System Lessons from Walking Doctor Team Operations in the Post-Flood Phase: Strengthening Primary Health Care in Hat Yai City, Thailand

Abstract

Urban flooding poses sustained public health challenges, particularly during the post - flood phase, which is often underemphasized compared with the emergency response period. This article aims to synthesize lessons learned from the implementation of a walking doctor team in post - flood health response in Hat Yai City, Songkhla Province, Thailand, using a primary health care framework as the analytical foundation. Data were derived from daily field operation reports of walking doctor teams, public health incident command records, and systematic reflections from real - world community - based practice. The main analytical period covered 1 - 5 December 2025, representing a phase of intensified post - flood operations. Results indicated that more than 11,000 service encounters were provided, predominantly addressing primary care - level health problems, including skin and foot infections, minor injuries, environmentally related communicable diseases, and disruptions in continuity of care among patients with chronic conditions. Vulnerable populations - including older adults, persons with disabilities, and homebound patients, emerged as priority groups requiring proactive outreach services. System-level analysis revealed critical gaps between disaster preparedness plans and community-level implementation, particularly in area coordination, medical supply management, communication systems, and reporting burdens. At the same time, adaptive leadership and frontline decision - making emerged as essential factors supporting service continuity and operational effectiveness under dynamic field conditions. These findings underscore the importance of community-based outreach mechanisms in strengthening primary health care responses during the post-flood phase in urban disaster settings.