Fragile but Not Distant: Bonds of Rajabhat bring you close

Mae Charao Subdistrict, located in Mae Ramat District, Tak Province, is a remote border area facing deep-rooted healthcare disparities. Twenty-one bedridden elderly residents in this region live in conditions of vulnerability due to their physical frailty, geographical isolation, and limited access to appropriate healthcare services. A preliminary community survey, conducted using the World Health Organization’s WHOQOL-BREF instrument, revealed that the elderly population’s average quality of life score was 30.23, far below the acceptable threshold. This data served as the foundation for launching a comprehensive initiative led by the Faculty of Nursing, Kamphaeng Phet Rajabhat University aiming to improve quality of life, promote sustainable care systems, and strengthen community participation.

The project was designed with three principal objectives: (1) to develop an integrated care model for frail elderly individuals; (2) to enhance the knowledge and caregiving capacity of community caregivers (CGs); and (3) to establish a sustainable system of community participation in elderly care. The initiative was guided by Social Support Theory, and its operational framework—named the SAIYI Model (meaning “thread” or “bond” in local dialect)—symbolizes the strength of human connection. The model comprised four key components: Structure: Establishing a systematic framework and operational procedures emphasizing collaboration and shared responsibility among public health officers, community leaders, and families), Attitude: Fostering compassion, awareness, and a sense of duty through Buddy CG activities conducted in local dialects to strengthen cultural bonds, Integrity: Promoting teamwork, ethical practice, and a sense of collective ownership leading to continuous improvement, and Yield: Employing evidence-based measurement to assess outcomes and ensure accountability.

The implementation process began with a contextual analysis to identify root causes of health disparities. Community participation mechanisms were then created around the principles of joint decision-making, co-implementation, shared benefits, and evaluation. Forty-five volunteers were trained as community caregivers, forming a robust local network capable of responding to the needs of bedridden elderly individuals.
The project outcomes were tangible and highly impactful. Quality of life scores among the elderly increased dramatically from 30.23 to 77.3, surpassing the target. A network of 56 caregivers was established, covering all communities in the subdistrict, while volunteers achieved an average knowledge score of 81.21%. Participation from the subdistrict-level Quality of Life Development Working Group rose from 35.21% to 89.21%, reflecting deeper inter-agency collaboration. Importantly, the program also reduced transportation costs for medical treatment, encouraged cross-subdistrict cooperation, and served as a prototype elderly care model applicable to other areas across Health Region 2.

Sustainability was ensured through intergenerational knowledge transfer, mentoring from Kamphaeng Phet Rajabhat University, and community-driven activities in the Karen ethnic language. Moving forward, the project will expand its Caregiver Buddy network to 60 members, develop a digital knowledge platform, organize biannual community forums, and disseminate results to the Ministry of Social Development and Human Security as an SDG-aligned best practice. This initiative demonstrates how compassion, collaboration, and education can interweave to form enduring threads of human connection—ensuring that even the most fragile lives are never distant nor forgotten.