Communities in Chiang Rai, Thailand, are grappling with severe health, economic, and environmental threats due to toxic heavy metal contamination in the Kok, Sai, Ruak, and Mekong rivers. The National Health Commission Office (NHCO) organized a tour to highlight the pollution's impact on local residents, particularly low-income farmers earning less than 5,000 baht per month. A health impact assessment involving 424 residents revealed that 91% noticed visible abnormalities in river conditions, and about 70% changed their water usage habits, opting for purchased drinking water. Economically, 63% of households reported monthly income losses averaging 1,200–1,300 baht due to declining tourism and river-related jobs, while families faced additional costs of 2,600 baht per month for clean water. Mr. Songpol Tulata, director of the NHCO's Northern Public Policy Office, emphasized the need for a consolidated approach among state agencies and proposed six major policy changes, including prioritizing transboundary pollution as a national agenda item and addressing the problem at its source.