In the wake of last Sunday's National Aids Day, MARY McCOLLUM of Cafod witnesses the epidemic's spread in Thailand — and how it is being fought
THE TRADITION of "Tokkeauw" in the north of Thailand is when an agent buys the harvest while the grain is still green in the field.
"Tokkeauw" also refers to the farmer's daughter: The agent pays for her last year at school and then takes her away to work in a big city or overseas. If she's lucky she will end up working on a construction site or as a waitress, but can equally easily find herself in a brothel or massage parlour. This is the beginning of the cycle that has led to 800,000 people becoming HIV-positive in Thailand.
Although the first cases of Aids/HIV were only discovered there in the mid-1980s, the rate of infection has now reached epidemic proportions. The pattern of the spread of the disease began with bisexual and homosexual men, followed by a rapid rise among drug-users and then among sex "workers". The fourth wave of infection which is now becoming evident is among the wives, and girlfriends of the men who use prostitutes — this is particularly evident among the villages and cities in the northern provinces.
Many of these women are now widows, isolated in small rural communities where people arc afraid of them, trying to bring up their children although they can barely earn a living as they are poorly educated and often too ill to do manual labour.
Thasanee is from Chanpaway, a suburb of Phayao city in the north of Thailand. At the age of 23 she is the sole survivor of four siblings. She is HIV-positive and a widow.
She met her husband, then a 20-year-old farmer, when she was just 15 years old. However, after six or seven years he left her and their two children. He returned after two failed relationships and within two years he had Aids and she was HIV-positive.
This pattern of infidelity is one that affects all Thai society, leaving young women dangerously dependent on their husbands and their husband's sexual behaviour. Thasanee has an 18-year-old daughter recently married in Bangkok. Thasanee said: "I worry for my daughter in Bangkok. I'm afraid of what will happen if they quarrel or have a misunderstanding and separate. They will become like me and my husband."
Mrs Usanee Nanasilp is a leading expert on HIV/Aids and secretary general of the Catholic commission on Aids in Thailand. She believes the traditional attitude to women in Thai society creates an environment for the rapid spread of HIV.
"In the north they have seen a lot of people die of Aids in the villages. Nearly every house has Aids. We have to change attitudes towards sex and sexual behaviour.
"We have been ruled by Kings for many years and believe that men are dominant — traditionally the could have many wives which showed they were rich and powerful. Parents think there's no need for women to be educated because after they are married they stay at home. Now men and women are becoming more equal and the situation will be better but we need more concrete laws to protect ourselves."
Valai Jumboonma lives in the village of Ampur Pan in Chiang Rai province — 48km from the provincial capital. When she told her neighbours she planned to start her own fish farm they are scathing: No one will want to buy your HIV fish, they said.
Valid, now 35, became a widow when she was 33. She discovered she was HIV-positive when her husband developed Aids. The date is indelibly etched in her mind 10 June 1994. After first suffering from headaches and developing a rash on the side of the head he became seriously ill. They called in the doctor.
E DIED ON 6 February, 1995. He was a timber trader who travelled all over Thailand for his work and, in Valai's own words, "he was quite a play
boy." But like the other women interviewed, she is not angry. He was older than she and treated her well when he was at home. That was enough.
After he died Valai and her daughter Gademanee (her name means gift) were rejected by the local community. Gademanee was mercilessly teased at school about her faniily dying of Aids. After the funeral of a neighbour, Valai joined the family for a meal: "When I bad finished my noodles they threw away my dishes; and they did the same to my parents'."
Valai heard through a radio programme about a small community of people in a nearby village of Sai Sam Pan who were all "HIV infected" and decided to contact them. "I was feeling very left out at home. Nobody cared and people were avoiding me so
it was very easy to approach the group. It makes a lot of difference because at home I have nobody to talk to but in the group there are others also affected who share common feelings and sympathy".,
She started her own People with Aids (PWA) group in her village a year ago with 20 members, four of whom have since died. Through the group, Valai started her own fish farm which, despite the warnings of her neighbours, is successful.
THE RADIO STATION which altered Valia to the support groups was run by Access, an NGO — nongovernmental organisation which works with people with Aids. Access worker Tiu Chiranuch explained the thinking behind the Sunday Afternoon radio programme which broadcasts from Chiang Rai city and has changed the lives of hundreds of people. The first hour is targeted at teenagers, educating them of the risk of contracting HIV. The second hour is a support service for those who are infected.
"HIV is a terrible secret here. It's not talked about. We tried to educate people through the radio programmes. We invite people who are HIV-positive to produce the programmes with us and that gives them back some self-esteem and hope.
"We interview people like the pharmacist who supplies medication, or we ask people who grow herbal remedies what's good, and we have interviewed a monk and a doctor interested in HIV".
I asked if they had ever had any complaints about the programmes and how they persuaded people to take part, especially if they were dealing with the taboo subject of sex.
Tiu said: "Last week we asked why you decide to have sex. Eight people responded four boys and four girls wrote letters. Most of the boys said for fun or pleasure while the girls talked about love and responsibility. In Thai culture it's unusual to talk about sex. We try to talk about love, friends and decisions about lifestyle."
The level of complaints is indicative of how attitudes have been changed through their work. I expected to hear of a deluge from people disgusted at the "immoral" or "obscene" content of the programme.
Tiu said: "Some times we get letters from someone because we play a song too often."