Doctor: America fortunate to have good health care

By EVAN JONES, Herald Staff Writer
Friday, January 24, 1992
Originally published in The Jasper Herald

JASPER - A local doctor who has treated patients in Asia says there's a world of difference in the quality of health care available there and here in America.

It is often difficult for Americans to understand that many poor countries cannot afford the modern medical equipment found even in small-town hospitals in this country, Dr. Richard Moss says.

Moss, 37, a New York-born otolaryngologist who practices in Jasper, spent three years treating patients in southern Asia and bringing American medical techniques to nations in that region. An otolaryngologist specializes in disorders of the ear, nose and throat.

In some of the poorer Asian countries, such as Nepal and Bangladesh, health care is so scarce that doctors are often forced to decide who will be treated and who will not, he says.

Usually, patients who have the best chance of survival get treatment. The number of children a patient has is often a deciding factor, Moss says.

"It's something for Americans to appreciate a little bit and under-stand the difference between what we have here and what exists al-most everyplace else in the world," he says.

Moss, a graduate of Indiana University's School of Medicine, became interested in Asian culture during a three-month visit to Japan in his senior year of medical school.

After completing his residency and training, he embarked on his three-year adventure to Asia, starting with Thailand in December 1987. For 1½ years, he worked at two Thai medical schools - Chiang Mai University in Chiang Mai and Prince of Sonkla University in Hat-yal:

Moss says he was invited out to those universities to work and teach, helping with the more challenging head and neck cancer cases. Many of the operating sessions served as good learning grounds for local doctors, and the operating rooms would sometimes be crowded.

He also gave lectures and seminars, made rounds and wrote articles.

Moss's particular area of interest is in treating head and neck cancers - an interest that has been joined by a fascination with Asian culture and society.

Because it is much older than western European culture, he says, Asian culture is a fountain-head of civilization and its wisdom and philosophy deserve respect.

One of the main attractions for him is the mannerisms of Asia's peoples. Most are respectful and polite, less confrontational and more enjoyable to work with than people of other lands Because of this, Moss says, his work there was greatly rewarding.

Because otolaryngology has changed greatly over the years, many of its new techniques had not reached those countries. Methods of reconstructive surgery-rebuilding areas that have to be removed because of cancerous infections - was also in demand, he says.

"There was a real epidemic, for some reason, of head and neck cancer in southeast Asia," he says.

Residents of those countries of-ten smoke heavily or chew betel nuts. The nuts give off a carcinogenic juice that increases the chances of getting cancer.

Moss says most of the cancer he saw was in an advanced state. This was mainly because the patients had poor access to health care and neglected their health. Also, there were many cases of malnutrition, infectious diseases and diarrhea, he says.

"In Thailand, the health care system is quite good. In general, they do have access to health care."

While in Thailand, Moss met his wife, Supit, a nurse with whom he frequently worked.

She didn't particularly like him at first, but he gradually won her over, Moss says. Their Buddhist-style wedding - conducted in the Thai language - included a blessing from a Buddhist monk.

During their travels, Mrs. Moss saved his life a number of times, he says. He was once surrounded by a gang of Nepalese toughs who would have killed him if not for her soothing voice and personality convincing them her husband was a good person and deserved to live, he says.

"If it weren't for her, I probably wouldn't be here today."

After the 1½ years in Thailand, the couple embarked together on short, two- to four-month visits to several countries. Their travels took them to Nepal, India and Bangladesh.

During his stay in Bangladesh, he worked through government agencies to promote awareness of head and neck cancers. He worked with that country's minister of health on the program.

He returned to the United States in November 1990.

"Primarily the reason was that I ran out of money." he says. His volunteer work, while rewarding on many levels, didn't provide him sufficient funds to live.

He did attempt to arrange sponsorship through the United Nations and other organizations, but after this fell through, he was forced to come back. Moss says he loved his work so much that if he could have continued there, he would have.

After a few months of searching. he finally decided to return to the part of the country where he had attended school. He selected Jasper as his new home.

His current practice in Jasper has been going for two months now, he says. Although work here is not quite as challenging as that he experienced in Asia, he says he does find southern Indiana appealing and there was a great deal of support for him to come here.

Just as he helped enlighten the doctors of southern Asia with new medical techniques, he is now at-tempting to bring awareness of other cultures to the people of Jasper. He plans to give lectures to local groups - both medical and non-medical - on his travels and experiences.

Supit is currently awaiting her exam results for her nurse's certification in this country. When that hurdle is cleared, she'll be able to assist him in the operating room, he says.

In the near future, he anticipates making some trips to Asia, possibly up to two weeks at a time. Also, he wants to work out an arrangement with Indiana University whereby surgeons can be brought to this country to visit him.