7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings)

Lifestyle and Health Care of the Western Husbands in , Province,

1. Mrs.Rujee Charupash, M.A. (Sociology), B.sc. (Nursing), Sirindhron College of Public Health, Khon Kaen. (Lecturer), [email protected]

Abstract This qualitative research aims to study lifestyle and health care of Western husbands who married Thai wives and live in Kumphawapi District, Udon Thani Province. Five samples were purposively selected and primary qualitative data were collected through non-participant observations and in-depth interviews. The data was reviewed by Methodological Triangulation; then, the Typological Analysis was presented descriptively. Results: 1) Lifestyle of the Western husbands: In daily life, they had low cost of living in the villages and lived on pensions or savings that are only sufficient. Accommodation and environmental conditions, such as mothers’ modern western facilities for their convenience and overall surroundings are neat and clean. 2) Health care: the Western husbands who have diabetes, hypertension and heart disease were looked after by Thai wives to maintain dietary requirements of the disease. Self- treatment occurred via use of the drugstore or the local private clinic for minor illnesses. If their symptoms were severe or if they needed a checkup, they used the services of a private hospital in Udon Thani Province. They used their pension and savings for medical treatments. If a treatment expense exceeded their budget, they would go back to their own countries. Recommendations: The future study should focus on official Thai wives whose elderly Western husbands have underlying chronic diseases in order to analyze their use of their health care services, welfare payments for medical expenses and how the disbursement system of Thailand likely serves elderly citizens from other countries.

Keywords: Lifestyle, health care, Western husbands

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 749

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) Background Cross-cultural marriages increasingly prevalent in Thailand today, especially in many provinces of the North East ,such as Udorn Thani Province that the findings of the study discovered that there were up to 5,700 foreign spouses from 33 countries living in the province. Most of them were German, British, American, Australian and French, and they had an average monthly income of about 100,000 baht. The study also found they met their wives through matchmaking companies, the internet and friends or relatives. There are currently around 50,000 Thai women married to German men, 30,000 married to French men, 30,000 to Americans, 25,000 to Australians, 10,000 to Britons, 8,742 to Swedes, 7,937 to Taiwanese, 3,000 to Austrians, 2,891 to Finns and 1,086 to Danes, according to statistics compiled by the Foreign Ministry. (Somkid Homnet, 2013).And the other study reveals that life of the couple after marriage can be categorized in 4 types; 1.Both husbands and wives lived in the wives' villages or the wives still living in hometown village.2. Both wives and husbands lived in metropolitan Thailand. 3. Husbands lived with their wives' families in Thailand. 4. Wives lived abroad with their husbands. Most are found in the second and third type. (Buapan Prompakping, et al, 2006:104-105). An also, the studied has found that, most of the Western husbands are retired and live with their wives in the rural area. Also, interestingly, these men are usually 8-10 years older than their Thai wives, and are either divorced from their western wives or widowed. Inevitably, these men are left to spend their lives alone as their children left them to have their own families, making these men feel lonely. These western men are from UK, Sweden, Norway, Germany, France and mostly other countries. Most of them are diagnosed with illness such as high blood pressure, diabetes and heart disease. The reason which these Western men gave for marrying Thai women was that they are well looked after and got the best care from Thai wives. If they were sick, Thai wives would take them to the doctor and served as an interpreter to communicate with the doctor about their illness and, upon returning home, Thai wives would follow the doctor's advice such as cooking what is appropriate to the disease of the Western husbands. Another reason why they prefer to live in Thailand is because of a low cost of living (due to the exchange rate of Thai baht lower than the western money), so that the western men have enough money to live permanently in a Thai village. (Rujee Charupash,2 010).Therefore, the researcher was interested to study the Western husbands who come to live permanently in Thailand

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 750

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) with a rural lifestyle in the rural and how they provide for their health care under different social and cultural .

Objectives To study lifestyle and health care of the Western husbands who live permanently in

villages with their Thai wife permanently in Kumphawapi Ddistrict, Udon Thani Province.

The benefits of this study The benefits of this study were that the information can be used in teaching students who, after graduation will work in the health services areas where the Western husbands live.

Conceptual Framework The purpose of this study is to understand the lifestyle of the Western husbands who live with Thai wives in the context of rural village of Kumphawapi District,Udon Thani Province including occupation, accommodation and environmental conditions and their health care issues in 5 areas; 1.Food and drug consumption 2.Physical exercise 3. Stress management4.Disease prevention and health promotion 5.Environmental management.

Research Methodology Area of study The 3 villages specific area of Kumphawapi District, Udon Thani Province in which there are the largest number of the Western husbands who have been living with Thai wives for at least 1 year.

Key informant A researcher recruited the key informants with purposive sampling in which by the health officer of the Tumtai’s sub district health promotion hospital, Kumphawapi District,UdornThani Province, who contacted with Thai wives of the Western husbands . The researcher began interviewing with the 1st voluntary interviewee, then using snowball sampling technique by which the 1st voluntary interviewee contacts to the 2nd voluntary interviewee who is foreigner living in the same village or nearby and are

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 751

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) willing to be interviewed provide data then the 2nd did the same things to the 3rd until the 5th, which has a total of 5 cases. Therefore, the sample size will depend on the willingness of interviewers to refer the researcher to friend and acquaintances.

Data collection and analysis Collected data were analyzed from November 2014 to March 2015 ,at 3 villages such as, M.3 Ban Tumtai,M.5 Ban Nonchuppa and M.6 Ban Huikogsri,Kumphawapi District, Udorn Thani Province. Data were collected by non-participant observations and in- depth interviews. Primary Qualitative Data from observations and interviews on the topic of lifestyle and the health care of the Western husband ‘s data were reviewed by Methodological Triangulation then, the analysis Typological Analysis, presented a descriptive. (Nanknoy Yanvare,2010).

Findings 1. Generalization of the Western husband It has been found that, of all 5 the Western husbands, the oldest of them is aged 64 and the youngest aged 34.They are from the UK, Germany, Denmark, Norway and Israel .Their former occupations include plumber, office workers, business owners and tax collectors. Upon retirement or removal from office of then they found themselves alone in the house or in homes for the elderly, due to being divorced from their wives. If they continued to live in their home country, they have to find additional income because of high cost of living and they have the underlying diseases, such as diabetes and hypertension. They have received information about Thailand and how to find Thai wife from the neighbor who has a Thai wife and that he talk about Thailand should remain able to live safely with the modern facilities that they can contact their relatives or children when needed, Thailand has the beautiful sea, and the delicious food, Thailand's weather is not very cold, it could not be depressing like their country when the winter comes, it is very cold and has a dismal long night, otherwise; there is a low cost of living and Thai Bath is low compared with the value of their own money. They feel that Thai wives can be both wife and care giver when they are sick. Furthermore, their lives in rural area are warm because of their wives’ relatives a lot who take great care to great importance to themselves, even as the western men.

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 752

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) 2. The lifestyle of the Western husbands In a daily life, they has low cost of living in the villages, some days they have to pay for anything, because their own home-grown rice and vegetables, were enough to eat. These make it possible to live on pensions or savings that are sufficient for monthly expenditure. It is enough to share with relatives of Thai wife. And the Western husbands said again “I think that I’ll not return to my home country (Norway and Denmark) again. They have cost the economy and an ability to adapt to the lifestyle of the Thai wife family. They earn some extra income from knowledge of the previous occupation, like the German husband, whose previous occupation as a plumber, in the village he earn money from repair their neighbors’ plumbing or electrical but sometimes he does it for free (sometimes charge). The Israeli husband and wife do to help the sugar plantations. And her husband, the British husband will receive special teaching English to high school students in the village. An accommodation and environment condition An accommodation of the Western husbands with the complete modern facilities can provides that which the westerners require, such as a pickup truck or saloon car, modern kitchen ,refrigerators, washing machines, flat–screen televisions, desktop computers, lap top, water heater, a toaster, coffee maker etc. And in case of the Environmental management; Overall surroundings of all the 5 households are mostly neat and clean with trash bin stationed outside of their houses. Clean water is accessible in every household (This is due to the fact that the western men do not trust rain water as they are fear contamination). Belongings are neatly put away and toilets are in a relatively clean state. Most of all, these houses are comfortable and clean with all the home appliances such as vacuum cleaners and home gardens for growing vegetables. 3. Health care 3.1 Disease Prevention and Health Promotion The Western husbands have their ways of preventing and curing diseases by using public and private health services. Most of them are aged over 60 year-old with congenital diseases, such as high blood pressure and diabetes, so they consulted physicians at local hospitals and clinics in order to stay in good health.

3.2 Stress Management The Western husbands are in the different environment from the surrounding people who are also of a different ethnicity, nationality, languages and religions, these makes

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 753

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) them the centre of attention from their Thai wives’ relatives. This are causes of discomfort that could eventually lead to stress. Therefore, the means to alleviate the stress are necessary. These involve drinking with fellow foreigners, playing sports, watching films and travelling. 3.3 Food and drug consumption For every the Western husbands, breakfast includes coffee, bread as for lunch and dinner; Their Thai wives provide them with Thai food or western food. Sometimes, they prepared the meals by themselves. In some case, the Western husband adapts to changing conditions and the new surroundings very easily such as, eating local food with his wife’ s family. In terms of food consumption, in the Western husband who without health problems and living temporarily with their Thai wives in the countryside, meals are usually bought from the local convenience stores. They refuse to eat local food which they find unfamiliar and too spicy. For those with cognitive diseases, they find that their lifestyle in Thailand is healthier as their wives are responsible for controlling their food intake (sugar level in the food.) In terms of medication consumption, it is quite convenient to visit local hospitals and clinics in case of illness. Moreover, the medication cost is relatively low and medication can be purchased in local drug stores. 3.4 Physical exercise For every the Western husbands, there are different types of exercise, depending on the time available and their financial situation. The Western husbands with health problems normally pay more attention to their exercise routine. Normally they jog around their village. In some cases, they assist their wives’ families in harvesting and vegetable growing within their residential areas. For those with no health problems, they exercise normally be jogging in the morning, golfing, and a daily brisk walk of about one hour. 3.5 Relaxation For every the Western husbands have their own preferred way of relaxing such as travelling, partying and drinking with fellow foreigner friends. Moreover, every Friday, they go golfing which does not only allow them to socialize with their friends but also serves as a means of relaxation.

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 754

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) Discussions The lifestyle of the Western husbands, including in a daily life, they has low cost of living in the villages, their own home-grown rice and vegetables, were enough to eat. These make it possible to live on pensions or savings that are sufficient for monthly expenditure. They use their working of their experience to get more income in the villages. Accommodation and environment conditions, such as they will have all modern western facilities for environment conditions. For the health care, such as the Western husbands who have diabetes, hypertension and heart disease, which must be looked after daily by Thai wives as the dietary requirements of the disease. Self treatment use of drugstores or the private medical, local private clinic for a minor illness but, if symptoms are severe or they need a check-up, they use the services of a private hospital in Udon Thani Province. They use payroll expenses from pension and the savings for medical treatment. If a treatment requires substantial sum of money, they will go back to their own country.

Recommendations Future studies should concentrate on the official Thai wives group who has the elderly The Western husbands with underlying chronic disease in order to know the use of the health services, welfare payment for medical expenses and information about the likely disbursement system of Thailand.

Acknowledgements I would like to express my thank to staff at Tum Tai Promotion hospital at Kumphawapi District , UdonThani Province for their co operation , Also, I would like to thank the Department of Research, Sirindron College of Public Health Khon Kaen for financial aid.

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 755

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) References Baupan Pompakping ., Asok Ponbumruung.,Nelvadee Prompakping., Supavadee Bunjud., Sumalai Puankaid., Kitayavadee Seeda.(2006).Cross-Culture Marriage of Women in the Northeast of Thailand.Retrieved from http://www.culture.go.th/research/ /isan/48_b.html Janjira Phondee ., & Sommai Jamkrajan.(2013). Cross cultural marriage: the impact and adaptation of Thai society. Journal of Education and Social Development, 7(2), 58-71. Kitiya Kumpumporn ., & Supapore Saichua.(2007, August 19).The self care behavioral of Nakhon Pathom Rajabhat University’s students. Retrieved from http://ps.npru ac.th /health/wp-content/uploads Kamolrat (Saksomboon) Turner & Suparpit (Maneesakorn) Von Bormann. (2013, August1). Health Service Utilization Behaviors and Quality of Care Perceived by Foreigners Living In Thailand .Retrievedfromhttp://www.tcithaijo.org/index.php naph/ article view/9816/0 Somkid Homnet .Retrieved May 1,2015,from http://www.thaiforeignspouse.com /Module/News/News Detail. aspx? Topic ID=12 Nanknoy Yanvare.(2010 ,September 14).Data analysis in qualitative research. Retrieved From http://www.thaiblogonline.com/sodpichai.blog?PostID=39655 Lurdsuk Tudwat.(2002). Self-care behaviors of the population at risk in the industrial area of Pecthburi Province. M.sc.(Public Health): Mahidol University. Mullika Mudtigo.(1993).Theories about health behavior, Research of Health Behavioral Network . : Ministry of Public Health. Orem, D.E. (1985).Nursing: Concept of Practice, 2nd edition. New York: McGraw Hill Book Co,Ltd. Pudtharaporn Pairuo.(1999).The relationship between selected factors and behaviors : Health Care of the Elderly in Nakhon Pathom. M.sc. (Public Health):Mahidol University. Pender, N.J.(2002) .Health Promotion in Nursing Practice.2nd edition. Norwalk Conn : Appleton & Lange. Rujee Charupash.(2010). The health service of the Western Son in laws and Cost of health services: A qualitative study of Northeast of Thailand. WCES 2013, Rome, 5-9 February 2013.

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 756

7th International Conference on Humanities and Social Sciences “ASEAN 2015: Challenges and Opportunities” (Proceedings) Yenjit Tinkarm.(2009). The cross-cultural marriages of girls Thailand with Japanese men . M.A: Khon Kaen University.

Faculty of Liberal Arts, Prince of Songkla University, June 5-6, 2015 757