Thailand AIDS on the Front LineSeptember 1989
U.S. NAVY ON SHORE
This is Pattaya, the famous resort located two and a half hours by car from Bangkok. Sailors from the U.S. 7th fleet are disembarking this morning. There are bars and hotels. The wooden boats, filled with soldiers bent on rest and recreation, reach the shore from the anchored warships every few minutes. In theshade of palm trees, women crowd around, waiting for their customers.
This is the second time for Mrs. Sommatra Troy (54) of the Thai AIDS Society to appeal for the prevention of the spread of AIDS here. She lived in America for 28 years and worked as a nurse in a Chicago hospital. Four years ago, a homosexual AIDS’ patient confessed to her, “My lover was a Thai,” and that gave her a shock. She doubts the Tourism Authority of Thailand admitted the existence of AIDS in Thailand when they campaigned in the U.S. in 1986.
America already had more than 40,000 AIDS’ patients in those days. “Someone has to take measures immediately, otherwise ……” She left her husband and three children in America and returned to her native country.
The World Health Organization presented statistics about AIDS’ patients and carriers in Thailand for the first time this year. The number of patients, 193 at the end of 1987, exploded to 3,180, 16th times as many, at the end of last year, 1988. Nowhere else in the world has experienced such a rapid increase.
“The government has concealed even the existence of AIDS in order to protect their tourism, their leading industry for earning foreign exchange,” Mrs. Troy vents her anger on them.
The sailors, clad in T-shirts and shorts, ignore the meddlesome woman and vanish arm in arm with the ladies. A young sailor said to me,”There’s a large box full of condoms on the boat and they recommend us to take condoms when getting off. Of course, they’re free. If fact, I brought several with me. Here they are. See? I’m DAIJOBU!” He was a second engineer on the carrier, Midway, and he’d learned his Japanese in Yokohama and Sasebo, its ports of registry.
Since 1981, when the first AIDS'(acquired immune deficiency syndrome) patient was identified in the U.S.A., the number of AIDS’ patients and AIDS’ virus carriers has rapidly increased, mainly in America, Europe, and Africa. Although the original panic has calmed down, AIDS exploding in Thailand, according WHO in a recent announcement. Why is the rest of Asia, including Japan, an area with little AIDS infection? We need to look at the reality of the situation and its background.
PATPPONG STREET
“Hey! Mister! We have lots of pretty girls!” Touts gives me a come on in the only Japanese sentence they know. This is Patppong, the biggest red light district in Bangkok. Young women dance side by side at the go-go bars.
Although tourism should be down in Thailand because of the rainy season, there were long queues at passport control in Don Maung International Airport. I heard hound Japanese voices there as well. Thailand earns an astonishing fifteen percent of the national budget from tourism. About four million tourists visited to Thailand last year. Forty-five thousand of those were Japanese.
In 1988, in a survey of 7,000 people at the Health Center in Chiang Mai, there were 608 HIV positive cases, including 267 prostitutes, 170 from blood transfusions, 86 drug addicts, and and 85 others. In the last two years and seven months, the incidence of HIV positive infection through heterosexual intercourse has dramatically increased 11.4 times, whereas it has increased only 2.6 times through intravenous injections, according to the Thai Ministry of Public Health.
I met Ms. Apis (42), a representative of Empower, a non-government organization that supports the girls who work in Patppong Street. “In our English conversation classes we teach the girls how to use condoms and pass out some booklets about preventing AIDS, but generally, men have not changed their attitude toward the girls. Because of the AIDS panic, it is becoming common for even 15-year-old girls to become prostitutes.”
At ten o’clock at night Patppong is ablaze with gaudy flashing colored lights, and the amplified beat almost splits the ears. “Our business hasn’t changed even after AIDS made a stir,” the manager (27) of one of the go-go bar’s said. “In my bar the girls always have medical checks at the contract doctor the day after they have customers. If any girl turns out positive, she will be fired immediately, So ……”
“Maybe one tenth of the customers don’t put on condoms,” Miss Phun (18) estimated at another bar. “I’m afraid of such men, so I charge them extra.” She sat on my knee and explained that she didn’t have enough money for her rent which was due the next day.
Taniya Street next to Patppong canters particularly to the Japanese. At a Japanese-style night club, I met Miss Teu, who speaks beautiful English. “Well, some 80 percent of the customers date the girls. One girl has about 15 customers a month. The medical check for general venereal diseases is held here every week and the check for AIDS is every six months.” Miss Teu told me that she wants to work in Japan.
It takes two to twelve weeks to detect the HIV antibody after the initial virus infection. Generally, the AIDS test check is not considered reliable for the first three months. “As far as AIDS is concerned, the most vulnerable and dangerous group in Thailand is the prostitutes. At the same time, the girls are the most difficult to deal with.” (Ministry of Public Health).
HOTBED OF AIDS
“LADIES and gentlemen!” the emcee begins. “You already know what AIDS is, don’t you?” Mixing the facts with black humor, he offers basic facts about AIDS and ways to prevent it. This emcee is himself a gay from Thailand’s show business world.
The audience hide their faces behind distributed leaflets, but laugh in spite of themselves. “Tonight’s main event,” the emcee announced, “is a condom wearing race!” Several men climb shyly on the stage. Each one is given a cucumber or a long radish. “Ready. Get set. Go!” shouts the emcee. As quick as a flash, the contestants raise their vegetables covered with colorful condoms.
I found a middle-aged man in Kimono went and came between the stage and the back room. Lek Masuda (38), a Thai-born Japanese, is the manager of Super Lek, a pioneering gay bar in Bangkok, and chairman of Gay Industry Management Conference.
“In Japan, you can’t campaign as openly as we do, can you?” Lek asked. “We are taking the lead because people see us as suspects of AIDS. The bias and discrimination against a specific group drive them underground. If that happens, no matter how good the countermeasures against AIDS, they will fail.
Klong Toey is the biggest slum in Bangkok. The red sun, reflecting on the zinc roofs of the shacks, turns a young lady’s profile into a silhouette. Noi (23) isnaturally beautiful, with a suntanned baby-face and short hair. On her left wrist under a bracelet, I notice a welt ──・the mark of a heroin injection.
“Six months ago,” Mrs. Nittaya, director of the AIDS project of the Duang Prath-eep Foundation, begins to explain about Noi, “I took her to have a HIV test. It turned out positive. She really should stop being a prostitute, but there is no other job for her. She has a nine-year-old son. So every two weeks we give her two dozen condoms and advise her to make her customers use them.”
“It’s not because of injections!” Noi declares. “I’ve never borrowed anyone else’s needle!” Nevertheless, there are four hundred six thousand drug addicts and one hundred thousand homosexuals in Thailand. Of course, there numbers are only estimates; the real figures are unknown.
BIAS
The only person whose real name has ever been reported in the Thai newspapers connected with AIDS is Mr. Shao Swasum (50).
I visited his home in a swamp surrounded by factories. His wife (45) was occupied with her side job of bundling vinyl bags. She explained that she and her husband lived separately. Suddenly a little girl, just coming home from school, ran into the room and cried,”I want to change my name!”
“This is our youngest child,” the wife continued. “She is seven years old. If my husband’s and I lived together, the neighbor children wouldn’t play with her.” She took me to her husband’s apartment. He began speaking in a low voice so that the people next door would not overhear our conversation. “We came to Bangkok seven years ago with forty thousand baht. That was money we got from mortgaging our field after I got sick and had to stop farming.” He had developed some kind of stomach disease and couldn’t keep any food down. In December of 1986 he went into the hospital for tow operations.
One day an officer suddenly came to the place where he worked to test his blood. A week later his case was confirmed ・・・AIDS. The cause was the blood trans-fusion he had had during the surgery. He was fired by the plastics factory where he had worked for three years as a guard.
In May of 1987, Mr. Swasum accused the hospital in the newspapers in Bangkok. The newspapers ran the story with real name and pictures・・・”Man Not in High Risk Group Gets AIDS Through Hospital Mistake.” As a result, about sixty thousand baht was donated to him, and last year he was given a job watering trees in the garden of the national hospital.
Then, in April 1989, everything started going wrong. He was sent to a hospital because he started showing symptoms, and he couldn’t eat anything. “People’s attitudes entirely changed, even those who had understood at first. In fact, although I could leave the hospital after a month, there wasn’t any place I could go, so I stayed for two months. The hospital was full of people with AIDS, and there were a lot of patients in the last stages of the disease who made a mess in their clothes, probably because the virus had attacked even their brains.” As soon as he left the hospital, he moved to this apartment without returning home even once.
After taking care of the little girl who complained that she was hungry, the wife added some details to her husband’s story. “We have three older children,but two of them lost jobs that had seemed certain. The rubber factory where I had just started working fired me after only five days, because they found out about my husband’s disease.” No one yet knows about who lives in the apartment that is always locked. The girl would not even draw near her father. “Why dose my husband……? I just want to throw a grenade in to that hospital.”
POVERTY
From a flimsy shack built of pieces taken from the rubbish, I could hear a weak cry. Inside, a woman was feeding a tiny wrinkled baby. The mother was twenty-two years old. She had been born in this same slum and had been a prostitute until she got married a year and a half ago. She and her husband are heroin addicts. When a blood test at the beginning of this year showed that both of them had AIDS, she was already five months pregnant. The boy was born with AIDS as well.
Mr. Pattphui (45), the director of the anti-drug project of the Duang Prateep Foundation explained calmly, “We have already had 146 addicts in the hospital in eight different groups. Of the 130 addicts in the first seven groups, 104 or eighty percent, had AIDS.” When these numbers were reported in the Thai media, the Ministry of Public Health was quite upset. The test results for the last group sent this April have not yet been announced.
“AIDS never waits for them to stop using drugs,” Mr. Pattphui continued. “So we have to stop the spread of AIDS from the needles. Although AIDS invariably brings death to the victim in several years, it is merely one of many unmanageable problems for those people. They are worried about how they will manage to eat today, not tomorrow.” The difficulties of slum life overlap.
In Bangkok, about 1.3 million people, one fifth of the entire population, live in the slums. Eighty-five percent of them earn less than 2,000 baht a month, according to a survey carried out by Chulalonkhorn University.
As Dr. Wantanaa, a lecturer at Kassesart University, pointed out,”Their cheap labor attracts foreign capital. The government seeks to keep the price of farm products low so that workers can afford to eat. This weakens the economy in the villages, farmers leave to enter the pool of cheap labor. It’s a typical vicious cycle.”
The baby continued crying even while it was trying to drink. He cannot suck milkbecause of painful cankers, a symptom of AIDS. Most of the month’s ration of milk given by the Duang Prateep Foundation is still left. The baby weighed 2,900 grams when he was born, but three days later his weight had already dropped to 2,500 grams. Although he has survived almost one month, the poor infant doesn’t appear to weigh more than 2,000 grams.
Slum dwellers turned to heroin in an attempt to ease their lives of desperation and dire poverty. They quickly became addicts. The women became the prostitutes to attract foreigners. These people are the gearwheels of the Thai economy, which is making tremendous progress. Between the gearwheels, the AIDS virus is spreading.
