Government of Thailand Battles AIDS Epidemic
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FRED DE SAM LAZARO, NewsHour Correspondent: Thailand’s Prabhat Namphu Buddhist monastery is an unlikely combination of AIDS hospice and tourist attraction. Amid displays of cadavers, visitors, including many school kids, observe what HIV does to the human body, in death and in life’s final stages.
Beyond hospice care, the temple’s goal is to educate the public, says Phra Alongkot, the founding abbot.
PHRA ALONGKOT DIKKAPANYO, Abbot, Prabhat Namphu Monastery: I hope that this year maybe more than 300,000 people come to our temple. That is the chance for our temple can give the knowledge for our people.
FRED DE SAM LAZARO: When we visited in 2002, dozens were dying each month, abandoned as they were in life by families who never bothered to collect their remains. But it was in 2002 that Thailand began to make available the once prohibitively expensive antiretroviral, or ARV drugs, for AIDS. That’s made a huge difference, says Michael Bassano, an American Catholic priest who volunteers here.
REV. MICHAEL BASSANO, Volunteer: It has changed the whole understanding of the place. I would say it’s the temple of life. We call it the hospice, but it’s the temple of life. People come here with HIV, and they sense that here they find family, acceptance, nourishment, and a willingness to keep living. And that changes the whole reality here. It is not just a place for people in their last days.
AIDS stigma still strong
FRED DE SAM LAZARO: But one thing has not changed.
REV. MICHAEL BASSANO: This is a new man. He just came.
FRED DE SAM LAZARO: That's the stigma faced by AIDS patients.
REV. MICHAEL BASSANO: He's 50 years old, but his family just left him. They came over and dropped him off. And they left him here with us. When he came he was all scaly, all full of scales.
FRED DE SAM LAZARO: This morning?
REV. MICHAEL BASSANO: This morning. So now we put Vaseline all over his body, and it's cleared up pretty well. So we wonder why at home they just didn't take care of him.
FRED DE SAM LAZARO: Many, like this man, are dropped off, their disease unattended, many with tuberculosis, a daunting infection they must survive before they are physically fit enough to go on the AIDS medicines.
REV. MICHAEL BASSANO: She's really struggling to keep living.
FRED DE SAM LAZARO: Some patients are too weakened to pull through, but more and more are surviving. A few have even formed a dance troupe, a testament to how ARV drugs can restore life to normal -- normal, that is, as long as they stay inside the walls of the temple, which is near the central Thailand city of Lopburi.
Educating communities about AIDS
NOK ENG, Temple Resident (through translator): The only time I go out of here is to get my medicine. If I put a long sleeve shirt on, my arms are covered and people won't notice my scars. I'd be very uncomfortable if I wore a shirt like this one.
FRED DE SAM LAZARO: Thirty-two-year-old Nok Eng came to the temple when her skin showed rashes, a classic HIV symptom. She left when her health improved but came right back in a few months. Health care was hard to find for her and her HIV-positive husband. And it was especially tough at her factory job, where people knew she was HIV-positive.
NOK ENG (through translator): Every day at lunch, I could hear people whispering next to me, gossiping about me, being sarcastic. I just couldn't take the criticism.
FRED DE SAM LAZARO: The most painful, her parents, who live in a rural community, wanted little to do with her.
NOK ENG: I told my parents that I wanted to come and visit, and they said, "Just stay where you are." They said that I would humiliate them.
FRED DE SAM LAZARO: The temple might provide knowledge, but Mechai Viravaidya, Thailand's best-known anti-AIDS campaigner, says it could be making the problem worse by isolating people with HIV.
MECHAI VIRAVAIDYA, Anti-AIDS Campaigner: People go there and they get frightened. "I'm afraid of these people. I don't want to see because they look terrible." And I would say the last choice would be to have a community of those living with HIV, like a leper colony.
FRED DE SAM LAZARO: Mechai is an economist known for quirky campaigns to popularize condoms. He's called the "Condom King," and many Thais call condoms "Mechais." Now, to fight the stigma over AIDS, he's taken a different approach, a program that offers loans to start small businesses. It's called Positive Partners.
MECHAI VIRAVAIDYA: We lend money to a pair of people, one infected, the other not infected. Together, they must do business. The uninfected person encourages you and also creates, tries very hard to create understanding or compassion within the village so that people who know that this person is living with HIV have a chance on a daily basis to communicate, to listen, and somebody explaining, "Look, that person is perfectly normal. You watch. I go with him. I let him ride on the back of my bike and all these things."
Facing ridicule and stereotypes
FRED DE SAM LAZARO: In the village of Banjan, Duang Deenok accepted an invitation from her HIV-positive aunt, Plak Damlako, to start a food business. She was nervous at first.
DUANG DEENOK (through translator): At first, everyone was pretty scared, so we went to talk to the doctor, because my auntie was taking care of all these children, feeding them. The doctor said that, if we're afraid that the children were infected, we could bring them in to get checked. And, again, the only way to get AIDS is from needles or sex.
FRED DE SAM LAZARO: Both women say they've been open about Plak's HIV status.
PLAK DAMLAKO, AIDS Patient (through translator): I go to hospital, and when I see people, they ask me, "Where have you been?" I tell them I was at the hospital. They ask me, "Why?" And I tell them I have AIDS. They say, "No, no, you don't have AIDS." I have to convince them that I have it.
FRED DE SAM LAZARO: The two women say there have been few problems with social acceptance, possibly because Plak shows no outward signs of illness. Sales of their fried chicken and spicy vegetables are brisk. It's one of about 900 new small enterprises funded by the Positive Partner program, everything from motorcycle repair to handicrafts to livestock raising. Duang says she only encounters an occasional snide comment at her food stall.
DUANG DEENOK: Some people say, "Hey, did you bring AIDS with you today?" When they act like this, I say, "AIDS isn't that easy to get. You can't get it from the ticks on a dog." I tell them that you only get AIDS from needles and sex. Think about it.
What I make here, you can eat. But if you do get AIDS, I'll take you to where you can get medicine. Sometimes I'm just sarcastic, because they're not always nice to me.
Teaching youth about AIDS
FRED DE SAM LAZARO: Because of highly successful awareness campaigns in the 1990s, most Thais learned how HIV is and is not transmitted. And the country's once high HIV infection rate came down almost 90 percent through the decade, but public education had tapered off in recent years, says Mechai.
MECHAI VIRAVAIDYA: And because public education has died down, knowledge of HIV, the extent to which it's discussed, goes down and down and down, so the stigma is still around and gets stronger because for the lack of public education. So we just have to continue to do more. And then the stigma will come down, but nothing works like actually seeing a person living with HIV and getting them to have experience with HIV people. That's the best experience at changing attitudes.
FRED DE SAM LAZARO: Mechai's non-government agency is trying to bring that experience to schools, as well. HIV-positive individuals spend time answering students' questions.
AIDS PATIENT: People can tell that, even though I have AIDS, I'm still living my life, doing my work. I just want to tell you guys, "Don't discriminate."
FRED DE SAM LAZARO: On the day we visited this rural school, the lectures were followed by sex education sessions for these high school students, a particularly worrying group. After declining for years, HIV infections among young Thais have gone upward again.
PHRA ALONGKOT DIKKAPANYO: More than 50 percent of the new cases who are infected with HIV are the children, our children. Big problem for our country.
FRED DE SAM LAZARO: Experts say the lesson from Thailand is that the message -- to fear AIDS, but not people with AIDS -- must be repeated again and again, or it will quickly be lost.