SEE THE COST was the theme of the first day of the event. "Suk Marathon 2." Held by the National Health Foundation (NHF) in collaboration with the Thai Health Promotion Foundation (ThaiHealth), it created a space for Thai society to see the price currently paid due to inequality.
The Suk Marathon 2: Suk City event at Samyan Mitrtown Hall, organized by the National Health Foundation (NHF) together with the Thai Health Promotion Foundation (ThaiHealth) and the Institute for Holistic Health Service Development (IHSD), was not a typical seminar. Instead, it was designed as a miniature simulated city where registered participants received personal passports and explored various zones as "Suk citizens." "Suk citizens."
The theme of the first day was SEE THE COST, focusing on the price society is paying due to inequality.
The person assigned to explain this concept was Dr. Somchai Chitsuchon, Director of Inclusive Development Research at the Thailand Development Research Institute (TDRI). He opened the morning session with a humorous disclaimer, wondering if his talk would turn the Suk Marathon into a "Suffering Marathon."
Dr. Somchai explained that inequality is a natural occurrence. People have different education levels and incomes. Even former communist countries had inequalities. The relevant question is not whether we are unequal, but what kind of inequality we have. He used the term. "Unjust inequality." This refers to inequality that cannot be explained solely by natural factors—not because of differing DNA or IQ, but because it is man-made, created by society.
To illustrate, Dr. Somchai told a story about two taxi drivers.
The first was in Singapore. Dr. Somchai said he asked the driver how he felt about inequality in his country. While driving past skyscrapers housing global financial firms, the driver pointed to the towers and said those people were much richer than him. His tone showed some distress, but when asked how bad he felt, he thought for a moment and said it was somewhat acceptable because those at the top had reached there through ability and effort.
The second taxi was in Bangkok. On the route from Suvarnabhumi Airport to the city, Dr. Somchai asked the same question. The answer was not okay because the driver felt some wealthy Thais had gotten rich through nepotism, corruption, and monopolies.
Both are inequalities, but one is more acceptable than the other. Dr. Somchai believes this sense of unfairness is what causes political instability, double standards in discourse, and prevents the country from uniting on important issues.
Dr. Somchai proposed measuring inequality by asking two questions: Are there many people in Thailand who are undeservedly rich? And are there many who are undeservedly poor? He said that when he asks these questions at various forums, almost everyone raises their hand.
The second question is more interesting because it refers to people who are not lazy, do not abuse substances, work hard, yet remain trapped in poverty. If a society has many such people, Dr. Somchai says it is a society with unjust inequality.
The figures shown that day made the word "cost" more concrete. Approximately 61.7 percent of Thais over age 15 have only completed lower secondary education or less. He challenged whether that is sufficient in such a rapidly changing world, and the answer is clearly no.
Before leaving the stage, Dr. Somchai concluded that by working together like a marathon, we might transform from a "Suffering Marathon" into a "Happiness Marathon."
His closing sentence sounded beautiful but left the audience wondering: what tools will be used for this transformation?
The answer was given in the afternoon forum called "Suk Story Stage." Rather than inviting academics, it featured frontline workers telling stories in three segments, covering early childhood, youth, and finally late-stage elderly care.
The first forum focused on the ICAP project—Integrated Child-Centered Active Learning Project—which develops early childhood education centered on the child, based on the High Scope curriculum. Panelists included San Sang Chuaychu, Assistant Director and ICAP Support; Ploy Pichaya, a preschool teacher from Chiang Khong; Siridon Naowilaicharoen, Mayor of Khun Han in Sisaket; Oranucha Mongkolrattanachat, Director of Child, Youth and Family Development Promotion; and Patama Iamlaong, Director of Financial and Educational Resource Policy, Office of the Education Council.
The lineup itself sent a message before speaking began: frontline teachers, local budget holders, policymakers, and budget allocators sat together on the same stage.
At the heart of the project is what they call "The 10-day miracle that transforms the classroom." A coaching team works with one classroom for 10 days: Day 1 is understanding and co-design with teachers; Days 2 to 5 involve setting up the classroom environment inside and out; Day 6, the team demonstrates daily processes to teachers; Days 7 to 10, teachers implement with the team as mentors.
Changes include creating five experience corners: blocks, home, storytelling, science, and art, alongside a Plan-Do-Review process where children plan, act, and reflect themselves, plus a storytelling activity that extends quality time from classroom to family.
Results presented, as of 31 October 2025, showed that among 3,021 children assessed with the DSPM tool before the project, 958 were suspected of developmental delay. Of 708 evaluated post-project, 692 children (98%) caught up developmentally to their age group.
After 12 weeks of the intervention, assessments of executive function (EF) showed only 3.9% of children scored below the standard, while 61.4% scored in the highest T-score group (>60), compared to a national average of about 18% in that group.
Over nine years, from 2016 to 30 June 2026, ICAP has implemented its curriculum in 1,534 classrooms across 1,178 centers and kindergartens in 75 provinces—except Maha Sarakham and Loei. It has trained 3,302 teachers and annually develops about 38,086 early childhood children.
Though impressive, these numbers face the reality that Thailand has about 20,000 early childhood centers serving over 850,000 children yearly. The challenge is time; plans aim to expand to 3,000 centers by 2029 and 6,500 by 2033.
ICAP is also among the first projects using the Pay for Success model. Project documents explain that this mechanism motivates both project owners and frontline workers, as they do not get paid unless they succeed.
The next forum focused on the Angel Teacher project, which trains teachers to identify, care for, and refer at-risk children early. Participants included Thepparatan Seedabut from Angel Teacher, Dr. Phattaya Chanaphan, director of Rajaprajanugroh 52 School in Loei, representatives from the Special Education Administration, and Dr. Nonglak Yodmongkol from the National Health Security Office (NHSO).
Data presented on 17 July showed that over three years, the network covers more than 200 schools, with 1,131 Angel Teachers screening over 20,000 students’ mental health and closely supporting over 2,000 vulnerable students. The number of students in the red risk group decreased by more than 20%.
However, what silenced the room was not these figures.
Rajaprajanugroh School was established by King Rama IX's initiative to provide 24-hour residential care for disadvantaged children. Some arrive from children's homes and shelters, and during semesters when parents can take children home, Dr. Phattaya said some children have nowhere to return to.
Before the Angel Teacher concept, teachers encountered children who were silent, avoided eye contact, cried alone, or showed violent behaviors—including self-harm, suicidal thoughts, depression, and drug involvement. The first question teachers asked was why the child harmed themselves.
Dr. Phattaya learned from medical teams in the project to stop asking "why" and instead build trust so children feel safe enough to share their stories.
The school developed the ANGEL Model, comprising Awareness—raising consciousness and designing mental health care systems; Nurture—cultivating Angel Teacher spirit and positive communication; Guidance—providing preventive advice and monitoring depression signs; Empowerment—opening "magic rooms" and using tools like Deep Listening and Digital Reflection Logs; and Learning—using data for lessons and creating positive energy repositories.
The "Magic Room" is a safe space for counseling, divided into activity corners including massage therapy, art therapy, meditation, game therapy, and music therapy. It now exists in all school buildings and dormitories, with 100% of teachers trained, up from an initial core group of 10.
Measured results using the PHQ-A depression screening showed that from academic years 2025 to 2026, among 510 students assessed in 2025 and 569 in 2026, those with severe depression dropped from 118 to 63—a 46.61% decrease—while those without depression increased from 121 to 191.
Dr. Phattaya shared the story of a child who had overdosed to end their life, self-harmed, lost emotional control, refused to attend school, and wanted to run away from the dormitory.
At the same forum, a representative from the NHSO explained that their involvement with education aims to ensure children with mental health problems do not first enter hospitals but find safety in schools, communities, and families. This year is the first NHSO pilot linking payments to results through Pay for Success in schools under the Office of the Basic Education Commission.
The final forum discussed the Yeuan Yen project. Participants included Professor Dr. Isarang Nuchprayoon, founder of"Yeuan Yen Social Enterprise,"Dr. Pawit Vanitchanon, president of the Community Hospital Directors Association, and Dr. Duangdao Sriyakul, deputy secretary-general of the National Health Foundation.
Professor Isarang explained the project’s name comes from visiting patients in the evening when family members return from work and gather, unlike hospital visits which often only talk to the elderly or the most available person.
He found that about 93% of elderly patients said, "We are not afraid of death; we are afraid of suffering." Knowing this, the project concluded these patients do not need to go to hospitals even once. Over eight years, Yeuan Yen has cared for about 2,500 cases—roughly 60% cancer patients and 40% elderly without cancer—with 72% able to die at home.
He said the team’s work is not just treatment but 24-hour family counseling, because the most hesitant are often the children who must be assured home care is correct.
Numerically, Professor Isarang cited NHSO data showing end-of-life care in Thailand costs about 100,000 to 200,000 baht per person, while Yeuan Yen’s approach costs about 5,000 baht per case. He emphasized that not every doctor needs to work in this field—only about 1% interest is sufficient.
Dr. Pawit, president of the Community Hospital Directors Association and director of Langsu Hospital, noted that end-of-life care is already part of community hospitals’ routine work. There are about 760 community hospitals nationwide, meaning infrastructure exists. He mentioned ongoing plans with the Ministry of Public Health and NHSO to pilot new payment methods in 97 model primary care units nationwide.
Throughout the day, the word most repeated was "outcome," but what lingered after the event were small images: classrooms transformed in ten days, magic rooms inside dormitories, and conversations with elders in the evening when families are together.
None of this requires new technology or laws—only decisions to pay for what truly impacts people’s lives rather than for completed activities. The question is how much longer Thailand will take to make that decision.