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Good Morning Chiangmai News Magazine
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.gifOn-line Edition ContentsFebruary2002




There's no shortage of HIV/AIDS information - but who reads it?

"How do you know that the beautiful or the handsome one doesn't have HIV?" asks the tiny, voluble woman doctor who 2 years ago was named 'Outstanding Physician' by her peers. David Hardy begins a 3 part series on the fight against the dread disease by Chiangmai's dynamic doctoring duo.

As often happens in their 4 homes, it was the turn of Dr.Vicharn Vithayasai to take care of the 26 kids last month. But it's not the number of homes or babies which makes he and his wife Dr Prakong such an unusual couple. Dr. Prakong was in San Francisco, USA, at a conference which she was asked to attend by the Thai Prime Minister's office! This was her third visit, and at the first she was described as "a heroine of HIV/AIDS care" and invited on to a world committee.

"When I first stood up and told 2,000 delegates what I had been doing, they gave me a standing ovation for 5 minutes. I cried!" she recalls proudly.

"In the next 5 years, only 8.3% of the national health budget will be allocated to HIV/AIDS education. But in a developing nation like Thailand we have a good chance to slow this down, using education and prevention" goes on the effervescent 56 year old at her usual breakneck speed.

"We can slow down the HIV epidemic in Chiangmai, but we have to improve faster than this! Condoms must be used the whole time, every time. It's all about preventing the exchange of bodily fluids. If people see blood for any reason, they worry about HIV. In fact this is very deceptive because the other bodily fluids are potentially much more dangerous than blood."


The Female Physicians' Association of Thailand named Dr Prakong the Oustanding Physician, 2000.

"The Godmother of HIV-infected children": "Kinnaree" in-flight magazine, March 2001.

In 1989, Chiangmai was "first and worst" in the national league table of HIV infection, 10th in 1999 and 14th in 2000. Phayao, Chiangrai, Lampang and Lamphun shared first place. Figures for 2001 still awaited. But the risk has now changed away from direct prostitution, because education in that area has been so intensive since 1989. Now it is 'indirect' prostitution and 'apparently sincere' conventional lovers who are the groups most at risk. "They think 'Oh what a beautiful girl', or 'Oh what a handsome young man, they can't possibly have picked up anything so dreadful as HIV'" says Dr. Prakong knowingly, acting out the roles and showing why she is such a charismatic speaker in Thai and English. "Now, 49% of women are infected by their lovers or husbands. Infection is now moving into 'respectable' families. Everyone should realise that it takes only a very few seconds of unsafe sex to become infected."

Her husband began testing people when the first HIV infections took place in Bangkok in 1984 - and in Chiangmai in 1987. It is clearly documented that infection started from foreigners in the homosexual community and by intravenous drug abusers who were sharing syringes and needles. Some of the homosexual men were actually bisexual and by July 1988 the potential killer had spread into the heterosexual community.

"Of the 2,000 cases of HIV I have seen, 96% are in the heterosexual community" states Dr Vicharn. By 1989 he had begun to concentrate on education in brothels.


"It was a little difficult at first, dealing with the brothel owners and the pimps, but I said 'Get all the benefits, don't get the virus!' When they saw that it was all to their advantage - free condoms, no other sexually transmitted diseases, no hepatitis 'B', no unwanted pregnancies, no time off, no infection meaning no payments for treatment - they all co-operated happily. If I'd put it the other way round and told them it was their duty to co-operate, well, they wouldn't have agreed!"

"Thai male sexual behaviour is part of nature, but, simply, we must not trust anybody" emphasises Dr Prakong. "Also, the idea in Thailand is that it is the female who is responsible for contraception. There are female sheaths available but they cost 30b each and they are very uncomfortable to wear."

"Teenagers just starting their sex lives are at very high risk" observed her husband. "They are excited but they are not informed! Peer group pressure can force them into sex - and into unsafe sex. It's like jumping into a racing car before you have passed your driving test."

"We have found that very many boys go to sex workers for their first experience. At the age of only 13, 1.1% of boys have done this. At 16 the figure rises to 45% and at 18 it's 80%. If they don't do this their friends might accuse them of being gay."

The woman dubbed by the Thai press the "saviour saint of children with AIDS" has given hundreds of talks over the years. "I say to the teenagers 'Why don't you become a pioneer? It will make you feel good about yourself - and some of your friends, but not all, will follow you. It's like saying 'no' to a cigarette. Dare to be a little different!"

"They can enjoy themselves, but they must protect themselves" chips in her husband. "Let's tell the people the truth. If they know, they can choose!"

What keeps them going?

"If you start out with zero expectations - then you've won already. This is what we have both done for the past 13 years," they agree.

The people they have met at the conferences have been vital to their establishment of the Support the Children Foundation under which the 4 Chiangmai homes are run. For 3 years, Non-Government Organisations abroad have donated left-over drugs, mostly from Switzerland and Britain.

"One found us through an interview I gave in the 'New York Times' in 1991," remembers Dr Prakong. "This is why the mass media is so very important." So how were 2 dedicated, hard working doctors moved to start their own Foundation?

"Abandoned babies with HIV were left in the Maharat Hospital where I worked because at that time government orphanages would not accept them," she explains. "We set up the Foundation in 1992 when we could no longer tolerate seeing more and more underweight, malnourished babies with no 'tender loving care'". Then the head of the allergy and immunology department, Chiang Mai University's Faculty of Medicine, Dr. Prakong had been teaching there for 27 years.



    Click for larger photograph

    Almost! This metal bas relief of a Mitsubishi A6M2 Zero-Sen actually represents an aircraft of the 64th Sentai, wich was stationed here at Chiangmai. Framed in dark Thai timber, each piece is numbered and only 1000 pieces will ever be produced. Made by Thai craftsmen with care.

    Measurement: 24 x 15 x 3.5 cm





"So I took early retirement 5 years ago to raise funds for the Support the Children Foundation. We have set it up as a model for others to follow." And what a responsible, hard-worked one, nursing 24 children round the clock in 4 separate homes!

There have been the heartbreaks and the joys, of course. Over those 5 years, 25 babies have died and 24 have turned to become HIV negative. The doctors' anti-retroviral drugs fight the virus and help restore the youngsters' immune systems. It takes 18 months of care before it is known whether they can become HIV negative or not. Many are adopted, mostly by generous families from overseas.

"There will be a constant stream of good people wanting to adopt" predicts Dr Prakong. "That's my aim, my dream, no more worries about them, but there will never be enough adoptive families. Our oldest member of the family is a girl aged 11, HIV positive and autistic, but very happy. When she first arrived she weighed 1.4kg and we thought she would never survive."

"I'm getting old at 56 and the economic crisis does not help. The Foundation costs us 2.7 million baht per year for drugs alone. It's complicated to maintain correct drugs dosages for children because they are growing. We have to measure body weight constantly and sometimes skin surface area to ensure correct dosage. But who will take care of them in the future?"

"All I can try to do is get more donations from all over the world to hire another doctor to take care of the children after I'm gone. The Chamber of Commerce are very helpful - and for business donors it's important to know that we are a tax deductible Foundation".

Dr Prakong appears in countless talk shows and writes and publishes her own books on the subject which she sends free to important leaders of public opinion - and sells to the public to raise funds. But the joy of their achievements is tempered by a stern realism, as her husband concludes: "I think that HIV will always be with us."

Next month: Educating the nation on HIV at every level - and how VIPs once had to be invited on an ocean cruise to get and keep their attention!

"After meeting Dr Prakong and seeing what she and her husband had done, I was completely in awe. They had done so much with so little. They are living proof that if you care enough, there will always be a way." Marina Mahathir, 'The Star', Malaysia, May 2000.

The Female Physicians Associaition of Thailand named Dr Prakong the Outstanding Physician, 2000. "The Godmother of HIV-infected children": 'Kinnaree' in-flight magazine, March 2001.

Support the Children Foundation

181/208, Moo 3, Potaram Road, Chotananivade 2 soi 6, Changpuak District, Chiangmai 50300. Tel/fax 408424. Siam Commercial Bank, account no 673-1 00837-7

.gifDavid Hardy

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