Safety is good - the doors lock securely, and there are tons of security. The place isn't nearly as remote as it seems when you're cruising up to it on a boat up the Mekong, it's really a quite short drive to Chiang Rai and even a shorter drive to Golden Triangle which is a good sized modern town. Really no need for helicopters and the like, and I'm sure they have arrangements with a nearby physician. We were there in rainy season (August) and the bugs weren't actually that bad. My own doctor (an immunologist with an active travel medicinet practice) even stopped taking his own malaria meds when he was there over the new year period as it got cold enough at night that he never saw a mosquito the whole time he was there. Swimming with elephants is news to me although you do ride them into their own watering hole where you help to bathe them while sitting atop them. It's really a fantastic place - the only part of the experience we were underwhelmed by was the spa, which isn't the point of a place like this anyway.