A Heavy Topic

Since the Youth Conference, a steady stream of events has kept life sufficiently busy. It has been a much more conducive tempo for me since I tend to function better being busy than not. In effect, there’s a lot to write about! Let’s rewind about a week...
On September 9, 2009, I departed from site with four women to one of the Eastern-most provinces bordering Laos called Mukdahan. The purpose of our trip was to attend a PHA occupational training. PHA = Person’s Having HIV/AIDS. It was a very vital and productive experience for myself and the women who came along. Two of these women were PHA’s and two, Health Volunteers. The act of traveling alone gave the women the opportunity to travel on their own and get a taste of self-reliance as we figured out bus tickets and schedules. Seemingly a simple task but nonetheless empowering in it’s own way—particularly since some of them had never traveled on their own before. The training allowed me to spend time with community members outside of our usual environment in a learning and intimate setting. This was particularly significant since I had not yet had a chance to build relationships with PHA’s one-on-one. Three of these women had never been out of Sisaket Province before so this was a monumental trip for them. It was particularly exciting because the training was held in a very calming location near the Mekong River. All the ladies got to see Laos for the first time ever. At the training, we meet other PHA’s, learned some practical skills (like making soaps/shampoos, an herbal compress, and basics about Thai massage), and most importantly, we discussed health issues such as how to keep healthy and overcome the societal stigma of having HIV/AIDS. Towards the end, we discussed viable projects and activities PHA’s could do in our community. I learned that most people in my community have little or no education on the facts about HIV/AIDS, safe sex, sexually transmitted diseases, and family planning. This was a sobering yet important realization. It became apparent during a session with a nurse about sexually transmitted diseases as I noted my ladies were asking the bulk of questions and fervently writing notes. Following, the five of us had a serious discussion about these issues and how villagers had little exposure to information. Even the PHA’s were not aware about all the facts surrounding HIV/AIDS—ironically in the middle of our discussion, one of them got a call from her husband (who is also a PHA) who told her about a recent tattoo he got. What?! Red flag. I almost had a heart attack! It was even more alarming that the women didn’t seem to acknowledge or understand how dangerous getting a tattoo was for a PHA.
In retrospect, the PHA’s were able to ask questions and engage in discussion at such a magnitude they had never been exposed to before. This helped them feel more assured and comfortable with themselves and about their own place in the community. The atmosphere definitely lent itself the space for each person to be themselves and let go of apprehensions.
By the end of the training, we were able to come up with a few project plans that we could do in our community. Together we decided a good start would be having a simply get-together with PHA’s in the sub-district to have an open discussion and get to know each other better over lunch. We realized, every PHA in our area (there are 10) might not be comfortable even doing this since there is no current PHA group/support system of the sort in our sub-district and some people prefer to have full anonymity. Another crucial area we decided to implore was becoming more active in teaching villagers and young adults important health and family planning issues. With Health Volunteers and PHA’s willing to participate, we plan to visit each village and give simple mini-workshop in order to disseminate information to adults and teenagers. In addition, we would like to pursue more occupational trainings in our area modeled after the training we received in Mukdahan. The ladies had many great ideas and seemed to be only very impressed with the whole experience. They were able to gain a new level of confidence and commitment to serve in their community. Personally, I was very thankful to have the opportunity to go and bring these ladies with me. We discovered many things about ourselves and the potential for making important differences in our community. Not only that, but it was also a lot of fun! At the end we had a nice celebration to acknowledge our achievements and sing a little karaoke—it wouldn’t be Thailand without karaoke.
I must pause here for a moment to fully divulge into the realities of HIV/AIDS and PHA’s in Thailand...
Before I came to Peace Corps, I really knew nothing about so many of the miniscule components of Thai society. HIV/AIDS being one of them. During Pre-Service Training 1, we went to an HIV/AIDS hospice center at a Buddhist temple. This is one of a kind center in Thailand as there are very little physical centers for HIV/AIDS patients to seek refuge and support from. The center operates with donations and some aid money. The center also is special in that it uses Buddhist principles to help people deal with their illness. It was a very overpowering experience. At the center, there was a museum of mummified AIDS patients and also preserved body parts. Coupled with the mummified bodies were the victim’s names, occupations, where they were from, how they contracted AIDS and when they died. Those who died donated their bodies to not only to science in this aspect but also to teach people about the disease in a humanistic manner. In another annex, there was a building that had piles of cloth representative of every single patient that had died at the temple that never had a family member or friend come to recover their remains. While at the temple, we met and talked to patients—something I had never really done before—other than maybe once middle school. Then, some of the patients put on a performance and we had Q & A. They told us about their lives having lived with this disease, their likes/dislikes, talents, passions, and families. It was an extremely eye-opening and emotional learning experience.
HIV/AIDS in Thailand has the highest prevalence in Asia with about 750,000 known to be positive. It was decreasing due to a large campaign for prevention but has risen more in recent year. This may or may not be due to a significance slow down of awareness and governmental support programs in the past few years. There’s also been less international aid coming in to tackle HIV/AIDS specifically—think PEPFAR.
Given what I’ve learned and what I can observe, I think the worst part of having HIV/AIDS in Thailand must be the societal stigma attached to it. Many people only associate it with prostitution and promiscuity. Therefore, it may be commonplace to understand a person with HIV/AIDS as being a harlot or a hooker or sexually irresponsible in some aspect. Which, in reality a good portion of the virus is passed from mother to child or husbands who solicit sex workers and give it to their wives. I’ve come across research suggesting that for every man with HIV/AIDS in Thailand, he will infect on average 2 women. Men either will not or do not get tested as often as women get tested. Women probably get checked more due to obvious family planning and reproductive health reasons. Therefore, when say, a married woman does get tested—no matter if she contracted it from her husband or not—she will most likely be the one to blame for having it and be ostracized and scrutinized more by the community. Like I said, I’m talking from the research that I’ve done and what I’ve observed so please don’t take my word as the final end-all. Bottom line, there is a huge societal stigma attached to HIV/AIDS. People who have it are scared they will either be disowned by their family & friends or they will overly burden them by making their loved ones feel obligated to take care of them.
Even my host family in Lop Buri, when I told them I was going to the hospice center, told me not to touch or get close or even talk to any of the patients there. It was very sad. The whole experience really taught me that it's not fair to ostracize people just because they're sick. We shouldn’t make judgments on someone’s past either because in situations like this, it’s impossible to know. They are still human beings and deserve to be treated with dignity and respect. They can still be a valuable part of society. It really made me want to do awareness campaigns and get involved with HIV/AIDS awareness at site. Also made me realize, there is a lot to be done in changing the perspective and misnomers Thai people have about HIV/AIDS. It's a terrible virus/disease and yes, it is contagious given certain circumstances. But, if you know the facts and your conscious of them, then what is there to be scared about when working and living with PHA’s?
Should we treat people with HIV/AIDS any differently than we treat our best friends and family? Should we separate them and oust them and understand them as invalids? Absolutely not. We can eat together, work together, play together, laugh together, cry together, talk together. Experience life together. There’s room in the world for everyone to coexist; compassionately, peacefully, and respectfully. To me, part of being human is acknowledging other human beings as you acknowledge yourself. And if you see yourself as someone with many qualities, indefinable, incandescent, and worthy then there’s no reason why other’s—no matter their circumstance—cannot be seen as this. Sometimes, I have to remind myself of the bigger picture, that what it means to be human and move around the earth (the auspiciousness of it all) is a much greater condition than being labeled a certain way by society or being confined to a certain condition.