DON'T LET YOUR LOVER BECOME YOUR
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
"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
The Female Physicians'
Association of Thailand named Dr Prakong the Oustanding Physician, 2000.
of HIV-infected children": "Kinnaree" in-flight magazine,
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.
JUST LIKE THE REAL THING?
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
PRICE: 1000 BAHT
PAYMENT CAN BE MADE ONLINE
VISA & MASTER CARD WELCOME
"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
"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