July 13, 1999
We care A problem shared Phuket health chief Dr Boonriang Chuchaisaengrat has been battling the disease-and the bigotry-that comes with HIV and Aids by raising awareness, tackling wider social problems and bringing people together in mutual support Karnjariya Sukrung At the day care centre at Vachira Hospital, Dr boonriang and other medical staff provide special care and check-ups for people infected with HIV. As well as providing medical care, the centre offers a forum in which patients can share their problems and offer each other mutual support. Noi (not her real name) used to fight Aids alone. She dared not share her ordeal with her children, family and friends. Only her husband, who died of Aids, knew the terrible secret. As a middle-age widow with no job, she sold everything of value in her home to support her three children. As her body became weak, her mind was eaten up by worry over her children's future. Fear of the social stigma of the disease causes many HIV/Aids patients to suffer in silence, even though this may prevent them getting proper health care. "I was afraid once people knew about my illness, my family and I would be thrown out of society," said Mrs Noi. Given the fear of becoming a social outcast, health experts says the country's official HIV/Aids statistics are chronically under reported. Dr Boonriang Chuchaisaengrat, Phuket's public health chief, believes this may also be true on Thailand's biggest island where official figures say 5,000 people are HIV-infected and suffer Aids-related diseases. About three percent of pregnant women are found to be HIV positive every month, said Dr Boonriang, adding there is no indication the figures are waning. "If society continues to shun the problem, the patients cannot get help. They will suffer. And so will society in general," said Dr Boonriang. About three years ago, Dr Boonriang and his team, started in earnest to look at alternative ways to tackle the problems faced by sufferers. They set up two funds: the Aids Phuket Foundation and the Health Hotline Fund. They also established a clinic for people with the virus. Dr Boonriang, as a member of the Phuket Civic Group, a group which works to promote a sense of community on Phuket, believes the key to the Aids crisis is not simply raising cash-but community empowerment. "To be able to live happily or healthily depends on our environs being healthy. So if we want to help an individual, we must help their community too," said Dr Boonriang. "Aids is one of the problems that stem from community failure. If we can strengthen the community, people will be more aware of their problems and be able to find solutions. "If the community is strong, Aids and other social ills will be eventually be contained," he said. Since, due to crime and a lack of education, poor communities are particularly vulnerable to HIV and Aids, a year ago Dr Boonriang started pioneering working with people in Saphan Hin, one of Phuket's 12 slum communities. The Saphan Hin community comprises of more than 100 families living largely hand-to-mouth by sorting and selling garbage. Saphan Hin also suffers a range of other social ills including crime and drugs problems. But since Dr Boonriang stepped in, things have began to change. The community now has a village committee which focuses on issues such as health, employment and children's education. Dr Boonriang admits that, for now at least, HIV and Aids is a difficult issue to tackle as prejudice against sufferers runs high. Rushing things, he said, may only cause more problems than offer solutions. "We can't go in there and say our main goal is to help Aids patients. No one will admit they are infected for fear of being ostracised. What we can do is extend our care to all the community-and keep the specific problems of Aids patients confidential." Under the programme, a team of doctors, nurses and volunteers visit Saphan Hin twice a month. And the Phuket Aids Foundation sets aside some of its budget to support education for all-including children with HIV. "After all, no children should be deprived of the chance of education," he said. Dr Boonriang believes such problems can only be realistically tackled if wider society lends a hand to his work. After enlisting the support of his professional peers, Dr Boonriang looked to Phuket's business sector-hotels, tour companies, and airlines-for support for his community development project. "It's important to get people from a higher social status to link with the underprivileged. From compassion comes helping hands. Business people can become important players in social work projects," Dr Boonriang said. After several site visits, the Sheraton Grande Laguna Beach adopted the slum project. At a recent fund-raising event, the Sheraton along with other hotels, airlines, tour companies and expatriates in Phuket, raised 1.4 million baht for the Saphan Hin project. Dr Boonriang sees electronic communication and the use of public radio as a challenge to the widespread discrimination faced by people with HIV. His Health Hotline Fund offers a 24-hour service. By ringing 01-606-5437 callers can talk to volunteer doctors and nurses who give advice and counselling on health matters. "Aids patients and their families can call any time.They can get advice without having to travel a long way to the hospital. And it means they have someone to share their fears with," said Dr Boonriang. The Hotline can also provide emergency financial assistance. Due to the popularity of the service, Dr Boonriang plans to buy more mobile phones to extend the service. And every Wednesday, between 8 a.m. and 9 a.m. and 6:30 p.m. and 7 p.m. the fund uses the radio waves to air health issues. "On air, the Aids patients and their families talk about their problems. Hopefully, this service will increase understanding and compassion for sufferers and raise awareness about the virus," Dr Boonriang said. Apart from the community work, Dr Boonriang teamed up with other doctors to found a care centre at Vachira Phuket Hospital specifically for HIV/Aids patients. On average, it costs 12,000 baht per month for anti-retroviral medicine-a price which makes treatment inaccessible to most people. Dr Nara Khangkaew who runs the centre said: "Because of the cost and because there are no guarantees, over the years many people have resorted to quacks. This is not cheap either-and there are dangers-it can still put patients' lives at risk." Then Dr Nara and his team decided to combine aspects of modern and traditional medicine. At the clinic, patients receive Western medicine and receive advice on foods, which according to traditional medicine, have healing or medicinal properties. For example, after research results from a Mahidol University study found marakeenok-a local plant-appeared to have properties to control the virus, Dr Nara decided to give it a try. "We advise patients to have marakeenok as part of their meals. It is an indigenous plant easily grown in our backyards, so why not? It's cheap and it might work." The centre also prepares herbal medicine for sufferers. A concoction called VC (Vachira) Concoction comprises of several herbs such as betel leaves, linchue mushroom, guava leaves, and marakeenok. "Each herb can help treat symptoms associated with Aids," he said. For instance, betel leaves have anti-viral and antibiotics qualities, while guava leaves can cure diarrhoea. "We don't know if this is really the right answer, but at least, it gives our patients more hope . It's cheap and so far it's been quite effective," Dr Nara said. Dr Boonriang hopes in implementing the ideal of a civil society, where people have a direct say in the management of their communities, problems of HIV and Aids, crime and drugs will decline in places like Saphan Hin slum. The clinic also provides counselling. Every other Sunday, around 30 patients get a check up at the centre, do exercise and take herbal medicine. About 10 doctors, nurses, psychiatrists, nutritionists, and physical therapists attend the centre to give the patients a range of support. But perhaps the most important part of the centre's activities is the fact it brings Aids patients together so they can share their experiences and offer support to each other. In the safety of a self-help group, HIV/Aids patients can vent their angers, frustrations, grief and fears. And they can provide comfort to each other. "They know what each other are going through. Talking to doctors and nurses cannot compare to speaking to those who have the disease and share the same problems," said Dr Nara. Now the members in the group know each other, they have formed a working group to help one another outside of the centre. Their activities include home visits, an education fund for Aids orphans and organising work to give members some income. Today, Mrs Noi is no longer trapped in the silent and hopeless haze of Aids. As a member of the clinic, she has friends who share her plight and whom she can talk to. Help is at hand-not only in the form of medical treatment for herself, but also a reassurance that there is a future for her children even after she is gone. And for a dying mother, that is probably the most important thing of all. Info for donations: Name: Health Hotline Fund (call 01-606-5347). Contact person: Dr Boonriang Chuchaisaengrat. Tel: (01) 978-2127. Bank:_ savings account name: Health Hotline Fund; account number 805-1-48674-9; Krung Thai Bank's Phuket branch. -savings account name: Aids Phuket Foundation; account number 805-1-48673-0; Krung Thai Bank's Phuket Branch. Or send a cheque payable to Post Publishing Public Company Limited (Aids Phuket Foundation) to Kusuma Mintakhin, Editorial Manager, 136 Na Ranong Road, off Sunthorn Kosa, Klong Toey, Bangkok 10110. Tel: 240-3700 ext 3224-5. Please include your name and address with your cheque so we can send you a receipt. "We Care" is a weekly series honouring people who believe in giving. Apart from supporting these causes, you can also let us know about people who unselfishly help others so we can tell people about their efforts. Fax "We Care" on 240-3668 or call 240-3700 ext 3208 or 3212. Or email sanitsuda@bangkokpost.net For a list of charities features in "We Care" see the Bangkok Post Web site at http://www.bangkokpost.net/outlookwecare/.		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