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COVER STORY:
AIDS in Thailand
October 11, 2002    Episode no. 606
Read This Week's November 7, 2008
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BOB ABERNETHY, anchor: Now, part two of our report on AIDS -- today, the situation in Thailand, the most successful of all the developing countries in bringing down HIV infections. One reason is the support of Buddhist monks for the government's anti-HIV campaign. Monks also run a hospice for those dying of AIDS and -- as a matter of public education -- encourage tourists to come visit. Fred de Sam Lazaro reports:

Photo of hospice exterior FRED DE SAM LAZARO: Many Buddhist temples are tourist attractions in Thailand. But this one, tucked away in the hills north of Bangkok is unusual. It was built a decade ago not as a traditional place of worship but as a hospice. A place where AIDS patients come to die with dignity.

There are about 300 beds here, a fraction of the demand. But there seems no limit to the number of tourists who come through to meet and take pictures near AIDS patients -- to view the stark crematory and bone room, where the bones and ashes of thousands of patients lie in piles, and the after-death room, a macabre display that more befits a pathology museum.

Photo of bones and ashes In fact tourist donations sustain this facility, not government funds. And the founding monk says it helps sensitize adults to the AIDS problem. Even school kids arrive daily by the busload.

Abbot PHRA ALONGKOT DIKKAPANYO (Wat Prabt Nam Phu Monastery): Our people -- if they can see by themself, not only listen or look at the picture, they can understand easily, and it is a good way of education in our country.

DE SAM LAZARO: Thailand has long been in the vanguard in tackling AIDS. It was the first Asian country to suffer an epidemic, stemming from another enduring tourist attraction: the commercial sex trade, which caters both to Thai and foreign tourists.

Photo of STOP AIDS condom When AIDS hit in the early 90s, Thailand had a quick response. Not so much with money or health services, but with its already highly successful family planning program, it had popularized one of the most effective weapons in AIDS prevention: the condom. The program was headed by Mechai Viravaidya, politician from a prominent Thai family; economist by training but best known as the condom king.

MECHAI VIRAVAIDYA (Head, Population and Development Authority): Look, it's just from a rubber tree like a tennis ball. If you're embarrassed by a condom you must be more embarrassed by a tennis ball. There's more rubber in it. We gave them out all over, and said, "Look the condom is clean if your mind is not dirty, so please take one."

DE SAM LAZARO: Early on, Viravaidya took his case to monasteries and monks because surveys showed they were the most influential people, particularly in rural areas of this predominantly Buddhist nation of 60 million. The monks were supportive.

Photo of Mechai Viravaidya Mr. VIRAVAIDYA: And in the Buddhist scriptures it said many births cause suffering, so Buddhism is not against family planning. And we even ended up with monks sprinkling holy water on pills and condoms for the sanctity of the family, before shipments went out into the villages.

DE SAM LAZARO: The condom and AIDS information campaign is widely credited with a dramatic drop in the number of HIV infections, from about 140,000 a year in 1990 to about 30,000, ten years later.

Fewer Thai men visit brothels and 90 percent of those who do now use condoms.

But hit hard by the Asian financial crisis in the late 90s, Thailand cut back funds to its AIDS campaign. That's blamed for an increase in infections among certain populations, including young pregnant women. Viravaidya says the message just isn't getting through to them effectively.

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Mr. VIRAVAIDYA: You can't just do it for a year and stop. You have to continue and change your message, put it into soap operas, commercial movies again, we have to redesign our public education program and make it a bit more jazzy compared to its last days of somewhat dullness.

DE SAM LAZARO: So it just basically lost steam?

Mr. VIRAVAIDYA: Yes.

DE SAM LAZARO: Viravaidya is confident Thailand's infection rate can be contained once again. Awareness is high, as is literacy, as is the availability of condoms.

The big problem is how to deal with the one million or so Thais already infected. Tens of thousands of previously symptom-free HIV patients are now in the visible, advanced or terminal stages of the disease. The campaigns may have raised awareness, but many say, not sympathy.

Photo of Phra Choochart PHRA CHOOCHART (AIDS Patient): I kept the secret for many years, but finally something happen in my skin, it began to appear. I cannot keep secrets anymore. So I became a monk, because in society, if you catch HIV, nobody want you, also your family.

DE SAM LAZARO: Phra Choochart is one of about a dozen monks who live here. Most of the beds are occupied by ordinary Thais, many from lower socio-economic groups. It's a refuge from a hostile world, but the emphasis seems more on efficiency than comfort.

Chris Lack is a recent medical graduate from Australia, one of several foreign volunteers.

Photo of Fred De Sam Lazaro and Dr. Chris Lack Dr. CHRIS LACK (Hospice Volunteer): Right, so these are the coffins that every day when patients die they're loaded into one of these and then the next morning they're taken in a truck out here and off to the crematorium. There are seven, seven ovens in the crematorium. So, apparently when they were building it they built it with the belief that, you know, I might just go over and check if this guy's alright. He's still alive, still alive. He will probably die tonight. He's held on for a couple days now when he didn't seem like he would, but he's pretty much ... all that moves now are his eyes and even his eyes only sometimes move. So, he's very much in the last stage.

DE SAM LAZARO: Death here is a no frills affair. Every day, an average of two to three patients die. Few relatives ever visit this place, attend a funeral or claim the ashes or bones.

Photo of Abbott Abbot DIKKAPANYO: I've tried to give knowledge for our people for long time, ten years. And nowaday they can visit the patients, they like to learn, they like to visit but they cannot touch the patient. Maybe in five or ten year in the future. Our hospice is like a school: it gives knowledge. People can come here and learn how to look after the patient in their family.

DE SAM LAZARO: The Abbott hopes Thais will learn from visits here that AIDS is not contagious through simple touch and caring, and that eventually more people will be cared for at home.

Photo of AIDS safety information And Thailand will soon make available at just one dollar a day anti-retroviral drugs. These expensive drugs, now common in the West, should extend the life expectancy of patients like these. But just as important is the task of preventing new infections.

Thailand's renewed campaign for HIV prevention and awareness will come from media personalities like Mechai Viravaidya and public health authorities. But the task of increasing compassion and more immediately hands-on care for many AIDS Thai patients have to come from its temples.

For RELIGION & ETHICS NEWSWEEKLY, this is Fred de Sam Lazaro at the Wat Prabt Nam Phu Monastery in Thailand.

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