Christians made and are making substantial contributions to health care and education in Thailand. Facilities such as Saint Louis Hospital, Bangkok Mission Hospital, Camillian Hospital, Bangkok Christian Hospital were once considered to be among the best in the country. Major Christian schools dot the map of Thailand. European and American missionaries introduced the printing press, western surgery, smallpox vaccinations, taught foreign languages and wrote linguistic dictionaries. Thai and Western Christians in the past 50 years, especially those in the Church of Christ in Thailand denomination, have been heavily engaged in administrative reform of church organizations, ecumenical and interreligious dialogue, social development projects, enculturation or adaptation of the Gospel for Thai culture and have been active in providing leadership in the Thai democracy movement, refugee relief, and improving the status of women, the handicapped and children.