors, nurses, aids, pharmacists, cashiers, and cleaners will always feel genuine compassion for the sick and suffering and that “Caring for the weakest on behalf of God Almighty” may be a daily practice, not just a motto.

Back to VOLUNTEERS FROM THE PAST