Last Christmas Eve, teenager Ice was helping prepare for a party in his Klong Toey community when a fight broke out near the stage and gunshots were fired.
THE PATIENT PATIENTS: A mother and her sick child wait for hours in a slow-moving queue of 30 baht healthcare patients to see a doctor for less than threeminutes.
The 18 year old fled the scene in search of a hiding place, shouting warnings to people on the street as he ran.
"I suddenly fell and saw blood on my shorts," Ice said.
"I didn't know what had happened as I hadn't felt anything, but I assumed I'd been shot. I was terrified and didn't know what to do.
"My brother, who had seen what happened took me to a nearby private hospital. I was aware it had a bad reputation, but it was an emergency and I needed treatment as quickly as possible."
What followed was a series of events unthinkable for a person not from the slums of Klong Toey who would assume they would receive prompt treatment for a gun shot wound, even under the government's 30 baht healthcare scheme. But the residents of Klong Toey, who say they are discriminated against as much for their accents and clothes as where they live, are used to poor treatment at one private hospital in the area.
"I got to the emergency room about 10pm," Ice said. "My brother told the nurse I'd been shot in the upper right thigh, but she didn't do anything. I had to get on the bed without any help. My brother presented my 30 baht healthcare card to the nurse but no one came to look at me."
After waiting for what seemed like an eternity, Ice said his pain became so bad he started to scream. The doctor on duty responded by telling a nurse to clean the wound and arrange for X-rays to be taken of his legs and chest.
After having the X-rays taken, Ice's wound was dressed and he was admitted for the night. He was placed on an intravenous drip and given antibiotics and painkillers.
The following morning Ice was told by a doctor that the bullet had not damaged any major blood vessels or muscles in his thigh. The teenager was relieved, though the happiness was shortlived.
''He told me that he wasn't going to operate to remove the bullet as doing so would likely cause an infection. He said my body would eventually push the bullet out on its own.''
Ice was not impressed.
''I'm not a doctor, and I've never been to medical school. But what that doctor told me was probably the most barbaric thing I've ever heard.''
Ice was discharged the following afternoon after being given a new dressing for his still-bleeding wound. After talking to his family, he decided to seek a second opinion at a different private hospital. A friend agreed to cover the expenses.
DESERVES BETTER: Space is at a premium in Klong Toey, as is decent healthcare for many.
At the new, ''up-market'' hospital, a doctor told Ice he needed to operate immediately, If the bullet was not removed the teenager risked being left with a permanent disability.
The operation took 30 minutes and Ice was discharged about three hours later. Before leaving, he told the surgeon about his treatment at the first hospital.
''The doctor told me that what had happened was unethical,'' Ice told Spectrum.
''He said I could have died as a result of the wound becoming infected before the bullet was removed.''
The cost of Ice's treatment at the second hospital was 60,000 baht, he said.
''My family reckon the reason the first hospital didn't want to do the surgery was because of the cost, and the fact that I'd only paid 30 baht.
''I tried to transfer my membership of the healthcare scheme to another hospital, but they were all full. But I won't go back to that first hospital as long as I live.''
HEALTH SCHEME IN THE SPOTLIGHT
Last month, the government approved a 191.6 billion baht budget to finance the 30 baht universal healthcare scheme for 2014.
However, in recent weeks the financial system underpinning the scheme has been in the news after rural doctors protested against the government's decision to cut their hardship allowance and replace it with a workload and performance-related system. From this month, most doctors will see their monthly allowances _ of 20,000-60,000 baht for people working in isolated zones and 30,000-70,000 baht for those in high-risk areas _ halved.
After hearing Ice's story, Spectrum spoke to people from the Klong Toey area (see sidebar), all of whom recounted tales of discrimination and shoddy treatment at the same private hospital under the 30 baht scheme.
They range from horror stories of surgical gauze being left in a woman's womb to a Lao mother being reluctant to use the entitlement to treat her half-Thai son because of racial abuse by nurses.
Spectrum attempted to contact the director of the hospital for comment on the the alleged mistreatment of patients, but was told no-one was available.
However, Boonserm Thongphu, coordinator of the National Health Security Office (NHSO) complaint centre covering the Klong Toey area said he was aware of the hospital's reputation.
''I've received hundreds of complaints from people in Klong Toey about misdiagnosis and bad treatment. I've been trying to collect evidence, such as the X-rays, doctors' reports, to back them up, but I've not had a lot of success,'' he said.
''Every time I've asked people to give me their documents, they've disappeared and never came back. I would love to help, but I can't do anything without proof. I don't know if the people are too lazy to help or are genuinely scared of something,'' Mr Boonserm said.
''I also have to wonder if what the locals told me is true. When I visited the 30 baht healthcare unit of the hospital in cognito I didn't find anything wrong with it.
''I did once raise the issue with the director of the hospital, but as before, I had no proof, so I was left with only hearsay and allegations. The director promised to look into the matter if I could provide him with some evidence, but I never received it.''
Mr Boonserm said he once asked a group of Klong Toey residents to go with him to the NHSO so they could ask for their memberships in the 30 baht scheme to be transferred to a different hospital.
''If they did that, the hospital would no longer get any funding from the NHSO,'' he said.
The NHSO pays hospitals about 1,000 baht a year for every patient registered under the 30 baht scheme. The private hospital at the centre of the controversy has more than 100,000 such patients, Mr Boonserm said.
''So you easily work out how much money it gets every year,'' he said.
THE RIGHT TO COMPLAIN
Patients who claim to have been mistreated under the 30 baht healthcare scheme can voice their complaints to the NHSO. For the past 10 years, the organisation has operated complaints centres, of which there are now 134 nationwide.
Winai Sawasdivorn, secretary-general of the NHSO, told Spectrum that he doubts the Klong Toey residents' allegations of mistreatment by the private hospital. All hospitals that participate in the 30 baht scheme meet the required standards, he said.
OVERSPILL: The large number of people on the 30 baht healthcare scheme waiting to see a doctor means that many are forced to queue outside the crowded hospital building.
''There are two elements that make a hospital trustworthy and dependable: convenience and standardised treatment,'' he said.
''We can't ensure all hospitals meet the required standard for convenience, but I can guarantee that every single one of them meets the standard for quality treatment. Therefore, I don't believe the allegations made by the Klong Toey residents.''
Mr Winai said that treatment standards at all hospitals are monitored by the NHSO.
''We regularly send third-party auditors to check up on service standards and all hospitals must have quality assurance certification. If they fail in any aspect, the NHSO has the right to remove them from the scheme,'' he said.
Anyone who feels they have been mistreated should contact the NHSO and it will investigate, Mr Winai said.
A spokesman for the NHSO agreed with Mr Winai, but added that patients should also seek to provide evidence of their mistreatment.
''We have investigated many cases in the past ... we are not afraid of anyone. The NHSO was set up to protect people,'' he said.
The spokesperson denied that the problem of mistreatment was due to a lack of funding.
''Every hospital in the scheme receives funding annually. The more patients the hospital treats, the more money they get, so there is no excuse for not providing proper treatments,'' he said.
''Also, if a patient is unhappy with the service they receive, they can apply to change their membership to another hospital. People are allowed to switch once a year,'' the spokesman said.
''We also have our 1330 hotline that's open 24 hours a day, seven days a week to handle complaints and queries,'' he said.
THE HOSPITAL THAT TREATS ITS PATIENTS LIKE PARIAHS
Spectrum talked to several Klong Toey residents who have been treated at the private hospital at the centre of the controversy and heard stories that ranged from casual neglect to seeming contempt.
'BETTER OFF PAYING'
Pa Noy, 67, had a swollen arm and was in a great deal of pain when she went to the hospital where she was registered under the 30 baht healthcare programme. The dismissive treatment she received there only made the situation worse, she says.
She was X-rayed and the attending physician made a quick and incorrect diagnosis.
''The doctor told me in a dismissive tone: 'I looked at your X-ray, and it's osteophytes [growths associated with osteoarthritis]. There's nothing to worry about.'
With that he threw her X-ray in a rubbish bin and sent her home with paracetamol.
''I told him that he's the doctor and he knows best,'' she said. ''But I was in so much pain and I didn't completely trust the doctor, so I retrieved my X-ray from the bin and went to Chulalongkorn Hospital for a second opinion.''
A doctor there looked at the X-ray and told her she wasn't suffering from osteophytes, but a varicose vein. ''That doctor gave me the proper treatment. Even though I had to pay for it, it was worth it. If I'd done nothing I'd still be in pain. Or worse.''
Her chief complaint, however, was not the misdiagnosis but the demeanour of the doctor and staff at the hospital.
It was not the only negative experience she would have at the hospital.
''Once, my son went there. He had hit his head and was bleeding a lot, but the nurses told him they couldn't treat him because his 30 baht healthcare card was registered with another hospital.
''After they said they couldn't treat him, the nurses went back to playing on their phones and touching up their makeup.''
Pa Noy said that someone had to retrieve her son's private insurance card from his home before hospital staff even began to clean up and stitch his wound.
''I assume they were afraid he wouldn't be able to afford the treatment, that's why they wouldn't admit him at first.''
In a sentiment echoed by many Klong Toey patients at the hospital, she said she would rather pay than receive such shoddy treatment for free.
''Whenever my family, friends or I have visited that hospital, they've spoken down to us. We were yelled at many times'' she said. ''I'd rather pay for proper treatment.''
Pa Noy said she was ''lucky'' to be able to register with another hospital.
''Even though it's much further away, I know I'll always get good treatment there. I feel bad for people who still have to rely on that hospital.''
'I'D RATHER DIE AT HOME'
Another elderly woman said the hospital has a notorious reputation in Klong Toey; residents there compare it to an abattoir, she said. ''Rumours of bad treatment at the hospital spread, and everyone knows that they shouldn't go there if they have a choice,'' she said. ''I wouldn't go there ... I'd rather die at home.''
The elderly lady again cited the demeanour of staff as a chief complaint.
''I never expect to be treated like a queen when I go to hospital, but I expect at least for my presence to be acknowledged. Patients should be more important to the staff than their phones, mirrors and combs.''
REJECTED AND HUMILIATED
Sa, 34, from Laos, is married to a Thai man and lives in Klong Toey, says she was exposed to blatant prejudice when she went to the hospital.
Sa was two months pregnant and wanted to give birth at the hospital. She was willing to pay the required fees.
A nurse asked for her ID card. When Sa told her she was from Laos, the nurse blew up. ''She just looked at me and yelled: 'We can't accept you!' I felt humiliated and sad. I went home and decided to go to a local clinic instead.
''I got a very warm welcome at the clinic. They told me they accept people of all nationalities and backgrounds. I gave birth to my son there, and everything went smoothly.''
MISDIAGNOSED AND MISTREATED
Pui, 25, went to the hospital in the middle of the night with her mother thinking she had dengue fever and wanting a blood test to confirm it.
''I knew the hospital had a really bad reputation, but I thought it would be different if I was paying.''
Her mother explained her symptoms to a nurse and requested a blood test.
''The nurse just looked at us and said: 'Blood tests are 2,000 baht, can you afford it?' My mother got the money out and the nurse's attitude changed.''
She had a blood test that night and another the following day, but hospital staff were unable to find out what was wrong with her.
''They put me on an IV drip and then sent me home. It had been four days and I wasn't getting better.''
She decided to go to the government hospital where she was registered under the 30 baht scheme. Pui had not went there previously as it was far from where she lived.
''A doctor took my blood and within 30 minutes said I had dengue fever and my platelet count was down to a critical level,'' she said. ''Luckily they diagnosed me in time. If I'd chosen to go back to the private hospital, I may not have made it.''
''I wasted 4,000 baht on two blood tests there, but I had better treatment for only 30 baht at the government hospital. I won't be going back to that private hospital, no matter what.''
Pui also told Spectrum about a friend who had given birth at the hospital and suffered from stomach ache after she was discharged.
''My friend went back to the hospital, and without taking an X-ray or any tests, the doctor said she had gastritis.''
They sent her home with some painkillers, but they didn't help. Pui's friend went to another hospital where they found gauze in her womb. ''She realised that the private hospital where she gave birth must have accidentally left it there.''
