Fellowship Site: Thailand

Chiang Mai University, founded in 1964, has 16 teaching faculties and offers undergraduate and graduate educational programs annually to about 20,000 students. The Medical Complex of the university comprises 6 teaching faculties and one health sciences research institute (RIHES). Doctoral and Master's degrees are offered in science and medicine and professional degrees in medicine, dentistry, nursing, pharmacy, allied health and veterinary medicine.

The Research Institute for Health Sciences (RIHES) serves as the research arm of the health science teaching faculties, and was formally constituted as part of Chiang Mai University in 1978. RIHES conducts biomedical, clinical, epidemiological and behavioral research on priority public health topics of concern to Thailand and its neighboring countries. Four principal themes of the research program are infectious and tropical diseases, reproductive health, pollution and environmental health, and human nutrition. RIHES has three major roles within the university:

1. to carry out research and research training;
2. to conduct an international postgraduate teaching program in health sciences; and
3. to serve as a resources and coordinating center on public health research. The four principal themes of the Institute's research program are infectious and tropical diseases, reproductive health, environmental health, and human nutrition.

In 1992, Johns Hopkins University Bloomberg School of Public Health established a collaborative research program with RIHES/Chiang Mai University with a focus on HIV/AIDS.

RIHES at Chiang Mai University offers visiting students new opportunities to study in an international research setting where there exists not only a large and expanding portfolio of NIH-funded research studies, but also a well-trained pool of research and staff willing and able to mentor students at several levels.

RIHES has sought to track emerging demographic, environmental and health trends and their consequences, at population and community level, for human exposures, behaviors and health outcomes. RIHES is an NIH-designated Clinical Trials Unit (CTU) for two clinical research Networks working on HIV/AIDS, namely, the AIDS Clinical Trials Group (ACTG) and the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT). In collaboration with Johns Hopkins University, RIHES is an NIH-designated Clinical Research Site (CRS) for the HIV Prevention Trials Group (HPTN).

The NIH-funded clinical research includes the following projects:

1. A Randomized Trial to Evaluate the Effectiveness of Antiretroviral Therapy plus HIV Primary Care versus HIV Primary Care Alone to Reduce the Sexual Transmission of HIV-1 in Serodiscordant Couples [HPTN-052].
2. A Phase III Randomized Open-Label Evaluation of the Efficacy of Three-Nucleoside Reverse Transcriptase Inhibitor Combinations for Initial Antiretroviral Treatment of HIV-1 Infected Persons in Resource-Limited Country [ACTG 5175].
3. A Phase III Randomized Open-Label Evaluation of the Efficacy of Three-Nucleoside Reverse Transcriptase Inhibitor Combinations for Initial Antiretroviral Treatment of HIV-1 Infected Persons in Resource-Limited Country [ACTG 5175].
4. Preventing Rural Thai Methamphetamine Abuse and HIV by Community Mobilization.
5. Community-Based Volunteer Counseling and Testing (CBVCT): Thailand.
6. Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men (MSM).
7. The Effects of New Alcohol Restrictions on Sexual Risk Behaviors among of Thai Underage Youth.
8. Assessment of Safety and Toxicity among Infants Born to HIV-1-Infected Women Enrolled in Antiretroviral Treatment Protocols in Diverse Areas of the World - A Limited Center Trial of the AIDS Clinical Trials Group (ACTG), the International Maternal Pediatric Adolescent AIDS Clinical Trials Group (IMPAACT), Conducted in Collaboration with the HPTN. [A5190-P1054].
9. A Phase II Study of the Pharmacokinetics of Nevirapine and the Incidence of Nevirapine Resistance Mutations in HIV-Infected Women Receiving a Single Intrapartum Dose of Nevirapine with the Concomitant Administration of Zidovudine/Didanosine/Lopinavir/Ritonavir [IMPAACT P-1032].
10. A Pilot Study of Lopinavir/Ritonavir in Participants Experiencing Virologic Relapse on NNRTI-Containing Regimens [ACTG A-5230].

Research work at RIHES will provide students with an exposure to actual field settings and relevant health challenges facing northern Thailand. Students are also able to gain experience in how studies are set up, organized and conducted in real-time. In addition to projects ongoing at RIHES, students also have the option of participating in research projects of individual faculty members, focusing on topics that span disciplines and include toxicology, neglected diseases (such as malaria and lymphatic filariasis), nutrition, and health and human rights. FICRS trainees can pursue individual research projects with JHU faculty independent of RIHES. These primarily involve Burma, migration, human rights, and health, in conjunction with other local and international partners, such as the Global Health Access Program (GHAP). These projects could include documentation of health and human rights status among internally displaced persons (IDPs) of Burma and more thematically-oriented projects covering topics such as reproductive health, malaria, lymphatic filariasis (elephantiasis), and HIV/AIDS. Given the diversity of topics, expertise, and geographic areas covered by these projects also provides ample opportunity for motivated students to design and pursue their own research projects, in response to community needs.

Housing Availability:
Students would initially be placed in the Chiang Mai University International Center, which is located equidistant from the two main campuses, the medical complex and the newer main campus, where RIHES has a research facility housed within the Graduate School complex. There are many other guesthouses near the medical complex and within a 10-minute walk to RIHES, where students have also stayed and competitive weekly and monthly rates are also available. Lodging costs will vary; decent apartments in the area can be found for $150 to $300 a month, while furnished houses usually run $300 to $600 per month. Utilities (water, electricity, and internet) are additional, around $100 a month.

Meals and transportation for most students average about $400-500/month in Chiang Mai. Transportation is not a problem in Chiang Mai. Although some students have purchased their own vehicles (a motorbike), most have not, finding walking shoes, a bicycle, or (if needed) public transport, sufficient. Taxis are readily available in the city and are inexpensive, consisting either of converted pickup trucks ("red trucks") or "tuk-tuks", 3-wheel vehicles meant to seat 2-3 persons.

Health Issues and Immunizations Needed for This Site:
Malaria, though endemic, is mainly confined to border areas. Dengue outbreaks are common during the rainy season, and precautions should be taken to avoid mosquito bites. The most common health threat for visitors (and young Thais) continues to be motor vehicle accidents, and simple precautions should not be forgotten.

See the Centers for Disease Control and Prevention Web site and The Yellow Book: Health Information for International Travel for additional information.

The FICRS program mandates that all Scholars see a physician prior to their assignment abroad. The site will require a formal letter from your physician stating that you have received the necessary immunizations prior to the start of your fellowship.

Safety and Danger Issues:
See the U.S. State Department Web site for information.

Language Requirements Other than English:
None. Faculty and many staff of RIHES and Chiang Mai University are bilingual (English/Thai). Our previous FICRS students have all taken Thai lessons and we strongly encourage them to learn Thai as a means of enhancing their cultural interaction with Thais outside the academic setting. Thai language lessons are readily available in Chiang Mai.

What is it like to live in Thailand?
Thailand is a stable, democratic state with a moderate standard of living (GDP per capita about 3,000 USD.) The health system is well developed, and public health is outstanding. Chiang Mai is a beautiful city of less than 1 million, over 700 years old, and of great cultural and historic importance to Thailand. It has a tremendous variety of culture and activities: trekking, rafting, biking, and other outdoor sports are available in the mountains just beyond the city limits. It has a hot tropical climate, with 3 seasons (monsoon, cool, hot). Many consider Chiang Mai one of the most liveable cities in Asia.