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After a great Asia-Oceania Regional Meeting in Pattaya a bunch of motivated students who had not had enough met in Bangkok for the HIV/AIDS study tour. We were nine Japanese, one Indonesian and one German. And we had an amazingly great time!

There are estimates that say that 1 million people living in Thailand are HIV positive, that is one in every 55 Thais. Every day up to 600 Thais are newly infected and every hour nine Thais die from AIDS.

Thailand has three main approaches to address this epidemic:

1. the prevention of new infections through education
2. Provide ARV-therapy as sustainable treatment of those infected. This is included in the governmental insurance program
3. Provide alternative therapy in the form of self-help groups, temples that offer accommodation, food and traditional medicine as well as other medical care

Those three branches were focused on during our study tour.

The tour consisted of two days with mostly lectures in the morning and visits to institutions in the afternoon. We learned quite a lot about herbal treatment and traditional medicine when fighting HIV/AIDS, the distribution of condoms in Bangkok, as well as the life HIV positive people face in Thailand. The visit of one family, where father, mother and the youngest boy of two children were infected was pretty impressive and showed us how many people do not take HIV as seriously as it should be taken. "Well, sometimes I forgot to take my anti-retroviral therapy, that might have led to the infection of my youngest son". However, we also had a Thai writer visit us who spoke about her experiences when confronted with the diagnosis of HIV. She has been writing an online journal ever since and so far four books have been published which have been a great success. The Ms Kaew diaries can be found under www.kaewdiary.com, but they are only in Thai.

Two lectures on herbal treatment had a different impact on our group. One was very impressive showing,scientifically that some herbs seem to have the same inhibiting power as some chemical protease inhibitors. Furthermore, we were shown that other herbal extracts can inhibit the binding of the virus to the host cell or prevent the integration of the viral DNA into the human chromosome. Studies are currently underway and we will definitely hear more about these herbal treatment in the future.

Visiting Empower in the Patpong area, the Bangkok red light district, offered some insight into an organization who's motto is "empower" (education means protection of women engaged in re-creation). It is a grass roots organization which offers support, assistance, and access to education for women workers in the entertainment industry. It also offers a centre which is open for women who work in Patpong to come in and have a cup of coffee, meet new friends, learn to make batik, learn some English, Japanese, and German. Women who come to the centre can also consult with our nurse about health issues. They support the daily-life of sex-workers by offering help in the form of education, law-issues, and self help information. Within the last 20 years more than 20000 women have been taking part in daily afternoon classes to get more informal education and to improve their language skills. For more information you may visit www.empowerfoundation.org for more information.

In the Thai Red Cross AIDS Research Centre we heard about the anonymous clinic where people can get anonymous HIV-testing with pre- and post-test counselling, CD4-counts and viral-load testing as well as chemoprophylaxis for opportunistic infections. Each year around 8000-9000 clients mostly from the general population use this offer, approximately 16% are tested positive. Unfortunately the follow up is very difficult and anti-retroviral therapy can not be given out anonymously. Next to the anonymous clinic the Thai Red Cross is very involved in tackling the combination of HIV and TB, offering free TB testing for people infected with HIV and the other way around. HIV+ women receive free ARV drugs of high potency to avoid the mother-to-child-transmission (MTCT) under the slogan "Save parents and prevent orphans".

Most touching on the tour were the visits to the human development foundation (HDF) with its Mother and Children's Home as well as the HIV/AIDS temple and the orphanage in Lopburi, about 2 hours north of Bangkok.

The HDF - Human Development Foundation in Bangkok offers a home for abandoned HIV+ mothers and orphaned children. They provide shelter, food, medicine, nursing and counselling. "The children go to school, laugh and play with the dignity of all other kids their age. The home itself fosters an environment of acceptance and empowerment. Our children have experienced a sense of loss and suffering that often defies comprehension, yet their joy in life and love of friendship are truly extraordinary." The HDF also offers an adult hospice and home care, the Mercy Centre is the largest free hospice in Bangkok. Almost half of their patients are nursed back to relative health and strength and return home to their families. AIDS education is also part of the HDF program. 34 slum communities are visited regularly: schools, factories and families at home are visited and receive education about AIDS prevention, care, and compassion. www.MercyCentre.org

The visit I found most impressive was definitely the one to the orphanage "Gerda's house" and the "Wat Phra Baht Nam Phu", the AIDS-temple in Lopburi. 400 beds are provided to care for HIV-AIDS patients. Some live in small houses if they are still able to take care of themselves while those too weak to continue on their own are taken into the hospital ward.

There is one room with 50 people reduced to skin and bones, too weak to wave off the flies in the room… as well as one room for case-studies. Dead bodies in an exhibition which shows who are the ones infected, the child, the mother, the father, the prostitute, the homosexual, the drug-addict… Next to each body the is their very own story which does not differ much from other stories that you can hear in the temple. The temple has existed for about 10 years now. Since then more than 10000 people have died on the temple grounds, the ashes are collected in little bags and boxes, piled up at the wall. Many patients find a new home in the temple after being shunned by society and left alone by their family. The temple finances the work through donations and volunteers are welcome to help out in the temple for a few weeks. See www.aidstemple.th.org for more detailed information.

There is a lot more that could be told, but this should be enough for the time-being…

If you have any further questions, if you would like to know more about anything mentioned in the lines above, please feel free to contact me!

Nora Matthaeas
SCORA Director 2004/2005