Published in Bangkok Post, Thailand

PANG jumps from the swing, takes a piece of paper, and tries to write her name in English. The five-year-old manages the P, A, and G, but the N invariably ends up as an M. She giggles as she tries again, and eventually makes it. Pang is a chubby-cheeked, cheerful, cheeky, little girl, seemingly like any other child her age. But Pang is HIV Positive.

She lives at the Camillian Social Centre in Rayong, along with 36 other children, and more than 50 adults.

The centre was launched more than 15 years ago and has successfully created a tranquil place for patients, and helped educate communities about HIV and AIDS. Italian priest Father Giovanni Contarin, who launched the centre, knows the importance of educating children like Pang for the future. He also knows how critical it is that Thai adults have a greater knowledge of HIV and AIDS. Many Thais still only associate the disease with working girls and tourists from the red-light centers of Pattaya, Patpong, and Patong. But it is Thais not involved in the sex trade that now indulge in the highest risk behaviour.

In Thailand, the rate of faithful wives who are infected by their promiscuous husbands is the highest in the world. The culture of having a ‘mia noi’, or minor wife, is still prevalent. In addition, young Thai girls are experimenting more with sex, often ignorant of the risks. Fr Giovanni knows that if things are to improve then it is Thai women, and not men, whose attitudes must change.

“In Thailand, nine per cent of girls between 14 and 18 have sex. Later when they come to have a boyfriend and girlfriend they don’t realise the past history. “Now, most of the infections are in the family and among many young people that are not in the sex trade. But Thai people still point to that group of working girls or the gay community.” In reality, more than 90 per cent of sex workers now use condoms, and the biggest problem is with other Thais. The need for knowledge may be obvious, but even being allowed to talk about HIV in schools and offices is a challenge in itself.

“It took two years to get permission to go into the government schools. They said ‘we don’t have the power to decide, we have to go through the provincial office.’ “After two years I said, in front of the governor, ‘I’m so bored, we are ready to go and we can do an action plan.” Eventually they were allowed in.

Factories first thought it would be invading workers’ freedom to impose such training upon them. Now 80 factories, 13 schools, and 12 communities receive help and training from the Camillian Center. In addition, each month about 25 working girls from Pattaya come for training. Listening to Fr Giovanni it’s impossible not to be moved. He talks frankly and passionately about the subject. For more than ten years he has worked with HIV, fighting prejudices and fear.

Things are improving. Drugs are more available and of better quality. The rate of infection has dropped from an annual figure of 150,000 ten years ago to around 20,000 today, although the reasons for this are economic as well as educational.

Fr Giovanni explained: “There are many factors behind the lower infection rate. There’s the condom campaign, education, and economics. 85 per cent of Thai married men have sex outside marriage monthly, but now these people have less money to do this.”

“This girl”, Fr Giovanni says pointing to a patient wrapped in a blanket watching television, “was not a prostitute. She is 19 and was married four times.” Fr Giovanni has been in Thailand for 20 years, and launched the Camillian Social Center ten years ago. He speaks with Italian passion and flair, and it is this desire for improvement which has helped get the place noticed.

Children at Camillian were born infected and many are orphans. Adults come from a variety of backgrounds and are generally referred to the center from hospitals. Some of their families visit, many do not. The center has a collection of small buildings, which includes a handicraft center, social area, playground, chapel, and a pavilion in the middle of a pond. A palliative care unit cares for sick patients and has a full-time nurse. Most children go to local schools and are taken on occasional outings, while the adults who are well enough do small tasks. Several adults live 40kms away at the Garden of Eden, a specially-designated area of land where the patients grow their own vegetables.

Workers

Food at the Camillian Centre often includes pasta and pizza (Fr Giovanni’s influence stretches everywhere) and is served by staff who are also HIV Positive. It’s one of the few centres in the world where the staff truly understand all the patients’ problems. Nearly all the staff here have HIV, including Tong, a former drug user who is now a nurse. He worked in hotels and for a bungee jump ride in Pattaya until he had a motorbike accident nearly ten years ago. A routine blood test showed he was HIV Positive – the result of heroin use. He continued to work until tuberculosis’ symptoms forced him to stop. The Camillian Centre looked after him for 11 months in its infirmary until he was well enough to work again.

He lived with his family but became increasingly worried about the chance of infecting them, and when the TB symptoms returned, he chose to move to the Camillian Center. He met his wife there and adopted his daughter, who are both also patients. Tong, 36, then trained for two years and now helps other patients in the infirmary, checking that they take their medicine and helping with any emotional or spiritual issues. The salary he receives means his family is able to rent a home outside the centre and live independently.

Sommit is 42 and from Chonburi and still experiences public reluctance to accept his condition. “When I go to the local shops some are OK and don’t mind, but some shops won’t put the chance in my hand. They just put it on the table.” Fr Giovani takes his message to the schools that are ready to listen. But the one irony behind a Catholic-based group’s involvement in HIV prevention is the church’s stance on condoms. Fr Giovanni circumvents this by telling women to use everything available to them to prevent problems, without ever mentioning the ‘C’ word. When it comes to saving lives, there’s a prerequisite to be practical.

As if proof were needed, the Father hands me two photographs of a girl. In the first she is in a hotel room, leaning provocatively against a dresser with her legs slightly apart. She is wearing a polka-dot skirt and an orange and brown hooped top. In the second photo, taken a year later, she is lying on a bed, her skeletal body covered by a shirt and incontinence pad; the ravaging effects of AIDS all too obvious. Fr Giovanni puts the photograph away and pulls out a scrapbook. Inside are newspaper cuttings of the first HIV centre in Bangkok. Each story tells how the site had to close after it was attacked by bombs and shot at by a sniper.

Thankfully, things are now much better. Preventative and educational work will ensure future Thai generations are at least armed with the knowledge of what HIV can do. Whether they choose to use the knowledge is another matter. As I leave, Pang is still struggling with the letter N, and a small boy, Peter, is now on the swing. He’s wearing a T-shirt with the famous Thai phrase logo ‘Same Same But Different’. Here, the words are especially poignant.

Info box

• More than 1.2 million people have been infected with HIV in Thailand. Of these, more than 370,000 have died.
• There are around 380,000 AIDS-related orphans in Thailand.
• The Camillian Missionaries came to Thailand 50 years ago to help the poor.
• For more details, visit www.camillian-rayong.org or telephone 038-685480.