Aids Temple Aims To Shock Complacent Thais

[george]

AIDS Temple Aims to Shock Complacent Thais

LOP BURI, Thailand (Reuters) - Tucked in lush rural hills, Thailand's "AIDS temple" aims to shock people out of their complacency with a macabre display of withered corpses and bones of the rejected dead.

Each day, scores of visitors troop through the country's largest Buddhist hospice, snapping pictures in hospital wards, the crematorium and a "Life Museum."

The first stop on a tour of Wat Phrabaht Nampu temple is a glass-windowed room where 12 formaldehyde-preserved bodies lie exposed on wooden slats. Their dark brown, leathery skin is stretched taut over bones. Snapshots next to each body remind viewers that the remains in front of them were once healthy people, living ordinary lives.

They include a sex worker infected by a customer, a woman infected by her husband and a child born with the disease. All were former patients who donated their bodies.

Thousands have died at the temple in just over a decade -- 172 in the first six months of this year -- and its founder believes the loneliness those patients endured is every bit as frightening as the corpses he has on display.

"It is the best medium to teach people. When they see the real thing, the death, they become more aware," said Abbot Alongkot Tikkapanyo, who started the hospice after watching a man die of AIDS.

Today, the saffron-robed monk is on the front line of Asia's struggle against the intolerance and ignorance faced by more than seven million people in the region living with HIV-AIDS.

The hospice is refuge to hundreds of men and women who come here to die, shunned by family too fearful or too poor to offer care.

VISITORS RARE

Bed-ridden and blinded by AIDS, 32-year-old Ekachai was brought to the temple by his mother four months ago. She has not visited since.

"I just want to go home," he says, pulling a wool blanket tight around his body, shivering despite the 35-degree heat.

Ekachai is one of 12 men in the "final stage" ward, most of them days away from death. Nurses massage aching muscles and bandage open sores, listening to taped music.

One of the more popular songs was written by the patients, "Pieng Nhang Kamlang Jai" (Only Hope and Support).

"Patients come here every day and they die here every day," said hospice worker Kongkiat Seweewunlop.

Families are a rare sight at the daily cremations handled by temple volunteers.

Mainly Buddhist Thailand is hailed as a success story in the global fight against the disease.

Unlike so many countries in Africa, it managed to diminish its infection rate with a widespread campaign to promote condoms in the 1990s -- largely among sex workers in the go-go bars of Bangkok and other cities.

But activists say the campaign has generated little sympathy for the one million Thais living with AIDS. A "climate of fear" fuels the spread of the disease in Asia.

Many Thais believe the disease -- which has killed about 400,000 and robbed the economy of up to $9 billion -- has been contained within the sex industry, affecting only prostitutes or needle drug users.

Alongkot wants to drive home the lesson that HIV, the virus that causes AIDS, is still infecting 20,000 Thais each year.

"I do this because I want to protect the Thai people from AIDS and educate them. I have been with patients and I know how they suffer," he told Reuters.

"Second, I want patients to live normally within society. I want to see them live in their own houses, with their families, in their communities."

HUMAN BONES

Outside the museum, visitors see a row of sculptures made from the crushed bones of those who have died at the temple.

Crafted by an artist whose brother has AIDS, the meter-long sculptures depict various modes of transmission, from a couple having sex to a mother with her child.

The project was a way to deal with the temple's growing collection of bones. Hundreds of boxes with names and identity numbers are still stored in a meditation hall and 7,000 cream-colored bags are kept outside near a Buddha image.

"We usually send the bones home to their families, but only 10 percent keep them. They are afraid the bones have AIDS," said Kongkiat.

The exhibit tends to upset visitors more than patients, he said, as two women on a tour crouched down for a better look.

One reached out her hand, but pulled back at the last moment.

"Are they really made of bones? I'm scared to touch them. I might get something," she said, quickly walking away.

Experts blame cultural and religious beliefs and a lack of education for the stigma linked to AIDS, preventing those with the disease from seeking treatment or counselling and testing services that are key to prevention.

Asian leaders are also reluctant to face the issue publicly.

Former U.S. President Bill Clinton, speaking in Beijing early in November, noted the positive impact on social attitudes in Nigeria when its president hugged an AIDS patient on national television.

But no top-level Chinese officials attended the speech where Clinton embraced a young man who announced he was infected. In Thailand, where AIDS funding has dropped since the 1997-98 Asian economic crisis, the prime minister had chaired the government's AIDS committee since the early 1990s.

But incumbent Thaksin Shinawatra has delegated that duty to the health minister, who carries less political weight.

"Our leaders are not interested in solving the AIDS problem," said Alongkot "So we see AIDS patients have to face their misfortune by themselves."

In the eight months since he arrived, 33-year-old Suthat has rarely left the temple grounds to go into town because of the open sores on his arms and legs.

"I can't do anything with other people. When I go to the market for noodles, everyone looks at me like I'm an alien."

Save for his mother, the former university worker has been abandoned by his friends and relatives. "They make it clear that I am hated by society. They don't accept me."

--Reuters 2003-11-30

[Nat]

Interesting tactic, however not sure how effective it will be. Social psychologists have found, in regards to aids awareness campaigns, that using high fear and shock tactics alone do not reduce the high-risk behaviour. Not sure if anyone remembers the aids awareness commercials using the Grimm Reaper - basically they had the Grimm Reaper bowling down people like they were bowling pins for having unprotected sex (they were quite disturbing). Anyway, presenting such extreme and disturbing images have the opposite effect, as individuals see the situation as hopeless - that is, they think "it's going to happen anyway, so why should I bother". Obviously, indviduals are all different and some fear is effective in modifying behaviour, but not when it's excessive.

[george]

Update from Reuters:

Thailand has AIDS drug plan, some doctors resist

BANGKOK, Dec 1 (Reuters) - Thailand pledged on Monday to provide life-saving AIDS drugs to 50,000 patients each year, but said it was facing resistance from some doctors.

Thailand, where one in 60 people are infected with HIV, endorsed a U.N. plan announced on World AIDS Day to rush anti-retroviral drugs (ARVs) to three million of the world's poor at a cost of $5.5 billion.

"Thailand is ready to provide ARV drugs to all (its) AIDS patients," said Doctor Phetsri Sirinirand of the health ministry. "Without ARVs, 50,000 AIDS patients (in Thailand) will die every year. The impact of AIDS has been enormous."

The government has already been working on plans to increase access to ARVs from the 2,000 patients treated under pilot projects in 2002.

But government officials and AIDS activists said a wider rollout in Thailand would require better trained healthcare workers, more testing facilities and support from families and the medical fraternity.

"Many doctors do not want to provide treatment and care for AIDS patients. They are overburdened," Sombat Thanprasertsuk, director of the government AIDS bureau, told reporters.

Doctors, particularly in smaller clinics and hospitals where one or two medical staff could face up to 100 patients a day, had balked at the extra workload, Sombat said.

"We have to talk to them and convince them that it is a treatable disease. The patients will be in a better quality of life, they can go back to work and raise their children," he added.

The government plans to more than double spending on ARVs to 700 million baht ($17 million) next year, with another 200 million baht set aside for training and lab support.

Officials said about half of the country's 800 state hospitals had formally agreed to the rollout of ARVs. The health ministry is still waiting for written confirmation from the rest.

The Government Pharmaceutical Organisation (GPO), which produces several generic ARV drugs, will supply 80 percent of the drugs needed for the rollout. The average cost is about 1,200 baht ($30) per patient.

AIDS activists are pushing Prime Minister Thaksin Shinawatra's government to get tough with doctors and hospitals that resist the new programme.

"The government has to make the policy clear and straightforward to all the doctors and hospital directors that they need to treat patients," said Doctor Praphan Phanuphak of the Thai Red Cross Aids Research Centre.

He said the programme would need more healthcare workers trained in delivering the drugs, and more labs for testing of CD4 counts -- which gauges the health of the immune system.

Sombat said the country's 19 CD4 sites would be expanded to 40 sites in a few months. But he said hospitals would be given time to adjust to the new policy.

"It is the policy of the government so all government hospitals will have to follow, but it is a matter of time," he said. ($1=39.90 Baht)

[george]

The Nation update:

Young must have easy access to condoms: activists

BANGKOK: Condoms need to be put within easy reach of the country’s youth to help curb the rising number of new HIV infections caused by unsafe sex among teenagers, HIV/Aids advocates said at an event marking World Aids Day yesterday.

A number of international studies had proven that condom vending machines in schools do not encourage casual sex among students, said Dr Praphan Phanuphak, director of the Thai Red Cross Aids Research Centre.

“Drop your ego at the door and accept reality. It [unsafe sex among teenagers] happens and we cannot prevent it, can you? But condoms can help make it safe,” he said.

Praphan was speaking in response to recent public opposition that led to the abandonment of a Public Health Ministry plan to install condom dispensers in university and college bathrooms.

University educators should shift their perspective towards providing condoms for their students, he said, adding, “You can save their lives ... it’s a form of merit making, not misconduct.”

The rate of new HIV infections continued to grow among the young globally, as well as in Thailand, said Praphan.

“Please believe this, it’s true. This is why we would like to bring condoms, the only sure protection, as close as possible to the target group,” said the doctor.

Separately, Senator Rabiabrat Pongpanich, a monogamy advocate who also has long worked in the field of HIV/Aids prevention, said she completely supported the idea of condom machines in educational institutions.

“Since we cannot prohibit the freedom to have sex, give your children a condom when they go to school. Please do not get mad at your husband if you see him carrying one as well – because he loves you,” the senator told a seminar on HIV/Aids.

From his experience gained through many years working on HIV/Aids protection campaigns, Suthee Samitsuwan said it was very difficult for many people, especially the young, to pick up a condom from a convenience store when they need them.

Therefore, he said, the condom machine is a very good solution.

“It’s time to open our minds to condoms and safe sex,” said Paisal Tunaud, an activist of the Thai Network for People Living with HIV/Aids.

--THE NATION