Thailand Shocks Afghan Doctors

[george]

Afghans' AIDS tour to Thailand: Culture shock

CHIANG MAI, Thailand - When a United Nations-sponsored tour about communities with AIDS led five doctors from Afghanistan into a risque Thai massage parlor, the men seemed thrilled to learn a few tricks of the trade. "Do you know what a breast massage is?" one of the Afghan doctors later asked during dinner. "The woman massages you with her breasts," he exclaimed, drawing peals of laughter from his Afghan colleagues.

"You must get a fatty massage from a fat woman," another chuckling Afghan doctor added during the meal. The next morning, however, the second doctor solemnly stressed that he had been "joking" about "the ladies" and insisted: "I am a responsible doctor from Afghanistan."

The massage-parlor visit was actually considered official business, as it was part of a training course titled "Community-based Response on HIV/AIDS" held in Chiang Mai from November 10-21. The United Nations Development Program (UNDP), the Thai government's Department of Technical and Economic Cooperation and Chiang Mai University's Faculty of Nursing invited the doctors, along with nearly a dozen other health officials and social workers from Afghanistan, East Timor and Sri Lanka, to visit Thailand to learn more about dealing with HIV and AIDS in their own countries.

"The aim is to enable the visitors to return to their home countries with practical means for community-based responses to combating the spread of HIV/AIDS," said UNDP regional communications officer Cherie Hart.

During the course, the foreign doctors and social workers learned how Thailand had worked to slow the spread of AIDS (acquired immune deficiency syndrome) within its borders, why patients live longer and prosper thanks to new medicines and the way in which some Thai communities had ended the "stigma and discrimination" against carriers of the human immunodeficiency virus (HIV) that can cause AIDS.

The delegates studied methods of HIV transmission, attended lectures, visited hospitals, met Thai doctors and patients and interacted with AIDS survivors who had created cottage industries to finance their treatment. They also visited a Buddhist temple where monks were teaching local students how to use condoms.

In addition, the UN invited a handful of journalists to travel with the delegates for three days to see how Thailand's experience in tackling HIV and AIDS could benefit less-developed countries wrecked by warfare. However, while the representatives from East Timor and Sri Lanka appeared fairly sedate during the tour, the Afghan doctors expressed intense culture shock - often surprising the media and their hosts.

Throughout the tour, the Afghan doctors usually appeared studious and serious, asking medical questions in halting English and making notes. But while traveling together in a separate mini van or eating after a seminar, the five men from Afghanistan often regaled one another about social behavior in Thailand, where, unlike Islamic Afghanistan, women do not wear the all-encompassing cloth burqas.

The five Afghan doctors commonly cited Islam as the reason the infection rate is low in their relatively isolated country compared with bustling, Buddhist-majority Thailand.

"It is because of the religion, because in Afghanistan all people are Muslim, and Islam does not accept things like Thailand," Dr Baz Mohammad Shirzad, Jalalabad-based deputy director of Afghanistan's Eastern Region Health Directorate, said in a taped interview. "Islam says, 'You have a wife and must be honest to the wife.' Islam does not accept sex like Thailand's people," Shirzad said.

His colleagues were also intrigued by the differences in social behavior between Afghanistan and Thailand.

"Afghanistan's people, if they know about a woman having sex with another [man] who is not her husband, they suggest killing her," said Shafiqullah Shahim, the Kabul-based Health Ministry's national HIV/AIDS control program officer. "But in Thailand, it is a simple thing, it is a common thing. Everywhere sex is possible, in hotels, in restaurants, everywhere. This is the main cause, I think" for the estimated 700,000 AIDS cases in Thailand, Shahim said in a taped interview.

And indeed, the Afghan doctors were able to witness the dynamics of the sex industry first-hand when they accompanied a Thai doctor on a visit to "commercial sex workers" in Thailand's second-biggest city, Chiang Mai.

"There was one place and the ladies were sitting there and they had labels and numbers," Shirzad said. "The first lady was 'superstar'. The rate was very expensive. And on another side sat other ladies. For the second line, the rate was reasonable. And on another side sat some other ladies and the rate was cheap," Shirzad added.

The Thai doctor "told me that in all of Thailand, especially in Chiang Mai, the HIV risk is very high because 40 percent of the [sex workers] are HIV-positive," he said.

"In Afghanistan, from 1986 to 2000, we had one [HIV] patient. He was an Afghan man who came from a foreign country and got it from sexual contact. He came to Kabul from Europe. From 2000 to 2002, we had seven patients. Today in Afghanistan we have 15 patients," Shirzad said. He estimated that "about 200" people may be HIV-infected in Afghanistan, though accurate figures were impossible to obtain.

However, despite his somewhat awe-induced comments, Shirzad praised Thailand's recent ability to decrease the spread of the virus and embrace patients stricken with HIV.

"Thai patients who are living with HIV/AIDS in the community, they are participating in all activities of the community," he said. "I think they are successful."

Source: AsiaTimes 2003-11-21

[TizMe]

Everywhere sex is possible, in hotels, in restaurants, everywhere.

He must have gone to a restaurant that I haven't seen.